Clinical Presentation, Imaging, and Management of Segmental Arterial Mediolysis: A Rare Vascular Disorder.

Objectives Our objective was to analyze the clinical presentation, imaging findings, and the management of segmental arterial mediolysis (SAM) in different case scenarios within our medical institution. Materials and Methods We retrospectively analyzed 13 cases of SAM in our institution from July 2017 to March 2020. The images from the cases were collected from picture archiving and communication system (PACS) along with other pertinent clinical information from the hospital's information system. All the patients we studied underwent contrast-enhanced computed tomography (CT) using a third-generation Siemens SOMATOM Force dual-source CT scanner. Once the dual-phase scanning was completed, the images were analyzed using the workstation's syngo.via software. Results Three out of the 13 cases required stent-grafting of the renal/celiac artery, and the involved branch of the superior mesenteric artery was embolized in one case. The rest of the cases were managed conservatively with antiplatelets/anticoagulants. Subsequent follow-ups of the patients were conducted and showed stabilization/regression of the initial findings without finding any evidence of worsening. Conclusion SAM should be considered when making a differential diagnosis of acute abdominal pain when associated with dissection or aneurysms in splanchnic arteries, and in cases of unexplained intra-abdominal hemorrhaging. The radiologist needs to be aware of this possibility to raise suspicion, alert the clinician, and guide appropriate management.

Renal Lymphangiectasia: An Unusual Mimicker of Cystic Renal Disease - A Case Series and Literature Review.

Cystic renal lesions are commonly seen on a daily basis in abdominal imaging. Even though most cystic renal lesions are benign simple cysts, complex and multifocal cystic renal diseases are also common with a vast number of differentials. One of the rare mimickers of this condition is renal lymphangiectasia, and the disease can be diagnosed if radiologists are aware of the imaging findings, and this can help the physician to offer the appropriate treatment. We report a case series of five cases in our hospital and also review the literature on renal lymphangiectasia, including its pathophysiology, clinical presentation, imaging appearances, complications, treatment, and differentials.