Haemocholecyst related to gallbladder malignancy

2020 ◽  
Vol 50 (3) ◽  
pp. 243-245
Author(s):  
Sukanta Ray ◽  
Ranajoy Ghosh ◽  
Sujan Khamrui ◽  
Amit Kumar Das ◽  
Suman Saha ◽  
...  
Keyword(s):  
Radical Surgery ◽  
Histopathological Examination ◽  
English Literature ◽  
Clinical Status ◽  
Cross Sectional ◽  
Blood Clots ◽  
Cross Sectional Imaging ◽  
Gallbladder Adenocarcinoma ◽  
Gallbladder Malignancy

A haemocholecyst is a clot-filled gallbladder caused by bleeding into its lumen. It is a rare entity with fewer than 50 cases reported in the English literature. Preoperative diagnosis is often not possible even with good quality cross-sectional imaging. Here, we present a case of a gallbladder mass, whose nature was only made clear at operation, where a hugely enlarged gallbladder was found filled with blood clots. There was neither liver infiltration nor regional lymphadenopathy. The clinical status of the patient demanded simple cholecystectomy. Histopathological examination, however, revealed a gallbladder adenocarcinoma, infiltrating the perimuscular connective tissue. Thus, more radical surgery was performed eight weeks later. At the 21-month follow-up, the patient was found to be well.

scholarly journals Simple vs ugly adnexal lesions: is ultrasonography alone good enough?

2019 ◽  
Vol 7 (8) ◽  
pp. 3020
Author(s):  
Rahul Dev Chauhan ◽  
Yashvir Mathur
Keyword(s):  
Histopathological Examination ◽  
Imaging Modality ◽  
Cross Sectional Study ◽  
Colour Doppler ◽  
Benign Lesions ◽  
Cross Sectional ◽  
Adnexal Masses ◽  
Cross Sectional Imaging ◽  
Ovarian Masses

Background: Ultrasound (USG) is easily available and effective imaging modality for adnexal lesions. A simple looking lesion on ultrasound is usually benign and an ugly looking adnexal lesion is either benign or malignant. This study aims to evaluate the varied appearance of simple and ugly benign adnexal lesions on USG and to find out any additional role of colour Doppler in such suspected benign lesions. The confirmation of diagnosis was done either by follow up appearance of lesions on USG or by histopathological evaluation.Methods: A total of 55 consecutive female patients with age between 18 to 50 years were enrolled in this prospective cross sectional study. USG and colour Doppler for all the lesions were done. The patients found to have malignant lesions on histopathological examination, were later excluded from the analysis. Follow up USG was done for all the cases. Those cases wherein there was no resolution of lesions even after 08 weeks, were given an option to undergo laparoscopy as next management step.Results: Out of 50 benign adnexal masses, 88% masses were ovarian in origin and 12% were tubal masses. Ovarian masses included hemorrhagic cysts, endometriosis, simple cysts, serous cystadenomas and ovarian dermoid. All extra-ovarian masses were hydrosalpinx. Colour Doppler did not add any additional finding. Some of the patients underwent diagnostic laparoscopy followed by excision of masses in majority of them.Conclusions: Benign adnexal lesions can have varied appearance ranging from simple to ugly on USG. Ultrasonographic features of benign lesions on USG can be appreciated very well even without further use of colour Doppler or cross sectional imaging. Follow up USG remains key modality for benign adnexal masses in absence of MRI.

State-of-the-art aortic imaging: Part II - applications in transcatheter aortic valve replacement and endovascular aortic aneurysm repair

VASA ◽  
2014 ◽  
Vol 43 (1) ◽  
pp. 6-26 ◽  
Author(s):  
Fabian Rengier ◽  
Philipp Geisbüsch ◽  
Paul Schoenhagen ◽  
Matthias Müller-Eschner ◽  
Rolf Vosshenrich ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Transcatheter Aortic Valve Replacement ◽  
Surgical Repair ◽  
Imaging Modality ◽  
Open Surgical Repair ◽  
Cross Sectional ◽  
Transcatheter Aortic Valve ◽  
Cross Sectional Imaging ◽  
Sectional Imaging

Transcatheter aortic valve replacement (TAVR) as well as thoracic and abdominal endovascular aortic repair (TEVAR and EVAR) rely on accurate pre- and postprocedural imaging. This review article discusses the application of imaging, including preprocedural assessment and measurements as well as postprocedural imaging of complications. Furthermore, the exciting perspective of computational fluid dynamics (CFD) based on cross-sectional imaging is presented. TAVR is a minimally invasive alternative for treatment of aortic valve stenosis in patients with high age and multiple comorbidities who cannot undergo traditional open surgical repair. Given the lack of direct visualization during the procedure, pre- and peri-procedural imaging forms an essential part of the intervention. Computed tomography angiography (CTA) is the imaging modality of choice for preprocedural planning. Routine postprocedural follow-up is performed by echocardiography to confirm treatment success and detect complications. EVAR and TEVAR are minimally invasive alternatives to open surgical repair of aortic pathologies. CTA constitutes the preferred imaging modality for both preoperative planning and postoperative follow-up including detection of endoleaks. Magnetic resonance imaging is an excellent alternative to CT for postoperative follow-up, and is especially beneficial for younger patients given the lack of radiation. Ultrasound is applied in screening and postoperative follow-up of abdominal aortic aneurysms, but cross-sectional imaging is required once abnormalities are detected. Contrast-enhanced ultrasound may be as sensitive as CTA in detecting endoleaks.

Cross-Sectional Imaging of Small Bowel Malignancies

2012 ◽  
Vol 63 (3) ◽  
pp. 215-221 ◽  
Author(s):  
Dellano D. Fernandes ◽  
Ram Prakash Galwa ◽  
Najla Fasih ◽  
Margaret Fraser-Hill
Keyword(s):  
Small Bowel ◽  
Accurate Diagnosis ◽  
Imaging Features ◽  
Cross Sectional ◽  
Conventional Endoscopy ◽  
Cross Sectional Imaging ◽  
Pretreatment Staging ◽  
Sectional Imaging ◽  
Histologic Subtypes

Small bowel malignancies are rare neoplasms, usually inaccessible to conventional endoscopy but detectable in many cases by cross-sectional imaging. Modern multidetector computed tomographies permit accurate diagnosis, complete pretreatment staging, and follow-up of these lesions. In this review, we describe the cross-sectional imaging features of the most frequent histologic subtypes of the small bowel malignancies.

Periaortic air in native and post-operative aorta on computed tomography

2021 ◽  
Author(s):  
Mansi Verma ◽  
Amit Ajit Deshpande ◽  
Niraj Nirmal Pandey ◽  
Sanjeev Kumar
Keyword(s):  
Computed Tomography ◽  
Clinical Laboratory ◽  
Radical Surgery ◽  
Imaging Finding ◽  
Radiological Findings ◽  
Catastrophic Event ◽  
Cross Sectional ◽  
Pictorial Review ◽  
Cross Sectional Imaging ◽  
Indispensable Tool

Periaortic air can be seen in various conditions which can be a benign imaging finding or harbinger of a catastrophic event. The causes vary in native aorta and post-operative aorta. A radiologist has an important part in the management process of these patients, as the treatment varies from conservative to radical surgery based on the aetiology. The presence of periaortic air seen in the light of various clinical, laboratory and radiological findings can guide the radiologist towards a particular aetiology. Cross-sectional imaging, mainly computed tomography, is an indispensable tool in recognising ectopic periaortic air and to identify the associated findings and eventually make an accurate diagnosis. We present a pictorial review of various causes of the periaortic air in native and postoperative aorta, the salient features and management of the described conditions.

A Tour of the Thymus: A Review of Thymic Lesions with Radiologic and Pathologic Correlation

2015 ◽  
Vol 66 (1) ◽  
pp. 5-15 ◽  
Author(s):  
Alan J. Goldstein ◽  
Isabel Oliva ◽  
Hedieh Honarpisheh ◽  
Ami Rubinowitz
Keyword(s):  
Imaging Studies ◽  
Dynamic Changes ◽  
Cross Sectional ◽  
Radiographic Diagnosis ◽  
Imaging Characteristics ◽  
Pathologic Features ◽  
Cross Sectional Imaging ◽  
Pathologic Lesions ◽  
Periods Of Stress

The thymus is routinely encountered on cross-sectional imaging studies of the chest. It has a variable appearance, undergoes dynamic changes during periods of stress, and demonstrates numerous different pathologic lesions. Understanding the imaging characteristics of these different lesions facilitates accurate radiographic diagnosis and can prevent unnecessary follow-up imaging and intervention. This article will review normal thymic anatomy and development, thymic hyperplasia and associated medical conditions, and the imaging and pathologic features of various benign and malignant thymic lesions.

Republished: Bilateral carotid and vertebral rete mirabile with vein of Galen aneurysmal malformation: an unreported association

2014 ◽  
Vol 8 (1) ◽  
pp. e1-e1 ◽  
Author(s):  
Prabath Kumar Mondel ◽  
Rashmi Saraf ◽  
Uday S Limaye
Keyword(s):  
Parent Artery ◽  
Vein Of Galen ◽  
Cross Sectional ◽  
The Past ◽  
Rete Mirabile ◽  
Bilateral Carotid ◽  
Recurrent Vomiting ◽  
Cross Sectional Imaging ◽  
Surgical Options

Rete mirabile is a fine meshwork of anastomosing vessels that replace the parent artery. A 30-year-old woman complained of slurring of speech, right eye proptosis, recurrent vomiting, and loss of bladder and bowel control, followed by drowsiness lasting 30–40 min, for the past 6 months. On cross sectional imaging and angiography, the patient was found to have a vein of Galen aneurysmal malformation, with bilateral carotid and vertebral rete mirabile. The patient was offered both endovascular and open surgical options but she refused any form of surgical treatment and opted for conservative management. At the 6 month follow-up, she continued to have occasional episodes of headache and vomiting but was otherwise normal. We describe the clinical, cross sectional, and angiographic features of this patient. A comparison with other patients with bilateral carotid and vertebral rete mirabile is also reported.

scholarly journals Liposarcoma of the Thyroid

Sarcoma ◽  
2004 ◽  
Vol 8 (2-3) ◽  
pp. 91-96 ◽  
Author(s):  
A. Mitra ◽  
C. Fisher ◽  
P. Rhys-Evans ◽  
C. Harmer
Keyword(s):  
Radical Surgery ◽  
English Literature ◽  
External Beam Radiotherapy ◽  
Myxoid Liposarcoma ◽  
High Dose ◽  
Pleomorphic Liposarcoma ◽  
Positive Margins ◽  
Margins Of Excision

Liposarcoma of the thyroid gland is rare with only 3 cases reported in the English literature. We present a further two patients whom we have recently treated: a 49 year old lady with a myxoid liposarcoma and a 71 year old man with a pleomorphic liposarcoma. Both underwent macroscopic excision of tumour but had positive margins, so were then treated with external beam radiotherapy. The former patient died from metastases 10 months after presentation, the latter remains alive but has developed metastatic disease on follow up at 24 months.We recommend the use of high dose radiotherapy following radical surgery as margins of excision are usually narrow in this most difficult region. The role of chemotherapy is yet to be established.

scholarly journals P357 Long-term outcomes of biologic therapy in Crohn’s disease complicated with internal fistulizing disease: BIOSCOPE study from GETECCU

2021 ◽  
Vol 15 (Supplement_1) ◽  
pp. S377-S378
Author(s):  
I Rodríguez-Lago ◽  
A Fernández-Clotet ◽  
F Mesonero ◽  
F J García-Alonso ◽  
M J Casanova ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Biologic Agent ◽  
Fistula Closure ◽  
Biologic Drugs ◽  
Biologic Treatment ◽  
Cross Sectional ◽  
Urinary Fistulas ◽  
Cross Sectional Imaging

Abstract Background The prevalence of penetrating disease in Crohn’s disease (CD) increases progressively over time, and evidence on the medical treatment of this complication is limited. The aim of this study was to evaluate the efficacy of biologic agents in CD complicated with internal fistulising disease. Methods A retrospective analysis of all adult patients from the ENEIDA registry (>68,000 patients) with CD who received at least one biologic agent -anti-TNF, ustekinumab or vedolizumab- for penetrating disease was performed. Exclusion criteria comprised treatment for perianal disease, enterocutaneous, anastomotic or periostomal fistula tracts. The main outcomes were fistula-related surgery and fistula closure on cross-sectional imaging. Preestablished secondary outcomes included the rate of abdominal abscess, the need for percutaneous drainage, the changes in the number of fistula tracts, fistula closure rates, and the safety profile.The baseline characteristics were analyzed by means of descriptive statistics and were compared by non-parametric tests. Predictive factors associated with surgery and fistula closure were evaluated by a multivariable logistic regression and survival analyses. Results A total of 710 patients (median age 38 years [IQR, 28-48], 59% male, 55% L3) receiving 791 biologic treatments were included at 53 sites (701 anti-TNF, 71 ustekinumab, and 19 vedolizumab). Patients had a median of 1 (range 1-5) fistula tracts, 49% of them entero-enteric followed by entero-colic (28%). After a median follow-up of 59 months (IQR, 27-105), 244 patients (31%) required surgery due to internal fistulising complications after 8.5 months (IQR, 3-24). Patients with ileocolonic disease (OR 1.99 [1.22-3.23]), entero-urinary fistulas (OR 2.35 [1.17-4.73]), or with a stricture distal to the fistula (OR 2.1 [1.31-3.36]) showed a higher risk of surgery, with no differences between biologic drugs (Figure 1). Combination therapy reduced the risk of surgery (HR 0.58 [0.37-0.90]). Fistula closure was observed in 24% of patients after a median of 15 months (IQR, 7.5-27). Patients with a lower number of fistula tracts showed a higher probability of closure (OR 1.72 [1.09-2.7]). Conclusion A high proportion of patients with internal fistulizing CD benefit from biologic treatment after a median of 5 years. During this follow-up, around two thirds of patients are free of surgery and one in every four patients achieves fistula closure.

scholarly journals Role of Cross-sectional Imaging (CT/MRI) in Characterization and Distinguishing Benign from Malignant/Potentially Malignant Cystic Lesions of Pancreas

2020 ◽  
Vol 10 ◽  
pp. 28
Author(s):  
Amy Sara Abraham ◽  
Betty Simon ◽  
Anu Eapen ◽  
Kirthi Sathyakumar ◽  
Anuradha Chandramohan ◽  
...  
Keyword(s):  
Histopathological Examination ◽  
Tertiary Care ◽  
Multivariate Logistic Regression Analysis ◽  
Mucinous Cystadenoma ◽  
Cystic Lesions ◽  
Cross Sectional ◽  
Potentially Malignant ◽  
Cross Sectional Imaging ◽  
Malignant Lesions ◽  
Sectional Imaging

Objectives: The aim of the study was to evaluate the accuracy of computed tomography/magnetic resonance imaging (CT/MRI) in characterizing cystic lesions of the pancreas and in differentiating between benign and malignant/potentially malignant lesions. Material and Methods: A retrospective study was performed on patients with pancreatic cystic lesions who underwent pre-operative imaging and surgery between October 2004 and April 2017 at a tertiary care teaching hospital. The images were reviewed for specific characteristics and diagnoses recorded independently by two radiologists who were blinded to the histopathological examination (HPE) report. Radiological diagnostic accuracy was assessed with HPE as reference standard. Results: A total of 80 patients fulfilled the inclusion criteria (M: F = 27:53). The final HPE diagnoses were solid pseudopapillary neoplasm (32.5%), walled off necrosis/pseudocyst (27.5%), mucinous cystadenoma (15%), serous cystadenoma (11.25%), intraductal papillary mucinous neoplasm (8.75%), mucinous cystadenocarcinoma (2.5%), simple epithelial cyst (1.25%), and unspecified benign cystic lesion (1.25%). Observer1 correctly identified the diagnosis in 73.75% of cases while observer 2 did so in 72.5%. Sensitivity for distinguishing benign versus malignant/potentially malignant lesions was 85.1% for observer 1 and 80.9% for observer 2. On multivariate logistic regression analysis: Solid cystic morphology, presence of mural nodule, and female gender were associated with premalignant/malignant lesions. Conclusion: Cross-sectional imaging is a valuable tool for characterization of pancreatic cystic lesions within its limitations.

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