Leiomyomatosis peritonealis disseminata with formation of endometrial cysts within tumors arising after supracervical laparoscopic hysterectomy.

BACKGROUND: Use of morcellation during laparoscopic hysterectomy may result in seeding of uterine tissue throughout the abdominal cavity and development of 'iatrogenic' leiomyomatosis peritonealis disseminata. CASE: Two years after a supracervical laparoscopic hysterectomy a 42-year-old parous women presented with abdominal pain and bloating. CT scans and subsequent surgical exploration reveled multiple solid tumors containing cysts filled with altered blood. Histologically the tumors had characteristic features of a benign leiomyoma with smooth muscle cells infiltrated by endometrial glands. CONCLUSION: Pieces of smooth muscle cell and endometrial uterine tissue lost in the abdominal cavity during morcellation may progress to leiomyomatosis peritonealis disseminata with unusual appearance.

External and middle ear diseases: radiological diagnosis based on clinical signs and symptoms.

OBJECTIVE: Pathology of the external and middle ear is the most frequent reason to prescribe antibiotics and perform surgery in children and young adults. In the majority of cases imaging studies are not performed; the need for imaging comes when complications are suspected or when treatment is not effective. This paper discusses indications for temporal bone imaging studies and presents the most frequent pathological conditions, together with differential diagnosis, clinical symptoms and methods of treatment. METHODS AND RESULTS: This pictorial review describes major external and middle ear diseases, with special regard to clinical findings and appropriate reporting. CONCLUSIONS: Apprehension of the complete clinical picture, together with imaging clues, narrows differential diagnosis and helps avoid mistakes. Evaluation of temporal bone pathologies requires close cooperation between the clinician and radiologist.

Anatomical variation of bony pelvis from the viewpoint of transobturator sling placement for stress urinary incontinence.

INTRODUCTION AND HYPOTHESIS: The aim of the study was to investigate the variability of bony pelvis architecture from the viewpoint of transobturator sling placement. METHODS: The pelvimetry was performed on 122 women who underwent pelvic computed tomography. Measurements included: the distance between the interobturator foramina line and inferior pubic symphysis (IF-PS distance) as well as pubic arch angle, pubic ramus width, and pubic symphysis length. RESULTS: The length of the IF-PS distance varied between 7.4 and 26.9 mm (mean 15.2 ± 4.3 mm, median 14.2 mm). The distribution of measurements was asymmetrical with a tilt of the values towards shorter distances. In 11.5% of women, the IF-PS distance was longer than 20 mm. The IF-PS distance correlated with the pubic ramus width (r = 0.37, p < 0.0001) and pubic arch angle (r = -0.22, p = 0.017). CONCLUSION: The IF-PS distance varies considerably in the general population of women.

Dynamic CT of hepatic cirrhosis.

The aim of this research was the estimation of the dynamic sequential CT scanning (d-CT) method of the cirrhotic liver. The examined group consisted of 23 patients (8 women and 15 men, average age--57) histopathologically diagnosed as the cirrhotic liver. Dynamic CT scanning was performed 30-40 seconds after contrast material injection administered with an automatic syringe in the amount of 125 ml at flow time 2-3 ml/s. After the administration of contrast material the measurements of the hepatic parenchyma density were taken both in the left and right lobes. Time-density curves of the liver, spleen and portal vein were drawn for each patient. The curves of the liver and spleen of cirrhotic liver patients were not different from the curves obtained due to examining people with no medical problems. The time of peak enhancement of the liver and spleen of cirrhotic liver patients was delayed compared with control group. Time-density curves of the liver and spleen were considerably flattened of peak and were slow and longer in washout phase. Moreover, the time of peak enhancement of the portal vein curves was longer and the curves were flattened. Three cirrhotic liver patients had focal neoplastic lesion. The patterns of the time-density curves of the liver in dynamic CT scanning may contain diagnostic information useful for prophylactic monitoring of the neoplastic lesion, which develops in hepatic cirrhosis.