scholarly journals Surgicel on the post-operative CT: an old trap for radiologists

2019 ◽  
Vol 5 (4) ◽  
pp. 20190041
Author(s):  
Flavius Parvulescu ◽  
Gaurav Sundar ◽  
Milind Shortri
Keyword(s):  
Interventional Radiology ◽  
Correct Diagnosis ◽  
Duodenal Perforation ◽  
Routine Procedure ◽  
Unnecessary Procedures ◽  
Operative Notes ◽  
Unnecessary Intervention ◽  
Radiological Technique ◽  
Gallbladder Fossa ◽  
Ct Studies

Percutaneous drainage of post-operative collections following abdominopelvic surgery has become standard practice and is a routine procedure in many interventional radiology (IR) departments. Such collections are commonly diagnosed on CT studies where the presence of Surgicel ® can mimic an abscess and lead to unnecessary procedures. We present a case where a duodenal perforation was masked by post-operative Surgicel in the gallbladder fossa, which in turn was mistaken for an infected biloma and referred for percutaneous interventional radiology drainage. Careful imaging review, correlation with operative notes and good diagnostic radiological technique led to a correct diagnosis and avoided unnecessary intervention.

scholarly journals Hepatic Haemangioma Masquerading as the Gallbladder in a Case of Gallbladder Agenesis: A Case Report and Literature Review

HPB Surgery ◽  
2010 ◽  
Vol 2010 ◽  
pp. 1-4 ◽  
Author(s):  
James A. Stephenson ◽  
Michael Norwood ◽  
Dhya Al-Leswas ◽  
Omer Al-Taan ◽  
Richard Beable ◽  
...  
Keyword(s):  
Clinical Presentation ◽  
Preoperative Imaging ◽  
Biliary Colic ◽  
Radiological Investigation ◽  
Hepatic Haemangioma ◽  
Gallbladder Agenesis ◽  
Operative Findings ◽  
Benign Liver ◽  
Unnecessary Intervention ◽  
Gallbladder Fossa

Gallbladder agenesis is uncommon. In contrast, liver haemangiomas are the most common type of benign liver lesions. We describe the first documented case of gallbladder agenesis where the clinical presentation was consistent with biliary colic, and radiological investigation suggested the presence of gallstones. Subsequent operative findings revealed a solitary haemangioma of the liver sited in the normal position of the gallbladder fossa but with absence of the gallbladder. It is important that clinicians should keep gallbladder agenesis in mind when the gallbladder appears abnormal on preoperative imaging studies and cannot be found at laparoscopy. As symptoms will improve in 98% of cases, it is very important to avoid unnecessary intervention in patients who have a negative laparoscopy. The clinical presentation, investigations, and operative findings are discussed with a review of other relevant reported cases in the literature.

scholarly journals Evaluation and Management of Acute Myelopathy

2021 ◽  
Vol 41 (05) ◽  
pp. 511-529
Author(s):  
Elia Sechi ◽  
Eoin P. Flanagan
Keyword(s):  
Spinal Cord ◽  
Correct Diagnosis ◽  
Resonance Imaging ◽  
Spinal Cord Damage ◽  
Urgent Surgery ◽  
Acute Myelopathy ◽  
Imaging Characteristics ◽  
Appropriate Treatment ◽  
Spinal Cord Disorders ◽  
Unnecessary Procedures

AbstractAcute myelopathies are spinal cord disorders characterized by a rapidly progressive course reaching nadir within hours to a few weeks that may result in severe disability. The multitude of underlying etiologies, complexities in confirming the diagnosis, and often unforgiving nature of spinal cord damage have always represented a challenge. Moreover, certain slowly progressive myelopathies may present acutely or show abrupt worsening in specific settings and thus further complicate the diagnostic workup. Awareness of the clinical and magnetic resonance imaging characteristics of different myelopathies and the specific settings where they occur is fundamental for a correct diagnosis. Neuroimaging helps distinguish compressive etiologies that may require urgent surgery from intrinsic etiologies that generally require medical treatment. Differentiation between various myelopathies is essential to establish timely and appropriate treatment and avoid harm from unnecessary procedures. This article reviews the contemporary spectrum of acute myelopathy etiologies and provides guidance for diagnosis and management.

scholarly journals Percutaneous transgastric interventional radiology-operated duodenoscopy for the identification of duodenal perforation and Graham patch dehiscence

2017 ◽  
Vol 12 (4) ◽  
pp. 790-793 ◽  
Author(s):  
Ravi Nara Srinivasa ◽  
Matthew L. Osher ◽  
Douglas A. Murrey ◽  
Jordan Bruce Fenlon ◽  
Charles Brewerton ◽  
...  
Keyword(s):  
Interventional Radiology ◽  
Duodenal Perforation ◽  
Graham Patch

scholarly journals A 61-year-old Female with Right Upper Abdominal Pain

2020 ◽  
Vol 4 (4) ◽  
pp. 630-631
Author(s):  
Drew Long ◽  
Brit Long
Keyword(s):  
Interventional Radiology ◽  
Abdominal Pain ◽  
Source Control ◽  
Day Hospital ◽  
Biliary Injury ◽  
Case Presentation ◽  
Image Guided ◽  
Upper Abdominal ◽  
Gallbladder Fossa

Case Presentation: A 61-year-old female presented to the emergency department with right upper quadrant abdominal pain following a cholecystectomy 18 days prior. Computed tomography (CT) of her abdomen demonstrated a large abscess in her post-hepatic fossa. She was admitted to the general surgery service and received an image-guided percutaneous drain placement with interventional radiology with immediate return of purulent material. She was discharged home after a three-day hospital course with outpatient antibiotics and follow-up. Discussion: Patients may have multiple complications following cholecystectomy, including infection, bleeding, biliary injury, bowel injury, or dropped stone. The emergency clinician must consider cholecystectomy complications including gallbladder fossa abscess in patients presenting with abdominal pain in the days to weeks following cholecystectomy, especially if they present with signs of sepsis. Critical actions include obtaining CT and/or ultrasonography, initiating broad spectrum antibiotics, and obtaining definitive source control by either surgery or interventional radiology.

scholarly journals Donut rush to laparoscopy: post-polypectomy electrocoagulation syndrome and the ‘pseudo-donut’ sign

2020 ◽  
Vol 6 (2) ◽  
pp. 20190023
Author(s):  
Isabella Plumptre ◽  
Timo Tolppa ◽  
Zaynab A.R. Jawad ◽  
Noman Zafar
Keyword(s):  
Differential Diagnosis ◽  
Abdominal Pain ◽  
Ct Scan ◽  
Diagnostic Laparoscopy ◽  
Routine Procedure ◽  
Radiological Findings ◽  
Colonoscopic Polypectomy ◽  
Unnecessary Intervention ◽  
Possible Cause

Colonoscopic polypectomy is a routine procedure with the potential for rare but well-known complications, including perforation and bleeding. Post-polypectomy electrocoagulation syndrome (PPES) is a less recognized cause of abdominal pain following this procedure. However, it is important to diagnose PPES in order to avoid unnecessary intervention. We present the case of a patient with abdominal pain after polypectomy. The patient underwent an unnecessary diagnostic laparoscopy on the basis of misinterpreted radiological findings. Her CT scan demonstrated the "donut" sign that was suggestive of ileocaecal intussusception. This case highlights the importance of recognizing PPES as a possible cause for abdominal pain after colonoscopic polypectomy and that it may also present with a "pseudodonut" sign on CT scan. It also demonstrates the importance of communicating and then integrating full clinical details with radiological findings when formulating a differential diagnosis.

scholarly journals Chilaiditi’s sign, a cause of pseudo-pneumoperitoneum: A case report

2018 ◽  
Vol 6 ◽  
pp. 2050313X1881221
Author(s):  
Benjamin Sachdev Manjit Singh ◽  
Muhammad Daniel Azlan Mahadzir ◽  
Tiong Chan Lee
Keyword(s):  
Case Report ◽  
Chest Radiograph ◽  
Surgical Intervention ◽  
Asymptomatic Patient ◽  
Correct Diagnosis ◽  
Radiological Finding ◽  
Diagnostic Dilemma ◽  
Unnecessary Procedures ◽  
The Right ◽  
Chilaiditi’S Sign

The differentiation between a pseudo-pneumoperitoneum and true pneumoperitoneum on an initial chest radiograph is challenging but essential to clinical practice. The former is managed conservatively whereas the latter may require surgical intervention. Chilaiditi’s sign describes a rare incidental radiological finding of gas filled bowel interpositioned between the right hemi-diaphragm and the liver, which is visible on a plain abdominal or chest radiograph. It is often misdiagnosed as a pneumoperitoneum. Correct diagnosis of Chilaiditi’s sign in an asymptomatic patient can prevent unnecessary procedures. We have reported one incidental chest radiograph with Chilaiditi’s sign in a patient presenting and treated for pneumonia. The report aims to illustrate the diagnostic dilemma experienced by clinicians in distinguishing a true versus pseudo-pneumoperitoneum on a chest radiograph.

Thin Pyrolytic Graphite Films for Electron Microscope Substrates

1971 ◽  
Vol 29 ◽  
pp. 226-227 ◽  
Author(s):  
George H. N. Riddle ◽  
Benjamin M. Siegel
Keyword(s):  
Vacuum Chamber ◽  
Pyrolytic Graphite ◽  
High Vacuum ◽  
Dark Field ◽  
Ultra High Vacuum ◽  
Graphite Substrate ◽  
Nickel Substrate ◽  
Routine Procedure ◽  
Field Electron Microscopy ◽  
Dark Field Electron

A routine procedure for growing very thin graphite substrate films has been developed. The films are grown pyrolytically in an ultra-high vacuum chamber by exposing (111) epitaxial nickel films to carbon monoxide gas. The nickel serves as a catalyst for the disproportionation of CO through the reaction 2C0 → C + CO2. The nickel catalyst is prepared by evaporation onto artificial mica at 400°C and annealing for 1/2 hour at 600°C in vacuum. Exposure of the annealed nickel to 1 torr CO for 3 hours at 500°C results in the growth of very thin continuous graphite films. The graphite is stripped from its nickel substrate in acid and mounted on holey formvar support films for use as specimen substrates.The graphite films, self-supporting over formvar holes up to five microns in diameter, have been studied by bright and dark field electron microscopy, by electron diffraction, and have been shadowed to reveal their topography and thickness. The films consist of individual crystallites typically a micron across with their basal planes parallel to the surface but oriented in different, apparently random directions about the normal to the basal plane.

Vesicular system associated with spermiogenesis of bullfrog

1987 ◽  
Vol 45 ◽  
pp. 818-819
Author(s):  
K. C. Liu ◽  
S. F. Tsay
Keyword(s):  
Electron Microscopy ◽  
Microscopic Study ◽  
Electron Microscopic Study ◽  
Reproductive System ◽  
Seminiferous Tubule ◽  
Rana Catesbeiana ◽  
Routine Procedure ◽  
Electron Microscopic ◽  
Twisted Tubules ◽  
Electron Lucent

In the histologic and electron microscopic study of the male reproductive system of bullfrog, Rana catesbeiana, a vesicular system associated with spermiogenesis was observed. It appeared in the lumenal space of the seminiferous tubule (Fig. 1), in the heads of spermatids (Fig. 2), associated with the chromatins of the spermatid (Fig. 4). As deduced from sections, this vesicular system consisted of vesicles of various size or a large group of waving and twisted tubules (Fig. 3), After routine procedure of treatment for electron microscopy, the lumens of both of the vesicles and tubules were electron lucent.In human, vesicles and vesicular system associated with reproductive cell and tissue were reported. In abnormal spermiogenesis, flower-like body, actually vesicles, and giant vesicle associated with the head of spermatid were observed. In both cases the number of vesicle was limited from a single one to a few.

Laryngeal Manifestations of Autoimmune Diseases

2020 ◽  
Vol 5 (2) ◽  
pp. 439-456
Author(s):  
Jenny L. Pierce
Keyword(s):  
Autoimmune Disease ◽  
Autoimmune Diseases ◽  
Patient Outcomes ◽  
Correct Diagnosis ◽  
Upper Airway ◽  
Clinical Implications ◽  
Laryngeal Function ◽  
The Past ◽  
Referral Practices ◽  
Timely Referral

Purpose This review article provides an overview of autoimmune diseases and their effects on voice and laryngeal function. Method A literature review was conducted in PubMed. Combinations of the following keywords were used: “autoimmune disease and upper airway,” “larynx,” “cough,” “voice,” “dysphonia,” and “dyspnea.” Precedence was given to articles published in the past 10 years due to recent advances in this area and to review articles. Ultimately, 115 articles were included for review. Results Approximately 81 autoimmune diseases exist, with 18 of those highlighted in the literature as having laryngeal involvement. The general and laryngeal manifestations of these 18 are discussed in detail, in addition to the clinical implications for a laryngeal expert. Conclusions Voice, breathing, and cough symptoms may be an indication of underlying autoimmune disease. However, these symptoms are often similar to those in the general population. Appropriate differential diagnosis and timely referral practices maximize patient outcomes. Guidelines are provided to facilitate correct diagnosis when an autoimmune disease is suspected.

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