[Extra-cardiac findings on coronary computed Tomography scanning]. / Anomalies extra-cardiaques de découverte fortuite en coroscanner.

BACKGROUND: Multi-detector-row computed tomography (MDCT) has emerged as method for non-invasive imaging of the heart. AIM: To investigate the frequency of the non cardiac findings in cardiac imaging with MDCT. METHODS: A total of 191 patients underwent cardiac imaging with 64-slice MDCT over a period of 8 months. The detected abnormalities were classified in major (implying an immediate workup and treatment or at least a further investigation) and minor abnormalities. RESULTS: Extra cardiac abnormalities were detected on 69 examinations (36 %). Major abnormalities were found in 17 % of the patients, and the minor abnormalities in 25,6 %. The scan revealed 4 cases of lung carcinomas, all at a still surgical stage. CONCLUSION: There were a significant number of non cardiac findings in cardiac MDCT. To avoid missing clinically important findings, we should carefully evaluate all the organs included in the scan.

[Management of blunt duodenal and pancreatic injuries in children (about a series of 8 cases)]. / Prise en charge des traumatismes fermés du bloc duodéno- pancréatique chez l'enfant (a propos d'une série de 8 cas).

AIM: The aim of this retrospective study is to report eight cases of blunt duodeno-pancreatic trauma in infants, emphasizing on the role of imaging in acute assessment of the lesions and in further management. METHODS: We reported eight cases of duodeno-pancreatic injuries between 2006 and 2008, 5 boys and 3 girls with an age ranging from 3 to 12 years (median age: 7 years). Trauma circumstances were: car accident (n=2), domestic injury (n=5) and bicycle's fall injury (n=1). All patients underwent abdominal ultrasonography and CT scan in the initial evaluation and during the follow-up. RESULTS: Imaging showed the following pancreatic lesions: 3 corporeal fractures, 2 caudal fractures and one between the corporeal and the caudal portions. Four pancreatic haematomas were found. The associated lesions were duodenal, splenic, hepatic and renal. Two isolated duodenal haematomas were found. Two patients improved spontaneously, the six others developed complications: 4 acute pancreatitis, two infections, 3 pseudocysts and one retroperitoneal collection. Management was chirurgical in one case, medical in two cases, endoscopic in 2 cases and three percutaneaous drainages were performed. CONCLUSION: Blunt duodeno-pancreatic injuries in children have to be evaluated by an early imaging modality, in order to perform acute assessment of the lesions. Primary conservative treatment is advocated while clinic, biologic and imaging follow-up is required to detect complications, which management can be endoscopic, percutaneous or surgical.