Bilateral renal hemorrhage in an anticoagulated patient: A rare case of Wunderlich syndrome.

We describe a rare case of Wunderlich syndrome with bilateral renal hemorrhage in a patient under anticoagulant therapy for atrial fibrillation. An 84-year-old woman came to our department complaining of acute bilateral flank pain. Clinical and laboratory examinations revealed a condition of hypovolemic shock. An abdominal contrast-enhanced CT scan detected the presence of a bilateral hemorrhage affecting the peri- and para-renal spaces. Planning an appropriate management strategy considering the anticoagulated treatment required a multidisciplinary approach in the case of the Wunderlich syndrome diagnosis.

Diagnostic imaging of a rare case of incidental adrenal ganglioneuroma.

A 53-year-old man complaining of pain in the right hypochondrium underwent an abdominal ultrasound that showed a left adrenal lesion. Further instrumental investigations (CT and MRI, both with contrast medium) were performed which diagnosed an adrenal ganglioneuroma, confirmed by the histological examination. The patient also underwent an endocrinological examination. The treatment was surgical and consisted of an adrenalectomy through video-laparoscopic access. Adrenal ganglioneuromas are rare tumors but well described and known in the literature. For this reason, this case report has primarily an educational purpose: the totality of the data collected (clinical, laboratoristic, instrumental, and histopathological) constituted a multidisciplinary case, with the focus on imaging.

Granulomatous prostatitis: mimicking locally advanced prostate adenocarcinoma.

We report the case of a 63-year-old male who came to the urology clinic with an increasing value of the prostate specific antigen and an asymmetrical enlargement at the digital rectal examination. The man was subjected to an MRI of the prostate following which a convincing radiological diagnosis of prostate cancer was made. The patient was assigned a provisional stage of disease T3a N0. In order to confirm this diagnosis, a prostate biopsy was performed but the histological analysis reported non-specific granulomatous prostatitis (GP). It is an uncommon condition that both clinically and radiologically on TRUS and MRI usually mimics prostate cancer (PCa), representing a diagnostic challenge due to its non-specific symptoms and aspecific radiological findings. In this case report we discuss the magnetic resonance imaging features of this rare clinical condition in order to help radiologists in the timely diagnosis for a correct diagnostic framing.

A rare case of isolated gallbladder rupture following blunt abdominal trauma.

Isolated gallbladder rupture are rare injuries. We present a case of gallbladder traumatic rupture in a 47-year-old patient involved in a motor vehicle collision, that presented abdominal pain with maximal intensity in the right upper quadrant.CT is the imaging technique of choice to diagnosis this entity, however the final diagnosis of gallbladder rupture is confirmed with laparoscopy. Cholecystectomy is the definitive treatment.