Giant megalo-ureter and duplex kidney in an asymptomatic adult.

An abdominal mass was palpated in an asymptomatic adult during a routine medical check-up. Ultrasonography and computed tomography scan diagnosed a simple renal cyst, a mesenteric cyst and a seminal vesicle cyst. At laparotomy a complete ureteral duplication and a giant ectopic megalo-ureter were diagnosed. Other complications were ruled out in the follow-up. Ureterectomy without heminephrectomy was performed and the patient remains asymptomatic 5 years after surgery.

Percutaneous transgastric cystoduodenostomy in the treatment of a pancreatic pseudocyst: a new approach.

A case of an infected pseudocyst in the head of the pancreas is presented. Due to its small size and fistulization to the duodenum, a drainage catheter was placed through the fistulous tract from a distant transgastric approach. The fistula was balloon dilated to improve its emptying. Sixteen months later the patient remains asymptomatic with no recurrence of the pseudocyst.

CT-guided paracoccygeal drainage of pelvic abscesses.

OBJECTIVE: Using the transrectal/transvaginal routes for the drainage of pelvic abscesses complicating colorectal surgery (anterior resection or abdominoperineal resection) is not always possible. The conventional transgluteal approach through the greater sciatic foramen, although proven to be a valuable access route, can have complications (mainly local pain). MATERIALS AND METHODS: To avoid these difficulties, a CT-guided paracoccygeal-infragluteal approach was used in the percutaneous drainage of deep pelvic (presacral and ischiorectal) abscesses presenting after colorectal surgery in six patients. RESULTS: Percutaneous drainage through this approach was successful in preventing the need for surgery in all six patients. No complications or recurrences were noted, and catheters were removed an average of 15 days after insertion. CONCLUSION: In comparison with the classical transgluteal approach, the paracoccygeal-infragluteal approach minimizes patient discomfort and minimizes the risk of potential injury to the sciatic plexus or blood vessels. This initial series shows that a CT-guided paracoccygeal-infragluteal approach is well tolerated, safe, and effective for the percutaneous drainage of pelvic abscesses developing after colorectal surgery.

Pancreatic pseudocyst in a gastrectomized patient: treatment with internalized endoprosthesis.

Direct percutaneous drainage of pancreatic pseudocysts in communication with the duct of Wirsung can lead to pancreaticocutaneous fistula. These patients are safely treated with the percutaneous transgastric approach. In a gastrectomized patient who developed a pseudocyst, we percutaneously placed in internal endoprosthesis from the duct of Wirsung to the afferent loop and gastric pouch.

Hydatid disease of the spleen: imaging findings in nine patients.

Splenic involvement is uncommon in patients with hydatid disease. The radiologic and clinical findings in nine patients with splenic hydatidosis are described. The three men and six women were 41-76 years old (mean, 58 years). Their histories and physical findings, the results of serologic tests for hydatidosis, and imaging procedures were evaluated. Plain abdominal radiographs were obtained in all nine patients, sonograms in six, and CT scans in seven. Plain films showed calcification of the cyst wall in four of the nine patients. On sonograms, five lesions were anechoic and one was echogenic. On CT scans, all lesions except one were of lower attenuation than the surrounding spleen. None of the lesions enhanced after administration of IV contrast material. Although rare, splenic hydatidosis should be included in the differential diagnosis when a cystic splenic lesion is identified with sonography or CT.

Portal thrombosis: percutaneous transhepatic treatment with urokinase--a case report.

We present a case report of a patient suffering from portal and superior mesenteric vein thrombosis secondary to splenectomy. No surgical procedure could be performed due to the extension of thrombus. Local fibrinolysis treatment with urokinase through a percutaneous transhepatic approach was decided upon, and this procedure had a successful patient outcome.