Idiopathic Spontaneous Rupture of Renal Pelvis in a Single Functioning Kidney

Spontaneous rupture of renal pelvis (SRRP) is a rare condition resulting in an extravasation of urine into retroperitoneal space. Due to the uncharacteristic symptoms, often mimicking renal colic, its diagnosis may be complicated. Herein, we report a case of a 73-year-old male with a solitary functioning kidney who presented with malaise and right-sided abdominal pain, rapidly followed by anuria. Laboratory tests showed the signs of AKI. Contrast-enhanced CT performed soon after the admission showed nonspecific abnormalities in the right middle abdomen suspected to be either inflammatory infiltration or surgical scarring. Symptomatic treatment was started, and an acute hemodialysis treatment was commenced. After a temporal improvement, the patient’s general condition worsened significantly, with exacerbated pain and massive increase in plasma creatinine. A second contrast-enhanced CT was performed with an addition of urography phase, revealing the extravasation of the contrast media in the location suggesting the rupture of the renal pelvis. The patient was treated successfully by the placement of a double-J ureteral stent into the ureter. Usually, a clear etiology of SRRP can be determined, that is, urinary tract obstruction, but in this case, we could not find a definite cause. It is important to remember that in the presence of a nonspecific abdominal pain and laboratory signs of AKI, a rare cause like SRRP should be taken into consideration. Performing a contrast CT scan with urography phase can save time in establishing a diagnosis and enable immediate urological intervention.

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Intravenous lobular capillary haemangioma presenting as neck discomfort associated with neck anteflexion

BMJ Case Reports ◽

10.1136/bcr-2020-237529 ◽

2021 ◽

Vol 14 (1) ◽

pp. e237529

Author(s):

Kotaro Ikeda ◽

Toshihisa Ichiba ◽

Kazunori Seo ◽

Yuji Okazaki

Keyword(s):

Histopathological Examination ◽

Rare Condition ◽

Pyogenic Granuloma ◽

Capillary Haemangioma ◽

Contrast Enhanced Ct ◽

Contrast Enhanced ◽

Clinical Presentations ◽

Enhanced Ct ◽

Left Neck ◽

Left Subclavian Vein

Lobular capillary haemangioma, also known as pyogenic granuloma, is a benign vascular tumour that usually originates in the skin and mucosal membrane. It sometimes derives from the lumen of a vein and the clinical presentations are various and non-specific. A 72-year-old woman complained of a sensation of pressure in her left neck for 1 month when cooking. Her left cephalic vein was enlarged with no signs of oedema, and cervical ultrasound revealed a space-occupying lesion in the left subclavian vein. Contrast-enhanced CT and MRI revealed an intravascular tumour. This tumour was removed with operation, and histopathological examination revealed intravascular capillary haemangioma. Intravascular lobular capillary haemangioma is a rare condition that occurs in the veins of the neck and upper extremities. Intravascular tumours could cause a unique symptom, such as neck discomfort associated with neck anteflexion.

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Negative predictive value of intravenous contrast-enhanced CT of the abdomen for patients presenting to the emergency department with undifferentiated upper abdominal pain

Emergency Radiology ◽

10.1007/s10140-011-0996-x ◽

2011 ◽

Vol 19 (1) ◽

pp. 19-26 ◽

Cited By ~ 10

Author(s):

Hyungjoo Ham ◽

Matthew D. F. McInnes ◽

Michael Woo ◽

Sylvie Lemonde

Keyword(s):

Emergency Department ◽

Abdominal Pain ◽

Negative Predictive Value ◽

Predictive Value ◽

Intravenous Contrast ◽

Contrast Enhanced Ct ◽

Contrast Enhanced ◽

Enhanced Ct ◽

Upper Abdominal

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The feasibility of deep learning-based synthetic contrast-enhanced CT from nonenhanced CT in emergency department patients with acute abdominal pain

Scientific Reports ◽

10.1038/s41598-021-99896-4 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Se Woo Kim ◽

Jung Hoon Kim ◽

Suha Kwak ◽

Minkyo Seo ◽

Changhyun Ryoo ◽

...

Keyword(s):

Emergency Department ◽

Abdominal Pain ◽

Deep Learning ◽

Acute Abdominal Pain ◽

Point Scale ◽

Contrast Enhanced Ct ◽

Underlying Malignancy ◽

Contrast Enhanced ◽

Enhanced Ct ◽

Emergency Department Patients

AbstractOur objective was to investigate the feasibility of deep learning-based synthetic contrast-enhanced CT (DL-SCE-CT) from nonenhanced CT (NECT) in patients who visited the emergency department (ED) with acute abdominal pain (AAP). We trained an algorithm generating DL-SCE-CT using NECT with paired precontrast/postcontrast images. For clinical application, 353 patients from three institutions who visited the ED with AAP were included. Six reviewers (experienced radiologists, ER1-3; training radiologists, TR1-3) made diagnostic and disposition decisions using NECT alone and then with NECT and DL-SCE-CT together. The radiologists’ confidence in decisions was graded using a 5-point scale. The diagnostic accuracy using DL-SCE-CT improved in three radiologists (50%, P = 0.023, 0.012, < 0.001, especially in 2/3 of TRs). The confidence of diagnosis and disposition improved significantly in five radiologists (83.3%, P < 0.001). Particularly, in subgroups with underlying malignancy and miscellaneous medical conditions (MMCs) and in CT-negative cases, more radiologists reported increased confidence in diagnosis (83.3% [5/6], 100.0% [6/6], and 83.3% [5/6], respectively) and disposition (66.7% [4/6], 83.3% [5/6] and 100% [6/6], respectively). In conclusion, DL-SCE-CT enhances the accuracy and confidence of diagnosis and disposition regarding patients with AAP in the ED, especially for less experienced radiologists, in CT-negative cases, and in certain disease subgroups with underlying malignancy and MMCs.

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Primary prostate lymphoma: A case report and literature review

International Journal of Immunopathology and Pharmacology ◽

10.1177/2058738419863217 ◽

2019 ◽

Vol 33 ◽

pp. 205873841986321 ◽

Cited By ~ 1

Author(s):

Kai Wang ◽

Ning Wang ◽

Ji Sun ◽

Yi Fan ◽

Lu Chen

Keyword(s):

Literature Review ◽

Ct Scan ◽

Urinary Tract Obstruction ◽

Specific Antigen ◽

B Cell Lymphoma ◽

Contrast Enhanced Ct ◽

Contrast Enhanced ◽

Enhanced Ct ◽

Puncture Biopsy ◽

To Receive

Primary prostate lymphoma (PPL) is rare. This article reports a case of PPL by retrospective analysis of the clinical data and review of the literature, in an attempt to explore the diagnosis, treatment, and prognosis of this rare disease. The present case involves a male patient who came to our hospital for medical consultation of dysuria. Serum prostate-specific antigen (PSA) was not remarkable. Pelvic computed tomography (CT) scan suggested obvious enlargement of the prostate and a tumor in the prostate, but the tumor was not significantly enhanced on contrast-enhanced CT scan. Ultrasound suggested obvious enlargement of the prostate with multiple local low-density echoes and rich blood flow signals inside. Histopathology of prostate biopsy suggested prostate diffuse large B-cell lymphoma (DLBCL). The patient refused chemotherapy but agreed to receive radiotherapy. After radiotherapy, the tumor became smaller and the International Prostate Symptom Score (IPSS) score was reduced. Our experience, together with literature review, suggests that prostate puncture biopsy is an important method for the diagnosis of PPL, and imaging examination can assist the diagnosis. Radiotherapy is able to reduce the tumor volume and relieve the symptoms of urinary tract obstruction, and chemotherapy can help achieve a better therapeutic outcome.

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Spontaneous Intraluminal Migration of Gossypiboma

Journal of Digestive Endoscopy ◽

10.1055/s-0039-1700256 ◽

2011 ◽

Vol 02 (01) ◽

pp. 022-024

Author(s):

Sebastian Saji

Keyword(s):

Abdominal Pain ◽

Ct Scan ◽

Sigmoid Colon ◽

Chronic Diarrhea ◽

Lower Abdominal Pain ◽

Contrast Enhanced Ct ◽

Contrast Enhanced ◽

Enhanced Ct ◽

Intraluminal Migration

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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Benign Cystic Mesothelioma in a Girl

APSP Journal of Case Reports ◽

10.21699/ajcr.v8i5.617 ◽

2017 ◽

Vol 8 (5) ◽

pp. 31

Author(s):

Aditya Pratap Singh ◽

Arun Kumar Gupta ◽

Dinesh Kumar Barolia ◽

Vinay Mathur

Keyword(s):

Abdominal Pain ◽

Cystic Lesion ◽

Acute Abdominal Pain ◽

Histopathological Examination ◽

Cystic Mass ◽

Contrast Enhanced Ct ◽

Contrast Enhanced ◽

Enhanced Ct ◽

Cystic Mesothelioma ◽

Uncommon Tumor

Benign cystic mesothelioma (BCM) is an uncommon tumor. A 9-year-old girl presented with acute abdominal pain and vomiting for the last 24 hours. Ultrasound abdomen and contrast enhanced CT scan were suggestive of cystic lesion. At laparotomy, a cystic mass arising from the peritoneum was found, which was excised completely. On histopathological examination it was diagnosed as benign mesothelioma.

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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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