Value of the surgical pancreatic duct anatomy and associated outcomes in pancreatic cancer.

INTRODUCTION: Pancreatic cancer recurrence following surgery is a significant challenge, and personalized surgical care is crucial. Topographical variations in pancreatic duct anatomy are frequent but often underestimated. This study aimed to investigate the potential importance of these variations in outcomes and patient survival after Whipple's procedures. METHODS: Data were collected from 105 patients with confirmed pancreatic head neoplasms who underwent surgery between 2008 and 2020. Radiological measurements of pancreatic duct location were performed, and statistical analysis was carried out using IBM SPSS. RESULTS: Inferior pancreatic duct topography was associated with an increased rate of metastatic spread and tumour recurrence. Additionally, inferior duct topography was associated with reduced overall and recurrence-free survival. Posterior pancreatic duct topography was associated with decreased incidence of perineural sheet infiltration and improved overall survival. DISCUSSION: These findings suggest that topographical diversity of pancreatic duct location can impact outcomes in Whipple's procedures. Intraoperative review of pancreatic duct location could help surgeons define areas of risk or safety and deliver a personalized surgical approach for patients with beneficial or deleterious anatomical profiles. This study provides valuable information to improve surgical management by identifying high-risk patients and delivering a personalized surgical approach with prognosis stratification.

Intraosseous hemangioma of the rib mimicking an aggressive chest wall tumor.

Bone hemangiomas are extremely rare in the ribs, with only a handful of cases reported in the literature. A case of a rib hemangioma is presented in which the pre-resection diagnosis was an aggressive chest wall tumor. The plain film, CT, MRI and bone scan features of the lesion were reviewed with the pathological correlation. On imaging, the lesion was expansile and lytic, and it also had fine bony trabeculae. The lesion also demonstrated growth beyond a disrupted bony cortex, suggesting malignancy. This case report adds to the literature on this rare condition and discusses the issues in the diagnosis of chest wall tumors.

Multiple mycotic aneurysms of the pulmonary arteries resolving with conservative management: multislice CT examination findings.

Mycotic pulmonary artery aneurysms are rare but potentially fatal complications of infective endocarditis. Three mycotic aneurysms developed in a 22-year-old female patient who had a history of intravenous drug use. She suffered from Staphylococcus aureus pneumonia and infective endocarditis. The patient was managed conservatively with antibiotics. She did not have hemoptysis during a prolonged hospital stay. Several multislice computed tomography examinations were performed to follow these aneurysms over a period of 19 months. The 2 smaller aneurysms had resolved by 9 weeks postdevelopment. The largest aneurysm was stable at 9 weeks and was smaller at 19 months, but it had not yet completely resolved. The literature on this rare condition was reviewed and its prognosis and management were discussed.

MDCT of acute lower gastrointestinal bleeding.

OBJECTIVE: We evaluated the use of MDCT in the diagnosis and management of lower gastrointestinal bleeding (hematochezia). CONCLUSION: MDCT is proposed as an alternative first-line investigation to locate lower gastrointestinal bleeding before placing the patient under observation or performing embolization or surgery.