[Acute abdomen in pediatric roentgenology (author's transl)]. / Akuut abdomen in radiopediatrie.

In vue of the successes of modern surgery, correct roentgenology in acute abdominal conditions of the infant and child is of utmost importance. History is very incomplete in children so that the most crucial question is when and how should X-ray investigation start? The answer is difficult to provide because of the necessity of early surgery which, in addition can be hindered by an unnecessary roentgenography. Often this cannot be repeated because of worsening in the patient's condition. Knowledge of specific pathology and of congenital malformations is necessary. One must be careful in using contrast medium in acute abdomens as it may worsen the situation. Hypertonic solutions can heavily modifie the fluid and electrolyte balance, especially in dehydrated children. Technical aspects deserve attention, for instance for treatment of invagination, or in congenital megacolon. The authors illustrate these problems with a few cases.

CT of the heel and midfoot.

The authors stress the importance of CT examination in certain pathologic conditions of the heel and midfoot. In this region the bone structures form complicated articulations which can be affected by a number of disorders. This study (43 cases) includes the normal CT images of the heel and midfoot and an illustration of the various pathologic conditions encountered in this region: heel traumata (18 cases), bone tumors (4 cases), congenital coalitions (5 cases), and some inflammatory and soft tissue disorders (12 cases). Depending on the clinical aspect a coronal and/or axial incidence with fine slice technique and adapted bone or soft tissue algorithm was chosen. Especially traumatic lesions and congenital coalitions can benefit from better therapy if a good visualisation is obtained. In uneasy instances, CT provides additional information.

Adrenal cortical carcinoma: a case report.

We present a case of adrenocortical carcinoma. Excretory urography and sonography revealed a left adrenal mass, which was confirmed by computer tomography and further delineated by arteriography. Complete surgical resection was possible. A summary of the clinical and radiological data is included.

Klatskin tumors: radiological and imaging findings in eleven patients.

A retrospective study of 11 patients with Klatskin tumor is presented. The series includes 3 men and 8 women with a mean age of 71 years (range: 61-84 years). Histologic examination revealed a well-differentiated cholangiocarcinoma in 7 cases, an undifferentiated type in 3 and a sclerosing type in one. Ultrasound plays an increasing role in setting a directive diagnosis. Preoperative localisation of the tumor and status of the intrahepatic bile ducts are best depicted with cholangiography. CT findings are non specific, but are useful for an adequate pre- and post-treatment staging.

[Appendicitis: advantages of US and CT in aspecific clinical and radiological findings]. / Appendicitis: voordelen van US en CT in aspecifieke klinische en radiologische bevindingen.

We present the case of a 23-year-old woman with atypical clinical and radiological findings of subacute appendicitis. When abdominal plain film and contrast medium enema examination show atypical findings and ultrasound results are uncertain, CT should be considered. CT after peroral and intravenous contrast administration can confirm or exclude the diagnosis of suspected appendicitis showing the possible presence, location and degree of inflammation, phlegmon and abscess masses.

Spinal meningeal cyst.

A case of meningeal cyst of the spine in the thoraco-lumbar region is described. Although water-soluble myelography may disclose a filling defect and possibly reveal communication between the cyst and the subarachnoid space, computerized tomographic myelography more readily reveals communication between the cyst and the subarachnoid space. This finding allows accurate diagnosis of a spinal meningeal cyst and rules out other mass lesions. A classification comprising three categories is made: spinal extradural meningeal cysts without spinal nerve root fibers (Type I), spinal extradural meningeal cysts with spinal nerve root fibers (Type II) and spinal intradural meningeal cysts (Type III). Final characterization is based on operative inspection and histological examination.

Abdominal cystic lymphangioma. A case report and a review of the literature.

Authors report a case of cystic lymphangioma of the mesenterium. The embryology and the histology are important to explain the radiological findings. To make the differential diagnosis with other cystic abdominal tumors it is very important to compare the radiological findings with other clinical symptoms.