Radiology case reports
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Hepatic portal venous gas, while a rare finding with a classically poor prognosis, is not always fatal. Mortality varies depending on the underlying etiology; bowel ischemia carries the highest mortality rate. Other etiologies include gastrointestinal obstruction, gastric ulcer, infectious processes (intraperitoneal abscess and gastroenteritis), inflammatory processes (ulcerative colitis, Crohn disease, chemotherapy-induced), and complications from endoscopic procedures. We report a case of a 68-year-old woman who presented with a week-long history of diminished intake, nausea, and vomiting, with unremarkable abdominal examination, who was found to have significant portal venous gas that completely resolved within 16 hours without surgical intervention.
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Radiology case reports · Oct 2020
Case ReportsPosterior reversible encephalopathy syndrome with Lilliputian hallucinations secondary to Takayasu's arteritis.
Posterior Reversible Encephalopathy Syndrome (PRES) is a rare complication of Takayasu's Arteritis. A 54-year-old, right-handed woman presented with Lilliputian visual hallucinations, postprandial abdominal pain, blurred vision and headaches. She then had a tonic-clonic seizure. ⋯ Risk factors for PRES include; pregnancy, immunosuppression, renal disease, hypertension and rheumatological disorders. Vasogenic oedema in affected lobes, most often occipital, is characteristic of PRES on neuroimaging. Prompt treatment of PRES can avoid catastrophic consequences such as death and can achieve complete resolution of symptoms and imaging abnormalities.
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Radiology case reports · Oct 2020
Case ReportsIdentification of perforated appendicitis within a right inguinal hernia sac (Amyand's hernia) by emergency abdominal CT scan: A case report.
Amyand's hernia (AH) is a rare condition in which the vermiform appendix is herniated into the inguinal sac regardless of whether the appendix appears normal or is inflamed. Most cases of AH are diagnosed intraoperatively at the time of inguinal hernia repair as its clinical diagnosis is difficult, and the role of computed tomography (CT) and other diagnostic imaging has not been described well in the literature. We report the case of a 79-year-old female who presented to the emergency department with nonspecific symptoms of nausea, vomiting, and constipation. ⋯ Complicated appendicitis in an AH is a surgical emergency, and an accurate diagnosis is necessary for proper triage of patients and appropriate management. CT plays a significant role in revealing an unsuspected diagnosis of AH. Radiologists must be aware of this rare presentation of the appendix in an inguinal hernia sac and be familiar with AH subtypes.
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Radiology case reports · Sep 2020
Case ReportsClinical features and chest CT findings of 3 cases of 2019 novel coronavirus (COVID-19) pneumonia.
Since December 2019, a new type of acute respiratory disease caused by the 2019 novel coronavirus (COVID-19) appeared to Wuhan, China. Currently, positive of virus nucleic acid in respiratory or blood samples is the gold standard for the diagnosis of the disease, but the nucleic acid test may be false negative. Chest CT examination plays an important role in diagnosis of COVID-19 pneumonia. ⋯ Ground-glass opacities with consolidation, air bronchogram, vascular enlargement, and halo sign were found. In the early stages of COVID-19 pneumonia, the laboratory parameters may be normal, the nucleic acid test may be false negative. Chest CT examination may be helpful for diagnosis of COVID-19 pneumonia.
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Radiology case reports · Aug 2020
Case ReportsUndiagnosed aortoesophageal fistula causing intramural hematoma of the esophagus.
Aortoesophageal fistula (AEF) is a rare, but life-threatening cause of intramural hematoma of the esophagus (IHE). Typical clinical presentation of AEF includes midthoracic pain and sentinel hemorrhage followed by massive, often fatal, hematemesis, with the period between sentinel hemorrhage and massive hematemesis generally varying from hours to days. ⋯ The fistula and associated hematoma were initially mischaracterized on imaging, and went undiagnosed for approximately 2 weeks before being iatrogenically disrupted during endoscopy. Though this case was successfully treated, aortoesophageal fistulas are associated with a high mortality, and aortoesophageal fistula/intramural hematoma of the esophagus should always be considered in the differential of an esophageal mass.