scholarly journals An unusual presentation of giant pancreatic pseudocyst in the parietal wall

2021 ◽  
pp. 366-368
Author(s):  
Ishita Laha ◽  
Swapnil Sen ◽  
Achintya Kumar Das
Keyword(s):  
Pancreatic Pseudocyst ◽  
Necrotizing Pancreatitis ◽  
Fluid Collection ◽  
Outlet Obstruction ◽  
Exploratory Laparotomy ◽  
Contrast Enhanced ◽  
Acute Necrotizing ◽  
True Cyst ◽  
Enhanced Computed Tomography ◽  
Contrast Enhanced Computed Tomography

A true cyst is a localized fluid collection covered by a capsule lined by epithelium, whereas, a pseudocyst does not consist specific lining of cells. We report one such case of a 37-year-old gentleman with giant pancreatic pseudocyst in the anterior abdominal wall which had developed secondary to acute necrotizing pancreatitis. A contrast-enhanced computed tomography scan showed a pseudocyst in the lesser sac and left pre-renal fossa. He was planned for exploration but within a month, he was at the emergency with yet another episode of gastric outlet obstruction with a huge hypogastric swelling compressing the stomach. The patient was resuscitated and immediately posted for exploratory laparotomy. To the surprise of surgeons, the lump was just below the umbilicus with whatsoever no relation with the pancreas. However, the expert opinion of the histopathologists suggested it to be a pseudocyst.

scholarly journals Pancreatic Pseudocyst with Mediastinal Extension Presenting as Pseudo-Kirklin Sign—Multimodality Imaging

2020 ◽  
Vol 3 (S 01) ◽  
pp. S54-S57
Author(s):  
Harshini Udayakumar ◽  
Venkatraman Indiran ◽  
Kalaichezhian Mariappan ◽  
Prabakaran Maduraimuthu
Keyword(s):  
Pancreatic Pseudocyst ◽  
Multimodality Imaging ◽  
Plain Radiography ◽  
Soft Tissue Shadow ◽  
Resonance Imaging ◽  
Contour Deformity ◽  
Contrast Enhanced ◽  
Enhanced Computed Tomography ◽  
Contrast Enhanced Computed Tomography ◽  
Pseudocyst Of The Pancreas

AbstractA mass lesion of the gastric cardia or fundus causing an alteration in the normal regular, translucent gastric fundal air shadow on a frontal erect chest radiograph is referred to as “the Kirklin sign.” Here we present “Pseudo-Kirklin sign” observed on the frontal radiograph of a 46-year-old male patient due to a soft tissue shadow/contour deformity of the fundal gas shadow caused by pseudocyst of the pancreas. We evaluated the patient using plain radiography, contrast enhanced computed tomography, magnetic resonance imaging, and endoscopic ultrasound (EUS) with the cyst drained under EUS guidance. So far only two cases of mediastinal pseudocysts have been drained successfully by EUS-guided aspiration.

Relationship of Arterial Changes in Acute Pancreatitis on CT Angiography with Modified CT Severity Index

2021 ◽  
Author(s):  
Sanya Vermani ◽  
Aditya Kaushal ◽  
Arshpreet Kaur ◽  
Mohit Singla
Keyword(s):  
Computed Tomography ◽  
Acute Pancreatitis ◽  
Necrotizing Pancreatitis ◽  
Fluid Collection ◽  
Vascular Complications ◽  
Severity Index ◽  
Arterial Complications ◽  
Acute Necrotizing ◽  
Cect Scan ◽  
Enhanced Computed Tomography

Abstract Purpose To evaluate the prevalence of arterial changes in patients with acute pancreatitis (AP) on computed tomography angiography (CTA) and determine their association with etiology of AP, presence of necrosis, collections and severity of AP. Materials and Methods A total of 50 patients (20 women, 30 men; mean age: 43.04 ± 13.98; age range: 18–77 years) with AP underwent contrast-enhanced computed tomography (CECT) scan and CTA of abdomen, which was evaluated for necrosis and fluid collection (s). On CTA, splanchnic arterial structures were assessed for vascular complications. Association between vascular changes and presence of necrosis, fluid collections, etiology of AP and severity of AP (as assessed by modified computed tomography severity index CTSI) was determined. Results Arterial complications were seen in 28 percent (14/50). The most frequently involved artery was superior pancreaticoduodenal artery (12 percent), followed by splenic artery (8 percent) and right gastric artery (8 percent; Fig. 1). No significant association was seen between arterial changes and gallstone or alcohol-induced AP. Arterial changes showed a significant association with presence of acute necrotizing pancreatitis (ANP), presence of collections and severe AP (CTSI 8–10) (p < 0.05 for each). Conclusion Arterial changes on CTA are frequently seen in patients of AP having ANP. There is a significant association between arterial changes and presence of necrosis, collections and severe AP.

SMALL INTESTINAL CARCINOID TUMOR-A CASE REPORT

2021 ◽  
pp. 36-37
Author(s):  
B. Santhi ◽  
S. Savitha ◽  
V. G. Vikraman
Keyword(s):  
Abdominal Pain ◽  
Small Bowel ◽  
Exploratory Laparotomy ◽  
Wall Thickening ◽  
Lower Quadrant ◽  
Polypoidal Lesion ◽  
Contrast Enhanced ◽  
Intraluminal Mass ◽  
Enhanced Computed Tomography ◽  
Contrast Enhanced Computed Tomography

Carcinoid tumors are neuroendocrine tumours, the most common tumour of the small bowel and its incidence is rising. Most carcinoid tumours grow slowly and mostly asymptomatic or may present with nonspecic abdominal pain or carcinoid syndrome. We had a 38 year old, female patient presented with generalized, intermittent, dull aching abdominal pain accompanied with distension and obstipation for 2 days with associated vomiting. She complained of weight loss and constipation during this period. On examination abdomen showed deep tenderness in periumbilical, right lower quadrant regions. No guarding, rigidity, mass or free uid. On per-rectal examination, there was no tenderness and the rectum was empty. Contrast enhanced computed tomography scan showed enhancing polypoidal lesion noted in distal ileum causing proximal dilatation of small bowel with air uid levels and circumferential wall thickening in dilated ileum proximal to polypoidal lesion, strongly enhancing nodal mass with specs of calcication, multiple mesentric lymph nodes and no liver metastasis. As the conservative management for 48 hours showed no improvement in symptoms, an emergency exploratory laparotomy was performed, and an intraluminal mass was identied from ileocecal junction causing obstruction with dilated loops of ileum and jejunum. Local resection of terminal ileum was performed and a side to side anastomoses was done using GI stapler. Histopathology showed diagnosis of neuroendocrine tumor

scholarly journals Imaging quiz: A child with multiple trauma

2018 ◽  
Vol 26 (1) ◽  
pp. 67-69
Author(s):  
Sercan Özkaçmaz
Keyword(s):  
Computed Tomography ◽  
Bone Fractures ◽  
Fluid Collection ◽  
Splenic Infarction ◽  
Careful Examination ◽  
Renal Infarction ◽  
Contrast Enhanced ◽  
Active Extravasation ◽  
Enhanced Computed Tomography ◽  
Contrast Enhanced Computed Tomography

Splenic and renal infarctions are embolic conditions which usually occur secondary to cardiac problems, thromboembolic systemic diseases, and infectious conditions such as sepsis. Trauma is a relatively rare cause of visceral infarctions. Traumatic segmental renal infarction associated with total splenic infarction is extremely rare. For detecting these visceral infarctions, contrast-enhanced computed tomography is essential, and a very careful examination is required for detecting very small infarctions and excluding total visceral infarctions. In isolated splenic or renal infarctions secondary to trauma, the common contrast-enhanced computed tomography findings are wedge-shaped or segmental hypodense areas in kidneys or spleen and rarely total visceral infarctions. Usually, intraperitoneal or retroperitoneal fluid collection which corresponds to bleeding from kidney or spleen is not seen in such cases. Also, the lack of evidence of active extravasation from renal/splenic arteries and pseudoaneurysm or dissection is an important finding of isolated traumatic splenic or renal infarctions. Because total infarctions can be misinterpreted in some cases, differences in density between intra-abdominal organs allowed by computed tomography must be carefully examined. Intestinal infarctions, the other abdominal injuries, pulmonary injuries, and pelvic or thoracic bone fractures usually accompany traumatic renal or splenic infarctions. In this report, we present contrast-enhanced computed tomography findings of a multitrauma pediatric case of traumatic total splenic and bilateral segmental renal infarction by reviewing the literature.

Erodes and bleeds, fistulises and obstructs: Bouveret’s syndrome

2020 ◽  
Vol 50 (4) ◽  
pp. 383-385
Author(s):  
Rinkal B Kakadiya ◽  
Uttam Thakur ◽  
Lileshwar Kaman ◽  
Harshal S Mandavdhare
Keyword(s):  
Gallstone Ileus ◽  
Outlet Obstruction ◽  
Bouveret’S Syndrome ◽  
Artery Pseudoaneurysm ◽  
Contrast Enhanced ◽  
Complications Of Cholelithiasis ◽  
Enhanced Computed Tomography ◽  
Bouveret's Syndrome ◽  
Contrast Enhanced Computed Tomography ◽  
Upper Gastrointestinal

One of the rare complications of cholelithiasis is gallstone ileus which occurs in <5% of patients. Among them, <3% develop Bouveret’s syndrome: gastric outlet obstruction by a large gallstone in the pylorus or duodenum. One large review of 128 patients showed it to present at a mean age of 74.1 ± 11.1 years with a mean gallstone size of 4.6 ± 1.5 cm, with nausea or vomiting in 86%, abdominal pain in 71% and haematemesis in 15%. The diagnosis is usually clear on oesophagogastroduodenoscopy or abdominal contrast-enhanced computed tomography. We present a case with massive upper gastrointestinal bleeding, due to erosion of a cystic artery pseudoaneurysm.

Gastric lipoma: a rare cause of massive haematemesis

2021 ◽  
Author(s):  
S Kumar ◽  
A Kumar ◽  
M Dayal ◽  
V Prakash
Keyword(s):  
Laparoscopic Resection ◽  
Outlet Obstruction ◽  
Haemodynamic Instability ◽  
Contrast Enhanced ◽  
Submucosal Lesions ◽  
Gi Bleed ◽  
Enhanced Computed Tomography ◽  
Gastric Lipoma ◽  
Contrast Enhanced Computed Tomography ◽  
Massive Haematemesis

Gastric lipomas are rare benign neoplasms of the stomach. These submucosal lesions and located mostly in the antral region of the stomach. Small lipomas are usually asymptomatic and are detected incidentally. When large, they may present with abdominal pain, gastrointestinal (GI) bleeding or gastric outlet obstruction. We hereby present a case of gastric lipoma in a 54-year-old man presenting with massive upper GI bleed and haemodynamic instability. The diagnosis was established with endoscopy and contrast-enhanced computed tomography of the abdomen. After resuscitation, the patient underwent laparoscopic resection of the antral lipoma.

scholarly journals Adrenal Angiomyolipoma with Gastric Outlet Obstruction

2017 ◽  
Vol 9 (3) ◽  
pp. 109-110 ◽  
Author(s):  
Richa Jaiman ◽  
Puneet K Srivastava
Keyword(s):  
Computed Tomography ◽  
Adrenal Gland ◽  
Gastric Outlet Obstruction ◽  
Adrenal Tumor ◽  
Outlet Obstruction ◽  
Epithelioid Cells ◽  
Pain Abdomen ◽  
Contrast Enhanced ◽  
Enhanced Computed Tomography ◽  
Contrast Enhanced Computed Tomography

ABSTRACT Angiomyolipoma is neoplasm that derives from perivascular epithelioid cells. It is a rare mesenchymal tumor, usually found in the kidney. Extrarenal angiomyolipoma is uncommon and the most common extrarenal site is the liver. Angiomyolipoma of adrenal is extremely rare, with only four cases reported in the literature. It usually presents as incidentaloma. We report a case of a 45-year-old female patient presenting with pain abdomen, nausea, and repeated episodes of vomiting. Contrast-enhanced computed tomography (CECT) abdomen revealed heterogeneous nonenhancing hypodense fatty lesion in right adrenal gland. Biochemical investigations were negative for functioning adrenal tumor. Right adrenalectomy was done with good outcome. Diagnosis was confirmed by histopathology. The patient recovered without any complications following surgery. How to cite this article Srivastava PK, Jaiman R. Adrenal Angiomyolipoma with Gastric Outlet Obstruction. World J Endoc Surg 2017;9(3):109-110.

scholarly journals A study of surgical outcome of necrotizing pancreatitis

2017 ◽  
Vol 5 (1) ◽  
pp. 305
Author(s):  
Bhondave Suraj Tukaram ◽  
Niranjan Dash ◽  
V. J. Thipse ◽  
J. M. Gadekar
Keyword(s):  
Conservative Management ◽  
Death Rate ◽  
Necrotizing Pancreatitis ◽  
Timing Of Surgery ◽  
The Other ◽  
Conservative Approach ◽  
Medical College ◽  
Contrast Enhanced ◽  
Enhanced Computed Tomography ◽  
Contrast Enhanced Computed Tomography

Background: Increasing understanding and literature regarding the management of Necrotizing Pancreatitis has laid paths for surgical and conservative management. Although a conservative approach is increasingly used, this study depicts the importance of surgical management in today’s era. The objective was to evaluate the surgical role in patients of documented Necrotizing Pancreatitis, with or without organ failure and debilitating symptoms by putting conservative management on a complementary part.Methods: Sixteen consecutive patients were reviewed with Necrotizing Pancreatitis managed at DVVPF’s Medical college and hospital, Ahmednagar between January 1, 2014, and July 1, 2017 documented by contrast-enhanced computed tomography (CECT).Results: Out of sixteen patients of Necrotizing Pancreatitis recruited for the study, 13 (81%) patients were surgically managed; among which death rate was 7%. Of the other 3(19%) patients which were conservatively managed, there was 1 (33%) death. Patient who died while conservative management would have been candidate for earlier surgical intervention.Conclusions: The results suggest that surgical approach can be applied successfully to manage most patients with Necrotizing Pancreatitis, still further evaluation being required for indication and timing of surgery.

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