ABSTRACT
INTRODUCTION: Postpartum haemorrhage is a major cause of maternal mortality. Although contrast-enhanced computed tomography (CE-CT) is useful to reveal arterial bleeding, its accuracy in postpartum haemorrhage is unclear. The aim of this study was to evaluate the accuracy of CE-CT scanning in detecting postpartum haemorrhage. METHODS: This was a retrospective observational study. We included patients with postpartum haemorrhage treated by emergency physicians in collaboration with obstetricians. We calculated the sensitivity, specificity, and positive and negative predictive values for CE-CT scanning to detect arterial bleeding. RESULTS: CE-CT scanning was performed in 52 patients, and 31 patients had extravasation. The sensitivity of CE-CT scanning to detect arterial extravasation was 100% (15/15), specificity was 28.6% (2/7), positive predictive value was 75% (15/20), and negative predictive value was 100% (2/2). CONCLUSION: We showed the sensitivity of CE-CT scanning to detect arterial extravasation in patients with postpartum haemorrhage to be 100%.
Subject(s)
Postpartum Hemorrhage/diagnostic imaging , Tomography, X-Ray Computed , Adult , Contrast Media , Female , Humans , Japan/epidemiology , Predictive Value of Tests , Retrospective Studies , Sensitivity and SpecificityABSTRACT
A 65-year-old woman with small cell lung carcinoma(T2N2M0, Stage â ¢A)underwent chemoradiation therapy. During the follow-up study after the partial response of chemoradiation therapy, the serum level of ProGRP was elevated. X-ray computed tomography(CT)showed a 8 cm long mesenteric mass adjacent to ileocecal vessels, which indicated high level of standardized uptake value(SUV)max(12.6)by fluorodeoxyglucose-positron emission tomography/computed tomography( FDG-PET/CT). No gastrointestinal malignancy was observed. Mesenteric nodal metastasis from lung carcinoma was primarily diagnosed, however, possible malignant lymphoma was differentiated. Surgical resection was planned as a diagnostic treatment, thus laparoscopic ileocecal resection was performed. The resected specimen presented a fused mass of several lymph nodes. Histopathology found consistent with mesenteric nodal metastases from small cell lung carcinoma. After surgery, adjuvant chemotherapy was administered. Spontaneous metastasis in the mesenteric lymph node from lung cancer is extremely rare. A case report and a review of the literature is presented.