Adrenal hemorrhage and hemorrhagic masses; diagnostic workup and imaging findings

2021 ◽  
pp. 20210753
Author(s):  
Mohamed Badawy ◽  
Ayman H. Gaballah ◽  
Dhakshinamoorthy Ganeshan ◽  
Amr Abdelalziz ◽  
Erick M. Remer ◽  
...  
Keyword(s):  
Potential Role ◽  
Rare Condition ◽  
Adrenal Hemorrhage ◽  
Medical Illness ◽  
Imaging Features ◽  
Bleeding Diathesis ◽  
High Clinical Suspicion ◽  
Common Causes ◽  
Life Threatening

Adrenal hemorrhage (AH) is a rare condition. It can be traumatic or non-traumatic. Most common causes are septicemia, coagulopathy or bleeding diathesis, and underlying neoplasms. Other reported less common causes of AH are COVID-19 and neonatal stress. Clinical diagnosis of AH is challenging due to its non-specific presentation and occurrence in the setting of acute medical illness. Therefore, most cases are diagnosed incidentally on imaging. Having high clinical suspicion in the proper clinical setting for AH is crucial to avoid life-threatening adrenal insufficiency that occurs in 16–50% of patients with bilateral AH. We discuss the clinical situations that predispose to AH, review the imaging features on different imaging modalities, highlight a variety of clinical cases, imaging features that should be concerning for an underlying neoplasm, and outline the potential role of interventional radiology in management of AH.

Juvenile xanthogranuloma of the subdural spaces mimicking chronic hematoma with positive FDG uptake on PET: case report

2020 ◽  
Vol 26 (4) ◽  
pp. 449-453
Author(s):  
Jacob A. Kahn ◽  
Jeffrey T. Waltz ◽  
Ramin M. Eskandari ◽  
Cynthia T. Welsh ◽  
Michael U. Antonucci
Keyword(s):  
Potential Role ◽  
Response To Treatment ◽  
Juvenile Xanthogranuloma ◽  
Imaging Features ◽  
Limited Information ◽  
Advanced Imaging ◽  
Systemic Involvement ◽  
The Central Nervous System ◽  
Infancy And Early Childhood

The authors report an unusual presentation of juvenile xanthogranuloma (JXG), a non–Langerhans cell histiocytosis of infancy and early childhood. This entity typically presents as a cutaneous head or neck nodule but can manifest with more systemic involvement including in the central nervous system. However, currently there is limited information regarding specific imaging features differentiating JXG from other neuropathological entities, with diagnosis typically made only after tissue sampling. The authors reviewed the initial images of a young patient with shunt-treated hydrocephalus and enlarging, chronic, extraaxial processes presumed to reflect subdural collections from overshunting, and they examine the operative discovery of a mass lesion that was pathologically proven to be JXG. Their results incorporate the important associated histological and advanced imaging features, including previously unreported metabolic activity on FDG PET. Ultimately, the case underscores the need to consider JXG in differential diagnoses of pediatric intracranial masses and highlights the potential role of PET in the initial diagnosis and response to treatment.

scholarly journals Case Report: Clostridium neonatale Bacteremia in a Preterm Neonate With Necrotizing Enterocolitis

2021 ◽  
Vol 9 ◽  
Author(s):  
Nadim Cassir ◽  
Isabelle Grandvuillemin ◽  
Manon Boxberger ◽  
Priscilla Jardot ◽  
Farid Boubred ◽  
...  
Keyword(s):  
Necrotizing Enterocolitis ◽  
Potential Role ◽  
Preterm Neonate ◽  
Gastrointestinal Disorder ◽  
Etiologic Agent ◽  
Preterm Neonates ◽  
Environmental Cleaning ◽  
Life Threatening

Necrotizing enterocolitis is a life-threatening acquired gastrointestinal disorder among preterm neonates and is associated with a high mortality rate and long-term neurodevelopmental morbidity. No etiologic agent has been definitively established; nonetheless, the most implicated bacteria include members of the Clostridium genus. We reported here on a case of Clostridium neonatale bacteremia in a preterm neonate with necrotizing enterocolitis, providing more information regarding the potential role of this bacterium in pathogenesis of necrotizing enterocolitis. We emphasized the sporulating form of C. neonatale that confers resistance to disinfectants usually applied for the hospital environmental cleaning. Further works are needed to establish the causal relationship between the occurrence of NEC and the isolation of C. neonatale, with promising perspectives in terms of diagnostic and therapeutic management.

Invasive cardiac aspergillosis as contiguous infiltration from mediastinum: Imaging evaluation using cardiac MRI

2021 ◽  
pp. 021849232110646
Author(s):  
Arun Sharma ◽  
Shayeri Roy Choudhury ◽  
Ajay Bahl ◽  
Uma Nahar ◽  
Manphool Singhal
Keyword(s):  
Cardiac Mri ◽  
Potential Role ◽  
Imaging Features ◽  
Diagnostic Challenge ◽  
Fatal Disease ◽  
Imaging Evaluation ◽  
Fungal Isolation ◽  
Appropriate Therapy ◽  
High Index Of Suspicion

Invasive cardiac aspergillosis is a rare, potentially fatal disease which poses a significant diagnostic challenge. Combination of clinical details, imaging features, fungal markers, serology and fungal isolation with demonstration of invasion is usually necessary to establish the diagnosis. High index of suspicion is the key for early diagnosis with potential role of cardiac MRI in its early detection, delineation of extent of involvement and guidance to the appropriate site for tissue sampling, thereby allowing for improved prognosis with early institution of appropriate therapy.

scholarly journals Bilateral Adrenal Hemorrhage in Coronavirus Disease 2019 Patient: A Case Report

2020 ◽  
Vol 105 (12) ◽  
pp. 3745-3749 ◽  
Author(s):  
Meir Frankel ◽  
Itamar Feldman ◽  
Michal Levine ◽  
Yigal Frank ◽  
Naama R Bogot ◽  
...  
Keyword(s):  
Adrenal Insufficiency ◽  
Rare Condition ◽  
Renal Vein Thrombosis ◽  
Adrenal Hemorrhage ◽  
Polymerase Chain Reaction Test ◽  
Primary Antiphospholipid Syndrome ◽  
Thromboembolic Events ◽  
Adrenal Axis ◽  
Bilateral Adrenal Hemorrhage ◽  
Life Threatening

Abstract Context Bilateral adrenal hemorrhage is a rare condition with potentially life-threatening consequences such as acute adrenal insufficiency. Early adrenal axis testing, as well as directed imaging, is crucial for immediate diagnosis and treatment. Coronavirus disease 2019 (COVID-19) has been associated with coagulopathy and thromboembolic events. Case description A 66-year-old woman presented with acute COVID-19 infection and primary adrenal insufficiency due to bilateral adrenal hemorrhage (BAH). She also had a renal vein thrombosis. Her past medical history revealed primary antiphospholipid syndrome (APLS). Four weeks after discharge she had no signs of COVID-19 infection and her polymerase chain reaction test for COVID-19 was negative, but she still needed glucocorticoid and mineralocorticoid replacement therapy. The combination of APLS and COVID-19 was probably responsible of the adrenal event as a “two-hit” mechanism. Conclusions COVID-19 infection is associated with coagulopathy and thromboembolic events, including BAH. Adrenal insufficiency is life threatening; therefore, we suggest that early adrenal axis testing for COVID-19 patients with clinical suspicion of adrenal insufficiency should be carried out.

scholarly journals Hemorrhagic Shock as a Sequela of Splenic Rupture in a Patient with Infectious Mononucleosis: Focus on the Potential Role of Salicylates

2012 ◽  
Vol 2012 ◽  
pp. 1-3 ◽  
Author(s):  
Konstantinos Bouliaris ◽  
Dimos Karangelis ◽  
Marios Daskalopoulos ◽  
Konstantinos Spanos ◽  
Michael Fanariotis ◽  
...  
Keyword(s):  
Hemorrhagic Shock ◽  
Infectious Mononucleosis ◽  
Potential Role ◽  
Splenic Rupture ◽  
Emergency Laparotomy ◽  
Hemorrhagic Complication ◽  
Spontaneous Splenic Rupture ◽  
Predisposing Factor ◽  
Life Threatening

Despite the fact that the vast majority of splenic ruptures are traumatic, infectious mononucleosis has been incriminated as a major predisposing factor that affects the integrity of the spleen, thus causing atraumatic ruptures and life-threatening hemorrhages. Herein we present a case of a 23-year-old Caucasian male who underwent an emergency laparotomy for acute abdomen and hemorrhagic shock, caused by spontaneous splenic rupture secondary to infectious mononucleosis. The potential role of salicylates in the development of a hemorrhagic complication in a patient with infectious mononucleosis is discussed.

scholarly journals The “Fountain of Death”: A Case Series on Tracheo-innominate Artery Fistula

2021 ◽  
Vol 20 (2) ◽  
Author(s):  
Jason Lo ◽  
Marina Mat Baki ◽  
Yeoh Xing Yi ◽  
Nik Hisyam Amirul ◽  
Zahirrudin Zakaria
Keyword(s):  
Potential Role ◽  
Rare Complication ◽  
Case Series ◽  
Innominate Artery ◽  
Survival Outcomes ◽  
Permissive Hypotension ◽  
Life Threatening ◽  
History Of ◽  
High Index Of Suspicion

Tracheo-innominate artery fistula (TIF) is a very rare complication related to tracheostomy and has been reported in 0.7% of patients, but certainly is one of the most life-threatening conditions. It is of paramount importance to maintain a high index of suspicion in evaluating patients with TIF and to anticipate occurrence of massive haemorrhage even during simple procedures related to tracheostomy such as tube change. We report 3 cases of TIF, each with a unique and unsuspecting history of the condition and review the emergency protocol in arresting the bleeding. We’ve also highlighted the potential role of permissive hypotension with sedation in improving survival outcomes of patients with TIF.

scholarly journals Surface Waters and Urban Brown Rats as Potential Sources of Human-Infective Cryptosporidium and Giardia in Vienna, Austria

2021 ◽  
Vol 9 (8) ◽  
pp. 1596
Author(s):  
Silvia Cervero-Aragó ◽  
Amélie Desvars-Larrive ◽  
Gerhard Lindner ◽  
Regina Sommer ◽  
Iveta Häfeli ◽  
...  
Keyword(s):  
Surface Waters ◽  
Potential Role ◽  
Intestinal Infections ◽  
Wide Range ◽  
Life Threatening ◽  
Veterinary Importance ◽  
Human Infections ◽  
Transmission Pathways ◽  
Insight Into

Cryptosporidium and Giardia are waterborne protozoa that cause intestinal infections in a wide range of warm-blooded animals. Human infections vary from asymptomatic to life-threatening in immunocompromised people, and can cause growth retardation in children. The aim of our study was to assess the prevalence and diversity of Cryptosporidium and Giardia in urban surface water and in brown rats trapped in the center of Vienna, Austria, using molecular methods, and to subsequently identify their source and potential transmission pathways. Out of 15 water samples taken from a side arm of the River Danube, Cryptosporidium and Giardia (oo)cysts were detected in 60% and 73% of them, with concentrations ranging between 0.3–4 oocysts/L and 0.6–96 cysts/L, respectively. Cryptosporidium and Giardia were identified in 13 and 16 out of 50 rats, respectively. Eimeria, a parasite of high veterinary importance, was also identified in seven rats. Parasite co-ocurrence was detected in nine rats. Rat-associated genotypes did not match those found in water, but matched Giardia previously isolated from patients with diarrhea in Austria, bringing up a potential role of rats as sources or reservoirs of zoonotic pathogenic Giardia. Following a One Health approach, molecular typing across potential animal and environmental reservoirs and human cases gives an insight into environmental transmission pathways and therefore helps design efficient surveillance strategies and relevant outbreak responses.

scholarly journals Magnetic Resonance Imaging features of breasts in patients

1970 ◽  
Vol 34 (2) ◽  
pp. 44-47 ◽  
Author(s):  
Shahnaz Choudhury ◽  
Ichiro Isomoto ◽  
Kuniaki Hyashi
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Potential Role ◽  
Nipple Discharge ◽  
Imaging Features ◽  
Resonance Imaging ◽  
Histopathological Correlation ◽  
Contrast Enhanced ◽  
Highly Sensitive

A retrospective study was conducted to demonstrate the potential role of dynamic contrast enhanced magnetic resonance imaging (DCEMRI) in the detection of breast lesions in 15 patients with nipple discharge. The DCEMRI findings were compared and correlated with the findings of ultrasonography and mammography. The results revealed that the character of the nipple discharge was mostly bloody and in few cases were serous. The imaging findings revealed that DCEMRI is highly sensitive and specific in the detection of breast canner and the histopathological correlation in such detection was highly significant (p<0.001) as compared to ultrasonography and mammography finding.Keywords: Magnetic Resonance Imaging; BreastDOI: 10.3329/bmrcb.v34i2.1174Bangladesh Med Res Counc Bull 2008; 34: 44-47

scholarly journals Pneumonia-related pneumatoceles in infants: CT assessment and image-guided treatment

2021 ◽  
Author(s):  
Elisa Mercanzin ◽  
Pietro Andrea Bonaffini ◽  
Antonino Barletta ◽  
Francesco Stanco ◽  
Clarissa Valle ◽  
...  
Keyword(s):  
Percutaneous Drainage ◽  
Potential Role ◽  
Scientific Literature ◽  
Case Series ◽  
Consensus Guidelines ◽  
Successful Management ◽  
Image Guided ◽  
Life Threatening

Lung pneumatoceles represent a potential life-threatening complication of pneumonia in infants, especially when they do not spontaneously reabsorb. In this category of patients, scientific literature lacks and no consensus guidelines for management have been proposed. Imaging plays a key role in the diagnosis, characterization, and follow-up of pneumatoceles. Image-guided percutaneous drainage can be considered a safe and effective treatment in children, although it is not widely recognized in newborns and infants. The aim of this case series review is to describe the main CT features of complicated or persistent pneumatoceles in infants and to highlight the potential role of image-guided percutaneous drainage as an effective approach for their treatment. Successful management of four infants affected by pneumonia-related pneumatoceles with percutaneous drainage is presented.

scholarly journals Successful Prasugrel Therapy for Recurrent Left Main Stent Thrombosis in a Clopidogrel Hyporesponder

2015 ◽  
Vol 42 (5) ◽  
pp. 483-486 ◽  
Author(s):  
Yi-Sik Kim ◽  
Sang-Rok Lee
Keyword(s):  
Stent Thrombosis ◽  
Stent Implantation ◽  
Potential Role ◽  
Poor Response ◽  
Antiplatelet Agents ◽  
Drug Eluting Stent ◽  
Variable Response ◽  
Life Threatening ◽  
Drug Eluting

Stent thrombosis is a life-threatening sequela of drug-eluting stent implantation. Dual antiplatelet therapy with aspirin and thienopyridine is typically used to prevent this catastrophic event. In terms of stent thrombosis, the major concern is the variable response of patients to clopidogrel, and this has raised interest in new antiplatelet agents. We present the case of a 64-year-old woman whom we successfully treated with prasugrel after she had repeated episodes of stent thrombosis caused by a poor response to clopidogrel. This case highlights the potential role of new antiplatelet agents for patients who are undergoing drug-eluting stent implantation.

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