Ingestion of heated tobacco sticks containing a micro-blade by children: the importance of performing a radiograph.

INTRODUCTION: Some tobacco sticks, such as TEREA™ heat sticks for IQOS ILUMA™, contain a blade. Both the nicotine part of the device and the micro-blade can be ingested by children. CASE SUMMARIES: We report two children, an 18-month-old boy and a 10-month-old girl, who ingested a heat stick containing a micro-blade. IMAGES: Radiography revealed the micro-blade to be in the child's mouth in the first case and the stomach in the second. Endoscopy was performed on the second child, confirming the presence of the blade in the stomach. CONCLUSION: We recommend performing a radiograph on all children who ingest tobacco sticks containing a micro-blade. If a metallic object is present, we recommend endoscopic removal to avoid traumatic lesions from the sharp edges.

Endovascular treatment of pulmonary artery aneurysm: Single case experience.

A peripheral pulmonary artery aneurysm (PAA) is a dilatation involving all 3-vessel wall layers (the intima, media, and adventitia) of a distal pulmonary artery. It represents a rare but potentially life-threatening condition. There are only some reviews of transcatheter embolization of unruptured idiopathic peripheral PAAs. Association with cardiac diseases, infections, vascular anomalies, pulmonary hypertension, and vasculitis has been noted. We report a case of a 38-year-old woman, with a history of third-degree atrioventricular (AV) block, treated with pacemaker placement, who presented a PAA in the left pulmonary lobe. Transcatheter coil embolization was performed, using a triple coaxial catheter system (a 6F outer, a 5F intermediate, and a 2.4F inner catheter) to prevent rupture and the aneurysm was successfully embolized. Although there is no consensus on the treatment for unruptured idiopathic peripheral PAAs, transcatheter embolization may be a promising treatment option.

Balloon-assisted, ultrasound-guided percutaneous real-time thrombin injection, for the arteriovenous fistula pseudoaneurysm treatment.

A pseudoaneurysm or false aneurysm is the consequence of a persistent blood leak caused generally by iatrogenic rupture of a vessel wall. The blood leak creates a new cavity delimited by surrounding tissues and allows blood flow to remain in continuity between this cavity and the vessel. In hemodialysis fistula, pseudoaneurysm generally results from repeated puncturing of the vein at the same site, leading to a bulging anatomical defect in the vein. Over the past few years, interventional radiological treatment has evolved and taken the place of surgery, with different kinds of percutaneous and endovascular treatment methods in pseudoaneurysm management. We reported a case report of successful treatment of arteriovenous fistula pseudoaneurysm with no-measurable neck. We performed ultrasound-guided percutaneous direct thrombin injection while an inflated balloon transiently obstructed flow out of the pseudoaneurysm, in order prevent non-target embolization.

Corrigendum to "Rescue of renal function after endovascular revascularization of acute aorto-renal bypass occlusion in a patient with solitary kidney: A case report" [Radiology Case Reports 17 (2022) 2698-2701].

[This corrects the article DOI: 10.1016/j.radcr.2022.04.023.].

Rescue of renal function after endovascular revascularization of acute aorto-renal bypass occlusion in a patient with solitary kidney: a case report.

Renal artery occlusion represents an early diagnostic urgency to prevent kidney injury or, even more grave, kidney failure. However, diagnosis is often a challenge due to nonspecific and sporadic symptoms and signs, resulting in misdiagnosis, missed, or delayed diagnosis. The patient ought to be evaluated by a multidisciplinary team to select the best treatment. We describe a 62-year-old man's case study. The patient had a left solitary kidney with an aortorenal artery bypass thrombosis. The renal function resumes 24 hours after the interventional radiology procedure. Based on our experience, revascularization of aortorenal artery bypass thrombosis may save renal function even after long ischemia times of over 24 hours.

Ureteral metastasis from gastric cancer after two years of subtotal gastrectomy: a case report.

True ureteral metastases from gastric cancer are extremely rare. Only a few cases of this condition have been reported. CT is the first-line imaging technique and may aid the diagnosis, even if the definitive diagnosis is histologic. We report a case of a 45-year-old female with a history of gastric cancer who underwent subtotal gastrectomy and presented 2 years later with ureteral metastasis and subsequently renal pelvis metastasis in absence of peritoneal involvement. A biopsy was required to rule out primary urothelial carcinoma and make a well-timed and proper diagnosis. We describe the pathologic and radiological features of this case, followed by a brief review of the literature included in the discussion.

Stenting of the superior vena cava and right pulmonary artery in a woman with a mediastinal mass and acute respiratory distress syndrome (ARDS).

We report the case of a woman with a mass in the anterior and middle mediastinum (a non-small-cell lung carcinoma), determining significant compression of both superior vena cava and right pulmonary artery. The patient developed acute respiratory distress syndrome , necessitating intubation and admission to the Intensive Care Unit . Radiotherapy sessions to reduce the mass effect were attempted, without significant clinical improvement. Due to the persistence of severe hypoxemia, stenting of the superior vena cava and the right pulmonary artery was performed, the latter resulting in a significant improvement of the arterial blood gas parameters, allowing extubation of the patient. In our opinion, stenting of the superior vena cava and the pulmonary artery (or its branches) is an effective and safe treatment; it should be considered in similar cases, especially if other - less invasive - treatments fail.

Locally advanced rectal cancer: Qualitative and quantitative evaluation of diffusion-weighted MR imaging in the response assessment after neoadjuvant chemo-radiotherapy.

PURPOSE: to investigate the added value of qualitative and quantitative evaluation of diffusion weighted (DW) magnetic resonance (MR) imaging in response assessment after neoadjuvant chemo-radiotherapy (CRT) in patients with locally advanced rectal cancer (LARC). METHODS: 31 patients with LARC (stage ≥ T3) were enrolled in the study. All patients underwent conventional MRI and DWI before starting therapy and after neoadjuvant CRT. All patients underwent surgery; pathologic staging represented the reference standard. For qualitative analysis, two radiologists retrospectively reviewed conventional MR images and the combined set of conventional and DW MR images and recorded their confidence level with respect to complete response (ypCR). For quantitative analysis, tumor's apparent diffusion coefficient (ADC) values were measured at each examination. ADC pre-CRT, ADC post-CRT and Δ ADC post-ADC pre of the three groups of response (ypCR, partial response ypPR, stable disease ypSD) were compared. Receiver-operating characteristics (ROC) curve analysis was employed to investigate the discriminatory capability for ypCR, responders (ypCR, ypPR) and ypSD of each measure. RESULTS: addition of DWI to conventional T2-weighted sequences improved diagnostic performance of MRI in the evaluation of ypCR. A low tumor ADC value in the pre-CRT examination, a high ADC value in the post-CRT examination, a high Δ ADC post-ADC pre [>0.3 (×10(-3) mm(2)/s)] were predictive of ypCR. CONCLUSIONS: DW sequences improve MR capability to evaluate tumor response to CRT. Nevertheless, no functional MR technique alone seems accurate enough to safely select patients with ypCR.