Contrast-Enhanced CT Scanning of the Liver and Pancreas

2021 ◽  
pp. 117-130
Author(s):  
Shintaro Ichikawa
2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Wen-Tao He ◽  
Xiong Wang ◽  
Wen Song ◽  
Xiao-Dong Song ◽  
Yan-Jun Lu ◽  
...  

Abstract Background Primary bilateral macronodular adrenocortical hyperplasia (PBMAH) is a rare form of adrenal Cushing’s syndrome. The slowly progressing expansion of bilateral adrenal tissues usually persists for dozens of years, leading to delayed onset with severe conditions due to chronic mild hypercortisolism. About 20–50% cases were found to be caused by inactivating mutation of armadillo repeat-containing protein 5 (ARMC5) gene. Case presentation A 51-year-old man was admitted for severe diabetes mellitus, resistant hypertension, centripedal obesity and edema. PBMAH was diagnosed after determination of adrenocorticotropic hormone and cortisol levels, dexamethasone suppression tests and abdominal contrast-enhanced CT scanning. The metabolic disorders of the patient remarkably improved after sequentially bilateral laparoscopic adrenalectomy combined with hormone replacement. Sanger sequencing showed germline nonsense mutation of ARMC5 c.967C>T (p.Gln323Ter). The second somatic missense mutation of ARMC5 was detected in one out of two resected nodules, reflecting the second-hit model of tumorigenesis. Routine genetic testing in his apparently healthy offspring showed one of two daughters and one son harbored the germline mutation. Conclusions In conclusion, our case report highlight the importance of genetic testing in the molecular diagnosis of PBMAH. Genetic screening in related family members will find out asymptomatic variant carriers to guide life-long follow-up.


CHEST Journal ◽  
1990 ◽  
Vol 97 (5) ◽  
pp. 1148-1151 ◽  
Author(s):  
Christopher G. Wathen ◽  
Keith M. Kerr ◽  
William Reid ◽  
Arthur J.A. Wightman ◽  
Jonathan J.K. Best ◽  
...  

2013 ◽  
pp. 175-178
Author(s):  
Vincenzo Bua ◽  
Lorenzo Marsigli ◽  
Roberto Nardi ◽  
Anna Maria Trivella ◽  
Salvatore Isceri ◽  
...  

Background: Hepatic aneurysms are extremely rare with very few cases reported, and most have been source of misdiagnosis and clinical pitfalls in emergency medicine. Presentation with intraabdominal hemorrhage is associated with a high mortality rate. Case report: We report the case of an adult male, referred for a severe acute pain in the left lower chest-upper quadrant abdomen pain. We present multislice contrast-enhanced CT-scanning and angiographic findings, and a life-saving emergency trancatheter embolization, using fragments of absorbable gelatin sponge. Emergency doctors should consider ruptured hepatic artery aneurysms in the differential diagnosis of acute abdominal pain and promptly cooperate with endovascular specialists to treat this life-threatening condition.


2016 ◽  
Vol 5 ◽  
pp. 18-23
Author(s):  
Amin Abolhasani Foroughi ◽  
Masoume Nazeri

In patients came with suspicious cerebrovascular accidents, CT scan can play a major roll for diagnosis and treatment planning. In these patients we can do non contrast enhanced CT scan followed by perfusion CT scan and CT angiography. This three step CT scanning can be called multimodal CT. This strategy can help us to roll out hemorrhage and other differential diagnosis, it is useful to detect the site of vascular occlusion, the infarcted zone and the at risk salvageable tissue, also we can assess collateral circulation. This multimodal CT scan take about 10 to 15minuts. 


1984 ◽  
Vol 4 (4) ◽  
pp. 253-254 ◽  
Author(s):  
Stanton G. Schultz ◽  
Thomas M. Harmon ◽  
Kenneth L. Nachtnebel

In a patient on continuous ambulatory peritoneal dialysis with localized abdominal and genital edema, the site of extraperitoneal dialysate leakage was determined by computerized tomographic scanning with intraperitoneal contrast enhancement. No adverse effects were encountered. The source of fluid leakage should be sought in CAPD patients with localized (i.e. genital) edema, because often they may have an undetected hernia or other peritoneal defect. Removal of the peritoneal dialysis catheter would not solve such a problem. In such cases, intraperitoneal contrast-enhanced CT scanning may represent an effective technique for identifying the site of dialysate leakage. Abdominal and inguinal hernias are well-recognized complications of con tinuous ambulatory peritoneal dialysis (CAPD). Dialysate may escape from the peritoneal space through such hernias; also the development of genital edema in a CAPD patient may indicate the presence of an inguinal hernia, which otherwise may be impossible to detect clinically (I). In CAPD patients who have had multiple abdominal operations, there may be numerous possible sites of hemia development and dialysate leakage, so that it may prove difficult to identify and repair the defect. We describe a patient in whom contrast-enhanced computerized tomographic scanning was used to identify the site of extraperitoneal dialysate leakage.


1997 ◽  
Vol 4 (3) ◽  
pp. 262-271 ◽  
Author(s):  
Peter Heilberger ◽  
Christian Schunn ◽  
Wolfgang Ritter ◽  
Sepp Weber ◽  
Dieter Raithel

Purpose: To report the feasibility and sensitivity of duplex sonography compared to computed tomography (CT) for aortic endograft follow-up surveillance. Methods: In a 26-month period, 113 aortic aneurysm patients received 79 tube and 34 bifurcated stent-grafts. Follow-up used contrast-enhanced CT scanning and duplex sonography with an intravenous ultrasound contrast agent (Levovist). Results: Eleven patients (9.7%) were converted to open repair; 1 died from hemorrhagic shock secondary to retroperitoneal hematoma. The mean follow-up time was 7.2 months (range 1 to 24), during which 5 patients died of unrelated causes. Sixteen primary (within 30 days) and 5 secondary endoleaks were detected by duplex after tube graft implantation. Among 5 endoleaks due to retrograde side-branch perfusion, 3 were detected only with contrast-enhanced duplex scanning. Iliac artery occlusion was also documented using duplex; however, 2 stent fractures could not be seen with ultrasound. Ten primary endoleaks were detected in bifurcated stent-graft patients. One endoleak originating from the distal iliac limb anchoring site was missed by duplex owing to bowel gas. Graft limb thrombosis was clearly identified by lack of a flow signal on duplex. Conclusions: Duplex sonography could be a valuable, reliable, and economical surveillance tool for endovascular aortic reconstructions. The adjunctive use of an intravenous ultrasound contrast agent increased the sensitivity for detecting endoleak to a level comparable to contrast-enhanced CT scanning. However, stent fractures may not be seen on ultrasound, and bowel gas can interfere with obtaining an adequate image.


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