scholarly journals Incidental non-complicated posterior rectus sheath hernia

2020 ◽  
Vol 6 (1) ◽  
pp. 20190072
Author(s):  
Peter Connell ◽  
James Hennebry ◽  
Senan Alsanjari ◽  
Riddhika Chakravartty ◽  
Mona Sabala
Keyword(s):  
Surgical Intervention ◽  
Incidental Finding ◽  
Rectus Sheath ◽  
Evidence Base ◽  
Cross Sectional ◽  
Posterior Portion ◽  
Rare Finding ◽  
Posterior Rectus Sheath ◽  
Cross Sectional Imaging ◽  
Uncommon Condition

Posterior rectus sheath hernia is a truly rare finding, with only 11 documented cases since the first report in 1937. A posterior rectus sheath hernia is herniation of bowel and/or omentum through the posterior portion of the rectus sheath, but not through any other structure. This can only occur medial to the spigelian fascia, differentiating it from a spigelian hernia. Previous missed cases have led to complications such as bowel incarceration, obstruction or even strangulation and have required surgical intervention. In this case report, we describe an incidental finding of a non-complicated posterior rectus sheath hernia in an 83-year-old male. Annotated cross-sectional imaging provides anatomical context that is not widely available in the existing literature. Due to its rarity and potential complications, it is also important to report this case in order to enhance the evidence base for posterior rectus sheath hernia and to familiarize this uncommon condition to radiologists, clinicians and surgeons.

Traumatic orbital ligament avulsion diagnosed with cross-sectional imaging in three dogs

2020 ◽  
Vol 8 (3) ◽  
pp. e001143
Author(s):  
Emilie M Hanot ◽  
David L Williams ◽  
Abby Caine
Keyword(s):  
Surgical Intervention ◽  
Specific Treatment ◽  
Linear Structure ◽  
Facial Trauma ◽  
Visual Axis ◽  
Cross Sectional ◽  
Zygomatic Process ◽  
Frontal Process ◽  
Cross Sectional Imaging ◽  
Uncommon Condition

The aim of the study was to describe the clinical and imaging findings of three dogs diagnosed with orbital ligament avulsion. Three immature dogs presented following a facial bite trauma, including multiple skull fractures and ventral, ventrolateral or rostrolateral displacement of the affected eye. The extent of lesions and orbital ligament avulsion were assessed and diagnosed using CT (n=2) or MRI (n=1). Orbital ligament avulsion was identified as an interruption of the linear structure between the zygomatic process of the frontal bone and the frontal process of the zygomatic bone. One dog was treated surgically to correct a visual axis alteration, while the remaining two dogs were managed conservatively. Orbital ligament avulsion is an uncommon condition that should be considered following a facial trauma. Concurrent lesions might necessitate surgical intervention, but it remains unclear if the avulsion of the orbital ligament itself requires a specific treatment.

scholarly journals A Rare Case of Chronic Appendicitis Superimposed on an Incarcerated de Garengeot Hernia Prospectively Identified on Computed Tomography

2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
Alyssa Goldbach ◽  
Partha Hota ◽  
Andrew Czulewicz ◽  
Christine Burgert-Lon ◽  
Omar Agosto
Keyword(s):  
Femoral Hernia ◽  
Surgical Intervention ◽  
Incidental Finding ◽  
Critical Role ◽  
Fluid Collection ◽  
Cross Sectional ◽  
Chronic Appendicitis ◽  
Hernia Sac ◽  
Cross Sectional Imaging ◽  
De Garengeot Hernia

The de Garengeot hernia is an uncommon and potentially confounding pathologic process in which the appendix is contained within a femoral hernia. While typically a benign incidental finding, superimposed acute appendicitis is a rare but serious complication. Identification of this entity is crucial to patient management and ultimately outcome with imaging playing a critical role. Cross-sectional imaging, with either CT or MRI, should be performed in all cases of suspected incarcerated de Garengeot hernia to facilitate the appropriate diagnosis and surgical intervention. Herein, we present the fifth case of a prospective CT diagnosis of the de Garengeot hernia in a 61-year-old female who presented with an irreducible right femoral hernia. The patient underwent CT examination which demonstrated the appendix within the femoral hernia sac with an associated periappendiceal fluid collection. The patient was taken for emergent surgical intervention at which time the appendix was found within the hernia sac. The appendix was removed, the defect repaired, and ultimately the patient recovered well.

Systemic arteriopulmonary venous fistula (APVF): case presentation of an asymptomatic individual and a review of the literature

2021 ◽  
Vol 14 (7) ◽  
pp. e241644
Author(s):  
Paul Jenkins ◽  
Prageeth Dissanayake ◽  
Richard Riordan
Keyword(s):  
Chest Radiograph ◽  
Cardiovascular Health ◽  
Incidental Finding ◽  
Chest Radiographs ◽  
Cross Sectional ◽  
Arterial Circulation ◽  
Cross Sectional Imaging ◽  
Venous Fistula ◽  
The Right

Abnormal communications between the systemic and pulmonary venous systems are rare but can present as a opacity on chest radiograph. A solitary vessel communicating as a fistula directly between the systemic arterial circulation and the pulmonary venous system is not widely described. These may have significant implications in the long-term cardiovascular health of an individual acting as a left to right shunt. There is no clear consensus as to the management, but surgical management and endovascular embolisation have been successfully used. We present a case where a systemic arteriaopulmonary fistula originating from the abdominal aorta and connecting to the right inferior pulmonary vein manifested as an incidental finding on a chest radiograph and was further evaluated on cross-sectional imaging in a young patient. Chest radiographs are non-specific and it is important to be aware of the less frequent but important pathologies that can be picked up on plain chest radiographs, which inturn should warrant further investigation. This is presented in conjunction with a review of the available literature along with a discussion regarding the differential diagnosis and management applicable to the general clinician.

scholarly journals S1572 Asymptomatic Agenesis of the Dorsal Pancreas: A Rare Incidental Finding on Cross Sectional Imaging

2021 ◽  
Vol 116 (1) ◽  
pp. S709-S709
Author(s):  
Mohammad Abdallah ◽  
Thomas Houghton ◽  
Michelle Baliss ◽  
Kevin Kline ◽  
Sreeram Parupudi
Keyword(s):  
Incidental Finding ◽  
Cross Sectional ◽  
Dorsal Pancreas ◽  
Cross Sectional Imaging ◽  
Sectional Imaging

scholarly journals Gastric Schwannoma

2018 ◽  
Vol 36 (2) ◽  
pp. 157
Author(s):  
Tanawat Pattarapuntakul
Keyword(s):  
Incidental Finding ◽  
Abdominal Mass ◽  
Mesenchymal Tumors ◽  
Cross Sectional ◽  
Presenting Symptoms ◽  
Gastric Schwannoma ◽  
Cross Sectional Imaging ◽  
Slow Growing ◽  
Radiology And Pathology ◽  
Upper Gastrointestinal

A gastric schwannoma is a rare primary spindle cell mesenchymal tumor of the digestive tract. Gastric schwannomas originate from Schwann cells of the peripheral nerves in the stomach. The majority of schwannomas are benign, slow growing tumors only a few of which develop into malignancies. Due to their indolent course, in most cases, gastric schwannomas are asymptomatic or discovered as an incidental finding on cross-sectional imaging or endoscopy. When symptomatic, the most common presenting symptoms are abdominal pain, upper gastrointestinal bleeding and intra- abdominal mass. Preoperatively, gastric schwannomas are difficult to differentiate from other mesenchymal tumors, such as gastrointestinal stroma or leiomyoma which develop from mesenchymal stem cells. The optimal management of the tumor is based on the symptoms of the patient, tumor size and histologic grading and the prognosis is excellent after complete surgical or endoscopic removal. Gastric schwannomas need multidisciplinary team management for definitive diagnosis and management, including specialists from gastroenterology, surgery, radiology and pathology.

scholarly journals Is anomalous origin of the left vertebral artery indeed a rare finding?

2012 ◽  
Vol 16 (4) ◽  
pp. 144-146
Author(s):  
Braham Van der Merwe ◽  
Christelle Ackermann ◽  
Shaun Scheepers ◽  
Sulaiman Moosa
Keyword(s):  
Endovascular Treatment ◽  
Vertebral Artery ◽  
Anomalous Origin ◽  
Left Vertebral Artery ◽  
Cross Sectional ◽  
Rare Finding ◽  
Pictorial Review ◽  
Cross Sectional Imaging ◽  
After Hours ◽  
Sectional Imaging

We present a pictorial review of anomalous origin of the left vertebral artery observed in 5 patients imaged in our after-hours trauma radiology unit within a period of 7 days. We raise the question of whether the incidence of anomalous origin of the left vertebral artery quoted in the radiology literature as 5% is really that low, and suggest that the current increased frequency of cross-sectional imaging could elevate the observed incidence of this anomaly in practice. We discuss the implications of vertebral artery anomalies in the endovascular treatment of aortic arch injuries.

scholarly journals Adrenal Incidentaloma: A Cautionary Tale of Three Cases of Adrenocortical Carcinoma Arising from Apparently Benign Incidentalomas

2011 ◽  
Vol 3 (3) ◽  
pp. 137-143
Author(s):  
Chris Armstrong ◽  
Janice L Pasieka ◽  
Adrian Harvey
Keyword(s):  
Adrenocortical Carcinoma ◽  
Surgical Intervention ◽  
Adrenal Incidentaloma ◽  
Adrenal Incidentalomas ◽  
Cross Sectional ◽  
Cross Sectional Imaging ◽  
Sectional Imaging ◽  
Biochemical Testing ◽  
Average Size

ABSTRACT Unexpected incidental findings on cross-sectional imaging are becoming more commonplace in today's medical practice. These are likely due to ongoing improvements in the resolution of cross-sectional imaging and our increasing use of these tests combined with an aging population. In the case of the adrenal incidentalomas the majority of these represent benign nonfunctional adenomas and these are believed to have no malignant potential. On the contrary adrenocortical carcinoma (ACC) is an uncommon malignancy that carries a high mortality. Current biochemical and radiological follow-up investigations are expensive and are of limited benefit in the majority of cases of adrenal incidentalomas. This has created a dilemma for the proper diagnostic, clinical and radiologic follow-up as well as the triggers for surgical intervention. We present a series of three patients presenting with ACC that retrospectively arose from a small incidentally found adrenal lesion. Three patients were identified with ACC arising from an apparently benign adrenal incidentaloma. The average size of the original lesion was 1.6 cm whereas the average size of their adrenal tumor was 9.3 cm when they presented with ACC. Two of the three cases were found to develop functional tumors at the time of the diagnosis of ACC. Two of the three cases underwent surgical resection. The third patient was found to have metastatic disease at presentation and declined surgical intervention. We agree that current follow-up guidelines result in an increasing burden on our healthcare system; with expensive biochemical testing and imaging for what in most cases will prove to be a benign adenoma, these three cases have influenced our current strategies for follow-up. At the present time, we continue to follow the AAES/AACE guidelines. The development of improved methods of biochemical, radiologic and tissue diagnosis may help to improve our ability to recognize an ACC in this population at an earlier and potentially curable stage.

scholarly journals 851 Giant Oncocytoma In A Solitary Kidney: A Case Report on Balancing Surgical Resection Against Surveillance

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
A Srivastava ◽  
J B Neves ◽  
M G B Tran
Keyword(s):  
Surgical Intervention ◽  
Left Kidney ◽  
Stage Iv ◽  
Solitary Kidney ◽  
Histopathological Analysis ◽  
Renal Lesion ◽  
Cross Sectional ◽  
Renal Lesions ◽  
Cross Sectional Imaging ◽  
Sectional Imaging

Abstract Renal oncocytomas are benign kidney neoplasms that are typically small, unilaterally localised (95%) and challenging to differentiate on cross-sectional imaging, hence requiring surgical intervention. We herein present the extremely rare case of a patient with giant, bilateral oncocytomas and oncocytosis, and chronic kidney disease (CKD) and discuss the associated treatment challenges. A 61-year-old male with no past medical history presented with CKD (eGFR of 32ml/min). On investigation, cross sectional imaging revealed bilateral, multifocal, solid and vascular renal lesions. The largest lesion measuring 115mm x 102mm was situated in the right kidney, with multiple lesions noted in the left kidney, measuring up to 44mm. He subsequently underwent a right radical nephrectomy and histopathological analysis reported oncocytosis of the background kidney. The largest left sided renal lesion was biopsied, also confirmatory of benign oncocytoma. eGFR after surgery was 26ml/min. Following patient-centric consultations, further surgical intervention for the left sided renal lesions was declined, aiming to avoid renal replacement therapy (RRT). He has remained on active surveillance with biannual scans for 6 years. The lesions in his remaining kidney have since grown and coalesced into a single large lesion, with axial dimensions in the most recent MRI scan of 104mm x 306mm. He has progressed to stage IV CKD (eGFR 16ml/min), but still currently without need of RRT. This case study underscores both the significance of shared decision making in urology and surgery. Ultimately, the most significant skill lies in knowing when to not operate, especially when presented with the rarest of cases.

scholarly journals Gastric Schwannoma

2018 ◽  
Vol 36 (2) ◽  
pp. 157
Author(s):  
Tanawat Pattarapuntakul
Keyword(s):  
Incidental Finding ◽  
Abdominal Mass ◽  
Mesenchymal Tumors ◽  
Cross Sectional ◽  
Presenting Symptoms ◽  
Gastric Schwannoma ◽  
Cross Sectional Imaging ◽  
Slow Growing ◽  
Radiology And Pathology ◽  
Upper Gastrointestinal

A gastric schwannoma is a rare primary spindle cell mesenchymal tumor of the digestive tract. Gastric schwannomas originate from Schwann cells of the peripheral nerves in the stomach. The majority of schwannomas are benign, slow growing tumors only a few of which develop into malignancies. Due to their indolent course, in most cases, gastric schwannomas are asymptomatic or discovered as an incidental finding on cross-sectional imaging or endoscopy. When symptomatic, the most common presenting symptoms are abdominal pain, upper gastrointestinal bleeding and intra- abdominal mass. Preoperatively, gastric schwannomas are difficult to differentiate from other mesenchymal tumors, such as gastrointestinal stroma or leiomyoma which develop from mesenchymal stem cells. The optimal management of the tumor is based on the symptoms of the patient, tumor size and histologic grading and the prognosis is excellent after complete surgical or endoscopic removal. Gastric schwannomas need multidisciplinary team management for definitive diagnosis and management, including specialists from gastroenterology, surgery, radiology and pathology.

Cystic Tumors of the Pancreas

2020 ◽  
Author(s):  
Nicholas J. Zyromski
Keyword(s):  
Incidental Finding ◽  
Pancreatic Cysts ◽  
Clinical Approach ◽  
Branch Duct ◽  
Cross Sectional ◽  
Intraductal Papillary Neoplasm ◽  
Asymptomatic Patients ◽  
Cystic Tumors ◽  
Cross Sectional Imaging ◽  
Papillary Neoplasm

Pancreatic cysts are common, affecting up to 10% of the general population. Widespread use of abdominal cross-sectional imaging has increasingly identified asymptomatic patients with "incidental" pancreatic cysts. Our understanding of common pancreatic cysts has improved; however, the ideal management of patients with pancreatic cysts (particularly those with malignant potential) has not been standardized. This review discusses the clinical approach to patients with pancreatic cysts, with particular attention to those with "premalignant" cysts such as intraductal papillary mucinous neoplasms (IPMNs). This review contains 17 figures, 13 tables, and 42 references. Keywords: Pancreatic tumor, cyst, branch duct intraductal papillary neoplasm, main duct intraductal papillary neoplasm, incidental finding, mucinous neoplasm

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