Spontaneous Intraluminal Migration of Gossypiboma

ABSTRACTRetained surgical mops following surgery is an avoidable but serious complication. They are seldom reported because of medicolegal implications but clinicians need to be aware about varied presentations of this entity to avoid unnecessary morbidity. We report a case of a 28-year-old woman who presented with chronic diarrhea and lower abdominal pain due to intraluminal migration of the surgical mop into the sigmoid colon 6 months after myomectomy of the uterus. The possibility of gossypiboma was suggested by the contrast-enhanced CT scan of the abdomen. Flexible sigmoidosocpy showed the remnants of the mop inside the lumen of the sigmoid colon. She underwent laparotomy and removal of the surgical mop and became completely asymptomatic. Though gossypiboma is rare clinicians should keep it in mind in patients who had undergone laparotomy previously. (J Dig Endosc2011;2(1):22-24)

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Obstructed ileocaecal tuberculosis with splenic tuberculosis and solid pseudopapillary tumour of tail of pancreas in an immunocompetent woman

BMJ Case Reports ◽

10.1136/bcr-2020-235195 ◽

2020 ◽

Vol 13 (9) ◽

pp. e235195

Author(s):

Surendran Paramasivam ◽

Magesh Murali ◽

Parimuthukumar Rajappa

Keyword(s):

Abdominal Pain ◽

Lower Abdominal Pain ◽

Emergency Laparotomy ◽

Solid Pseudopapillary Tumour ◽

Contrast Enhanced Ct ◽

Contrast Enhanced ◽

Enhanced Ct ◽

Splenic Tuberculosis ◽

Ileocaecal Junction ◽

Time Of Admission

A 22-year-old young woman presented with fever, lower abdominal pain and vomiting for 20 days. She had persistent fever and abdominal pain. Fever panel was negative. Clinical features were suggestive of subacute small bowel obstruction. Contrast-enhanced CT abdomen showed thickening of distal ileum, ileocaecal junction and caecum with conglomerate necrotic nodal mass in the ileocolic mesentry along with a lesion in the tail of pancreas. Patient was discussed with multidisciplinary team and decided to undergo a single-stage procedure after adequate nutritional optimisation. During optimisation, she underwent acute obstruction and hence taken up for emergency laparotomy proceeded to right haemicolectomy with distal pancreatectomy and splenectomy 4 weeks after the time of admission. Histopathology showed ileocaecal tuberculosis and solid pseudopapillary tumour with margins free of tumour. Approach of obstructed ileocaecal tuberculosis in the setting of incidental diagnosis of solid pseudopapillary tumour of pancreas in a moribund patient was challenging.

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Sigmoid Volvulus in Pregnancy Assessed by Contrast-Enhanced Computed Tomography Scanning

Case Reports in Obstetrics and Gynecology ◽

10.1155/2021/6692483 ◽

2021 ◽

Vol 2021 ◽

pp. 1-4

Author(s):

Toshiaki Watanabe ◽

Tadatsugu Kinjo ◽

Yoshino Kinjyo ◽

Hayase Nitta ◽

Hitoshi Masamoto ◽

...

Keyword(s):

Pregnant Women ◽

Sigmoid Colon ◽

Intestinal Resection ◽

Lower Abdominal Pain ◽

Sigmoid Volvulus ◽

Primiparous Woman ◽

Contrast Enhanced Ct ◽

Contrast Enhanced ◽

Enhanced Ct ◽

Computed Tomography Scanning

Sigmoid volvulus requires urgent treatment, and it is particularly rare among pregnant women without a history of laparotomy. A delay in diagnosis may lead to serious consequences for the mother and fetus, and a rapid diagnosis and treatment in this setting is essential. The patient was a 19-year-old primiparous woman. She complained of repeated exacerbations and remissions of abrupt lower abdominal pain for the past 2 days and was transported to our hospital at 33 weeks of gestation. Ultrasonography revealed no placental thickening, and maternal bowel dilation was difficult to identify. Plain abdominal X-ray showed a dilated colon on the left side of the abdomen. Contrast-enhanced CT scan of the abdomen revealed a volvulus on the dorsal side of the uterus. The proximal end of the transverse to sigmoid colon was markedly dilated, and the distal end was collapsed. The elevated lactate level on blood gas analysis suggested intestinal ischemia. She was suspected of having a sigmoid volvulus at 33 weeks and 3 days of gestation. We decided to perform a cesarean section to secure the operative field for an intestinal resection following delivery. A male weighing 1840 g with Apgar scores 8/8 was delivered. The sigmoid colon was approximately 80 cm in length. A 360-degree clockwise rotation of was observed with a very distended but viable sigmoid loop. Following reduction of the volvulus, the sigmoid colon was fixed to the left side of the peritoneum. The mother had an uneventful postoperative course, and the infant was discharged without any sequelae. This case demonstrates two important lessons. First, sigmoid volvulus can occur in pregnant women even if they never had a laparotomy. Second, abdominal contrast-enhanced CT is useful for rapid diagnostic and treatment decisions relative to this pathology.

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The contrast-enhanced CT scan in the diagnosis of isodense subdural hematoma

Journal of Neurosurgery ◽

10.3171/jns.1979.50.1.0064 ◽

1979 ◽

Vol 50 (1) ◽

pp. 64-69 ◽

Cited By ~ 22

Author(s):

Fong Y. Tsai ◽

James E. Huprich ◽

Hervey D. Segall ◽

James S. Teal

Keyword(s):

Cerebral Cortex ◽

Ct Scan ◽

Subdural Hematoma ◽

Correct Diagnosis ◽

Content Type ◽

Subdural Hematomas ◽

Contrast Enhanced Ct ◽

Contrast Enhanced ◽

Enhanced Ct ◽

Fine Print

✓ The authors review 29 cases of surgically-proven isodense subdural hematomas examined by non-contrast and contrast-enhanced computerized tomography scans. Three types of isodense collections were noted: homogeneous isodense collections, mixed-density collections, and gravitational layering within subdural collections. Contrast enhancement within the cerebral cortex, cortical vessels, and subdural membranes led to the correct diagnosis in each case. Contrast-enhanced scans are essential for the evaluation of isodense subdural hematomas.

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Abdominal case of the day. Focal liver enhancement on contrast-enhanced CT scan caused by obstruction of the superior vena cava (SVC).

American Journal of Roentgenology ◽

10.2214/ajr.169.1.9207535 ◽

1997 ◽

Vol 169 (1) ◽

pp. 250-250 ◽

Cited By ~ 2

Author(s):

T E Herbener ◽

V Basile ◽

D Nakamoto ◽

H E Butler ◽

S P Pickering

Keyword(s):

Ct Scan ◽

Superior Vena Cava ◽

Superior Vena ◽

Vena Cava ◽

Contrast Enhanced Ct ◽

Contrast Enhanced ◽

Enhanced Ct

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Is CT Angiogram of the Abdominal Vessels Needed following the Diagnosis of Ischemic Colitis? A Multicenter Community Study

ISRN Gastroenterology ◽

10.1155/2014/756926 ◽

2014 ◽

Vol 2014 ◽

pp. 1-8 ◽

Cited By ~ 4

Author(s):

Muhammed Sherid ◽

Salih Samo ◽

Samian Sulaiman ◽

Husein Husein ◽

Sankara N. Sethuraman ◽

...

Keyword(s):

Ct Scan ◽

Ischemic Colitis ◽

Celiac Trunk ◽

Ct Angiogram ◽

Contrast Enhanced Ct ◽

Contrast Enhanced ◽

Enhanced Ct ◽

Group 3 ◽

Group 5 ◽

Atherosclerotic Changes

Background. CT angiogram is frequently obtained after diagnosis of ischemic colitis (IC). Aims. To investigate the vascular findings of CT angiogram as compared to contrast-enhanced CT scan and whether this modality changes the management or prognosis of IC. Methods. We conducted a retrospective analysis of patients with IC from 2007 to 2013. Results. CT angiogram was performed in 34 patients (28.81%), whereas contrast-enhanced CT scan was performed in 54 patients (45.76%). In CT angiogram group, 8 patients (23.5%) had atherosclerotic changes. Stenosis was found in 12 patients (35.3%) (9: celiac trunk, 3: SMA). Among this group, one patient underwent colectomy and another underwent angioplasty of the celiac trunk who died within 30 days. Among contrast-enhanced CT scan group, 5 patients (9.3%) had atherosclerotic changes. Stenosis was found in 5 patients (9.3%) (3: celiac trunk, 1: SMA, and 1: IMA). Among this group, 3 patients had colectomy and one died within 30 days. There was no statistical difference between both groups in all vascular findings except the stenosis which was higher in CT angiogram group (P=0.0025). Neither the need for surgery nor all-cause mortality was different between both groups. Conclusion. CT angiogram did not provide any useful findings that altered the management or the prognosis of IC.

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Contrast enhanced CT scan 1-year after admission. The bifurcated surgical graft of the abdominal aorta with visceral sidegrafts is seen

ASVIDE ◽

10.21037/asvide.2018.292 ◽

2018 ◽

Vol 5 ◽

pp. 292-292

Author(s):

Paul Schoenhagen

Keyword(s):

Ct Scan ◽

Abdominal Aorta ◽

Contrast Enhanced Ct ◽

Contrast Enhanced ◽

Enhanced Ct

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Delayed response to proton beam treatment of hepatocellular carcinoma

BJR|case reports ◽

10.1259/bjrcr.20180125 ◽

2020 ◽

Vol 6 (1) ◽

pp. 20180125

Author(s):

Chee-Wai Cheng ◽

Mitchell Machtay ◽

Jennifer Dorth ◽

Olga Sergeeva ◽

Hangsheng Xia ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Ct Scan ◽

Proton Beam ◽

Arterial Phase ◽

Delayed Response ◽

Data Set ◽

Contrast Enhanced Ct ◽

Contrast Enhanced ◽

Enhanced Ct ◽

Imaging Response

Hepatocellular carcinoma (HCC) has become one of the leading causes of cancer death worldwide. There has been anecdotal report regarding the effectiveness of proton beam treatment for HCC. In this pre-clinical investigation, the woodchuck model of viral hepatitis infection-induced HCC was used for proton beam treatment experiment. The radiopaque fiducial markers that are biodegradable were injected around the tumor under ultrasound guidance to facilitate positioning in sequential treatments. An α cradle mode was used to ensure reproducibility of animal positioning on the treatment couch. A CT scan was performed first for contouring by a radiation oncologist. The CT data set with contours was then exported for dose planning. Three fractionations, each 750 CcGyE, were applied every other day with a Mevion S250 passive scattering proton therapy system. Multiphase contrast-enhanced CT scans were performed after the treatment and at later times for follow-ups. 3 weeks post-treatment, shrinking of the HCC nodule was detected and constituted to a partial response (30% reduction along the long axis). By week nine after treatment, the nodule disappeared during the arterial phase of multiphase contrast-enhanced CT scan. Pathological evaluation corroborated with this imaging response. A delayed, but complete imaging response to proton beam treatment applied to HCC was achieved with this unique and clinically relevant animal model of HCC.

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