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While the Revised Atlanta Classification outlines the primary complications of acute pancreatitis, it is crucial to recognize additional factors that contribute to morbidity and mortality associated with acute pancreatitis. In this review, we discuss the imaging-based classification and staging of acute pancreatitis as described by the Revised Atlanta Classification, but also provide a comprehensive understanding of the pancreatic anatomy and its relation to surrounding structures, which is essential for imaging-based assessment of both acute pancreatitis and its complications. We further extend the discussion beyond common complications such as pseudocysts and walled-off necrosis to include lesser-known but significant complications such as peripancreatic infection, disconnected ductal disconnection syndrome, thrombosis, hemorrhage, and gastrointestinal complications. Additionally, illustrative examples are presented to highlight relevant points pertaining to real-life imaging assessment of acute pancreatitis and its complications.
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Abstract Ischemic strokes secondary to occlusion of large vessels have been described in patients with COVID-19. Also, venous thrombosis and pulmonary thromboembolism have been related to the disease. Vascular occlusion may be associated with a prothrombotic state due to COVID-19-related coagulopathy and endotheliopathy. Intracranial hemorrhagic lesions can additionally be seen in these patients. The causative mechanism of hemorrhage could be associated with anticoagulant therapy or factors such as coagulopathy and endotheliopathy. We report on cases of ischemic, thrombotic, and hemorrhagic complications in six patients diagnosed with SARS-CoV-2 infection. Chest computed tomography (CT) showed typical SARS-CoV-2 pneumonia findings in all the cases, which were all confirmed by either serology or reverse transcription polymerase chain reaction (RT-PCR) tests.
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Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Tromboembolia/complicações , COVID-19/complicações , Diagnóstico por Imagem/métodos , AVC Isquêmico , HemorragiaRESUMO
Abstract Background Lung ultrasound (LUS) can detect interstitial alveolar changes confined to the subpleural region, like those described in Covid-19. Objetive To evaluate how LUS findings correlate with chest computed tomography (CT) in patients admitted to the emergency department (ED) with suspicion of Covid-19. Methods Cross-sectional study of 20 patients (median age 43 years; interquartile range, 37-63 years; 50% male). All patients underwent LUS and chest CT on the day of ED admission. Each hemithorax was divided into 6 segments with similar landmarks, and equivalent scores (sc) of lesion severity were defined for both methods. The number of affected segments on LUS (LUSseg) was divided into tertiles (0-1, 2-5, and ≥6), and compared with number of affected segments on CT (CTseg), LUSsc, CTsc, and percentage of affected lung parenchyma through visual analysis (CTvis). ANOVA or Kruskal-Wallis test for continuous variables, chi-square test for categorical variables, and receiver operating characteristic (ROC) curve analysis to define optimal cutoff points were performed. P<0.05 was considered statistically significant. Results Median LUSsc, CTsc, CTseg, and CTvis were significantly different between groups. A clear separation between groups was demonstrated; patients with <2 affected segments on LUS were defined as low risk. The ROC curve showed good discriminative power to predict ≥6 affected segments on CT, with an area under the curve (AUC) of 0.97 and 0.98 for >7 LUSsc and >3 LUSseg, respectively. Conclusion LUS findings correlate with chest CT, and can help identify patients with normal lung or minor pulmonary involvement secondary to Covid-19. Int J Cardiovasc Sci. 2020; [online].ahead print, PP.0-0
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Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios X/métodos , Ultrassonografia/métodos , Estudos Transversais , Triagem/métodos , Serviço Hospitalar de Emergência , COVID-19/diagnósticoRESUMO
BACKGROUND: The advent of antiretroviral therapy increased the life expectancy of human immunodeficiency virus (HIV)-positive patients and, consequently, the morbidity and mortality due to neoplasms. Plasmablastic lymphoma is one such neoplasm that generally presents with involvement of the oral cavity; cases of extra-oral involvement are rare. CASE REPORT: We report a case of plasmablastic lymphoma in a 46-year-old woman for whom the initial clinical manifestation was a painless perineal tumor accompanied by fecal incontinence. CONCLUSIONS: The possibility of this neoplasm should be considered in patients with HIV/acquired immune deficiency syndrome (HIV/AIDS) because its early diagnosis is essential so that the start of the treatment is not delayed.
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Neoplasias do Ânus/diagnóstico , Infecções por HIV/complicações , HIV , Neoplasias de Plasmócitos/diagnóstico , Neoplasias do Ânus/complicações , Biópsia , Diagnóstico Diferencial , Feminino , Humanos , Linfoma Relacionado a AIDS/diagnóstico , Imageamento por Ressonância Magnética , Pessoa de Meia-Idade , Neoplasias de Plasmócitos/complicaçõesRESUMO
Os autores descrevem o caso de uma paciente jovem com amenorreia primária e caracteres sexuais secundários normais. A investigação diagnóstica constatou a ocorrência da síndrome de Mayer-Rokitansky-Kuster-Hauser.
The authors describe the case of a young female patient with primary amenorrhea and normal secondary sexual characteristics. The diagnostic investigation demonstrated the occurrence of Mayer-Rokitansky-Kuster-Hauser's syndrome.