RESUMEN
Pseudotumoral xanthogranulomatous pyelonephritis is a rare chronic renal infection. Preoperative diagnosis is difficult because of its non-specific presentation. The purpose of this retrospective review of 8 cases is to assess the value of different imaging techniques in the evaluation of this pathology. Six males and 2 females, aged 29 to 75 years were included. The right kidney was involved in 5 cases and the left kidney was involved in 3 cases. Involvement was upper polar in 2 cases and lower polar in 6 cases. A kidney stone was present in 3 cases. US showed a heterogeneous hypoechoic lesion in 3 cases, a homogeneous hypoechoic lesion in 3 cases, and isoechoic lesion in 1 case and a cystic lesion in 1 case. CT showed a focal solid lesion with peripheral enhancement in 4 cases and a cystic mass with peripheral enhancement in 3 cases. US features are non-specific. CT shows a non-specific renal mass, the presence of obstruction and demonstrates perirenal involvement. Preoperative MRI, not performed in our patient population, demonstrates specific changes in the perirenal fat that suggests the diagnosis. The diagnosis of pseudotumoral xanthogranulomatous pyelonephritis can be suspected on a constellation of clinical and laboratory findings combined with non-specific features on CT and US and specific MRI features of perirenal fat changes. Percutaneous biopsy may be needed in selected cases to confirm diagnosis.
Asunto(s)
Diagnóstico por Imagen , Pielonefritis Xantogranulomatosa/diagnóstico , Tejido Adiposo/patología , Adulto , Anciano , Biopsia con Aguja , Diagnóstico Diferencial , Femenino , Humanos , Cálculos Renales/diagnóstico , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Pielonefritis Xantogranulomatosa/diagnóstico por imagen , Estudios Retrospectivos , Tomografía Computarizada por Rayos X , UltrasonografíaRESUMEN
The authors report the case of a vertebromedullary hydatidosis revealed by medullar compression in a 40-year-old male patient. Magnetic resonance imaging showed lesions of the seventh and eighth dorsal vertebras, cystic lesions in the epidural space and in the perivertebral soft tissues. Surgical excision lead to clinical cure. Vertebromedullary hydatidosis is rare and severe. Modern techniques of imaging are very helpful for the diagnosis and the follow-up of patients after treatment.
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Equinococosis/complicaciones , Imagen por Resonancia Magnética , Compresión de la Médula Espinal/etiología , Espondilitis/etiología , Vértebras Torácicas/parasitología , Adulto , Legrado , Equinococosis/diagnóstico , Equinococosis/diagnóstico por imagen , Equinococosis/patología , Equinococosis/cirugía , Espacio Epidural/parasitología , Reacciones Falso Negativas , Humanos , Laminectomía , Masculino , Oxígeno/administración & dosificación , Oxígeno/uso terapéutico , Compresión de la Médula Espinal/diagnóstico por imagen , Compresión de la Médula Espinal/patología , Espondilitis/diagnóstico por imagen , Espondilitis/parasitología , Espondilitis/patología , Irrigación Terapéutica , Vértebras Torácicas/cirugía , Tomografía Computarizada por Rayos X , UltrasonografíaRESUMEN
Pachydermoperiostosis or primary hypertrophic osteoarthropathy is a benign genetically determined disease, manifested by finger clubbing, hypertrophic skin changes and periosteal bone formation. It is rarely reported and was for a long time misdiagnosed and confused with secondary hypertrophic osteoarthropathy. We present the imaging features in two cases and review the literature.
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Osteoartropatía Hipertrófica Primaria/diagnóstico por imagen , Adulto , Humanos , Masculino , Persona de Mediana Edad , RadiografíaRESUMEN
INTRODUCTION: Isolated spontaneous dissection of the superior mesenteric artery is the most common digestive artery dissection. It is a rare cause of acute abdomen. Only a few hundred cases have been reported in the literature. CASE REPORT: We report a 40-year-old man with a past medical history of high blood pressure who presented abdominal pain that was related to a spontaneous dissection of the superior mesenteric artery. Computed tomography revealed an isolated dissection of superior mesenteric artery. There were no evidence of bowel ischemia. We decided a conservative treatment and the outcome was favorable, without recurrent symptoms or disease progression. CONCLUSION: Based on this case report, we discuss the etiology of this vascular lesion and the contribution of computed tomography in the diagnosis, the therapeutic strategy and the follow-up of spontaneous dissection of superior mesenteric artery.
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Abdomen Agudo/etiología , Disección Aórtica/complicaciones , Disección Aórtica/patología , Arteria Mesentérica Superior/patología , Abdomen Agudo/diagnóstico por imagen , Abdomen Agudo/patología , Adulto , Disección Aórtica/diagnóstico por imagen , Humanos , Masculino , Arteria Mesentérica Superior/diagnóstico por imagen , Tomografía Computarizada por Rayos XRESUMEN
INTRODUCTION: The purpose of this study is to specify the role of imaging in the initial management of ballistic traumas. METHODS: This is a retrospective study that colligated 83 victims of a gunshot wound during demonstrations, treated in our trauma centre between 12 January and 3 February 2011. All of the patients were haemodynamically stable and examined by conventional radiography and/or ultrasound and/or 16-slice CT-scan (CT). RESULTS: The mean age of the victims was 26years with a sex ratio of 0.02. All wounds were unique. Injury to the limbs was most common in 75.5% of the cases (n=64) followed by that of the torso in 19.5% of the cases (n=16). Wounds in the spine (n=2), brain (n=2) and facial skeleton (n=1) were observed. Conventional x-rays objectified 32 cases of open fractures 95% of which were in the legs. Twenty-one of the victims of gunshot wounds had a CT-scan that objectified the path of the bullet and an assessment of the wound was made in all cases. The confrontation of the data from the CT-scan and that noted during surgery and during the monitoring demonstrated that the CT-scan is very efficient in the diagnosis of pleural effusion, vascular wounds, thoracic parenchymatous wounds and wounds of the solid organs and brain lesions and the facial skeleton. However, the sensitivity is low for the diagnosis of hollow organs. CONCLUSION: The CT-scan is very useful in the initial care of stable patients with gunshot wounds as regards the haemodynamics and helps objectify the path of the bullet and obtain a precise assessment of the damage. Conventional x-rays are unavoidable for wounds to the legs and spine.
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Tomografía Computarizada por Rayos X , Heridas por Arma de Fuego/diagnóstico por imagen , Adolescente , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Ultrasonografía , Adulto JovenRESUMEN
We report a case of subchondral osteoid osteoma of the tarsal navicular bone. Osteoid osteomas are often located in the foot, mainly in the talus. This is the first report in the literature of a tarsal navicular bone localization. Diagnosis was difficult and established late due to misleading clinical presentation simulating mediotarsal arthritis.
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Neoplasias Óseas/diagnóstico , Neoplasias Óseas/patología , Osteoma/diagnóstico , Osteoma/patología , Huesos Tarsianos/patología , Adulto , Artritis/diagnóstico , Diagnóstico Diferencial , Humanos , MasculinoRESUMEN
Cystic teratoma of the diaphragm is a rare, generally asymptomatic, disease. We report a case which was disclosed by the development of fever and pain in the left hypochondria. Imaging ruled out surgical emergency and led to the diagnosis, describing the relations of the tumor.
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Diafragma/patología , Neoplasias de los Músculos/diagnóstico , Teratoma/diagnóstico , Adolescente , Diagnóstico Diferencial , Diafragma/diagnóstico por imagen , Fiebre/etiología , Humanos , Masculino , Neoplasias de los Músculos/diagnóstico por imagen , Neoplasias de los Músculos/patología , Dolor/etiología , Radiografía , Teratoma/diagnóstico por imagen , Teratoma/patologíaRESUMEN
PURPOSE: Traumatic thoracic aortic rupture are commonly localised in one site essentially in the aortic isthmus but multiple localisation are not uncommon. The authors reported the case of a young man who had a double localisation of RTA after a violent car accident. CASE REPORT: A 23-year-old man had a violent car crush involving sudden deceleration. He had multiple injuries essentially: a traumatic thoracic injury with acute posttraumatic aortic rupture in double localization, in the isthmus and in the descending thoracic aorta. He underwent thoracic endovascular aortic repair (TEVAR) with the use of stent graft three weeks after his car accident. The endovascular treatment was successful and no case of perigraft leakage has been detected during a meaning follow-up of five months. CONCLUSION: The systematic analysis of the whole thoracic aortic vessel is crucial to not misdiagnose eventual multiple aortic rupture.
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Aorta Torácica/lesiones , Rotura de la Aorta/etiología , Humanos , Masculino , Adulto JovenRESUMEN
INTRODUCTION: Primary epiploic appendagitis is known to be a rare finding among causes of acute abdomen. Depending on location, it may mimic several disorders such as colonic diverticulitis and acute appendicitis. Diagnosis is sometimes performed during surgery. METHODS: This is a retrospective descriptive study. The authors report the contribution of imaging for the diagnosis of appendagitis in seven patients investigated between July 2010 and April 2013 by abdominal and pelvic ultrasound or computed tomography (CT). RESULTS: CT scan confirmed the diagnosis in six patients avoiding unnecessary surgery and hospitalization. The seventh patient was a pregnant woman in whom the diagnosis of appendagitis was made during surgery for appendicitis. CONCLUSION: Appendagitis is a rare cause of acute abdominal pain. Outcome is favorable with medical treatment only. Abdominal ultrasound and CT are helpful diagnostic tests avoiding useless surgical procedure.
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Colon/irrigación sanguínea , Diagnóstico por Imagen/métodos , Infarto/diagnóstico , Abdomen Agudo/diagnóstico , Abdomen Agudo/etiología , Adulto , Apendicitis/diagnóstico , Diagnóstico Diferencial , Femenino , Humanos , Infarto/complicaciones , Vólvulo Intestinal/diagnóstico , Masculino , Persona de Mediana Edad , Embarazo , Complicaciones del Embarazo/diagnóstico , Estudios Retrospectivos , Tomografía Computarizada por Rayos X , UltrasonografíaRESUMEN
Colonic ameboma is a rare inflammatory pseudo-tumor of the colon that can mimic cancer development. This case was located in the cecum and appeared malignant from a macroscopic view. Accordingly a right hemicolectomy was performed, followed by an end-to-side ileocolic anastomosis. The pathology study enabled us to correct the diagnosis and affirm its amebic origin.
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Enfermedades del Colon/diagnóstico , Disentería Amebiana/diagnóstico , Neoplasias del Ciego/diagnóstico , Colectomía , Enfermedades del Colon/cirugía , Diagnóstico Diferencial , Disentería Amebiana/cirugía , Humanos , Masculino , Persona de Mediana EdadRESUMEN
Postoperative visual loss is a rare but disastrous complication that can be observed after spinal surgery. We report the case of a 39-year-old woman involved in a traffic accident that caused trauma to the cervical spine causing right hemiplegia, who underwent a prolonged spinal operation in the prone position and complained of monocular blindness 1 day postoperatively. The ophthalmologic examination showed no involvement of the ocular globe. The orbitocerebral MRI showed definite diagnostic arguments for orbital vascular injury. The symptoms did not completely disappear after 1 year of treatment. We consider the potential etiological factors contributing to this unilateral postoperative visual loss and suggest strategies to reduce the incidence of this complication in spinal surgery.
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Complicaciones Posoperatorias/diagnóstico por imagen , Columna Vertebral/cirugía , Trastornos de la Visión/diagnóstico por imagen , Adulto , Ceguera/diagnóstico por imagen , Ceguera/etiología , Encéfalo/diagnóstico por imagen , Femenino , Humanos , Imagen por Resonancia Magnética , Neuropatía Óptica Isquémica/complicaciones , Neuropatía Óptica Isquémica/diagnóstico por imagen , Neuropatía Óptica Isquémica/etiología , Complicaciones Posoperatorias/etiología , Tomografía Computarizada por Rayos X , Trastornos de la Visión/etiologíaAsunto(s)
Dolor Abdominal/diagnóstico por imagen , Ilion/anomalías , Ilion/diagnóstico por imagen , Imagenología Tridimensional , Neoplasias Renales/cirugía , Nefrectomía , Complicaciones Posoperatorias/diagnóstico por imagen , Tomografía Computarizada por Rayos X , Diagnóstico Diferencial , Humanos , Masculino , Persona de Mediana EdadRESUMEN
Eagle's syndrome, also known as elongated styloid process, is an entity that may be the source of craniofacial and cervical pain. It is frequently reported but is probably more common than generally considered. The symptoms related to Eagle's syndrome can be confused with those attributed to a wide variety of Oropharyngeal and Maxillofacial diseases. The paucity of information in the radiologic literature prompted this report.