CT Appearances in Treated Abdominal Tuberculosis: A Radiologist's Dilemma

2021 ◽  
Author(s):  
Vinita Rathi ◽  
Varun Yadav ◽  
Bonny S. Deep ◽  
Shuchi Bhatt ◽  
Subhash Giri
Keyword(s):  
Small Bowel ◽  
Lymph Nodes ◽  
Ct Scan ◽  
Wall Thickness ◽  
Residual Disease ◽  
Multidetector Ct ◽  
Abdominal Tuberculosis ◽  
Adult Patients ◽  
Wall Thickening ◽  
Ileocecal Tuberculosis

Abstract Objective To study the CT appearances of the abdomen after completion of antitubercular therapy (ATT) in adult patients. Methods Multidetector CT scan abdomen was done in 20 adults within 1 month of completing ATT. CT appearances were compared with pretreatment scans which were available in 7 cases. Results We found that residual ileocecal wall thickening and enhancement was significant (p < 0.05) after treatment in cases of ileocecal tuberculosis (TB). Mild decrease in wall thickness and diameter of the involved dilated small bowel loops was seen. Numerous large, matted nodes with necrosis persisted in the mesentery and retroperitoneum in treated TB, but reduction in the size of nodes was appreciated. Conclusion Our results help to fill the vacuum in the database of CT appearances in treated abdominal TB. Persistence of bowel changes and lymph nodes should not be mistaken for recurrence of TB or residual disease.

Recurrence patterns in patients with abnormal cardiophrenic lymph nodes at ovarian cancer diagnosis

2020 ◽  
Vol 30 (4) ◽  
pp. 504-508 ◽  
Author(s):  
Alyssa Larish ◽  
Ismail Mert ◽  
Michaela McGree ◽  
Amy Weaver ◽  
Shannon Sheedy ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Lymph Nodes ◽  
Ct Scan ◽  
Residual Disease ◽  
Assessment Scale ◽  
Qualitative Assessment ◽  
Debulking Surgery ◽  
Primary Debulking Surgery ◽  
Response To Chemotherapy ◽  
Increased Risk

ObjectivesMetastases in cardiophrenic lymph nodes noted at diagnosis of epithelial ovarian cancer confer a poor prognosis. It is unclear if cardiophrenic nodal metastases portend an atypical pattern of recurrence. We report on patients with radiographically involved cardiophrenic lymph nodes who underwent optimal primary debulking surgery to describe patterns of recurrence and response to chemotherapy.MethodsPatients undergoing primary debulking surgery for stage IIIC/IV epithelial ovarian carcinoma with residual disease ≤1.0 cm at our institution from 2003 to 2011 with a pre-operative computed tomography (CT) scan were identified. Scans were reviewed by blinded radiologists, who identified abnormal cardiophrenic lymph nodes via a qualitative assessment scale based on size, heterogeneity, and architecture.ResultsOf the 250 patients identified, a recurrence site was documented in 22/27 (81.5%) with abnormal pre-operative cardiophrenic lymph nodes (defined by an elevated Qualitative Assessment Scale (QAS) score of ≥4), and in 128/223 (57.4%) without abnormal pre-operative cardiophrenic lymph nodes. Median short axis and long axis lymph node diameters for these patients was 9 (range 6–15) mm and 15 (range 11–22) mm, respectively. Cardiophrenic lymph nodes were resected in one patient. Patients with abnormal cardiophrenic nodes are more likely to have synchronous recurrence in thorax/pelvis and abdomen (50.0% (11/22) vs 25.0% (32/128), p=0.02) and less likely to have isolated recurrence in pelvis or abdomen (40.9% (9/22) vs 68.0% (87/128)). All patients who had a CT scan after six cycles of chemotherapy had improvement (defined as reduction of QAS score) in cardiophrenic lymphadenopathy.ConclusionsDespite cardiophrenic adenopathy demonstrating a complete radiographic response to chemotherapy, their presence pre-operatively is associated with an increased risk of recurrence in the thorax. Knowledge of this propensity to recur in the thorax is important to ensure all extra-abdominal recurrence sites are diagnosed and managed appropriately.

scholarly journals The role of MDCT in the diagnosis of small bowel obstruction secondary to multiple adhesion bands: A case report

2019 ◽  
pp. 4407-4410
Author(s):  
Farideh Gharekhanloo ◽  
Masoud Esnaashari
Keyword(s):  
Small Bowel ◽  
Ct Scan ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Multidetector Ct ◽  
Contrast Enhanced Ct ◽  
Technological Advances ◽  
Contrast Enhanced ◽  
Enhanced Ct ◽  
History Of

Adhesion band is a major cause of small bowel obstruction. Traditionally, the obtained results of computed tomography (CT) scan were indicative of adhesion band as an etiology for small bowel obstruction. However, adhesion is easily diagnosed today due to technological advances in radiology and high-quality multidetector CT. It is important to avoid the possible complications of bowel obstruction in the early and appropriate surgical intervention. This article is a report of a 45-year-old woman with abdominal pain and history of previous abdominal surgery. A contrast-enhanced CT scan showed multiple adhesion bands ensued the abrupt narrowing of bowel diameter and closed small-bowel loops obstruction. Furthermore, multiple bands were clearly observed and adhesiolysis was performed in the surgery.

scholarly journals Significance of Gastric Wall Thickening Detected in Abdominal CT Scan to Predict Gastric Malignancy

2019 ◽  
Vol 2019 ◽  
pp. 1-6
Author(s):  
A. Akbas ◽  
H. Bakir ◽  
M. F. Dasiran ◽  
H. Dagmura ◽  
Z. Ozmen ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Ct Scan ◽  
Wall Thickness ◽  
Gastric Wall ◽  
Hemoglobin Level ◽  
Wall Thickening ◽  
Endoscopic Evaluation ◽  
Abdominal Ct ◽  
Abdominal Ct Scan ◽  
Gastric Malignancy

Background. Early diagnosis of gastric cancer is one of the most important parameters affecting the survival of the disease. In this study, we aimed to stress the importance of antrum wall thickness in CT examination. Method. The study included 111 patients between ages of 18 and 95 who had antral wall thickening in computed tomography and also had endoscopic evaluation performed in the same clinic. The patients were divided into two groups as benign and malignant according to the pathology results. The thickness of the antrum wall in computed tomography, hemoglobin and albumin levels, and age was compared among these two groups. Parameters with significant differences were further analyzed by multivariate analysis using logistic regression analysis. Results. Of the 111 patients included in the study, 57 were male and 54 were female. Mean age was 65 years. Fifty-one patients were classified as benign and 60 patients as malignant. Mean age of the malignant patients was 70, while that of benign patients was 59 (p<0.05). Antrum wall thickness was 13.68 ± 3.27 mm in malignant patients and 9.22 ± 2.17 mm in benign patients (p<0.05). Similarly, hemoglobin level was significantly different in malignant and benign patients (10.78 ± 1.57 g/dl and 12.64 ± 1.43 g/dl, respectively; p<0.05). Albumin levels were 3.36 ± 0.57 mg/dl in malignant patients and 3.97 ± 0.57 mg/dl in benign patients (p<0.05). Conclusion. Evaluation of antrum wall thickness, age, hemoglobin, and albumin values together may contribute to distinguishing the benign and malignant pathologies involving this region in patients with suspected stomach wall thickening in abdominal CT scan.

scholarly journals ACE Inhibitor Induced Isolated Angioedema of the Small Bowel: A Rare Complication of a Common Medication

2021 ◽  
Vol 2021 ◽  
pp. 1-4 ◽  
Author(s):  
Marc D. Squillante ◽  
Anna Trujillo ◽  
Joseph Norton ◽  
Saurabh Bansal ◽  
David Dragoo
Keyword(s):  
Small Bowel ◽  
Ct Scan ◽  
Rare Complication ◽  
The Body ◽  
Wall Thickening ◽  
Interstitial Tissue ◽  
Moderate Amount ◽  
Entire Small Bowel ◽  
Difficulty Breathing ◽  
Mucosal Edema

Angioedema is a subcutaneous or submucosal tissue swelling due to capillary leakage and transudation of fluid into the interstitial tissue. It can be localized or generalized as part of a widespread reaction known as anaphylaxis. Millions of people in United States and all over the world receive ACEI antihypertensive therapy. ACEI is known to cause angioedema with an incidence of 0.7 percent. We present a case of 40-year-old female who was started on lisinopril three days prior to presentation for newly diagnosed hypertension. She presented with nonspecific severe abdominal pain, nausea, and vomiting. She denied having difficulty breathing or swelling anywhere in the body. On exam, she did not have facial, lip, tongue, or throat swelling. Her abdomen was tender without guarding or rigidity. Laboratory examination was unrevealing except for mild leukocytosis. Computed tomography scan (CT scan) of the abdomen with oral and IV contrast revealed a moderate amount of ascites with diffuse wall thickening, hyperenhancement, and mucosal edema of the entire small bowel. In the absence of any other pathology, matching history, and imaging findings highly suggestive of angioedema, she was diagnosed with isolated small bowel angioedema as a result of ACEI therapy. She was managed conservatively, and lisinopril was discontinued. A week later on follow-up, all her symptoms had resolved, and repeat CT scan showed resolution of all findings.

Capsule Endoscopy Is Superior to Multidetector CT Scan for Evaluation of Small Bowel Disorders: A Meta-analysis

2015 ◽  
Vol 110 ◽  
pp. S992-S993
Author(s):  
Shabana F. Pasha ◽  
Ryan McLemore ◽  
Amy K. Hara ◽  
Michael D. Crowell ◽  
Jonathan A. Leighton
Keyword(s):  
Small Bowel ◽  
Ct Scan ◽  
Capsule Endoscopy ◽  
Multidetector Ct ◽  
Meta Analysis ◽  
Bowel Disorders

Assessment of Myocardial Viability in Persistent Defects on Thallium-201 SPECT after Reinjection Using Gradient-Echo MRI

1996 ◽  
Vol 35 (05) ◽  
pp. 146-152 ◽  
Author(s):  
A. Kögler ◽  
H.-A. Schmitt ◽  
D. Emrich ◽  
H. Kreuzer ◽  
D. L. Munz ◽  
...  
Keyword(s):  
Wall Thickness ◽  
Myocardial Viability ◽  
Cardiac Cycle ◽  
Single Photon ◽  
Contractile Function ◽  
Left Ventricular ◽  
Wall Thickening ◽  
Gradient Echo ◽  
Systolic Wall Thickening

SummaryThis prospective study assessed myocardial viability in 30 patients with coronary heart disease and persistent defects despite reinjection on TI-201 single-photon computed tomography (SPECT). In each patient, three observers graded TI-201 uptake in 7 left ventricular wall segments. Gradient-echo magnetic resonance imaging in the region of the persistent defect generated 12 to 16 short axis views representing a cardiac cycle. A total of 120 segments were analyzed. Mean end-diastolic wall thickness and systolic wall thickening (± SD) was 11.5 ± 2.7 mm and 5.8 ± 3.9 mm in 48 segments with normal TI-201 uptake, 10.1 ± 3.4 mm and 3.7 ± 3.1 mm in 31 with reversible lesions, 11.3 ± 2.8 mm and 3.3 ± 1.9 mm in 10 with mild persistent defects, 9.2 ± 2.9 mm and 3.2 ±2.2 mm in 15 with moderate persistent defects, 5.8 ± 1.7 mm and 1.3 ± 1.4 mm in 16 with severe persistent defects, respectively. Significant differences in mean end-diastolic wall thickness (p <0.0005) and systolic wall thickening (p <0.005) were found only between segments with severe persistent defects and all other groups, but not among the other groups. On follow-up in 11 patients after revascularization, 6 segments with mild-to-moderate persistent defects showed improvement in mean systolic wall thickening that was not seen in 6 other segments with severe persistent defects. These data indicate that most myocardial segments with mild and moderate persistent TI-201 defects after reinjection still contain viable tissue. Segments with severe persistent defects, however, represent predominantly nonviable myocardium without contractile function.

scholarly journals A prospective study evaluating preoperative (clinical, imaging) and intraoperative predictors of suboptimal debulking in advanced epithelial ovarian cancer

2016 ◽  
Author(s):  
Anupama Rajanbabu ◽  
Kiran Bagul ◽  
Keyword(s):  
Ovarian Cancer ◽  
Small Bowel ◽  
Ct Scan ◽  
Epithelial Ovarian Cancer ◽  
Survival Benefit ◽  
Demographic Data ◽  
Univariate Analysis ◽  
Imaging Results ◽  
Advanced Epithelial Ovarian Cancer ◽  
Optimal Debulking

Introduction: In advanced epithelial ovarian cancer, there is a survival benefit for patients who achieve optimalcytoreduction. Suboptimallycytoreduced patients are at risk of the increased morbidity of a surgery without associated survival benefit. Predicting which patients can undergo optimal cytoreduction represents a critical decision-making point. Present study analyses the predictors, pre operative (clinical and radiologic) and intraoperative of suboptimal debulking. Methods: This was a prospective observational study conducted at Amrita Institute of Medical Sciences from March 2013 to May 2015. All the patients with clinically (physical examination, laboratory and imaging results) diagnosed Stage IIIc epithelial ovarian, fallopian tube, or primary peritoneal carcinoma (PPC) who were planed for primary debulking surgery were included. The demographic data and details of tumor markers, radiological investigations including CT scan, intra operative findings and histopathologic details were collected. Statistical analysis was done using SPSS v20.0. Results: 36 patients fit the inclusion criteria. Gross ascites wasthe clinical parameter found to be associated with suboptimal debulking. CT scan had low sensitivity (35-53%) in diagnosing small bowel mesenteric and porta hepatis disease and high sensitivity in diagnosing diffuse peritoneal thickening, omental disease, diaphragmatic and nodal disease. On univariate analysis diffuse peritoneal thickening and small bowel serosa and mesenteric disease were significantly consistent with sub optimal debulking. Conclusion: Finding out disease at the sites which are associated with suboptimal debulking (diffuse peritoneal thickening, smallbowel mesenteric and serosal disease) pre operatively or at the beginning of surgery can predict optimal debulking and can help avoid un necessary surgery.

scholarly journals Challenge in diagnosis of late onset necrotizing enterocolitis in a term infant: a case report

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Gunadi ◽  
Dian Nirmala Sirait ◽  
Aditya Rifqi Fauzi ◽  
Ninditya Nugroho ◽  
Fadil Fahri ◽  
...  
Keyword(s):  
Ct Scan ◽  
Necrotizing Enterocolitis ◽  
Intestinal Inflammation ◽  
Late Onset ◽  
Gastrointestinal Disease ◽  
Early Recognition ◽  
Ileocecal Valve ◽  
Abdominal Distention ◽  
Clinical Deterioration ◽  
Wall Thickening

Abstract Background Necrotizing enterocolitis (NEC) is a common devastating inflammatory gastrointestinal disease and frequently occurs in premature infants. Here, we reported a case of late-onset NEC in a term neonate with good outcome after surgery for long-term follow-up. Case presentation Ten-week-old male came to emergency unit due to prolonged diarrhea and abdominal distention. He was born at gestational age of 40 weeks with birth weight and Apgar score of 2800 g and 7/8, respectively. He had no history of formula feeding. Two weeks before admitted to the hospital, the patient had frequent diarrhea with fever. He was found lethargic with abdominal distention, absence of bowel sounds and abdominal tenderness. Plain abdominal x-ray and CT scan showed gastric and intestinal dilatation and gasless colon, suggesting a small bowel obstruction, and bowel wall thickening indicating peritonitis, without any free subdiaphragmatic air (pneumoperitoneum). Moreover, the patient did not have a congenital heart disease. While in intensive medical treatment, he showed a continuous clinical deterioration. All findings were suggestive of intestinal inflammation with clinical deterioration, and we decided to perform an emergency exploratory laparotomy and found an ischemia along the jejunoileal with a perforation at 25 cm above the ileocecal valve. Subsequently, we performed a double-barrel ileostomy through a separate incision from the laparotomy. Histopathological findings confirmed the diagnosis of NEC. We closed the stoma at postoperative day 43. The patient was discharged uneventfully a month after stoma closure. Conclusion Abdominal CT scan might be useful to establish an early recognition of late-onset NEC; thus, immediate surgical intervention might be performed to decrease its morbidity and mortality. Moreover, late-onset NEC in term neonates might occur without any risk factors or significant co-morbidities.

scholarly journals Role of Removed Lymph Nodes on the Prognosis of M0 Small-Bowel Neuroendocrine Tumors: a Propensity Score Matching Analysis from SEER Database

2021 ◽  
Author(s):  
Jie-bin Xie ◽  
Yue-shan Pang ◽  
Xun Li ◽  
Xiao-ting Wu
Keyword(s):  
Small Bowel ◽  
Propensity Score ◽  
Lymph Nodes ◽  
Propensity Score Matching ◽  
Neuroendocrine Tumors ◽  
Prognostic Value ◽  
Radical Resection ◽  
Clinicopathological Characteristics ◽  
Seer Database ◽  
Resection Group

Abstract Background Current studies on the number of removed lymph nodes (LNs) and their prognostic value in small-bowel neuroendocrine tumors (SBNETs) are limited. This study aimed to clarify the prognostic value of removed LNs for SBNETs. Methods SBNET patients without distant metastasis from 2004 to 2017 in the SEER database were included. The optimal cutoff values of examined LNs (ELNs) and negative LNs (NLNs) were calculated by the X-tile software. Propensity score matching (PSM) was done to match patients 1:1 on clinicopathological characteristics between the two groups. The Kaplan-Meier method with log-rank test and multivariable Cox proportional-hazards regression model were used to evaluate the prognostic effect of removed LNs. Results The cutoff values of 14 for ELNs and 9 for NLNs could well distinguish patients with different prognoses. After 1:1 PSM, the differences in clinicopathological characteristics between the two groups were significantly reduced (all P > 0.05). Removal of more than one LN significantly improved the prognosis of the patients (P < 0.001). The number of lymphatic metastasis in the sufficiently radical resection group (SRR, 3.74 ± 3.278, ELN > 14 and NLN > 9) was significantly more than that in the insufficiently radical resection group (ISRR, 2.72 ± 3.19, ELN < 14 or NLN < 9). The 10-year overall survival (OS) of the SRR was significantly better than that of the ISRR (HR = 1.65, P = 0.001, 95% CI: 1.24–2.19). Conclusion Both ELNs and NLNs can well predict the OS of patients. Systematic removal of more than 14 LNs and more than 9 NLNs can increase the OS of SBNET patients.

scholarly journals Quantitative analysis of total macrophage content in adult mouse tissues. Immunochemical studies with monoclonal antibody F4/80.

1985 ◽  
Vol 161 (3) ◽  
pp. 475-489 ◽  
Author(s):  
S H Lee ◽  
P M Starkey ◽  
S Gordon
Keyword(s):  
Bone Marrow ◽  
Small Bowel ◽  
Lymph Nodes ◽  
Large Bowel ◽  
Adult Mouse ◽  
Specific Antigen ◽  
Lymphoid Tissues ◽  
Mesenteric Lymph Nodes ◽  
Mesenteric Lymph ◽  
Mouse Tissues

We have estimated the macrophage content of different tissues of the normal adult mouse using F4/80, a highly specific antigen marker for mature mouse macrophages. An absorption indirect binding assay was used to quantitate F4/80 antigen against a calibration standard made from the J774.2 macrophage-like cell line. The richest sources of tissue F4/80 antigen were found to be bone marrow, spleen, cervical and mesenteric lymph nodes, large bowel, liver, kidneys, and small bowel. The organs that have the highest total F4/80 antigen content are the liver, large bowel, small bowel, bone marrow, spleen, cervical and mesenteric lymph nodes, and kidney. We conclude that the mononuclear phagocyte system is mainly distributed in the gastrointestinal tract and liver, followed by hemopoietic and lymphoid tissues.

Sign in / Sign up

Export Citation Format

Share Document