Pseudoaneurysm in a chronic pancreatitis patient: report of a case, with emphasis on contrast-enhanced sonograms.

The association between pseudoaneurysm of the splenic artery and pancreatitis is now established. Rupture of an aneurysm is a lethal condition, and early diagnosis and treatment are required to prevent this hazardous life-threatening complication. In our case, early detection of pseudoaneurysm of the splenic artery enabled us to start prompt embolization, which yielded good results. Splenic infarction is known to be an important and frequent complication of transarterial embolization of splenic artery aneurysms. Thus, when performing transarterial embolization of a splenic artery aneurysm, this complication must be kept in mind and it is absolutely necessary to confirm the presence or absence of this complication after embolization of the aneurysm. In our case of pseudoaneurysm of the splenic artery due to acute aggravation of chronic pancreatitis, contrast-enhanced ultrasonography confirmed the spleen to be free from infarction. Thus, this technique is strongly recommended in such instances.

Multiple anechoic hepatic nodules in a patient with malignant lymphoma: report of a case with an emphasis on B-mode sonograms.

We present a case of hepatic malignant lymphoma (ML) in which the hepatic ML nodules were imaged as round anechoic nodules with posterior echo enhancement, mimicking hepatic cysts on B-mode ultrasonography (US). However, the boundary echo between the nodules and the surrounding hepatic tissue seemed to be less distinct than that of a hepatic cyst. Contrast-enhanced US showed the nodules to be hypervascular, which ruled out the possibility of hepatic cysts. Our observation stresses the importance of boundary echo for the diagnosis of hepatic ML on B-mode US. We also offer a possible explanation for this phenomenon.

Portal tumor thrombus secondary to gastric carcinoma: report of a case with an emphasis on color Doppler ultrasound findings.

We report the case of a 67-year-old woman with portal tumor thrombus (PTT) associated with gastric carcinoma. Abdominal ultrasound (US) revealed a marked thickening of the gastric wall and a mass lesion in the splenic vein. Color Doppler US showed the intraportal mass to be blood flow-poor and revealed a gastroepiploic vein extending from the splenic hilum to the portal confluence, passing behind the peritoneum. These findings corresponded well with gastric carcinoma with PTT. Endoscopy confirmed the presence of an advanced type II carcinoma predominantly located in the upper body, which yielded histological results consistent with a well-differentiated adenocarcinoma. The patient's general condition deteriorated rapidly, and she died 2 months later. To the best of our knowledge, this is the first report describing the presence of a large gastroepiploic vein secondary to gastric carcinoma-associated PTT.