A case of combined gastrojejunal and gastrocolic fistula secondary to gastric cancer.

A rare case of gastric cancer associated with gastrojejunal and gastrocolic fistula is presented. A 56-year-old man who had been diagnosed with advanced gastric cancer(Borrmann's type III) 5 months previously was admitted due to watery diarrhea and frequent vomiting for 2 weeks. Fluoroscopic examination was visualized two abnormal passage of contrast medium from the stomach, one to the colon, and the other to the jejunum. Gastrofiberscopy revealed that the tumor on the great curvature of the body appeared to penetrate into the colon, while the other one on the antrum directly invaded into the jejunum. The patient was treated conservatively with total parenteral nutrition and pain control.

MR imaging of tubo-ovarian abscess.

UNLABELLED: PURPOSE AND MATERIAL AND METHODS: MR findings of 9 surgically proven tubo-ovarian abscesses were analyzed in 8 patients. The images were evaluated for signal intensity characteristics and morphologic appearance of the mass, and presence of secondary changes in adjacent pelvic organs and structures. RESULTS: The signal intensity of the lesions on T1-weighted images was hypointense to the surrounding muscle and myometrium in 5 patients, isointense in 3 and hyperintense in 1. On T2-weighted images the signal intensity was hyperintense (n = 6) or heterogeneous (n = 3). A thin rim (1-3 mm) with hyperintensity on T1-weighted images was noted in the innermost aspect of the masses. Other findings were ill-defined margin, thickened wall, multiple internal septa, shading and gas collection. "Mesh-like" linear strands were noted in the pelvis in all patients, with involvement of adjacent pelvic organs in 7 and lymphadenopathy in 3. CONCLUSIONS: In this limited number of cases MR imaging showed great potential for demonstrating the extent of the disease, characterizing the lesions and making a specific diagnosis.

Abdominal actinomycosis: CT findings in 10 patients.

OBJECTIVE: The purpose of this study was to analyze the CT findings in 10 patients with abdominal actinomycosis to determine the appearance of lesions and the pattern of spread of the disease. MATERIALS AND METHODS: We retrospectively reviewed the CT findings in 10 patients with pathologically proved actinomycosis. Involved areas were the pelvis (n = 4), greater omentum (n = 3), liver (n = 2), and kidney (n = 1). Contrast-enhanced (oral and IV) CT scans were available in all patients. Unenhanced CT scans were also available in six patients. RESULTS: CT scans showed mostly solid masses with focal areas of diminished attenuation in seven patients and mostly cystic masses with thickened walls in three. CT findings confirmed the infiltrative nature of the disease, showing its tendency to invade across tissue planes and boundaries. Dense inhomogeneous contrast enhancement in the walls or solid components of masses was seen in eight patients. Minimal lymphadenopathy was seen in only two patients. CONCLUSION: Although nonspecific, actinomycosis should be included in the differential diagnosis when CT scans show an infiltrative mass with unusual aggressiveness and dense inhomogeneous contrast enhancement, especially in patients with fever, leukocytosis, or long-term use of intrauterine contraceptive devices.