scholarly journals Problems in the differential diagnosis of abdominal non-organ tumors

2020 ◽  
Vol 49 ◽  
Author(s):  
E. S. Kolobanova ◽  
B. M. Medvedeva
Keyword(s):  
Differential Diagnosis ◽  
Small Intestine ◽  
Medical Treatment ◽  
Contrast Enhancement ◽  
Abdominal Cavity ◽  
Castleman Disease ◽  
Intravenous Contrast ◽  
National Medical ◽  
Abdominal Masses ◽  
Ct Data

Rationale: The differential diagnosis between lesions requiring surgical intervention and those necessitating medical treatment poses a significant problem for current imaging methods of fat-containing masses in the small intestine mesenterium.Aim: To identify differential diagnostic criteria for various fat-containing neoplasms of abdominal cavity at the preoperative stage.Materials and methods: This retrospective study included data from 29  patients (16  women and 13 men, aged 32 to 81 years, mean age 56 years) with fat-containing masses in the small intestine mesenterium who had undergone preoperative examination at N.N. Blokhin National Medical Research Center of Oncology from 2016 to 2020. Abdominal computed tomography (CT) with intravenous contrast enhancement and assessment of the size, contours, structure and involvement of main vessels was performed in all patients. To interpret single soft tissue nodes within the mass, we used our own list of main CT symptoms (number, size, shape, contours and structure of nodes, degree of their contrast enhancement, and maximal amplification).Results: Fat-containing abdominal masses were morphologically verified as follows: mesenteric panniculitis 13  (45%), well differentiated liposarcoma 10  (35%), lymphoproliferative disorders 4  (14%), lipoma and Castleman disease 1  case each (3%). Twelve (12) of 29  patients (41%) had surgery for various types of tumors, while 17  (59%) patients received appropriate medical treatment after a puncture biopsy-based morphological diagnosis. The CT sensitivity for the detection of fat-containing abdominal neoplasms in our series was 93,1%. The paper describes the radiological signs of the above mentioned mass types with an emphasis on the complexity of their diagnosis.Conclusion: In most cases, CT data can accurately differentiate abdominal liposarcomas from other benign and malignant masses in the small intestine mesenterium.

scholarly journals Effect of the dynamic curve type from the perifocal infiltration zone obtained by magnetic resonance imaging on prognosis in pelvic pathologies in women

2020 ◽  
Vol 16 (1) ◽  
pp. 71-77
Author(s):  
T. A. Bergen ◽  
V. A. Fokin ◽  
G. E. Trufanov ◽  
A. V. Smagina ◽  
I. A. Soynov
Keyword(s):  
Magnetic Resonance Imaging ◽  
Differential Diagnosis ◽  
Magnetic Resonance ◽  
Contrast Enhancement ◽  
Prognostic Significance ◽  
Resonance Imaging ◽  
Intravenous Contrast ◽  
Dynamic Contrast Enhancement ◽  
Pelvic Mri ◽  
Prognostic Accuracy

The aim of the study is to evaluate the role and prognostic significance of magnetic resonance imaging (MRI) perfusion methods in prognosis of disease course and outcome based on evaluation of the perifocal infiltration zone in pelvic disorders in women.Materials and methods. Retrospective analysis of pelvic MRI data obtained using MRI system with induced magnetic field of 1.5 T was performed. The study included 530 protocols of pelvic scans in women. Two equal groups (n = 265) of patients with oncological and nononcological pathologies of pelvic organs were formed; after application of propensity score matching, each group contained 165 patients. All examination protocols included dynamic contrast enhancement. The obtained data were statistically analyzed using the Stata 13 software.Results. In the study, types of dynamic curves obtained using dynamic contrast enhancement from the perifocal infiltration zone were analyzed. There was no data showing a correlation between the type of dynamic curve from the zone of perifocal changes and disease prognosis or possibility of differential diagnosis.Conclusions. Evaluation of the perifocal infiltration zone per MRI results with intravenous contrast does not affect prognostic accuracy of the method (p >0.05); contrast can be used only for differential diagnosis or evaluation of local advancement of the process.

scholarly journals Possibilities of Diffusion-Weighted MRI in the Differential Diagnosis of Early Recurrences of Retroperitoneal Liposarcomas and Postoperative Changes

2021 ◽  
Vol 4 (3) ◽  
pp. 44-55
Author(s):  
E. S. Kolobanova ◽  
B. M. Medvedeva
Keyword(s):  
Differential Diagnosis ◽  
Abdominal Cavity ◽  
Dynamic Control ◽  
Greater Omentum ◽  
Intravenous Contrast ◽  
Diffusion Weighted ◽  
Postoperative Changes ◽  
Contrast Enhanced ◽  
Mri Protocol ◽  
Suspected Recurrence

Purpose: To evaluate contrast-enhanced magnetic resonance imaging (CE‑MRI) and diffusion-weighted (DWI) in the detection and differential diagnosis of recurrent of retroperitoneal liposarcomas with postoperative changes.Material and methods: The retrospective study included of 23 patients previously operated on for retroperitoneal inorganic liposarcomas. All patients underwent MRI of the abdominal cavity and pelvis with intravenous contrast with further assessment of the size, shape, structure and characteristics of the accumulation of contrast agent in the detected formation.Results: Morphological verification were performed in 17 patients (74 %), in 6 cases (26 %) patients were left for dynamic control for 1–3 years. Local relapses were detected in 16 patients (67 %), postoperative changes — in 7 (33 %) patients, of which in 2 cases deformation of adipose tissue and fibrotic changes in the area of surgery was determined, in 3 patients granulomas were revealed, and in two patients — volvulus of the greater omentum and lymphocele. The sensitivity of MRI with intravenous contrast enhancement was 68.7 %, specificity 71.4 % and accuracy 69.6 %. The addition of DWI to the standard MRI protocol in patients with suspected recurrence of retroperitoneal liposarcoma to increase the sensitivity of the method in the differential diagnosis of recurrent drugs from postoperative changes to 93.7 % (15 out of 16), specificity up to 100 % (7 out of 7) and accuracy up to 95.6 % (22 out of 23).Conclusion: The joint use of MRI with intravenous contrast and DW‑MRI increases the information content in the detection and differential diagnosis of small-sized recurrent tumors in dedifferentiated and myxoid types of liposarcomas with postoperative changes. 

Synchronous celiac axis and superior mesenteric artery embolism

VASA ◽  
2011 ◽  
Vol 40 (6) ◽  
pp. 495-498 ◽  
Author(s):  
Rajkovic ◽  
Zelic ◽  
Papes ◽  
Cizmek ◽  
Arslani
Keyword(s):  
Atrial Fibrillation ◽  
Small Intestine ◽  
Abdominal Pain ◽  
Ct Scan ◽  
Superior Mesenteric Artery ◽  
Mesenteric Artery ◽  
Abdominal Cavity ◽  
Celiac Axis ◽  
Contrast Administration ◽  
Artery Embolism

We present a case of combined celiac axis and superior mesenteric artery embolism in a 70-year-old patient that was examined in emergency department for atrial fibrillation and diffuse abdominal pain. Standard abdominal x-ray showed air in the portal vein. CT scan with contrast showed air in the lumen of the stomach and small intestine, bowel distension with wall thickening, and a free gallstone in the abdominal cavity. Massive embolism of both celiac axis and superior mesenteric artery was seen after contrast administration. On laparotomy, complete necrosis of the liver, spleen, stomach and small intestine was found. Gallbladder was gangrenous and perforated, and the gallstone had migrated into the abdominal cavity. We found free air that crackled on palpation of the veins of the gastric surface. The patient’s condition was incurable and she died of multiple organ failure a few hours after surgery. Acute visceral thromboembolism should always be excluded first if a combination of atrial fibrillation and abdominal pain exists. Determining the serum levels of d-dimers and lactate, combined with CT scan with contrast administration can, in most cases, confirm the diagnosis and lead to faster surgical intervention. It is crucial to act early on clinical suspicion and not to wait for the development of hard evidence.

scholarly journals Metastatic Melanoma Presenting as Intussusception in an 80-Year-Old Man: A Case Report

2013 ◽  
Vol 2013 ◽  
pp. 1-3 ◽  
Author(s):  
Sarah Alghamdi ◽  
Yumna Omarzai
Keyword(s):  
Differential Diagnosis ◽  
Small Intestine ◽  
Gastrointestinal Tract ◽  
Metastatic Melanoma ◽  
Clinical Presentation ◽  
Gastrointestinal Symptoms ◽  
Common Site ◽  
Neoplastic Process ◽  
History Of ◽  
Uncommon Neoplasm

Malignant melanoma of the gastrointestinal tract is an uncommon neoplasm that could be primary or metastatic. Small intestine represents the most common site for the metastatic melanoma; however, it could be found anywhere in the gastrointestinal tract. Intussusception is a rare cause of intestinal obstruction in adults compared to children. In 90% of the cases, the underlying cause can be found, and in 65% of the cases, intussusception is caused by the neoplastic process. The majority of the neoplasms are benign, and about 15% are malignant. Metastatic melanoma is one of the most common metastatic malignancies to the gastrointestinal tract; however, the premortem diagnosis is rarely made. Here, we report an uncommon clinical presentation of metastatic melanoma causing intussusception in an 80-year-old man. This diagnosis should be considered in a differential diagnosis in any patient who presents with gastrointestinal symptoms and a history of melanoma.

Providing Comfort or Prolonging Death for a Baby with “Dead Gut Syndrome”?

1999 ◽  
Vol 8 (4) ◽  
pp. 538-538 ◽  
Author(s):  
MARK G. KUCZEWSKI
Keyword(s):  
Small Intestine ◽  
Prenatal Diagnosis ◽  
Abdominal Cavity ◽  
Length Of Gestation

The patient was born at 29 weeks gestation. There was a prenatal diagnosis that the child's small intestine had developed outside of the abdominal cavity. The length of gestation had made the initial prognosis good. But after birth, surgery to place the intestine back into the abdominal cavity found that the baby actually had very little small intestine and a diagnosis of “dead gut syndrome” was made. The amount of small intestine was not compatible with survival. The transplant service saw the baby twice and each time said the baby's profile did not meet the transplant protocol.

High resolution CT of cervical disk herniation: the value of intravenous contrast enhancement

1991 ◽  
Vol 27 (2) ◽  
pp. 213
Author(s):  
Heoung Keun Kang ◽  
Yong Yeun Jeong ◽  
Won Jee Lee ◽  
Jae Kyu Kim ◽  
Jin Gyoon Park ◽  
...  
Keyword(s):  
High Resolution ◽  
Contrast Enhancement ◽  
Disk Herniation ◽  
Intravenous Contrast ◽  
High Resolution Ct ◽  
Cervical Disk Herniation ◽  
Cervical Disk

scholarly journals Laparoscopic Resection of a Giant Dedifferentiated Primary Retroperitoneal Mucinous Cystadenoma (PRMC) in a Young Woman: A Case Report and Literature Review

2021 ◽  
Vol 6 (1) ◽  
Author(s):  
Wu L ◽  
Li X ◽  
Li J ◽  
Lai Y
Keyword(s):  
Differential Diagnosis ◽  
Case Report ◽  
Literature Review ◽  
Benign Tumor ◽  
Laparoscopic Resection ◽  
Abdominal Cavity ◽  
Mucinous Cystadenoma ◽  
Rare Benign Tumor ◽  
Primary Retroperitoneal

Background: PRMC is a very rare benign tumor of the abdominal cavity that usually occurs in women, and PRMC demonstrate no specific findings on CT. There are many reports on the differential diagnosis and discussion of PRMC imaging, but there are few reports on the treatment of dedifferentiated PRMC using laparoscopic resection and postoperative follow-up.

scholarly journals Application of a temporary intestinal storage device in a small intestine gunshot wound dog model

2021 ◽  
Author(s):  
Weihang Wu ◽  
Mingwei Wang ◽  
Weikang Zhou ◽  
Yuewen Zhu ◽  
Tianyu Lin ◽  
...  
Keyword(s):  
Small Intestine ◽  
Gunshot Wound ◽  
Inflammatory Cell ◽  
Treatment Time ◽  
Abdominal Cavity ◽  
First Aid ◽  
Storage Device ◽  
Wound Model ◽  
Transmission Electron ◽  
Normal Intestine

Abstract Background: We aimed to verify the feasibility of a novel temporary intestinal storage device (TISD) using a simple intestinal gunshot wound model. Methods: Ten female beagle dogs were fasted for 12 hours and anesthetized. An incision protector was inserted into a 10-cm abdominal incision. The small intestine was exposed to the body by natural drooping. An automatic rifle was used to shoot the intestine from a distance of 25 meters to introduce a simple intestinal gunshot wound. The three phases of first aid for war injuries were followed: Care Under Fire, Tactical Field Care, and Tactical Evacuation Care. For Tactical Field Care, a novel TISD was used to reconstruct the ruptured intestine, and necrotic intestinal tissue was stored. The abdominal cavity was temporarily closed, and the abdomen was opened for exploration 4 hours after surgery. Treatment time was observed during Care Under Fire, transfer time was observed from Tactical Field Care to Tactical Evacuation Care, rescue was observed during Tactical Evacuation Care, and the treatment time of each intestinal segment was measured. After 4 hours, intestinal vitality was observed, and the heart, liver, spleen, lung, kidney, stomach, normal intestine, and necrotic intestine were examined before and 4 hours after surgery by light microscopy. The broken ends of the intestine were connected to the intestinal reconstruction device before and 4 hours after surgery and were examined by transmission electron microscopy. Results: The processing time of Care Under Fire was 41.55 ± 10.46 seconds, which is shorter than the maximum time limit of the battlefield first aid principle. Transit time from Care Under Fire to Tactical Field Care transit was 60.78 ± 15.95 seconds, which is shorter than the battlefield first aid principle. The treatment time of Tactical Field Care was 29.75 ± 5.13 minutes, and the reconstruction time of each intestinal segment was 4.44 ± 0.31 minutes. One dog died of anesthetic overdose, two died of splenic bleeding, and the rest completed all phases. The abdominal cavity was explored 4 hours after surgery, and the TISD was positioned. Intestinal tract reconstruction was normal, and no obvious necrosis was observed. Necrotic intestine had the same vitality as before storage. With light microscopy, the heart, liver, spleen, lung, kidney, and stomach showed no obvious necrosis, inflammatory cell infiltration, or necrosis of normal intestine before and after surgery. Before and 4 hours after surgery, intestinal necrosis involved local necrosis of villi and tissues, and marked inflammatory cell infiltration. Transmission electron microscopy showed that the villi of the intestinal stump connected to the TISD before surgery were intact, and no obvious necrosis was observed. The villi of the intestinal stump were moderately damaged after surgery, and focal necrosis was observed. Conclusions: The novel TISD can be used in the emergency treatment of simple small intestine gunshot wounds in beagle dogs and can prevent further deterioration after intestinal injury. Background: We aimed to verify the feasibility of a novel temporary intestinal storage device (TISD) using a simple intestinal gunshot wound model.

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