Abdominal imaging
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The magnetic resonance imaging (MRI) differential diagnosis of intrahepatic biloma from intrahepatic subacute hematoma has been reported in two cases. The biloma was heterogenously intense on T1-weighted images and homogenously hyperintense on T2-weighted images. The hematoma was hyperintense on the both T1- and T2-weighted MR images. The clinical significance of this MRI difference is that intrahepatic biloma needs drainage, whereas intrahepatic hematoma can heal spontaneously.
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Dynamic barium radiology with cine- or video recording has been the most frequently used technique for assessing patients with pharyngeal dysphagia. Although the diagnostic yield of the barium swallow has been high, many patients with pharyngeal dysphagia have normal dynamic barium radiology and remain a diagnostic dilemma. Could manometry add important diagnostic information in these patients? ⋯ Solid-state computerized manometry is a useful adjunct to videoradiography and can provide potentially important additional information in the diagnosis of dysphagia patients.
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Case Reports
Emphysematous pyelonephritis with resultant emphysematous cholecystitis secondary to hematogenous dissemination.
Both emphysematous pyelonephritis and emphysematous cholecystitis are uncommon, but potentially fatal, clinical entities. The simultaneous diagnosis of these two entities in the same patient has not previously been reported. ⋯ Additionally, the unique circumstances of this case offer support for the proposal that emphysematous cholecystitis may often be secondary to hematogenous seeding/embolic phenomena rather than obstruction of the cystic duct. Prompt diagnosis is essential, as prompt intervention can minimize mortality and morbidity.
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Case Reports
Nonpalpable rectus sheath hematoma clinically masquerading as appendicitis: US and CT diagnosis.
Within a period of 5 years, we encountered three patients with a small rectus sheath hematoma, presenting with clinical signs of appendicitis. The rectus sheath hematoma was diagnosed by ultrasound (US) in all three cases and confirmed by computed tomography (CT) in two. ⋯ In patients who are sonographically examined for suspected appendicitis, the abdominal wall should be studied as well, to exclude a nonpalpable rectus sheath hematoma. In cases in which a hematoma is found, an unnecessary appendectomy can be prevented.
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The purpose of this study was to determine the magnetic resonance (MR) features of intrahepatic cholangiocarcinoma. ⋯ The typical MR appearance of intrahepatic cholangiocarcinoma is a large well-delineated nonencapsulated tumor associated with intrahepatic venous encasement.