[Crossed renal ectopia: radiological possibilities of helicoidal CAT]. / Ectopia renal cruzada: posibilidades radiológicas de la TAC helicoidal.

OBJECTIVES: To evaluate the diagnostical possibilities of helicoidal CAT in crossed renal ectopy (CRE) and review 36 cases published in Spain, including our 3 new patients. CLINICAL CASES: We present two women and a man aged between 54 and 82 who were diagnosed of left CRE. One of them showed an ureterocele and other one presented a splenic angiosarcoma. DISCUSSION: Main embriological theories, clinical presentation, associated anomalies and different radiological systems used in the diagnosis of this infrequent congenital malformation are evaluated.

[Pulmonary thromboembolism after chronic bladder distention]. / Thrombo-embolie pulmonaire à la suite d'une rétention vésicale chronique.

OBJECTIVE: To report a case of pulmonary embolism secondary to chronic over-distended bladder, responsible for iliac vein obstruction. CLINICAL CASE: A 73-year-old patient presented with sudden onset of pulmonary embolism, confirmed by isotope lung scan, after drainage of 2,300 cc of urine from an over-distended bladder, responsible for bilateral iliac vein obstruction and a bilateral obstructive uropathy. The patient had a favourable course after anticoagulation with heparin and temporary bladder catheterization, leading to resolution of the peripheral oedema and obstructive uropathy. CONCLUSION: About thirty cases of obstruction of large pelvic vessels due to over-distended bladder have been reported to date. However, and after an extensive review of the literature, this case appears to be the first report of pulmonary embolism secondary to chronic over-distended bladder.

[Inguinal bladder hernia in the adult]. / Hernias vesicales inguinales del adulto.

OBJECTIVE: To describe four additional cases of adult inguinal bladder hernia. METHODS: From 1986 to 1998, four cases of bladder inguinal herniation were diagnosed at our services. The etiology, diagnosis, treatment, associated conditions and complications are presented. RESULTS: Two cases had resulted from benign prostatic hyperplasia; one underwent TUR and the other was treated with alpha-blockers. The remaining two cases were due to prostatic carcinoma and were treated with hormone therapy. The bladder hernia was surgically repaired in three cases; the last patient refused surgery. CONCLUSIONS: A bladder hernia that is incidentally discovered during herniorrhaphy can be resolved without difficulty. However, problems may arise when an unsuspected bladder hernia is undetected due to preoperative bladder emptying and is included in the sutures of herniorrhaphy. When important bladder hernias are diagnosed preoperatively, surgical resolution is always indicated, as well as treatment by surgery or drugs of the urinary obstruction that contributed to the condition.

Port site metastases after laparoscopic cholecystectomy for an unexpected gallbladder carcinoma.

Laparoscopic cholecystectomy is a proven, well-accepted surgical technique for removing the diseased gallbladder and has rapidly become the surgical procedure of choice over conventional open cholecystectomy. Radiologists must be aware of the possibility of inadvertent dissemination of incidental gallbladder cancer during laparoscopic cholecystectomy. We report a case of this unusual complication: a patient with port site metastases after laparoscopic cholecystectomy for an unexpected gallbladder carcinoma at an early stage.

Unusual retrovesical masses in men.

Retrovesical masses in men not related to prostatic carcinoma or hyperplasia is an uncommon pathology. Rare masses or unusual manifestations of those common diseases are a diagnostic dilemma. We review our experience in three unusual retrovesical masses in men: carcinosarcoma filling a giant bladder diverticulum; cystic prostatic carcinoma; and acquired cystic dilatation of the seminal vesicle associated with a prostatic carcinoma that obstructed and invaded the vesicle. We report the imaging findings and review the literature. In our experience, the imaging findings are usually not specific for doing a precise diagnosis and biopsy procedures are necessary.