[General adverse reactions to contrast agents. Classification and general concepts]. / Reacciones adversas generales a los contrastes. Clasificación y conceptos generales.

General adverse reactions to intravenous contrast agents are uncommon, although relevant due to the growing number of radiologic tests that use iodinated or gadolinium-based contrast agents. Although most of these reactions are mild, some patients can experience significant reactions that radiologists should know how to prevent and treat.

Hematoma pélvico subepitelial / Subepithelial Pelvic Hematoma

Introducción: El hematoma pélvico subepitelial (lesión de Antopol-Goldman) es una rara entidad que clínicamente simula una neoplasia renal o pélvica, cuyo diagnóstico definitivo se establece, en la mayoría de las ocasiones, por el anatomopatólogo tras la nefrectomía. Para evitar esta, son esenciales las pruebas de imagen y una alta sospecha diagnóstica. Material y métodos: Se presenta a una paciente de 43 años, sin antecedentes de interés, que acudió con un cuadro de dolor agudo en la fosa renal izquierda tras un esfuerzo físico y que fue estudiada mediante ecografía, tomografía computarizada (TC) y evolutivamente con resonancia magnética (RM). Resultados: Las exploraciones radiológicas mostraron una lesión en el seno renal izquierdo con características sugestivas de hematoma subepitelial de la pelvis renal, sin datos que sugiriesen una lesión subyacente. El tratamiento de la paciente fue conservador, confirmándose en exploraciones de seguimiento la desaparición de la lesión. Conclusión: El conocimiento de los hallazgos radiológicos de la lesión de Antopol-Goldman en las distintas pruebas de imagen y un índice de sospecha elevado son cruciales en el manejo de los pacientes afectados por esta infrecuente entidad, pudiendo evitar una nefrectomía innecesaria (AU)

Introduction: Subepithelial pelvic hematoma (Antopol Goldman lesion) is a rare condition that may clinical and radiologically simulate a renal or pelvic neoplasm and whose final diagnosis has been established after nephrectomy in most published cases. To avoid misdiagnosis, imaging tests and high diagnostic suspicion are essential. Material and methods: We present the case of a 43-year-old woman with no background of interest who was admitted to our Hospital complaining of acute left flank pain after a physical effort. The patient was studied by Ultrasonography, Computed Tomography and evolutively by Magnetic Resonance Imaging. Results: The radiologic exams showed a lesion in the left renal sinus with characteristics suggestive of subepithelial pelvic hematoma and without data revealing any underlying lesion. The patient was treated conservatively and follow-up examinations confirmed the disappearance of the lesion. Conclusion: Knowledge of the radiologic features of Antopol Goldman lesion as well as a high degree of clinical suspicion are crucial in the management of patients affected by this uncommon condition and may avoid an unnecessary nephrectomy (AU)

Necrosis grasa intraabdominal / Intraabdominal fat necrosis

Los procesos que cursan con necrosis grasa intraabdominal se manifiestan frecuentemente por dolor abdominal agudo/subagudo, hallazgos clínicos que pueden ser originados por afecciones tan variadas como la apendicitis epiploica, el infarto omental, la necrosis grasa encapsulada, la paniculitis mesentérica, la apendicitis, la diverticulitis y ciertas neoplasias. En este contexto, y a pesar de que la localización anatómica del dolor y la sintomatología acompañante pueden ayudar a la orientación diagnóstica, ésta puede ser equívoca llevando a una cirugía innecesaria. Para el diagnóstico van a resultar imprescindibles pruebas de imagen como la ecografía y, sobre todo la tomografía computarizada, debiendo el radiólogo reconocer los hallazgos característicos de cada una de ellas, lo que permitirá el adecuado manejo del dolor abdominal y prevenir una cirugía innecesaria (AU)

The processes that course with intraabdominal fat necrosis often manifest with acute or subacute abdominal pain; these clinical findings can be caused by various conditions, including epiploic appendagitis, omental infarction, encapsulated fat necrosis, mesenteric panniculitis, appendicitis, diverticulitis, and certain neoplasms. In this context, although the anatomic location of the pain and accompanying symptomatology can help orient the diagnosis, there is a risk of unnecessary surgery. Imaging tests like ultrasonography and especially computed tomography are essential for diagnosing intraabdominal fat necrosis. Radiologists must be familiar with the characteristic findings for all the conditions that can cause acute or subacute abdominal pain to ensure appropriate management and prevent unnecessary surgery (AU)

[Subepithelial pelvic hematoma]. / Hematoma pélvico subepitelial.

INTRODUCTION: Subepithelial pelvic hematoma (Antopol Goldman lesion) is a rare condition that may clinical and radiologically simulate a renal or pelvic neoplasm and whose final diagnosis has been established after nephrectomy in most published cases. To avoid misdiagnosis, imaging tests and high diagnostic suspicion are essential. MATERIAL AND METHODS: We present the case of a 43-year-old woman with no background of interest who was admitted to our Hospital complaining of acute left flank pain after a physical effort. The patient was studied by Ultrasonography, Computed Tomography and evolutively by Magnetic Resonance Imaging. RESULTS: The radiologic exams showed a lesion in the left renal sinus with characteristics suggestive of subepithelial pelvic hematoma and without data revealing any underlying lesion. The patient was treated conservatively and follow-up examinations confirmed the disappearance of the lesion. CONCLUSION: Knowledge of the radiologic features of Antopol Goldman lesion as well as a high degree of clinical suspicion are crucial in the management of patients affected by this uncommon condition and may avoid an unnecessary nephrectomy.

Sindrome de Ortner como causa de disfonía en paciente fumador / Ortner syndrome as the cause of dysphony in smokers

El síndrome de Ortner es una causa rara de parálisis del nervio recurrente laríngeo izquierdo debido a una etiología cardiovascular. Presentamos el caso clínico de un hombre de 70 años con historia de disfonía de un mes y medio de evolución diagnosticado de síndrome de Ortner por aneurisma del cayado aórtico (AU)

Ortner's syndrome is a rare cause of left recurrent laryngeal nerve paralysis due to a cardiovascular aetiology. We present a 70 years old man case with one and a half month history of dysphonia with Ortner’s syndrome caused by aortic arch aneurysm diagnosed (AU)

[Intraabdominal fat necrosis]. / Necrosis grasa intraabdominal.

The processes that course with intraabdominal fat necrosis often manifest with acute or subacute abdominal pain; these clinical findings can be caused by various conditions, including epiploic appendagitis, omental infarction, encapsulated fat necrosis, mesenteric panniculitis, appendicitis, diverticulitis, and certain neoplasms. In this context, although the anatomic location of the pain and accompanying symptomatology can help orient the diagnosis, there is a risk of unnecessary surgery. Imaging tests like ultrasonography and especially computed tomography are essential for diagnosing intraabdominal fat necrosis. Radiologists must be familiar with the characteristic findings for all the conditions that can cause acute or subacute abdominal pain to ensure appropriate management and prevent unnecessary surgery.