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Abdominal aortic aneurysm has been described as a rare condition touching 1% of the population over the age of 50 years with a high percentage of mortality. Aneurysms progress in size, causing deadly complications such as ruptures and fistulas. Computed tomography angiography is considered the gold standard imaging exam for the evaluation of abdominal aortic aneurysms and their complications. We report the case of an elderly patient admitted to the emergency room due to recurrent gastrointestinal bleeding. The computed tomography imaging findings were in favor of an abdominal aortic aneurysm complicated with a primary aortoduodenal fistula.
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Uterine scar pregnancy is a rare form of ectopic pregnancy that is life-threatening and functionally compromising due to complications such as hemorrhage or early uterine rupture. We report the case of a 41-year-old patient admitted for metrorrhagia at 13 weeks' amenorrhea. Transvaginal ultrasound allowed early diagnosis of pregnancy on uterine scar and MRI-guided therapeutic management indicating hysterectomy. This study and literature review aims to highlight the importance of imaging features in the diagnosis and management of this rare condition, knowledge of which may improve prognosis.
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Pneumosinus dilatans (PSD) is an abnormal dilatation and enlargement of one or more paranasal sinuses, extending beyond the anatomic bony boundaries, without defect or thinning of its bony walls. It is documented by only a few reports. Usually asymptomatic, it is in general found incidentally on imaging. It is important for radiologists to recognize the diagnosis and rule out eventual associated conditions such as meningiomas, orbital tumors, arachnoid cysts, and fibrous dysplasia. We report the case of PSD diagnosed incidentally in a 51-year-old female patient who presented to the emergency department with confusion.
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We report a case of a 43-year-old woman admitted to the emergency's department for an externalized mass through the vulva. The exploration by magnetic resonance imaging shows complete uterine inversion caused by a giant leiomyoma. Non-puerperal uterine inversion is a rare condition that is usually difficult to diagnose clinically. The role of imaging, specifically magnetic resonance imaging, is essential for the diagnosis, to establish the classification and to adapt the management.
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INTRODUCTION: The mechanical complications of acute myocardial infarction (AMI) still kill despite the evolution of medicine. Early diagnosis and adequate management are necessary to improve the prognosis, and this requires first, a good clinical examination that should raise the suspicion of a mechanical complication, then the echocardiography is performed to confirm the diagnosis. CASE PRESENTATION: We present a case of a 64-year-old patient admitted to the emergency room for jaundice with delayed ST-segment elevation myocardial infarction (STEMI). Physical examination revealed signs of right heart failure, which led us to associate jaundice with signs of acute liver failure secondary to right heart failure. Echocardiography confirmed the diagnosis of a ventricular septal rupture (VSR) with left-right shunt, and a significant dilation of the right ventricle. The patient underwent surgical closure of the VSR with fatal evolution. DISCUSSION: VSR is a rare life-threatening mechanical complication of AMI. The clinical signs depend on the left-right shunt and the onset of heart failure, which are 2 major determinants of the therapeutic strategy and the timing of the surgery. Despite surgical closure of the VSR, the mortality remains high, but the prognosis is better in patients treated with surgery than in patients who are treated medically only. CONCLUSION: The clinical presentation of VSR may differ from a patient to another. Good clinical sense and echocardiography are essential to set early diagnosis, and thus decide on the adequate management at the right time.
