RESUMO
In reference to the article by Láinez Ramos-Bossini AJ et al., recently published in your Journal, we would like to provide our experience regarding a probable causal association between pneumoperitoneum and pneumatosis intestinalis in patients affected by COVID-19 (1).
Assuntos
COVID-19 , Pneumatose Cistoide Intestinal , Pneumoperitônio , Humanos , Achados Incidentais , Pneumatose Cistoide Intestinal/complicações , Pneumatose Cistoide Intestinal/diagnóstico por imagem , Pneumoperitônio/diagnóstico por imagem , Pneumoperitônio/etiologia , SARS-CoV-2RESUMO
Here, we present the case of a 51-year-old male with pain in the right hypochondrium, jaundice, fever, chills and septic shock. A computed tomography (CT) scan showed a juxtapapillary diverticulum with inflammatory changes, which caused bile duct ectasia and left biliary radicals. We considered this to be a septic shock of a biliary origin due to the cholangitis associated with Lemmel syndrome, with signs of juxtapapillary diverticulitis.
Assuntos
Colangite , Diverticulite , Divertículo , Duodenopatias , Icterícia , Colangite/diagnóstico por imagem , Colangite/etiologia , Diverticulite/complicações , Diverticulite/diagnóstico por imagem , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
We report the case of a patient with acute exacerbation of chronic pancreatitis and he suffered an atraumatic splenic rupture. Splenic rupture not associated with trauma is a rare entity that can occurs in normal spleen (spontaneous) or damaged spleen (pathological). This entity may be associated with local inflammatory processes, such as pancreatitis. Ultrasound is a non-invasive technique which is used in unstable patients. CT is useful for making a diagnosis of extension in patients with hemodynamic stability. Atraumatic splenic rupture as a complication of chronic pancreatitis is an unusual disease that requires a high index of suspicion which allows us an early diagnosis because it is a treatable entity that compromises the patient's life.
Assuntos
Pancreatite Crônica/complicações , Ruptura Esplênica/etiologia , Alcoolismo/complicações , Humanos , Masculino , Pessoa de Meia-Idade , Pancreatite Crônica/diagnóstico por imagem , Ruptura Espontânea , Ruptura Esplênica/diagnóstico por imagem , Tomografia Computadorizada por Raios X , UltrassonografiaRESUMO
Extraarticular synovial osteochondromatosis is a very rare benign disease whose aetiology may be primary or secondary to pre-existing pathology or after trauma. The diagnosis can be made with plain radiography and CT, and MRI is necessary to evaluate the non-mineralized soft tissue component and assess extension. It must be confirmed with a pathological study by biopsy or resection. There is up to a 5% chance of malignant transformation. The treatment of choice for the extensive extra-articular form is surgery by open resection. The case presented illustrates an atypical form of secondary extraarticular OCS with multiple involvement of the leg, ankle and foot.
Assuntos
Condromatose Sinovial , Tornozelo/diagnóstico por imagem , Articulação do Tornozelo/diagnóstico por imagem , Condromatose Sinovial/diagnóstico por imagem , Humanos , Perna (Membro) , RadiografiaRESUMO
Extraarticular synovial osteochondromatosis is a very rare benign disease whose aetiology may be primary or secondary to pre-existing pathology or after trauma. The diagnosis can be made with plain radiography and CT, and MRI is necessary to evaluate the non-mineralized soft tissue component and assess extension. It must be confirmed with a pathological study by biopsy or resection. There is up to a 5% chance of malignant transformation. The treatment of choice for the extensive extra-articular form is surgery by open resection. The case presented illustrates an atypical form of secondary extraarticular OCS with multiple involvement of the leg, ankle and foot.
RESUMO
This article describes different types of vertebral fractures that affect the thoracolumbar spine and the most relevant contributions of the different classification systems to vertebral fracture management. The vertebral fractures types are based on the three columns model of Denis that includes compression, burst, flexion-distraction and fracture-dislocation types. The most recent classifications systems of these types of fractures are reviewed, including the Thoracolumbar Injury Classification and Severity score (TLICS) and the Arbeitsgemeinschaft für Osteosynthesefragen Spine Thoracolumbar Injury Classification and Severity score (AOSpine-TLICS). Correct classification requires a quantitative imaging approach in which several measurements determine TLICS or AOSpine-TLICS grade. If the TLICS score is greater than 4, or the AOSpine-TLICS is greater than 5, surgical management is indicated. In this review, the most important imaging findings and measurements on radiography, multidetector computed tomography (MDCT) and magnetic resonance imaging (MRI) are described. These include degree of vertebral wedging and percentage of vertebral height loss in compression fractures, degree of interpedicular distance widening and spinal canal stenosis in burst fractures, and the degree of vertebral translation or interspinous widening in more severe fractures types, such as flexion-distraction and fracture-dislocation. These findings and measurements are illustrated with schemes and cases of our archives in a didactic way.