Pseudoaneurysm and post-traumatic arteriovenous fistula in pulmonary artery branch: Case report and review of the literature.

Pseudoaneurysms of a pulmonary artery branch are a rare complication in cases of penetrating chest trauma. Other more frequent causes are secondary to infections or iatrogenesis. We present the case of a 16-year-old male patient who returns weeks after having sustained a stab wound to the chest, complaining of hemoptysis and chest pain. Imaging studies help detect and characterize a partially thrombosed pseudoaneurysm arising from the artery that supplies the anterior segment of the right upper lobe, with an associated post-traumatic pulmonary arteriovenous fistula. The patient was successfully treated with endovascular arterial embolization. Identifying this entity opportunely has an impact on the survival of this patient, avoiding risk secondary to massive bleeding by making an adequate treatment.

Sacral schwannoma: case report and review of the literature.

Schwannomas are tumors of the macroglia cells, most frequently localized to the brain, in the pontocerebellar angle. We present the case of a 53 year-old female patient who presented multiple times with diffuse abdominal pain and was initially diagnosed as having a complex right adnexal mass. Exploratory laparotomy found a retroperitoneal mass and later on, the presence of a sacral schwannoma was found, suspected initially on contrast magnetic resonance imaging of the abdomen and pelvis, and confirmed by means of lesional biopsy and histopathology. This is a rare and unusual presentation accounting for only 5% of this tumor location and poses a challenge for imaging diagnosis, directly impacting the approach to the patient and any future interventions. There are few reports in the literature about giant sacral schwannomas, but these tumors have been found to extend within the spinal space towards the vertebral space, even occupying part of the abdomen. Hence, the importance of recognizing the presence of this tumor as well as its imaging features.

Incidental finding of left vertebral artery agenesis: Case report.

Vertebral artery agenesis is a rare congenital malformation, with few reported cases in the literature and no epidemiological data in the world at this point in time. The importance of diagnosis lies in identifying a potential risk factor for future ischemic events of the posterior circulation, in particular in the young population. It is also important to determine the etiology of chronic headache of unexplained cause that could be attributed to this entity. The present case describes this finding in a 27-year-old female patient with no pathological history, with multiple stab wounds was brought to the emergency room of our hospital .During the study of whether the wounds caused had been penetrating to the neck, a CT angiography was performed. The CT documented an incidental finding of absent left transverse foramen of the cervical vertebrae, absence of the left vertebral artery from its origin in the ipsilateral subclavian artery and a single dolichoectatic right vertebral artery crossing the midline at the entrance to the foramen magnum.

Temporal superficial arteritis as differential diagnosis in patients with atherosclerotic changes due to advanced chronic renal disease: case report and review of the literature.

Giant cell arteritis is an autoimmune disease that affects medium and large caliber vessels, creating deposits of inflammatory clusters on the arterial wall. It is the most common form of large vessel vasculitis, but given the variability of biopsy efficiency and of other diagnostic strategies employed, the diagnosis of this disease is challenging. We report the case of a 69-year-old female patient who presented with neurological deficit and increased bilateral sensation in the temporal region associated with excruciating headache. Workup revealed calcification of the superficial temporal, vertebral and ophthalmic arteries, as well as suggestive findings on Doppler ultrasound such as the halo sign, pointing to superficial temporal arteritis though not excluding the possibility of those calcifications being consistent with atherosclerosis in a patient with advanced chronic renal disease, which has been reported as giving rise to false-positive results. Knowledge of the main differences between the 2 diagnoses is important, given the wide range of diagnostic imaging possibilities which can avoid the need for biopsy.

Infective Endocarditis Masked by Narrow Focus Thinking, Inadequate Physical Examination and Analgesic Medication.

It is important not to miss a diagnosis of infective endocarditis. It is fatal if untreated and most often successfully treatable if recognized. We report a classic case of subacute bacterial endocarditis with Osler nodes and Janeway lesions due to viridans streptococci from an oral source of poor dentition, infecting a presumably abnormal mitral valve. The diagnosis was missed repeatedly by multiple different clinicians over the course of seven months. Detailed analysis of this case suggests some of the pitfalls that led to the delay in diagnosis. The infective endocarditis was masked by analgesic medication, inadequate physical examination, and narrow focus thinking. The images of this case can serve as a reminder of the features of infective endocarditis. The detailed history and discussion can provide potential lessons in how to not miss the diagnosis of infective endocarditis.

Embarazo abdominal calcificado de 40 años de evolución, hallazgo incidental: Presentación de caso / Calcified Abdominal Pregnancy 40 Years of Evolution, Incidental Finding: a Case Report

Debido a la baja incidencia de embarazos ectópicos abdominales y, más aún, de la formación de litopedion, se reporta el caso de una paciente de 84 años quien consulta por cuadro clínico de colelitiasis y pancreatitis de origen biliar, con hallazgo incidental de litopedion en cavidad abdominal de más de 40 años, documentado y diagnosticado por medio de radiografía convencional de abdomen y confirmado con tomografía computarizada multidetector (TCMD). Se realizó una revisión de la literatura mundial sobre los aspectos clínicos, radiológicos y patológicos del embarazo abdominal con presentación de litopedion

Due to the low incidence of abdominal ectopic pregnancy and, even more, of the formation of lithopedion, the case of an 84-years-old female patient is presented, who was admitted with clinical symptoms of cholelithiasis and biliary pancreatitis, with an incidental finding of lithopedion in the abdominal cavity, of more than 40 years. It was documented and diagnosed using conventional abdominal radiography, and confirmed with multidetector computed tomography (MDCT). The article presents a review of world literature on the clinical, radiological and pathological features of abdominal pregnancy with lithopedion.

Síndrome de Gardner, diagnóstico por tomografía computarizada y colonoscopia virtual: reporte de caso / Diagnosis of gardner syndrome using computed tomography and virtual colonoscopy: case report

El síndrome de Gardner es una entidad poco frecuente, que se hereda de forma autosómica dominante. Los pacientes afectados presentan poliposis colónica, osteomatosis y otras características comunes. La importancia de hacer el diagnóstico radica en que el 100 de los casos sufre transformación maligna de los pólipos adenomatosos intestinales. En este artículo se presenta un caso y se revisa el síndrome como fue descrito originalmente, sus manifestaciones clínicas y los hallazgos imaginológicos.

Conducta terapéutica actual en las lesiones severas de extremidades / Present therapeutic management of severe extremity injuries

Se realizó una revisión bibliográfica sobre diversos aspectos de las lesiones de extremidades con el fin de determinar su complejidad y un planteamiento terapéutico adecuado. Se expresan criterios diagnósticos y opciones para el tratamiento de las partes blandas, lo que se considera como el factor determinante en el manejo inicial y definitivo, así como los métodos específicos de estabilización esquelética en dependencia de las características individuales de las fracturas, lesiones concomitantes, de la experiencia y el juicio clínico en estas lesiones potencialmente devastadoras, ya sean en tiempo de paz o bajo condiciones de guerra