scholarly journals A Case of Isolated Celiac Artery Dissection Accompanied by Splenic Infarction Detected by Ultrasonography in the Emergency Department

2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Author(s):  
Kazumasa Emori ◽  
Nobuhiro Takeuchi ◽  
Junichi Soneda
Keyword(s):  
Emergency Department ◽  
Celiac Artery ◽  
Splenic Infarction ◽  
Artery Dissection ◽  
Emergency Setting ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced ◽  
Enhanced Ct ◽  
History Of ◽  
Enhanced Computed Tomography

A 46-year-old male with a history of hypertension visited the emergency department (ED) by ambulance complaining of sudden pain in the left side of his back. Ultrasonography (USG) performed at ED revealed splenic infarction along with occlusion and dissection of the celiac and splenic arteries without abdominal artery dissection. Contrast enhanced computed tomography (CT) revealed the same result. Consequently, spontaneous isolated celiac artery dissection (SICAD) was diagnosed. Because his blood pressure was high (159/70 mmHg), antihypertensive medicine was administered (nicardipine and carvedilol). After his blood reached optimal levels (130/80 mmHg), symptoms disappeared. Follow-up USG and contrast enhanced CT performed 8 days and 4 months after onset revealed amelioration of splenic infarction and improvement of the narrowed artery. Here, we report a case of SICAD with splenic infarction presenting with severe left-sided back pain and discuss the relevance of USG in an emergency setting.

scholarly journals Chest Pain of Uncertain Aetiology: Role of Contrast Enhanced Computed Tomography in the Emergency Department

2016 ◽  
Vol 10 (1) ◽  
pp. 205-211
Author(s):  
Firas Yassin ◽  
Chris Sawh ◽  
Pankaj Garg
Keyword(s):  
Emergency Department ◽  
Chest Pain ◽  
Acute Chest Pain ◽  
Coronary Event ◽  
Computed Tomographic ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced ◽  
Enhanced Ct ◽  
Enhanced Computed Tomography

There is increasing role of computed tomographic (CT) in the assessment of acute chest pain in the emergency department especially when the diagnosis is not clear. We report a case where non ECG gated contrast enhanced CT in the emergency department for rule-out of pulmonary embolus guided to the actual diagnosis, which was, acute coronary event, as evidenced by the presence of perfusion defect.

scholarly journals Asymptomatic hepatic artery dissection early after living-donor liver transplantation with simultaneous splenectomy: two case reports

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Keita Shimata ◽  
Yasuhiko Sugawara ◽  
Tomoaki Irie ◽  
Yuzuru Sambommatsu ◽  
Masashi Kadohisa ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Hepatic Artery ◽  
False Lumen ◽  
Celiac Artery ◽  
Artery Dissection ◽  
Left Hepatic Artery ◽  
Donor Liver Transplantation ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced ◽  
Enhanced Ct

Abstract Background Hepatic artery dissection after liver transplantation is an uncommon morbidity. The onset mechanism and management for this disorder remain unclear. The present report describes the cases of two patients with hepatic artery dissection after living-donor liver transplantation (LDLT) with simultaneous splenectomy and provides new insight into the onset mechanism of this disorder. Case presentation: Case 1 A 51-year-old man with liver cirrhosis caused by hepatitis B virus underwent LDLT with a right lobe graft and splenectomy simultaneously. The recipient’s right hepatic artery had partial dissection at the anastomosis site; therefore, his left hepatic artery was anastomosed. Contrast-enhanced computed tomography (CT) on postoperative day (POD) 27 showed dissection from his celiac artery to his left hepatic artery with bleeding in the false lumen. There was a risk of rupture of the false lumen; therefore, emergency interventional radiology and coil embolization of the false lumen were performed. The patient was doing well at 6 months after LDLT. Case 2 A 58-year-old woman with liver cirrhosis caused by primary biliary cholangitis underwent LDLT with a left lobe graft and splenectomy simultaneously. Her hepatic artery had a dissection that extended from her left hepatic artery to the proper hepatic artery. The gastroduodenal artery was anastomosed. Contrast-enhanced CT on POD 8 revealed dissection from the celiac artery to the common hepatic artery as well as a pseudoaneurysm at the celiac artery. We managed the patient with conservative treatment and performed daily follow-ups with Doppler ultrasonography examination and serial contrast-enhanced CT. At the time of writing this report, the patient was doing well at 34 months after LDLT. Conclusions Patients who have an intimal dissection at the anastomosis site and/or simultaneous splenectomy are at a higher risk of hepatic artery dissection. Most patients with asymptomatic hepatic artery dissections can be treated conservatively. Blood flow in the intrahepatic artery should be checked frequently using Doppler ultrasonography or contrast-enhanced CT soon after diagnosis.

scholarly journals Morphometric analysis of the splenic artery using contrast-enhanced computed tomography (CT)

2020 ◽  
Author(s):  
David J. Brinkman ◽  
Stephanie Troquay ◽  
Wouter J. de Jonge ◽  
Eric D. Irwin ◽  
Margriet J. Vervoordeldonk ◽  
...  
Keyword(s):  
Immune Modulation ◽  
Splenic Artery ◽  
Experimental Studies ◽  
Pancreatic Tissue ◽  
Branching Pattern ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced ◽  
Enhanced Ct ◽  
And Gender ◽  
Enhanced Computed Tomography

Abstract Purpose To evaluate the morphology and course of the splenic artery, which might impact the surgical implantation of systems that stimulate the nerves surrounding the splenic artery. Experimental studies indicate that these nerves play an important part in immune modulation, and might be a potential target in the treatment of autoimmune diseases. Methods This retrospective cohort study made use of contrast-enhanced CT images from 40 male and 40 female patients (age 30–69) that underwent a CT examination of the aorta, kidneys or pancreas. Anatomic features were described including total splenic artery length, calibers, tortuosity, the presence of arterial loops and the branching pattern of the splenic artery. Results No age-gender-related differences could be found related to tortuosity or branching pattern. The length of splenic artery in contact with pancreatic tissue decreased with increasing age, but was not different between genders. Artery diameters were wider in male compared to female subjects. Loops of variable directions, that represent a part of the artery that curls out of the pancreatic tissue, were identified in each age-gender category and were present in nearly all subjects (86%). Conclusion This study suggests that although some anatomic features of the splenic artery are subject to factors as age and gender, the tortuosity of the splenic artery is not age dependent. Most subjects had one or multiple loops, which can serve as a target for neuromodulatory devices. Future studies should investigate whether splenic nerve stimulation is safe and feasible.

Malignant Brenner tumour of the ovary manifesting as distal intestinal obstruction and perforation

2020 ◽  
Vol 13 (6) ◽  
pp. e235394
Author(s):  
Brijesh Kumar Singh ◽  
Sudipta Saha ◽  
Shilpi Agarwal ◽  
Yashwant Singh Rathore
Keyword(s):  
Present Report ◽  
Iliac Fossa ◽  
Colonic Obstruction ◽  
Exploratory Laparotomy ◽  
Abdominal Radiograph ◽  
Palpable Mass ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced ◽  
Enhanced Ct ◽  
History Of

A rare case of malignant Brenner tumour of ovary manifesting with intestinal perforation due to colonic infiltration is elaborated in the present report. Brenner’s tumour accounts for 1%–2% of all ovarian neoplasms and malignant Brenner tumour is even rarer and only about 5% of Brenner tumours are malignant. A 62-year-old woman came to surgical emergency with 1-month history of abdominal pain, vomiting and constipation with a palpable mass in right iliac fossa. Abdominal radiograph was suggestive of colonic obstruction. Contrast-enhanced CT of the abdomen revealed cystic right ovarian mass of 10.2×8.8 cm2 with pneumoperitoneum. Exploratory laparotomy was done, which revealed mass arising from right ovary involving terminal ileum, cecum and ascending colon. Possibility of ovarian malignancy was kept. Patient underwent debulking surgery along with ileostomy and descending colon mucous fistula was created. Histology was compatible with malignant Brenner tumour of the ovary.

scholarly journals Misdiagnosis of Rectus Abdominis Abscess Owing to Delayed Contrast-Enhanced Computed Tomography

2021 ◽  
Author(s):  
Yuichiro Nagase ◽  
Yukinori Harada
Keyword(s):  
Computed Tomography ◽  
Laboratory Tests ◽  
Rectus Abdominis ◽  
Rectus Abdominis Muscle ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced ◽  
Enhanced Ct ◽  
The Right ◽  
Enhanced Computed Tomography ◽  
Contrast Enhanced Computed Tomography

A 77-year-old man, who was on anticoagulation, presented with a painful lump on the right abdominal wall. Laboratory tests showed slight anaemia and elevated inflammatory markers. Abdominal plain computed tomography (CT) revealed a mass in the right rectus abdominis muscle. He was admitted with a diagnosis of primary rectus abdominis haematoma. However, on the next day, the diagnosis was corrected to primary rectus abdominis abscess, following contrast-enhanced CT of the abdomen. This case illustrates the importance of considering primary rectus abdominis abscess in patients with suspected primary rectus abdominis haematoma, and contrast should be used when performing CT.

scholarly journals Differentiating Central Lung Tumors from Atelectasis with Contrast-Enhanced CT-Based Radiomics Features

2021 ◽  
Vol 2021 ◽  
pp. 1-10
Author(s):  
Rui Chai ◽  
Qi Wang ◽  
Pinle Qin ◽  
Jianchao Zeng ◽  
Jiwei Ren ◽  
...  
Keyword(s):  
Information Gain ◽  
Ct Images ◽  
Classification Model ◽  
Lung Cancers ◽  
Contrast Enhanced Ct ◽  
Pulmonary Cancer ◽  
Contrast Enhanced ◽  
Enhanced Ct ◽  
Enhanced Computed Tomography ◽  
Contrast Enhanced Computed Tomography

Objectives. To evaluate the utility of radiomics features in differentiating central lung cancers and atelectasis on contrast-enhanced computed tomography (CT) images. This study is retrospective. Materials and Methods. In this study, 36 patients with central pulmonary cancer and atelectasis between July 2013 and June 2018 were identified. A total of 1,653 2D and 2,327 3D radiomics features were extracted from segmented lung cancers and atelectasis on contrast-enhanced CT. The refined features were investigated for usefulness in classifying lung cancer and atelectasis according to the information gain, and 10 models were trained based on these features. The classification model is trained and tested at the region level and pixel level, respectively. Results. Among all the extracted features, 334 2D features and 1,507 3D features had an information gain (IG) greater than 0.1. The highest accuracy (AC) of the region classifiers was 0.9375. The best Dice score, Hausdorff distance, and voxel AC were 0.2076, 45.28, and 0.8675, respectively. Conclusions. Radiomics features derived from contrast-enhanced CT images can differentiate lung cancers and atelectasis at the regional and voxel levels.

Horseshoe Kidney Blunt Trauma With Double Laceration: Endovascular Management

2020 ◽  
Vol 54 (7) ◽  
pp. 643-645
Author(s):  
Enrico Boninsegna ◽  
Emilio Simonini ◽  
Stefano Crosara ◽  
Carlo Sozzi ◽  
Stefano Colopi
Keyword(s):  
Abdominal Trauma ◽  
Horseshoe Kidney ◽  
Left Common Iliac Artery ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced ◽  
Enhanced Ct ◽  
Arterial Hemorrhage ◽  
Endovascular Approach ◽  
Perinephric Hematoma ◽  
Enhanced Computed Tomography

A 78-year-old male patient was admitted to our hospital after abdominal trauma. Contrast-enhanced computed tomography (CT) scan demonstrated a horseshoe kidney with a perinephric hematoma and evidence of arterial hemorrhage. An anomalous renal arterial anatomy was noted as well, with a renal artery originating from the left common iliac artery. He was successfully treated via an endovascular approach. Varying forms of vascularization may complicate angiographic treatment of patients with abdominal trauma in a setting of kidney anomalies. Obtaining and evaluating contrast-enhanced CT angiography can identify anomalous vessels and can be invaluable when deciding on the most appropriate interventional approach.

Suspected haemorrhagic cystitis in a dog as delayed complication after contrast-enhanced computed tomography

2020 ◽  
Vol 8 (1) ◽  
pp. e001011
Author(s):  
Nausikaa Devriendt ◽  
Norbert van de Velde ◽  
Emmelie Stock ◽  
Evelien de Bakker ◽  
Hilde de Rooster
Keyword(s):  
Ct Scan ◽  
Clinical Signs ◽  
Lumbar Vertebra ◽  
Multimodal Analgesia ◽  
Haemorrhagic Cystitis ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced ◽  
Enhanced Ct ◽  
Delayed Complication ◽  
Enhanced Computed Tomography

A 10-month-old female intact Australian shepherd dog was diagnosed with an intrapelvic mass. Blood and urinanalyses were unremarkable. A contrast-enhanced CT scan was performed to define the extent of the mass. A large, expansile, heterogeneous mass, extending from the ventral aspect of the last lumbar vertebra until the second caudate vertebra and invading the vertebral canal at the lumbosacral junction with displacement of all organs in the caudal abdomen, was diagnosed. Two days after the CT scan, the dog was euthanased because of deterioration of clinical signs despite the start of multimodal analgesia. Necropsy and subsequent histology and immunohistochemistry revealed the presence of a plasmacytoma and haemorrhagic cystitis. The haemorrhagic cystitis was most likely caused by the contrast agent used for the CT scan that remained in the bladder for a prolonged time, secondary to subobstruction of the urethra.

scholarly journals Osteoblastic Metastases Mimickers on Contrast Enhanced CT

2017 ◽  
Vol 2017 ◽  
pp. 1-4
Author(s):  
Fahad Al-Lhedan ◽  
Sam Samaan ◽  
Wanzhen Zeng
Keyword(s):  
Cord Compression ◽  
Prior History ◽  
Venous Flow ◽  
Osseous Lesion ◽  
Osseous Metastases ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced ◽  
Enhanced Ct ◽  
History Of ◽  
Primary Bone

Secondary osseous involvement in lymphoma is more common compared to primary bone lymphoma. The finding of osseous lesion can be incidentally discovered during the course of the disease. However, osseous metastases are infrequently silent. Detection of osseous metastases is crucial for accurate staging and optimal treatment planning of lymphoma. The aim of imaging is to identify the presence and extent of osseous disease and to assess for possible complications such as pathological fracture of the load-bearing bones and cord compression if the lesion is spinal. We are presenting two patients with treated lymphoma who were in complete remission. On routine follow-up contrast enhanced CT, there were new osteoblastic lesions in the spine worrisome for metastases. Additional studies were performed for further evaluation of both of them which did not demonstrate any corresponding suspicious osseous lesion. The patients have a prior history of chronic venous occlusive thrombosis that resulted in collaterals formation. Contrast enhancement of the vertebral body marrow secondary to collaterals formation and venous flow through the vertebral venous plexus can mimic the appearance of spinal osteoblastic metastases.

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