RESUMO
This case highlights a rare but potentially life-threatening complication of a contraceptive implant insertion that was corrected by a noninvasive endovascular procedure. This procedure requires a quick intervention to be successful.
Assuntos
Anticoncepcionais Femininos/administração & dosagem , Desogestrel/administração & dosagem , Implantes de Medicamento/efeitos adversos , Falha de Equipamento , Migração de Corpo Estranho , Artéria Pulmonar , Adulto , Implantes de Medicamento/administração & dosagem , Feminino , Migração de Corpo Estranho/cirurgia , HumanosRESUMO
Invasive peritoneal disease includes more than just peritoneal carcinomatosis. Although this is the most common aetiology, especially when a primary is found, other conditions may be responsible for peritoneal invasion. A rigorous analysis of CT features taken together with the clinical and biological context usually allows the main differential diagnoses, which entail different types of management, to be drawn out. Pseudomyxoma peritonei, peritoneal lymphomatosis, tuberculosis, peritoneal mesothelioma, diffuse peritoneal leiomyomatosis, and benign splenosis are the main differential diagnoses.
Assuntos
Carcinoma/diagnóstico por imagem , Carcinoma/secundário , Neoplasias Peritoneais/diagnóstico por imagem , Neoplasias Peritoneais/secundário , Tomografia Computadorizada por Raios X/métodos , Diagnóstico Diferencial , Humanos , Peritônio/diagnóstico por imagem , Sensibilidade e EspecificidadeAssuntos
Hemoperitônio/etiologia , Hemoperitônio/terapia , Leiomioma/complicações , Leiomioma/terapia , Leiomiomatose/complicações , Leiomiomatose/terapia , Choque Hemorrágico/etiologia , Choque Hemorrágico/terapia , Embolização da Artéria Uterina , Neoplasias Uterinas/complicações , Neoplasias Uterinas/terapia , Doença Aguda , Adulto , Angiografia , Terapia Combinada , Comportamento Cooperativo , Diagnóstico Diferencial , Feminino , Hemoperitônio/diagnóstico , Humanos , Histerectomia , Processamento de Imagem Assistida por Computador , Comunicação Interdisciplinar , Leiomioma/irrigação sanguínea , Leiomioma/diagnóstico , Leiomiomatose/irrigação sanguínea , Leiomiomatose/diagnóstico , Pessoa de Meia-Idade , Choque Hemorrágico/diagnóstico , Tomografia Computadorizada por Raios X , Neoplasias Uterinas/irrigação sanguínea , Neoplasias Uterinas/diagnósticoRESUMO
OBJECTIVE: To assess the value of magnetic resonance cholangiography with gadobenate dimeglumine (Gd-BOPTA) where there is a suspicion of bile leakage in the post-liver transplant patient. PATIENTS AND METHODS: Eight patients who had undergone a liver transplant underwent 14 MR cholangiograms, five of whom presented bile leakage while the other three had no biliary system complications. The results were compared to conventional bile duct opacification (by endoscopy or t-tube cholangiogram). The analysis covered whether there was opacification of the common bile duct and intrahepatic bile ducts on T1-weighted sequences after an injection of Gd-BOPTA on delayed biliary excretion phase sequences that were carried out on average 74 min after the injection. Enhancing perihepatic collections were also taken into account. RESULTS: Opacification of the bile ducts on delayed-phase MR cholangiogram sequences was always seen in the absence of bile leakage, and was never found when leakage was present. Enhancing perihepatic collections pointed to bile leakage every time. CONCLUSION: Gd-BOPTA-enhanced MR cholangiography is a simple and non-invasive technique for detecting bile leakage in the post-liver transplant patient.
