Necrotizing Fasciitis Secondary to a Primary Suture for Anoperineal Trauma by Motorcycle Accident in a Healthy Adult

A 41-year-old man experienced a swollen scrotum three days after a motorcycle accident and presented to our hospital. He had had a primary suture repair for anoperineal trauma in an outside hospital at the time of the injury. He presented to us with general fatigue, low grade fevers, and perineal pain. Abdominal computed tomography showed subcutaneous emphysema from the scrotum to the left chest. The sutured wound had foul-smelling discharge and white exudate. We made the diagnosis of necrotizing fasciitis and immediately opened the sutured wound and performed initial debridement and lavage with copious irrigation. We continued antibiotics and lavage of the wound until the infection was controlled. Fortunately, the necrotizing fasciitis did not worsen and he was discharged after 15 days. Our experience indicates that anoperineal injuries should not be closed without careful and intensive follow-up due to the potential of developing necrotizing fasciitis.

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Compound dorsal dislocation of lunate with trapezoid fracture

Clinics and Practice ◽

10.4081/cp.2016.879 ◽

2016 ◽

Vol 6 (4) ◽

Cited By ~ 1

Author(s):

Bong-Sung Kim ◽

Gerrit Grieb ◽

Patrick Rhodius ◽

Arne H. Böcker ◽

Jan-Philipp Stromps ◽

...

Keyword(s):

Computed Tomography ◽

Conservative Treatment ◽

Satisfactory Result ◽

Closed Reduction ◽

Kirschner Wires ◽

Partial Loss ◽

X Ray ◽

Motorcycle Accident ◽

Loss Of Strength

We report about a dorsal dislocation of the lunate accompanied by a trapezoid fracture in a 41-year old male patient after a motorcycle accident. The lunate dislocation with no dorsal or volar intercalated segment instability (DISI, VISI) was diagnosed by x-ray whereas the trapezoid fracture was only diagnosable by computed tomography. A closed reduction and internal fixation of the lunate by two Kirschner wires was performed, the trapezoid fracture was conservatively treated. Surgery was followed by immobilization, intense physiotherapy and close follow-up. Even though complaints such as swelling and pain subsided during the course of rehabilitation, partial loss of strength and range of motion remained even after 16 months. In conclusion, a conservative treatment of trapezoid fractures seems to be sufficient in most cases. Closed reduction with Kwire fixation led to an overall satisfactory result in our case. For dorsal lunate dislocations in general, open reduction should be performed when close reduction is unsuccessful or DISI/VISI are observed in radiographs after attempted close reduction.

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Computed Tomography Follow-Up Assessment of Patients with Low-Grade Appendiceal Mucinous Neoplasms: Evaluation of Risk for Pseudomyxoma Peritonei

Annals of Surgical Oncology ◽

10.1245/s10434-016-5623-3 ◽

2017 ◽

Vol 24 (7) ◽

pp. 1778-1782 ◽

Cited By ~ 11

Author(s):

Catarina Tiselius ◽

Csaba Kindler ◽

Jayant Shetye ◽

Henry Letocha ◽

Kenneth Smedh

Keyword(s):

Computed Tomography ◽

Pseudomyxoma Peritonei ◽

Low Grade ◽

Mucinous Neoplasms

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The Lung Reporting and Data System (LU-RADS): A Proposal for Computed Tomography Screening

Canadian Association of Radiologists Journal ◽

10.1016/j.carj.2014.03.004 ◽

2014 ◽

Vol 65 (2) ◽

pp. 121-134 ◽

Cited By ~ 33

Author(s):

Daria Manos ◽

Jean M. Seely ◽

Jana Taylor ◽

Joy Borgaonkar ◽

Heidi C. Roberts ◽

...

Keyword(s):

Computed Tomography ◽

Screening Program ◽

Positive Outcome ◽

Data System ◽

Routine Screening ◽

Low Grade ◽

Minimal Risk ◽

Implementation Challenges ◽

Risk Of Malignancy

Despite the positive outcome of the recent randomized trial of computed tomography (CT) screening for lung cancer, substantial implementation challenges remain, including the clear reporting of relative risk and suggested workup of screen-detected nodules. Based on current literature, we propose a 6-level Lung-Reporting and Data System (LU-RADS) that classifies screening CTs by the nodule with the highest malignancy risk. As the LU-RADS level increases, the risk of malignancy increases. The LU-RADS level is linked directly to suggested follow-up pathways. Compared with current narrative reporting, this structure should improve communication with patients and clinicians, and provide a data collection framework to facilitate screening program evaluation and radiologist training. In overview, category 1 includes CTs with no nodules and returns the subject to routine screening. Category 2 scans harbor minimal risk, including <5 mm, perifissural, or long-term stable nodules that require no further workup before the next routine screening CT. Category 3 scans contain indeterminate nodules and require CT follow up with the interval dependent on nodule size (small [5-9 mm] or large [≥10 mm] and possibly transient). Category 4 scans are suspicious and are subdivided into 4A, low risk of malignancy; 4B, likely low-grade adenocarcinoma; and 4C, likely malignant. The 4B and 4C nodules have a high likelihood of neoplasm simply based on screening CT features, even if positron emission tomography, needle biopsy, and/or bronchoscopy are negative. Category 5 nodules demonstrate frankly malignant behavior on screening CT, and category 6 scans contain tissue-proven malignancies.

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Low-grade Gliomas associated with Epilepsy: Long-term Follow-up with Computed Tomography

Neurologia medico-chirurgica ◽

10.2176/nmc.28.667 ◽

1988 ◽

Vol 28 (7) ◽

pp. 667-672

Author(s):

Hirokazu KAWANO ◽

Minoru HAYASHI ◽

Hidenori KOBAYASHI ◽

Yuji HANDA ◽

Masanori KABUTO ◽

...

Keyword(s):

Computed Tomography ◽

Low Grade ◽

Low Grade Gliomas ◽

Long Term Follow Up

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Progression rate in Bosniak category IIF complex renal cysts

Radiologia Brasileira ◽

10.1590/0100-3984.2018.0038 ◽

2019 ◽

Vol 52 (3) ◽

pp. 155-160 ◽

Cited By ~ 3

Author(s):

Amanda de Vasconcelos Chambi Tames ◽

Eduardo Kaiser Ururahy Nunes Fonseca ◽

Fernando Ide Yamauchi ◽

Gabriela Maia Soares Messaggi Arrais ◽

Thais Caldara Mussi de Andrade ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Computed Tomography ◽

Magnetic Resonance ◽

Renal Cysts ◽

Final Analysis ◽

Progression Rate ◽

Low Grade ◽

Resonance Imaging ◽

Malignancy Rate

Abstract Objective: To evaluate progression rate of Bosniak category IIF complex renal cysts and the malignancy rate among surgically resected cysts. Materials and Methods: We performed a database search for complex renal cysts classified as Bosniak category IIF on computed tomography or magnetic resonance imaging between January 2008 and April 2016. Follow-up examinations (computed tomography or magnetic resonance imaging) were used in order to evaluate progression (Bosniak category reclassification) and stability, the latter being defined as remaining stable for a minimum of six months. Pathology reports were used as the reference to assess the malignancy rate of surgically resected cysts. Results: A total of 152 cysts in 143 patients were included in the final analysis. Seven cysts (4.6%) were reclassified on follow-up studies, and mean time to progression was 20 months (range, 1 month to 4 years). Three cysts were surgically resected. All three were diagnosed as low-grade malignant renal cell carcinomas (RCCs): one clear cell RCC and two papillary RCCs. The remaining 145 cysts remained unchanged after a mean follow-up period of 28 months (range, 6 to 118 months). Conclusion: The progression rate in Bosniak category IIF cysts was low. Even lesions that were upgraded on follow-up remained stable, indicating an indolent behavior. Our data support the idea of conservative management of Bosniak IIF renal cyst.

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Multislice imaging of gastrointestinal stromal tumors

10.32512/jmr.1.1.2018/3.14 ◽

2018 ◽

pp. 3-14

Keyword(s):

Computed Tomography ◽

Key Words ◽

Gold Standard ◽

Gastrointestinal Stromal Tumors ◽

Mesenchymal Tumors ◽

Stromal Tumors ◽

Preferential Localization ◽

Multislice Imaging ◽

Computed Tomography Diagnosis

Gastrointestinal stromal tumors (GIST) are the most common mesenchymal tumors of the digestive tract (1%). These tumors express the CD 117 in 95% of cases. The stomach is the preferential localization (70%). Diagnosis is difficult and sometimes late. Progress of imaging has greatly improved the management and the prognosis. Computed tomography (CT) is the gold standard for diagnosis, staging, and treatment follow-up. The increasing recognition of GIST’s histopathology and the prolonged survival revealed some suggestive imaging aspects. Key words: gastro-intestinal stromal tumors; computed tomography; diagnosis

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