Emergency radiology
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Emergency radiology · Jul 2009
Case ReportsHemorrhagic mesenteric cystic lymphangioma presenting with acute lower abdominal pain: the diagnostic clues on MR imaging.
A 32-year-old woman complained of acute lower abdominal pain. Computed tomography showed a complex multilocular cystic mass at the right adnexal region. Magnetic resonance imaging demonstrated the origin of the mass to be the small bowel mesentery. ⋯ The diagnosis of a hemorrhagic mesenteric cystic lymphangioma was confirmed at surgery and pathologic analysis. Cystic lymphangioma should be included in the differential diagnosis of acute abdominal pain. The detection of septal fat may be helpful in the diagnosis of cystic lymphangioma when it shows unusual radiological appearances.
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Emergency radiology · May 2009
Case ReportsLeft-sided perforated acute appendicitis in an adult with midgut malrotation: the role of computed tomography.
We report a case of left-sided perforated acute appendicitis in the patient with midgut malrotation. Embryology, clinical findings, and radiological presentation are discussed. Highly prevalent disease presents here in the unusual location and thus in the unusual presentation. The emergency room physician and radiologist should be aware of these unique clinical presentations so that appropriate surgical intervention may be initiated promptly.
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Emergency radiology · May 2009
Case ReportsRenewed endovascular repair for recurrent acute abdominal aortic aneurysm.
The aim of the study was to describe the successful endovascular management of a patient who was admitted urgently with a second episode of acute abdominal aortic aneurysm (AAA) 30 months after emergency endovascular abdominal aortic aneurysm repair (eEVAR) for a ruptured AAA. The patient, an 84 year-old male physician, presented with severe acute abdominal and back pain. ⋯ The patient is alive and well 6 months postoperatively. This case indicates the need for follow-up after eEVAR, but also that complications can be managed endovascularly.
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Emergency radiology · Mar 2009
Case ReportsAn unusual case of bronchial rupture--pneumomediastinum appearing 7 days after blunt chest trauma.
We present a case of bronchial disruption after blunt chest trauma, which is unusual because the pneumomediastinum on the chest radiograph was detected 7 days after the injury. The first day imaging methods of the thorax showed only the fractures of the first and third left rib without any complications. ⋯ This case shows that a finding of pneumomediastinum after blunt chest trauma should always merit further investigation of its cause, even in cases of postponed detection of pneumomediastinum and regardless of the absence of other indicators of tracheobronchial disruption. Although fiber-optic tracheobronchoscopy is considered a diagnostic golden standard, in this case, diagnosis was clearly confirmed by spiral CT scan, due to thin slices and continuous data acquisition.
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Emergency radiology · Mar 2009
Assessing potential spinal injury in the intubated multitrauma patient: does MRI add value?
The purpose of the study was to determine the role of magnetic resonance imaging (MRI) in intubated multitrauma patients with normal computed tomography (CT) in excluding unstable ligamentous injury to the cervical spine. A retrospective evaluation was done on those multitrauma patients admitted to the intensive care unit of a level 1 trauma centre who had normal single-slice helical CT cervical spine and underwent MRI for cervical spine clearance from 1/1/04 to 30/6/05. ⋯ Single-slice helical CT with sagittal reformats had a negative predictive value of 82% for discoligamentous injury and 100% for unstable injury. A normal single-slice helical CT with sagittal reformats of the cervical spine in intubated trauma patients excluded unstable injuries at follow-up cervical spine MR imaging.