Quadriplegia and rhabdomyolysis as a presenting feature of Conn’s syndrome

2021 ◽  
Vol 14 (1) ◽  
pp. e234686
Author(s):  
Sumanth Kollipara ◽  
Shruthi Ravindra ◽  
Kanthilatha Pai ◽  
Sahana Shetty
Keyword(s):  
Adrenal Adenoma ◽  
Secondary Hypertension ◽  
Acute Onset ◽  
Conn’S Syndrome ◽  
Presenting Symptoms ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced ◽  
Accelerated Hypertension ◽  
Biochemical Evaluation ◽  
Elevated Creatinine

Conn’s syndrome is an important endocrine cause for secondary hypertension. Hypokalaemia paralysis and rhabdomyolysis with accelerated hypertension may be the presenting symptoms of Conn’s syndrome. Here, we present one such case of a 38-year-old woman presenting with accelerated hypertension and acute onset quadriplegia. On biochemical evaluation, she was found to have severe hypokalaemia, metabolic alkalosis and elevated creatinine phosphokinase. Further evaluation revealed an elevated aldosterone renin ratio suggestive of primary hyperaldosteronism which was localised to left adrenal adenoma on contrast-enhanced CT. Patient’s blood pressure and serum potassium levels normalised after resection of the adrenal adenoma.

scholarly journals Portal venous gas in intestinal malrotation with mild midgut volvulus

2019 ◽  
Vol 5 (1) ◽  
Author(s):  
Ryuichiro Hirose ◽  
Hiroki Kai ◽  
Kaori Inatomi ◽  
Tsuyoshi Iwanaka ◽  
Naomi Morishima ◽  
...  
Keyword(s):  
Gas Bubbles ◽  
Acute Onset ◽  
Intestinal Malrotation ◽  
Midgut Volvulus ◽  
Portal Venous Gas ◽  
Ischemic Change ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced ◽  
Whirlpool Sign ◽  
Operative Findings

Abstract Background Portal venous gas has been considered as a radiological sign requiring urgent operative intervention; however, the reports concerning portal venous gas associated with favorable outcome are recently increasing. Case presentation We describe a 9-month-old boy with acute onset high fever and vomiting. The ultrasonography demonstrated micro-gas bubbles continuously floating in the intrahepatic portal vein. Contrast-enhanced CT, performed 1 h later from echography, revealed a whirlpool sign suggesting an intestinal malrotation with midgut volvulus, but with no signs of residual intrahepatic gas. Operative findings showed a mild volvulus with neither congestion nor ischemic change of the twisted bowel. Detorsion and Ladd’s procedure were completed laparoscopically. Conclusions Transient portal venous gas bubbles may be generated even in the mild intestinal volvulus with no bowel ischemia. Ultrasonography can be a sensitive detector to visualize such small amounts of gas.

Diagnostic computed tomography in acute interscapular pain

Heart ◽  
2019 ◽  
Vol 106 (2) ◽  
pp. 126-163
Author(s):  
Shruti S Joshi ◽  
Mardi Hamra ◽  
David E Newby
Keyword(s):  
Left Ventricular Systolic Dysfunction ◽  
Systolic Dysfunction ◽  
Venous Pressure ◽  
Sudden Onset ◽  
Acute Onset ◽  
Left Ventricular ◽  
List Type ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced ◽  
Enhanced Ct

Clinical introductionA man in his 60s with no medical history presented with sudden-onset, severe interscapular pain. He was in circulatory shock with a blood pressure of 65/30 mm Hg, heart rate of 115 beats per minute, respiratory rate of 32 breaths per minute and a room air oxygen saturation of 89%. Examination demonstrated weak peripheral pulses, an elevated jugular venous pressure, faint dual heart sounds, no cardiac murmurs and bilateral lung crepitations. An ECG was recorded which showed a broad QRS (figure 1A). There were no previous ECGs to compare this with. In view of his presentation with acute-onset interscapular pain, CT of the aorta was organised by the emergency department clinicians (figure 1B–D). After the CT result was obtained, the on-call cardiologist was contacted and a bedside echocardiogram performed. This demonstrated severe left ventricular systolic dysfunction with akinesia of the apex and lateral walls. The patient was then transferred to the catheter laboratory for an emergency invasive coronary angiogram.Figure 1ECG and CT images at presentation (A) 12 lead ECG. (B) Contrast enhanced CT aorta - coronal view. (C) Contrast enhanced CT aorta - axial view. (D) CT aorta showing 4 chamber view of the heart.What is the most likely diagnosis?Pulmonary embolism.Aortic dissection.Acute myocardial infarction.Cardiac tamponade.

scholarly journals Appendicular abscess masquerading as right testicular mass

2019 ◽  
Vol 12 (5) ◽  
pp. e229038
Author(s):  
Pon Rachel Vedamanickam
Keyword(s):  
Spermatic Cord ◽  
Iliac Fossa ◽  
Acute Onset ◽  
Testicular Mass ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced ◽  
Enhanced Ct ◽  
The Right

A 38-year-old man presented with an acute onset of pain and swelling of the right testis. On examination, he was tender in the right iliac fossa (RIF) with a grossly enlarged and tender right testis. Ultrasonography and contrast-enhanced CT of the abdomen and pelvis revealed right epididymo-orchitis, a bulky and inflamed right spermatic cord and a well- defined, thick-walled collection in the RIF.

Sinonasal polyposis complicated with extradural abscess and lateral rectus palsy

2021 ◽  
Vol 14 (5) ◽  
pp. e242667
Author(s):  
Aswin Chandran ◽  
Harithraa Cheniappangoundar Baskar ◽  
Anup Singh ◽  
Rajeev Kumar
Keyword(s):  
Nasal Polyposis ◽  
Early Recognition ◽  
Clinical Findings ◽  
Acute Onset ◽  
Mortality And Morbidity ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced ◽  
Enhanced Ct ◽  
High Index Of Suspicion ◽  
Orbital Complications

Sinogenic intracranial and orbital complications are infrequent complications of chronic rhinosinusitis with nasal polyposis (CRSwNP), leading to potentially fatal intracranial and orbital sequelae. The mortality and morbidity associated with these complications remain high despite the widespread use of antibiotics. We report a patient with CRSwNP presenting with acute onset extradural empyema and sixth nerve palsy in whom the diagnosis was delayed, necessitating early surgical intervention. Our case shows that delay in management and underdiagnosis of sinusitis with nasal polyposis can lead to devastating complications. A high index of suspicion, early recognition of the clinical findings and radiological evaluation with contrast-enhanced CT of paranasal sinuses, orbit and brain are essential to rule out fatal complications associated with CRSwNP. Timely endoscopic intervention and the use of antibiotics can lead to good outcomes, even in complicated cases.

Early diagnosis of poststernotomy mediastinitis: Are there typical findings in contrast-enhanced CT?

2009 ◽  
Vol 56 (S 01) ◽  
Author(s):  
C Schimmer ◽  
M Weininger ◽  
K Hamouda ◽  
C Ritter ◽  
SP Sommer ◽  
...  
Keyword(s):  
Early Diagnosis ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced ◽  
Enhanced Ct

IMAGING CHARACTERISTIS OF MDCT IN NASOPHARYNGEAL CARCINOMA

2014 ◽  
pp. 159-167
Author(s):  
Huu Thuan Ngo ◽  
Minh Loi Hoang ◽  
Van Dinh Nguyen ◽  
Dinh Duyen Nguyen
Keyword(s):  
Nasopharyngeal Carcinoma ◽  
Lymph Nodes ◽  
Lateral Wall ◽  
Cross Sectional Study ◽  
Slice Thickness ◽  
Cross Sectional ◽  
Lymph Nodes Metastasis ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced ◽  
Key Words Nasopharyngeal Carcinoma

Objectives: Imaging characteristis of MDCT in nasopharyngeal carcinoma. Subject and methods: Cross- sectional study in 51patients with nasopharyngeal carcinoma by MDCT at Danang Cancer Hospital from January 2013 to July 2014. Results: The findings reveal that the tumor in lateral wall (66.7%), diameter > 2cm (64.7%), hypodensity (98%), contrast- enhanced CT (62.7%). Blunting of fossa of Rosenmuller (96.1%), invasion of parapharyngeal space (62.7%), destruction of pterygoid bone (19.6%), invasion of skull base (17.6%), destruction of sphenoid bone (9.8%). Lymph nodes metastasis (96.1%), diameter (> 1- 3cm) is 58.8%. T-staging by CT showed T1 (35.3%), T2 (37.3%), T3 (17.6%) and T4 (9.8%). N- staging by CT showed N2 (66.7%), N3a- N3b (19.6%). Staging of Nasopharyngeal carcinoma: stage II-III (60.8%), stage IVA-IVB (23.5%) and stage IVC (11.8%). Conclusions: MDCT with a thinner slice thickness and high quality images is able to detect lymph nodes metastasis with small size and those in deep neck area and assess comprehensively the invasion of the tumor. Key words: Nasopharyngeal carcinoma, MDCT

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