Ultrasonography and computed tomography of afferent loop obstruction.

The US and CT findings in a case of afferent loop obstruction after total gastrectomy are reported. A U-shaped fluid filled tubular structure crossing the midline between the abdominal aorta and the superior mesenteric artery (SMA) is a characteristic US and CT image of an afferent loop obstruction. CT is helpful to recognize the bowel wall and to demonstrate its relationship with the biliary system. Its vague clinical picture and confusing laboratory findings may mimic pseudocysts.

Familial occurrence of paragangliomas.

The occurrence of paragangliomas in three members of the same family is reported. It concerned a left carotid body tumor in one patient, a left carotid body tumor in her older sister, and a concomitant jugulotympanic and vagal body tumor in their younger brother. The radiological diagnosis in these patients was based on the typical hypervascular character in specific locations both on angiography and computed tomography. The familial occurrence of these lesions should be kept in mind whenever a chemodectoma is found, even in the absence of clinical symptoms in the direct relatives of the patients.

Spontaneous retroperitoneal renal hemorrhage: imaging and angiographic findings in five patients.

The authors describe one case and report four other of pathologically proven spontaneous retroperitoneal renal hemorrhage due to a ruptured hemorrhagic cyst (2 cases), a renal cell carcinoma, an angiomyolipoma, and a tubular adenoma. The contribution of US, CT, and angiography to the diagnosis is discussed and the recent literature is reviewed.

Common hepatic artery aneurysm: diagnosis with duplex sonography and color Doppler.

Hepatic artery aneurysms are uncommon lesions, often with a nonspecific clinical presentation and difficult to diagnose before rupture. The authors report a case which was correctly diagnosed with non-invasive procedures (duplex sonography and color Doppler).

Combined percutaneous balloon dilation and extracorporeal shock wave lithotripsy for treatment of biliary stricture and common bile duct stones.

We report a case of cholangitis, liver abscess, and common bile duct stones in a patient with a benign stricture at a choledochojejunal anastomosis, 3 yr after a complicated duodenohemipancreatectomy. Because surgical reintervention seemed inappropriate, a percutaneous transhepatic balloon dilation was performed after temporary internal-external biliary drainage. Extracorporeal shockwave lithotripsy (ESWL) was successfully applied to fragment all common bile duct stones, with subsequent spontaneous evacuation of all stone fragments through the dilated bilioenteric anastomosis. Only one similar case report has been published before (1), though with a different sequence of therapeutic modalities. Moreover, according to our literature review, this is the first report of ESWL of common bile duct stones by means of the Dornier Compact Lithotriptor (Dornier, Germany) with electromagnetic shockwave source.