RESUMO
Lipoblastoma is a rare benign neoplasm of foetal fat tissue. To our knowledge, less than ten cases of omental lipoblastoma have been reported in the literature. We present a new case of omental lipoblastoma in a 3-month old girl. The role of CT in the diagnosis and surgery planning of this tumor will be discussed.
Assuntos
Lipoma , Omento , Neoplasias Peritoneais , Pré-Escolar , Feminino , Humanos , Lipoma/diagnóstico por imagem , Neoplasias Peritoneais/diagnóstico por imagem , RadiografiaRESUMO
The purpose of this study was to evaluate the efficiency and safety of oesophageal balloon dilatation in strictures secondary to surgical treatment of oesophageal atresia in 25 children. Patients comprised 15 males and 10 females, aged 1-36 months. Median age was 4 months (interquartile range (IQR)=19). The strictures were more than 50% of oesophageal lumen and the delay from surgical treatment to balloon dilatation varied from 1 month to 36 months. Associated gastroesophageal reflux was noted in 15 patients. All procedures were performed under sedation using fluoroscopic guidance. Balloons of increasing diameter, 4-20 mm were used. Water soluble contrast swallow was performed after each dilatation session. A total of 115 balloon dilatation sessions were performed with a range of 1-14 procedures per patient (median 4 dilatations, IQR=4.5). Dilatation relieved the stricture in all patients over a follow-up period varying from 4 months to 33 months. The best results were noted in children under 6 months, who needed two or few dilatation sessions, with relative risk (RR) of 0.52 and 95% confidence interval of 0.29-0.92. The presence of associated gastroesophageal reflux indicated a high risk (RR of 12, p<0.001) for undergoing more than two balloon dilatation sessions. The only serious complications observed were two cases of oesophageal perforation, which were treated conservatively. Fluoroscopically guided balloon dilatation is a safe and effective treatment in the management of strictures secondary to surgical repair of oesophageal atresia, especially when started early (within 6 months of surgery) and not associated with gastroesophageal reflux.
Assuntos
Cateterismo/métodos , Atresia Esofágica/cirurgia , Estenose Esofágica/terapia , Complicações Pós-Operatórias/terapia , Cateterismo/efeitos adversos , Pré-Escolar , Atresia Esofágica/diagnóstico por imagem , Perfuração Esofágica/etiologia , Estenose Esofágica/diagnóstico por imagem , Estenose Esofágica/etiologia , Feminino , Refluxo Gastroesofágico/terapia , Humanos , Lactente , Masculino , Complicações Pós-Operatórias/diagnóstico por imagem , Complicações Pós-Operatórias/etiologia , Estudos Prospectivos , Radiografia , Resultado do TratamentoRESUMO
Spontaneous portosystemic venous shunts (SPVSs) within the hepatic parenchyma are rare. Fewer than 50 cases have been reported, and most of them were diagnosed by angiography. We present a case of SPVS diagnosed by color Doppler sonography in a 5-year-old boy admitted for bleeding due to rupture of esophageal varices. Conventional color and power Doppler sonography as well as CT showed a large shunt between the posterior branch of the right portal vein and the inferior vena cava. We believe that accurate diagnosis and follow-up of SPVS can be done with color Doppler sonography without resorting to angiography.
Assuntos
Anormalidades do Sistema Digestório/diagnóstico por imagem , Varizes Esofágicas e Gástricas/diagnóstico por imagem , Veia Porta/diagnóstico por imagem , Ultrassonografia Doppler em Cores/métodos , Veia Cava Inferior/diagnóstico por imagem , Pré-Escolar , Anormalidades do Sistema Digestório/complicações , Varizes Esofágicas e Gástricas/etiologia , Hematemese/diagnóstico por imagem , Hematemese/etiologia , Humanos , Masculino , Veia Porta/anormalidades , Derivação Portossistêmica Cirúrgica , Sensibilidade e Especificidade , Veia Cava Inferior/anormalidadesRESUMO
Septic arthritis of the posterior lumbar joints is extremely rare. The clinical picture of this unusual site of infection can easily lead to confusion with spondylodiscitis which is more common. We report a case of a 50-year-old woman with Staphylococcus aureus septic arthritis of the left L5-S1 lumbar facet joint. CT scan was helpful to establish the diagnosis and to guide the percutaneous needle biopsy.
Assuntos
Artrite Infecciosa/diagnóstico por imagem , Disco Intervertebral , Vértebras Lombares , Infecções Estafilocócicas/diagnóstico por imagem , Feminino , Humanos , Pessoa de Meia-Idade , RadiografiaRESUMO
BACKGROUND: Primary psoas abscess is very rare in childhood; its diagnosis and treatment can be improved by the use of recent imaging techniques. PATIENTS: Six children, aged 11 months to 10 years (mean: 51 months) were admitted from January 1987 to 15 December 1993 because they suffered mainly from fever, lumbar pain and/or homolateral flexed hip. Examination showed a painful inguinal mass in five patients and hyperleucocytosis in all. X-rays showed disappearance of the external limit of psoas in two patients; ultrasonography showed enlarged psoas in all, associated with hypoechogenic mass in two and without echo in four patients. CT scan showed the abscess in all cases, permitting a needle aspiration for bacteriological studies: Staphycococcus aureus was present in five cases. Drainage of the abscess by CT-guided percutaneous catheter was performed in two patients. Surgical drainage was performed in three including one for whom percutaneous catheter drainage did not succeed. The two other patients were only given antibiotics. CONCLUSION: CT-guided needle aspiration to establish presence and nature of fluid collection is a well established technique that may be extended to treatment of psoas abscesses.
Assuntos
Abscesso do Psoas/diagnóstico , Infecções Estafilocócicas/diagnóstico , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Abscesso do Psoas/diagnóstico por imagem , Abscesso do Psoas/terapia , Estudos Retrospectivos , Infecções Estafilocócicas/diagnóstico por imagem , Infecções Estafilocócicas/terapia , Tomografia Computadorizada por Raios X , UltrassonografiaRESUMO
Mondini's malformation is a rare internal ear malformation. It's often discovered in childhood in the course of perception deafness check up, or repetitive meningitis in some other cases. The authors report a case of complex Mondini's malformation with fistulas of cerebro-spinal-fluid in oval and round windows, and stress the interest of high resolution computed tomography.
Assuntos
Orelha Interna/anormalidades , Otorreia de Líquido Cefalorraquidiano/etiologia , Pré-Escolar , Orelha Interna/diagnóstico por imagem , Orelha Interna/embriologia , Feminino , Humanos , Imageamento por Ressonância Magnética , Tomografia Computadorizada por Raios XRESUMO
We present one case of bursa formation secondary to a scapular osteochondroma. This rare condition can simulate, clinically and radiologically, a sarcomatous transformation. CT scan is helpful to demonstrate the scapular osteochondroma and the adjacent bursa.
Assuntos
Bursite/etiologia , Exostose/complicações , Escápula , Bursite/diagnóstico por imagem , Criança , Exostose/diagnóstico por imagem , Feminino , Humanos , Tomografia Computadorizada por Raios XRESUMO
A population-based echotomographic (ECT) and serological survey of hydatidosis was carried out in a high risk community located in Central Tunisia. 1434 subjects over 5 years of age (93.3% of the population in this age range) underwent an abdominal echotomography (ECT) and a serological test (ELISA with confirmation by counterelectrophoresis). The ECT prevalence rate was 3.5% and increased with age reaching 7.7% in the over 39 years age group. Most subjects (96.0%) had liver cyst(s). The serological prevalence rate was 2.9%. A strong agreement was found between ECT and serological results (Kappa test = 0.449). Taking ECT as a reference, the relative specificity and sensitivity of serology were 99.3 and 62.0 respectively. Most ECT positive seronegative subjects had calcified cysts. These results confirm the presence of highly endemic foci of hydatidosis in Central Tunisia, show a good agreement between serological and ECT results at a population level and demonstrate the high feasibility of ECT as a screening technique.
Assuntos
Anticorpos Anti-Helmínticos/sangue , Equinococose Hepática/epidemiologia , Equinococose/epidemiologia , Echinococcus/imunologia , Adolescente , Adulto , Fatores Etários , Idoso , Animais , Criança , Contraimunoeletroforese , Equinococose/diagnóstico por imagem , Ensaio de Imunoadsorção Enzimática , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Prevalência , Fatores Sexuais , Tunísia/epidemiologia , UltrassonografiaRESUMO
In 80 to 90% of cases, hydatid disease affects the liver and the lung. In only 2% of cases is it localised in the pelvis. On the clinical level there is no specific sign of pelvic hydatid disease. The diagnosis used to be difficult but it has become easy, thanks to modern methods of imaging. The authors report 3 cases that were diagnosed by ultrasound and tomodensitometry. Surgical removal, which was carried out in each case without difficulty, was successful. They review the ultrasound and tomodensitometry pictures of hydatid disease and the principles of its surgical treatment.