RESUMEN
Malrotation is part of a spectrum of small and large bowel positional and fixational abnormalities caused by the failure of the fetal intestine to complete a 270-degree rotation around the superior mesenteric artery axis. Rarely, it presents in the adult as a cause of acute small bowel obstruction. Chronic symptoms of malrotation in adults are subtle, and include intermittent abdominal pain, nausea and vomiting. We present two cases of malrotation in octogenarian men presenting acutely with small bowel obstruction. Both patients were treated with emergency surgery. In one case the chronic symptoms resolved postoperatively. Malrotation and midgut volvulus should be considered as a rare differential diagnosis for small bowel obstruction in adults. Suspicions should be increased when there is a history of recurrent presentations with similar symptoms.
Asunto(s)
Obstrucción Intestinal/cirugía , Vólvulo Intestinal/congénito , Intestino Delgado/cirugía , Anciano de 80 o más Años , Estreñimiento/etiología , Humanos , Obstrucción Intestinal/diagnóstico por imagen , Obstrucción Intestinal/etiología , Vólvulo Intestinal/diagnóstico por imagen , Vólvulo Intestinal/cirugía , Intestino Delgado/diagnóstico por imagen , Masculino , Náusea/etiología , Periodo Posprandial , Tomografía Computarizada por Rayos X , Resultado del Tratamiento , Vómitos/etiologíaRESUMEN
A 60-year-old male was admitted with massive upper gastrointestinal bleeding following a gastric biopsy. Repeat gastroduodenoscopy failed to identify the source. Angiography identified bleeding from an arteriovenous malformation at the fundus of the stomach. This was controlled by embolisation.
Asunto(s)
Malformaciones Arteriovenosas/complicaciones , Embolización Terapéutica/métodos , Hemorragia Gastrointestinal/etiología , Angiografía/métodos , Malformaciones Arteriovenosas/diagnóstico por imagen , Malformaciones Arteriovenosas/terapia , Biopsia/efectos adversos , Endoscopía Gastrointestinal , Fundus Gástrico/irrigación sanguínea , Fundus Gástrico/patología , Hemorragia Gastrointestinal/terapia , Hematemesis/etiología , Humanos , Masculino , Melena/etiología , Persona de Mediana EdadRESUMEN
Ovarian cysts autoamputation is an extremely rare complication. All reported cases were removed by laparotomy. A successful laparoscopic removal is presented.
Asunto(s)
Laparoscopía , Quistes Ováricos/complicaciones , Quistes Ováricos/cirugía , Femenino , Humanos , Recién NacidoRESUMEN
Tc-99m labeled red blood cell scintigraphy is a valuable, noninvasive technique for differentiating hepatic hemangioma from other lesions by demonstrating a "perfusion blood pool mismatch." The characteristic finding on dynamic CT scan of peripheral and subsequent central enhancement is not usually seen on Tc-99m RBC angiography, probably due to rapid mixing and dilution of the radionuclide and low resolution of the gamma camera. A case of multiple hepatic hemangioma is presented in which Tc-99m RBC dynamic angiography demonstrated peripheral enhancement with subsequent central filling. In addition, delayed static images showed more hepatic lesions.
Asunto(s)
Hemangioma/diagnóstico por imagen , Neoplasias Hepáticas/diagnóstico por imagen , Neoplasias Primarias Múltiples/diagnóstico por imagen , Adulto , Eritrocitos , Humanos , Hígado/diagnóstico por imagen , Masculino , Radiografía , Cintigrafía , TecnecioRESUMEN
The carotid angiographic studies performed in a teaching hospital (King Khalid University Hospital, Riyadh) in Saudi Arabia were reviewed, and the incidence of lesions demonstrated was analysed. Intracranial tumours accounted for 50% of the lesions, with meningiomas being 40%, whilst arteriovenous malformations accounted for 5.9% of lesions. It was noted that the incidence of atherosclerosis and arteritis was low, and the examination was almost without complications. Some lesions supplied by vertebral arteries were missed. In view of this, vertebral angiography is advocated in those cases with suspected supratentorial tumour especially when the carotid angiograms are normal.
Asunto(s)
Angiografía/normas , Encefalopatías/diagnóstico por imagen , Arterias Carótidas/diagnóstico por imagen , Adolescente , Adulto , Anciano , Angiografía/métodos , Encefalopatías/epidemiología , Encefalopatías/patología , Niño , Preescolar , Femenino , Hospitales de Enseñanza , Humanos , Incidencia , Lactante , Recién Nacido , Masculino , Persona de Mediana Edad , Arabia Saudita/epidemiología , Tomografía Computarizada por Rayos XRESUMEN
A detailed radiologic and anatomic study of one horseshoe lung syndrome has already been published from this centre. A further case of horseshoe lung, which was also diagnosed prospectively by radiology, is described. Alongside, this is a set of a group of three conditions: we describe a right accessory lung with a peculiar feeding arterial branch originating from the left basal pulmonary artery. The bronchogram and oesophagogram of this case were normal. The other is a case of bridging bronchus where the left lower lobe bronchus originates from the right main stem bronchus. This was discovered at post mortem bronchogram performed on a 19 weeks foetus. Finally, in the dog, we found that the pulmonary angiogram and bronchogram display close similarity to human horseshoe lung though the dog has two separate lungs. The common denominator of all above cases is the presence of a pulmonary arterial branch or bronchus crossing the midline from the ipsi to the contralateral side. Therefore, it may be concluded "in contradiction to the common belief" that pulmonary angiography or bronchography alone is not sufficient for the diagnosis of horseshoe lung. When only one of these investigations is available, computerized tomography is necessary to show the isthmic lung tissue before the diagnosis of horseshoe lung is confirmed.
