scholarly journals A Rare Case of Life-Threatening Bleeding Caused by a Jejunal GIST

2019 ◽  
pp. 1-2
Author(s):  
Aloka Liyanage ◽  
Aloka Liyanage ◽  
R Kalaiselvan ◽  
R Rajaganeshan ◽  
S P B Thalgaspitiya
Keyword(s):  
Rare Case ◽  
Haemorrhagic Shock ◽  
Gi Tract ◽  
Gastrointestinal Stromal Tumours ◽  
Cross Sectional ◽  
Male Preponderance ◽  
Cross Sectional Imaging ◽  
Life Threatening ◽  
Intermittent Bleeding ◽  
Mesenchymal Tumours

Gastrointestinal Stromal Tumours (GISTs) are rare mesenchymal tumours that are specific to GI tract. GISTs usually associated with advanced age and have a slight male preponderance. GISTs are commonly found in stomach. Jujunal GISTs are the rarest and account for about 0.1-3% of all GI tumours [1]. The most common clinical manifestation of symptomatic GISTs includes intermittent bleeding due to mucosal ulceration. Massive, life threatening gastrointestinal (GI) bleeding is a rare occurrence. We report a rare case of bleeding Jejunal GIST in a 32-year-old female who presented with haemorrhagic shock that required resuscitative laparotomy. Histopathology and immunohistochemistry confirmed the tumour to have features of GIST with clear margins and post-operative cross-sectional imaging excluded any metastatic deposits.

scholarly journals Malignant Mesenchymal Renal Tumor: A Rare Case of Primary Renal Fibrosarcoma

2013 ◽  
Vol 3 ◽  
pp. 52 ◽  
Author(s):  
Madanmohan Gupta ◽  
Nandini U. Bahri ◽  
Pankaj Watal ◽  
Shilpa L. Chudasama ◽  
Swetang G. Brahmbhatt ◽  
...  
Keyword(s):  
Rare Case ◽  
Renal Mass ◽  
Renal Tumor ◽  
Abdominal Discomfort ◽  
Renal Neoplasms ◽  
Cross Sectional ◽  
Elderly Female ◽  
Mesenchymal Neoplasms ◽  
Cross Sectional Imaging ◽  
Rare Group

Malignant mesenchymal neoplasms of kidney constitute a rare group of tumors. Primary fibrosarcoma of kidney is an extremely rare subtype of primary malignant mesenchymal renal neoplasms. An elderly female presented with a gradually increasing abdominal lump and mild abdominal discomfort. On cross-sectional imaging, the lesion showed features suggestive of an atypical renal mass not conforming to either ball or bean type growth pattern. The mass was surgically removed and on histopathological and immunohistological investigations diagnosed to be primary renal fibrosarcoma.

scholarly journals Pulmonary Arterial Dilatation: Imaging Evaluation Using Multidetector Computed Tomography

2021 ◽  
Author(s):  
Sreenivasa Narayana Raju ◽  
Niraj Nirmal Pandey ◽  
Arun Sharma ◽  
Amarinder Singh Malhi ◽  
Siddharthan Deepti ◽  
...  
Keyword(s):  
Pulmonary Artery ◽  
Bronchial Tree ◽  
Pulmonary Angiography ◽  
Ct Pulmonary Angiography ◽  
Imaging Evaluation ◽  
Cross Sectional ◽  
Clinical Background ◽  
Cross Sectional Imaging ◽  
Life Threatening ◽  
Pulmonary Arterial

AbstractPulmonary artery dilatation comprises a heterogeneous group of disorders. Early diagnosis is important as the presentation may be incidental, chronic, or acute and life threatening depending upon the etiology. Cross-sectional imaging plays an important role, with CT pulmonary angiography being regarded as the first line investigation in the evaluation of pulmonary artery pathologies. Moreover, effects of pulmonary artery lesions on proximal and distal circulation can also be ascertained with the detection of associated conditions. Special attention should also be given to the left main coronary artery and the trachea-bronchial tree as they may be extrinsically compressed by the dilated pulmonary artery. In context of an appropriate clinical background, CT pulmonary angiography also helps in treatment planning, prognostication, and follow-up of these patients. This review mainly deals with imaging evaluation of the pulmonary arterial dilatations on CT with emphasis on the gamut of etiologies in the adult as well as pediatric populations.

scholarly journals A rare case of cranial metastasis from an initial presentation of hepatocellular carcinoma

2020 ◽  
Vol 8 (8) ◽  
pp. 3088
Author(s):  
Chetan Kalal ◽  
Adinath Wagh ◽  
Atif Patel ◽  
Harshad Joshi ◽  
Ravindra Surude ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Rare Case ◽  
Parietal Bone ◽  
Initial Presentation ◽  
Cross Sectional ◽  
Detailed History ◽  
Cross Sectional Imaging ◽  
History Of ◽  
Sectional Imaging ◽  
Cranial Metastasis

Cranial metastases from hepatocellular carcinoma (HCC) has been seldom reported. Reported herein is the case of a painless parietal bone mass as an initial presentation of HCC in a 63-year-old female patient who was subsequently diagnosed to have HCV related cirrhosis. The biopsy from cranial lesion was confirmatory of HCC on immunohistochemistry. The patient had no known history of chronic liver disease. The presented diagnosis was made through detailed history, laboratory parameters and cross sectional imaging.

scholarly journals P-EGS03 Curious Case of Life Threatening Gastrointestinal Bleed

2021 ◽  
Vol 108 (Supplement_9) ◽  
Author(s):  
VIBHA SINGH
Keyword(s):  
Arteriovenous Malformation ◽  
Gastrointestinal Stromal Tumors ◽  
Severe Anaemia ◽  
Intestinal Bleeding ◽  
Cross Sectional ◽  
Stromal Tumors ◽  
Cross Sectional Imaging ◽  
Life Threatening ◽  
Cells Of Cajal ◽  
Resection And Anastomosis

Abstract Background Gastrointestinal stromal tumors are mesenchymal in origin, being derived from the interstitial cells of Cajal. These can be found anywhere in the gastrointestinal tract and are commonly found in the stomach followed by the small bowel. Gastrointestinal stromal tumors are usually asymptomatic and are often found incidentally. Chronic bleeding is one of the most common presentation. Gastrointestinal stromal tumors presenting with massive gastro intestinal haemorrhage and mimicking arteriovenous malformation on radiology are rare with only few cases reported. Methods Herein we present such a case of a 45-year-old gentleman with massive gastro intestinal bleeding. At presentation, patient was in congestive heart failure due to severe anaemia with a hemoglobin of 2.9g/dL. CECT Angiography localised the bleed to be from a jejunal mass lesion with radiological features consistent with those of arteriovenous malformation. Patient underwent laparoscopy assisted resection and anastomosis. Results Histopathology examination revealed a low risk jejunal gastrointestinal stromal tumor with no evidence of arteriovenous malformation. The mass was removed completely and the patient was discharged on 5th post-operative day. Patient was followed up in the out-patient department and was found to be doing well. Conclusions Gastrointestinal stromal tumors though relatively uncommon should be kept as important differentials for acute torrential gastrointestinal bleeding. It is highlighted that a presentation of gastrointestinal stromal tumors similar to that of arteriovenous malformations on cross sectional imaging should be kept in mind. The present case is reported in hope of expanding the knowledge of a rare occurrence, its aetiology, clinical impact and treatment.

scholarly journals A Rare Case of Fungal Necrotising Otitis Externa Centred on the Left Temporomandibular Joint

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
A. Khan ◽  
E. Omakobia ◽  
S. Hasnie ◽  
R. Barton ◽  
P. Gopalan ◽  
...  
Keyword(s):  
Temporomandibular Joint ◽  
Antifungal Therapy ◽  
Otitis Externa ◽  
Pcr Analysis ◽  
Causative Organism ◽  
Cross Sectional ◽  
Chronic Renal Impairment ◽  
Cross Sectional Imaging ◽  
Life Threatening ◽  
High Index Of Suspicion

Introduction. Necrotising otitis externa (NOE) is a rare life-threatening complication of simple otitis externa which can be difficult to diagnose and manage. It is very rarely centred on the temporomandibular joint (TMJ). Fungi cause NOE in approximately 5–20% of patients, and a high index of suspicion is required for diagnosis, particularly when there is no improvement with prolonged topical and intravenous antibiotic therapy. Objective. To report a novel case of fungal NOE centred on the left TMJ in an immunocompromised adult male with a focus on investigations and optimal management. Case Report. A 67-year-old male with comorbid chronic renal impairment presented to our otolaryngology department with prolonged left otalgia and otorrhoea. Subsequent cross-sectional imaging demonstrated left NOE centred on the TMJ. Poor resolution with prolonged courses of systemic and topical anti-pseudomonal antibiotics prompted maxillofacial surgical input for left TMJ exploration, washout, and biopsy from the joint capsule. The causative organism was identified as Aspergillus flavus on PCR analysis. The patient was successfully treated with oral posaconazole and repeated topical insertions of amphotericin B-soaked ribbon gauze to the left ear. Discussion. A combination of various imaging modalities including CT, MRI, Tc-99, and gallium-67 are utilised in clinical practice both to diagnose NOE and subsequently monitor disease progression or resolution. Immunocompromised patients with confirmed fungal NOE may require a combination of treatments including surgical debridement and prolonged antifungal therapy for a number of months, if not lifelong, treatment. Initiating empirical antifungal therapy may be justified in some patients. However, this should be judged on a case-by-case basis and guided by discussion with the local microbiology and infectious diseases departments. However, there is no national guideline or consensus regarding treatment of these patients, especially in cases of fungal NOE.

Oculostapedial synkinesis following idiopathic facial palsy: something to listen out for

2018 ◽  
Vol 132 (8) ◽  
pp. 757-758
Author(s):  
T Williams ◽  
B Tungland ◽  
N Stobbs ◽  
G Watson
Keyword(s):  
Facial Palsy ◽  
Complete Resolution ◽  
Rare Case ◽  
Surgical Intervention ◽  
Rare Complication ◽  
Facial Movement ◽  
Cross Sectional ◽  
Team Members ◽  
Cross Sectional Imaging ◽  
Idiopathic Facial Palsy

AbstractObjectiveThis paper presents a rare case of oculostapedial synkinesis.Case reportAfter partial resolution of an idiopathic facial palsy, a male patient presented with persistent distortion of hearing when blinking and closing his eye. Audiometry findings were unremarkable, and cross-sectional imaging of the facial nerve revealed no abnormalities apart from an incidental contralateral meningioma. Initial conservative management, with referral to a specialist physiotherapist, failed to resolve the symptoms. The patient subsequently opted for surgical intervention, and underwent a transmeatal tympanotomy and transection of the stapedial tendon. Following this, he had complete resolution of symptoms.ConclusionOculostapedial synkinesis is a rare complication of facial palsy, but is recognised in the literature. Given its unusual presentation, it can be overlooked, especially by more junior team members. This case highlights the need to pay careful attention to patients' symptoms and listen out for the description of hearing distortion on facial movement.

scholarly journals Abdominal malrotation overlooked at extensive cross-sectional imaging and leading to life-threatening gastrointestinal bleeding

Endoscopy ◽  
2015 ◽  
Vol 47 (S 01) ◽  
pp. E639-E640
Author(s):  
Alexander Arlt ◽  
Dörthe Schuldt ◽  
Susanna Nikolaus ◽  
Clemens Schafmayer ◽  
Witig von Schoenfels ◽  
...  
Keyword(s):  
Gastrointestinal Bleeding ◽  
Cross Sectional ◽  
Cross Sectional Imaging ◽  
Life Threatening ◽  
Sectional Imaging

scholarly journals Acute Renal Infection in Adult, Part 1: An Overview of What the Radiologist Needs to Know

2019 ◽  
Vol 03 (02) ◽  
pp. 126-136
Author(s):  
Suman Hazarika ◽  
Rochita Venkataramanan ◽  
Tonmoy Das ◽  
Sukanya Deuri ◽  
Shalini Lohchab ◽  
...  
Keyword(s):  
Medical Condition ◽  
Therapeutic Interventions ◽  
Emphysematous Pyelonephritis ◽  
Cross Sectional ◽  
Perinephric Abscess ◽  
Risk Of Progression ◽  
Progression Of Disease ◽  
Cross Sectional Imaging ◽  
Life Threatening ◽  
Renal Infection

AbstractAcute renal infection or acute pyelonephritis (AP) denotes the process of inflammation of the renal parenchyma and its collecting system and the urothelium following infection. Uncomplicated AP commonly affects otherwise healthy, young women without structural or functional urinary tract abnormalities and without relevant comorbidities. More severe and complicated AP occurs in patients with a structurally or functionally abnormal genitourinary tract, or in persons with a predisposing medical condition like immune compromised state and diabetes. Complicated AP is characterized by a broader spectrum of clinical presentations, a wider variety of infecting organisms, and a greater risk of progression to a complication, such as intrarenal or perinephric abscess or emphysematous pyelonephritis and has the capacity to damage the organ and at times maybe life threatening. Role of imaging in renal infection is secondary, and in most situations, imaging is done to confirm the clinical diagnosis, map progression of disease in immune-compromised group of patients, or to evaluate for potential complications and therapeutic interventions. This article attempts to discuss the pathophysiology of AP from the standpoint of medical imaging and also brings out illustrative examples of various manifestations of AP and its complications. It provides imaging insight into various stages of inflammation, development of complication, and a roadmap for understanding AP through cross-sectional imaging.

scholarly journals 302 Migratory Foreign Body in The Neck- How A Fishbone Morphed into A Piece of Glass In 18 Months

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
S Horlick ◽  
S Sehgal ◽  
B Al-Dulaimy ◽  
R Anmolsingh ◽  
J Goswamy
Keyword(s):  
Foreign Body ◽  
Vascular Complications ◽  
Neck Exploration ◽  
Cross Sectional ◽  
Persistent Symptoms ◽  
Soft Diet ◽  
Cross Sectional Imaging ◽  
Life Threatening ◽  
Fish Ingestion ◽  
The Right

Abstract Background Foreign body (FB) ingestion is a common presentation to ear, nose, and throat (ENT) surgeons. Usual culprits include fish or chicken bones, steak, or non-organic items. FBs can be categorised into batteries, hard objects, and soft boluses. Hard objects that have not passed beyond the post-cricoid region require removal to minimise perforation risk. In rare cases FBs are reported to migrate extra-luminally into surrounding tissues of the neck necessitating cross-sectional imaging ahead of neck exploration. Case Report A 70-year-old lady presented to A&E with a sensation of FBs in her throat. She was aphagic without dyspnoea. Home-cooked fish ingestion was the precursor. Panendoscopy was clear. The patient was discharged once tolerating fluids and soft diet. She presented 14 months later to the ENT clinic with a persistent FB sensation in her throat. A computed-tomography scan of neck showed a right sided, radio-opaque, 3 cm foreign body sitting just anterior to the carotid sheath, behind the right superior thyroid lobe. An elective external neck exploration revealed a 3 cm shard of glass which was successfully removed without complications. Conclusions Extra-luminal migration of FBs is extremely rare. They may present with life-threatening suppurative or vascular complications. A literature review revealed that migratory FBs tend to be sharp and long such as needles, wires, or fishbones. To allow prompt diagnosis and management, we propose a low threshold for CT imaging in instances with a clear history and persistent symptoms even when panendoscopy is negative.

Cross-Sectional Imaging of Nontraumatic Peritoneal and Mesenteric Emergencies

2013 ◽  
Vol 64 (2) ◽  
pp. 148-153 ◽  
Author(s):  
Michael N. Patlas ◽  
Abdullah Alabousi ◽  
Mariano Scaglione ◽  
Luigia Romano ◽  
Jorge A. Soto
Keyword(s):  
Emergency Department ◽  
Correct Diagnosis ◽  
Cross Sectional ◽  
Cross Sectional Imaging ◽  
Life Threatening ◽  
Emergency Radiologist ◽  
Mesenteric Adenitis ◽  
Sectional Imaging ◽  
High Index Of Suspicion

Multiple nontraumatic peritoneal and mesenteric emergencies are encountered at imaging of patients in the emergency department. Peritoneal and mesenteric emergencies are usually detected in patients in the emergency department during evaluation of nonspecific abdominal pain. A high index of suspicion is required for the establishment of early diagnosis and aversion of life-threatening complications in cases of peritoneal carcinomatosis, nontraumatic hemoperitoneum, and peritonitis. A correct diagnosis of omental infarction, mesenteric adenitis, and mesenteric panniculitis helps patients primarily by avoiding unnecessary surgery. In this review article, we illustrate the cross-sectional imaging appearance of various nontraumatic peritoneal and mesenteric emergencies by emphasizing the role of the emergency radiologist in detecting and managing these entities.

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