Erratum to 'Pancreas divisum causing recurrent pancreatitis in a young patient: A case report' [Radiology Case Reports 18 (2023) 3535-3538].

[This corrects the article DOI: 10.1016/j.radcr.2023.07.028.].

Pancreas divisum causing recurrent pancreatitis in a young patient: A case report.

Pancreas divisum (PD) is the most common congenital variant of the pancreatic ductal system, in which only a few patients develop symptomatic disease. Overall, PD is an underrecognized cause of many cases of recurrent acute pancreatitis. The PD must be systematically suspected in case of multiple episodes of acute idiopathic pancreatitis when exhaustive etiological investigations are negative. We present a 37-year-old woman whom presented several previous pancreatic pains. She came to the emergency department for epigastric pain, accompanied by post-prandial dietary vomiting after a copious meal. Lipasemia was greater than 3 times normal (498 UI/L). An abdominal computed tomography (CT) and magnetic resonance cholangiopancreatography (MRCP) showed a PD. The patient improved after the initial management measures. An endoscopic cholangiopancreatography was planned after the resolution of the acute episode. Recurrent pancreatitis is defined as 2 or more episodes of distinct acute pancreatitis with more than 3 months between episodes. Patients with this condition are usually asymptomatic while 5% of patients develop acute pancreatitis or chronic pancreatitis. We can underline the interest of deepening the radiological and endoscopic investigations to make the diagnosis of PD and to propose an endoscopic or surgical treatment, in order to avoid recurrences.

Renal artery pseudoaneurysms post percutaneous nephrolithotomy: A case report.

Percutaneous Nephrolithotomy (PCNL) is a standard, safe and efficient method for removing large renal calculi. This pathology is associated with a risk of life-threatening Iatrogenic Renal Vascular Injuries, such as pseudoaneurysm (1%-3%). We report the case of a 49 old year male patient with Hematuria post PCNL for renal calculi. Computed tomography renal angiography was indicated which showed a pseudoaneurysm in the lower pole of the left kidney confirmed by digital subtraction angiography. Super selective endovascular embolization was successfully performed with conservation of the left-over vascularization of the kidney. No postoperative complications were seen. We aimed to report this case and to review the literature regarding endovascular management of kidney pseudoaneurysms after PCNL.

Gastrointestinal stromal tumor of the small intestine with lung metastasis.

Gastrointestinal stromal tumours (GISTs) represent 1% of primary gastrointestinal cancers. These tumors most frequently metastasise to the liver and peritoneum and rarely to the lungs. We report the case of a 79-year-old woman with gastrointestinal stromal tumor of the small intestine and pulmonary metastases. Contrast-enhanced computed tomography (CT) revealed a focal mass centered around the last intestinal loop associated with pulmonary bilateral masses. The diagnosis of gist of the small bowel was confirmed by histopathological and immunohistochemical analyses of bioptic material obtained from CT guided biopsy of pulmonary lesions. To the best of our knowledge, only few cases had been reported in medical literature as This mode of presentation is unusual, with computed tomography (CT) playing a significant role in the diagnosis and management.

Gallstone ileus: An unusual cause of intestinal obstruction.

Gallstone ileus is an infrequent cause of intestinal obstruction. It is typically the result of cholecystoduodenal fistula, computed tomography scan is the best modality for the diagnosis. Surgical removal of the gallstone is the pillar of treatment to relieve intestinal obstruction. We report the case of a 77-year-old male with features of a small bowel obstruction. Computed tomography scan of the abdomen showed pneumobilia, a cholecystoduodenal fistula, and small bowel obstruction features suspicious for gallstone ileus. The patient had a laparotomy and removal of two gallstones via an enterotomy without postoperative complications.

Cerebral fat embolism syndrome after long bone fracture: A case report.

Cerebral fat embolism is a rare and potentially fatal condition that may occur following a long bone fracture. Its characterized by respiratory, neurological, and mucocutaneous signs. Isolated severe brain syndrome remains exceptional. We report a 21-year-old male patient admitted for the cerebral manifestation of a fat embolism syndrome due to a fracture of long bone after a traffic accident injury. Neurological deterioration after a free interval was seen with generalized tonic-clonic seizures. MRI of the brain was indicated which showed numerous multifocal hyperintensities involving the deep white matter of both hemispheres producing a "starfield" appearance. This pattern of cytotoxic cerebral edema, with lesions in the white matter rather than the grey matter, is indicative of the subacute stage of fat embolism. The patient was treated with comprehensive support in the intensive care unit, he returned to normal neurological function and was discharged after 3 weeks of hospitalization.

Metastatic rectal gastrointestinal stromal tumor with intestinal obstruction: A rare case report.

Gastrointestinal stromal tumors (GISTs) arising from the rectum are rare. We report the case of an aggressive rectal gastrointestinal stromal tumor (GIST) in a 60-year-old female that presented for symptoms of constipation and lower gastrointestinal bleeding. Upon rectal examination, a hard mass was found at 6cm from the anal marge. An MRI was indicated that shows a well-demarcated lesion originates from the distal rectum with exophytic growth and central necrosis. The diagnosis of rectal gist was confirmed by colonoscopy with biopsy and immunohistochemical analyses of bioptic material. Liver metastases were seen on computerized tomography (CT). She was referred for palliative chemotherapy. The patient had suffered from intestinal obstruction three weeks after his initial presentation and passed away shortly thereafter. We aimed to report this case as an aggressive and rare GIST localization.

A Fatal Case of Strangulated Pericecal Hernia.

Pericecal hernia, a subtype of internal hernia, is a rare and unusual cause of small-bowel obstruction (SBO). We report the case of a pericecal hernia in an 80-year-old woman who presented to the emergency department with symptoms of SBO. She experienced colicky diffuse abdominal pain associated with vomiting and obstipation for over five days. Abdominal examination showed rebound tenderness in the right iliac fossa without any mass palpation. Computed tomography noted a "sac-like" structure in the right iliac fossa with dilated and ischemic small-bowel loops within. Exploratory laparotomy showed strangulated pericecal hernia and non-viable small bowel loops in the inferior ileocecal recess. Extensive resection and defect repair followed by small-bowel end-to-end primary anastomosis was made. After two days of ICU admission, patient died from septic shock. This case report highlights the need for prompt diagnosis, followed by surgical intervention to lower mortality of SBO of internal hernia origin, especially in cases where no previous surgery is noted.

Hemorrhagic Shock Revealing Rupture of Splenic Artery Pseudoaneurysm Three Years After Post-Traumatic Pancreatitis.

Splenic artery pseudoaneurysm (SAP) is an uncommon entity but extremely serious, given the high mortality rate if untreated. Only a limited literature reports association with post-traumatic pancreatitis. We report the case of a 30-year-old man, who was brought to the emergency department (ED) for acute confusion. His past medical history includes trauma of right hypochondriac and epigastric regions, three years ago. Three days before his admission to the hospital, he experienced abdominal pain with nausea and vomiting, without transit disorders or fever. When examined, the patient was disoriented, pale with profuse sweating, cold extremities, and a temperature of 36.3°C. Blood pressure was 75/51 mmHg, heart rate was 126 beats per minute, and oxygen saturation was 96% on room air. The abdominal exam detected generalized abdominal sensitivity. A CT angiography of the abdomen revealed hemoperitoneum of medium abundance, with extravasation of the contrast product from the splenic artery. The size of the spleen was normal with a lower polar hypodense area. In addition, a pancreas of normal size, steady outlinings, seat of bilobed cystic formation suggested a pancreatic pseudocyst. This led us to suspect a rupture of a pseudoaneurysm of the splenic artery. A laparotomy was performed and showed an estimated 2 L hemoperitoneum. Active bleeding was noted from an SAP in the mid-portion of the splenic artery, next to the pancreatic pseudocyst. Ligation of the splenic artery and splenectomy was carried out. The patient was discharged home on the 10th post-operative day. Our case highlights an uncommon cause of hemorrhagic shock, but critical to recognize. Indeed, ruptured SAP needs to be promptly detected and managed, to avoid fatal complications if left untreated.

[Hydrocele of the canal of Nuck detected during infertility evaluation: an atypical case report]. / Une hydrocèle du canal de Nuck découverte au cours d´un bilan d´infertilité: à propos d'un cas atypique.

Hydrocele of the canal of Nuck is a rare woman condition often detected during childhood. We here report a rare case of hydrocele detected in adulthood during infertility evaluation. The patient presented with chronic non painful right inguinal swelling. Imaging test demonstrated typical image of hydrocele of the canal of Nuck. The ultrasound found cyst formation with few thin septa and MRI did not find any communication with the peritoneum. The same imaging tests were performed which showed non-partitioned bicornuate uterus that could fall under the framework of infertility evaluation. The main purpose of this study was to report the typical imaging features of hydrocele of the canal of Nuck, which is a little known diagnosis that should be integrated into differential diagnoses of inguinal swellings in women.

Renal angiomyolipoma with renal vein extension.

Renal angiomyolipomas are uncommon benign tumors containing fatty tissue. Only a few cases of infiltrating angiomyolipomas have been reported. We aimed to describe a case of a 65-year-old woman presenting a peripheral angiomyolipoma of the left kidney with CT evidence of involvement of the renal vein. The lesion has been found incidentally during abdominal CT for an unrelated reason. The patient underwent surgical treatment considering the vascular extension of the lesion and the risk of thromboembolic complications. The pathological analysis confirmed the diagnosis of renal AML in the upper pole of the left kidney invading the renal vein without malignancy.No post-operative complications and the evolution was favorable.

Anal Cancer with Atypical Brain and Cranial Bones Metastasis: About 2 Cases and Literature Review.

Canal anal cancer is a rare tumor that accounts for 2% of all colorectal neoplasms, with a low propensity for metastasis. The spread of anal squamous cell carcinoma to the brain is exceedingly rare and has been previously reported only 5 times in the medical literature. However, the first and only case of cranial bone metastasis from anal canal carcinoma was described in 2019. The purpose of this article is to add our cases to the limited literature for the management of metastatic anal cancer. The current study presents 2 cases of patients diagnosed with squamous cell carcinoma of the anal canal how underwent chemo and radiotherapy. Despite the treatment our patients developed neurological symptoms, cerebral magnetic resonance imaging showed brain lesions for the first case, and cranial bones metastasis for the second one, histopathology confirmed these lesions to be a poorly differentiated squamous cell carcinoma, consistent with the known primary tumor of the anal canal. Unfortunately, both patients succumbed quickly to systemic complications of the disease during these treatments. Despite its rarity, brain metastasis should be considered in any patient with a history of anal cancer presented neurological symptoms.

Recurrent costovertebral hydatidosis with epidural extension.

Osseous echinococcosis is a relatively rare entity and that of the rib is even rare. Few cases of costal echinococcosis have been reported in the literature so far. We report a case of a recurrent costovertebral hydatidosis with epidural extension in a 49-year-old man who presented with paraparesis and back pain. MRI of the dorsal spine was performed. The imaging features were suggestive of echinococcosis involving the rib and vertebrae with epidural extension. This diagnosis was confirmed histopathologically after surgical treatment. The evolution was marked by the reappearance of the same symptoms due to recurrence. The prognosis of costovertebral hydatidosis is gloomy despite radical surgical treatment due to the frequency of recurrences. This case highlights the role of MRI for the diagnosis and follow-up of patients after treatment.

Chondrosarcoma of the parapharyngeal space: Case report and literature review of an extremely rare location.

Chondrosarcoma of the head and neck region is a rare disease, representing approximately 0.1% of all head and neck neoplasms. Parapharyngeal location is extremely rare and low-grade ones are even rarer. Surgery alone or followed by adjuvant radiotherapy is the treatment of choice. In this article, we report a case of a 67-year-old male with low-grade parapharyngeal chondrosarcoma who presented with a 3-month history of dysphagia. A cervical magnetic resonance imaging was performed that shows a well-defined mass located at the right parapharyngeal space, causing medial deviation of the mucosal space. Surgical resection of the tumor without neck dissection followed by adjuvant radiotherapy was undertaken with a favorable response. The purpose of this article is to add our case to the limited literature for good management of parapharyngeal chondrosarcomas.

Ansa pancreatica: a rare cause of acute recurrent episode in chronic pancreatitis.

Ansa pancreatica is a rare anatomic variation of pancreatic ducts. It is a predisposing factor of recurrent pancreatitis. In this case report, we describe a case of a 24-year-old male suffering from an ansa pancreatica with a non-patent major papilla, diagnosed on magnetic resonance cholangiopancreatography (MRCP).The ansa pancreatica was revealed by an episode of acute pancreatitis attacks in chronic pancreatitis. Endoscopic retrograde cholangiopancreatography (ERCP) confirmed important abrupt dilation in the main pancreatic duct with an ansa loop in the pancreatic duct in the head of the pancreas, and a sphincterotomy of the minor papilla was performed. The procedure was difficult and the placement of a long-term pancreatic stent during the ERCP was impossible, thus a surgical pancreatico-jejunostomy was proposed as a treatment of an ansa pancreatica with a non-patent major papilla.

Curvilinear pericallosal lipomas diagnosed incidentally during evaluation following trauma with corpus callosum abnormalities in two patients.

Pericallosal lipomas are the most habitual location for an intracranial lipoma. They are fat-containing lesions arising from the interhemispheric fissure intimately related to the corpus callosum, which is often abnormal. They originate from aberrant differentiation of the persistent primitive meninx. Most Pericallosal lipomas are asymptomatic and come into clinical attention during neuroradiological investigations for other conditions. MRI is the modality of choice to characterize not only the extent of the lipoma but also the frequently associated agenesis/dysgenesis of the corpus callosum. Pericallosal lipomas can be divided into two groups: The Tubulonodular type and The curvilinear type. Curvilinear lipomas are less common than Tubulonodular. We report the clinical and radiological findings of curvilinear Pericallosal lipoma in two patients with corpus callosum abnormalities revealed incidentally during evaluation following trauma.

Clinical and radiological resolution of vertebral sarcoidosis mimicking metastatic disease.

Sarcoidosis is a disease that exhibits extreme heterogeneous clinical manifestations. Bone involvement in sarcoidosis is rare (1%-13%), and involvement of the vertebrae is even rarer. Usually, it is a diagnosis of exclusion with nonspecific characteristics in imaging. A 35-year-old male, who has no significant medical history£. He came to clinical examination for lower back and associated bilateral lower extremity pain. Magnetic resonance imaging (MRI) was performed to exclude disc-related pathology. It demonstrates left paramedian lumbar disc herniation at L4-L5 level. Multiple small enhancing lesions throughout the lumbar vertebrae were discovered as an incidental finding. An 18F-labeled fluorodeoxyglucose was performed to evaluate for metastatic disease that shows hypermetabolic apical right nodule of the lung parenchyma with multiple mediastinal and right iliac external adenopathy. Increased uptake throughout the lumbar vertebral lesions was also seen. A CT-guided biopsy of the right apical lung nodule and one of the vertebral lesions (L3) revealed noncaseating granulomas consistent with sarcoidosis. We introduce steroid treatment with favorable evolution of vertebral lesions. Vertebral sarcoidosis cannot be certainly differentiated from metastatic disease based on imaging only. Accurate diagnosis is only attainable by histopathological verification of the lesions.