scholarly journals P56 Gastrointestinal manifestations of COVID-19: a retrospective analysis

BJS Open ◽  
2021 ◽  
Vol 5 (Supplement_1) ◽  
Author(s):  
Osamah Niaz ◽  
Aaliya Uddin ◽  
Sangeetha Thomas ◽  
Katherine Harries ◽  
Sarah-Jane Walton ◽  
...  
Keyword(s):  
Ct Scan ◽  
Retrospective Analysis ◽  
Gastrointestinal Symptoms ◽  
District General Hospital ◽  
Chest Ct ◽  
Ct Scans ◽  
Abdominal Ct ◽  
Angiotensin Converting Enzyme 2 ◽  
Gastrointestinal Manifestations ◽  
Abdominal Ct Scan

Abstract Introduction Emerging data suggests that SARS-CoV-2 acts via the angiotensin-converting-enzyme-2 (ACE2) receptors in the cells, also present in the gastrointestinal and liver cells, resulting in gastrointestinal manifestations of COVID-19. It is challenging to diagnose COVID-19 in patients presenting with only gastrointestinal symptoms, with early suspicion and visualisation of the lung bases on computerised tomography(CT) abdomen scans being helpful. Methods Single-centre retrospective analysis of abdominal/chest CT scans was conducted within a District General Hospital. From the 6000 CT scans between March and April 2020, 1557(26%) were abdominal, 230 of which had chest CT scans with COVID-19 positive changes. 49 patients with CT abdomen and a positive CT Chest were shortlisted. All recorded documentation was assessed using online clinical portal and tabulated using Microsoft Excel®. Subdivision into 3 groups was: 1) primary gastrointestinal symptom, normal CT abdomen, 2) common COVID-19 symptoms with gastrointestinal symptoms, normal CT abdomen 3) gastrointestinal symptoms, abdominal pathology on radiology. Results COVID-19 related changes were seen on CT scans with no abdominal pathology noted in 33% (n = 16) patients with primary gastrointestinal symptoms. Further 18% (9 patients) presented with gastrointestinal symptoms alongside other common COVID-19 symptoms, however abdominal CT scan was normal. CT abdomen of these 25 patients were studied by a consultant radiologist, who examined the lung bases on the abdominal CT scan for COVID-19 related changes, which was seen in 92% patients. In 8% of the cases where the lung bases on the CT abdomen were normal, COVID-19 related changes were apparent on the CT chest. Conclusions CT scans of the abdomen should be supplemented with CT scans of the chest, when appropriate, for early accurate diagnosis, early treatment and triage to the correct wards, especially at the height of the pandemic.

scholarly journals A case of Vaccine-Induced Thrombotic Thrombocytopenia (VITT) with thrombosis of the superior mesenteric artery after ChAdOx1 nCov-19 COVID-19 Vaccine

2021 ◽  
Vol 17 (4) ◽  
Author(s):  
Laura Pini ◽  
Paolo Malerba ◽  
Jordan Giordani ◽  
Deborah Stassaldi ◽  
Carlo Aggiusti ◽  
...  
Keyword(s):  
Ct Scan ◽  
Superior Mesenteric Artery ◽  
Mesenteric Artery ◽  
Gastrointestinal Symptoms ◽  
Arterial System ◽  
Severe Thrombocytopenia ◽  
Rapid Improvement ◽  
Abdominal Ct ◽  
Abdominal Ct Scan ◽  
Laboratory Investigations

We describe the case of a 64 years-old woman admitted to the Emergency Department of the ASST-Spedali Civili of Brescia with fever and gastrointestinal symptoms 10 days after the first dose of ChAdOx1 nCov-19 vaccine. Laboratory investigations showed severe thrombocytopenia and high D-dimer, while an abdominal CT scan reported a partially occluding thrombosis of the superior mesenteric artery. Following treatment with fondaparinux, immunoglobulins and high dosage steroid therapy, we observed a rapid improvement of patient’s conditions. An ELISA assay showed the presence of antibodies against heparin PF4-complex. Subsequent abdominal CT-scan showed the superior mesenteric artery thrombosis resolution, and the patient was finally discharged after 12 days of hospitalization. Several reports pointed to the venous system as the main district affected by Vaccine-Induced Thrombotic Thrombocytopenia (VITT), while a peculiar feature of this report is the involvement of the mesenteric arterial system. Further investigation of VITT’s pathophysiological mechanisms is mandatory to develop preventive strategies and effective treatments.

TRAUMA GINJAL

2020 ◽  
Vol 4 (1) ◽  
pp. 52-57
Author(s):  
Noflih Sulistia ◽  
Bambang Soeprijanto ◽  
Indrastuti Normahayu ◽  
Lenny Violetta
Keyword(s):  
Ct Scan ◽  
Pediatric Patients ◽  
Radiological Examination ◽  
Renal Trauma ◽  
Abdominal Ct ◽  
Abdominal Ct Scan

Renal trauma in children is more common than in adults. Clinically in pediatric patients with renal trauma do not always describe the degreeof trauma. Radiological examination, especially abdominal CT-scan with contrast, can help evaluate the damage to the kidneys so that it candetermine the degree of trauma.

Study on the Radiation Dose of Abdominal CT Scan Using Dual Energy

2018 ◽  
Vol 20 (2) ◽  
pp. 123-132
Author(s):  
Dae-hyun Park ◽  
Young-Kyoon Kim ◽  
Jong-Ho Ahn ◽  
Kwang-Hyun Chang ◽  
Yoon-Chul Nam ◽  
...  
Keyword(s):  
Radiation Dose ◽  
Ct Scan ◽  
Dual Energy ◽  
Abdominal Ct ◽  
Abdominal Ct Scan

scholarly journals Splenic abscess caused by Streptococcus anginosus bacteremia secondary to urinary tract infection: a case report and literature review

Open Medicine ◽  
2020 ◽  
Vol 15 (1) ◽  
pp. 997-1002
Author(s):  
Hao Wu ◽  
Rui Zheng
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Ct Scan ◽  
Splenic Abscess ◽  
Low Density ◽  
Abdominal Ct ◽  
Streptococcus Anginosus ◽  
Abdominal Ct Scan ◽  
Tract Infections

AbstractOrgan abscesses caused by Streptococcus anginosus are relatively rare. We report the case of an elderly woman with splenic abscess caused by S. anginosus bacteremia after urinary tract infection. An 82-year-old woman had a history of frequency of urination, urgency, and fever with chills for over 10 days prior to admission. An abdominal computed tomography (CT) scan performed in the emergency room revealed a low-density lesion in the spleen, kidney cysts, some exudation around the kidney, and cystitis should be valued. She was treated with ceftriaxone and imipenem/cilastatin. After admission, the blood culture yielded positive results for S. anginosus. A contrast-enhanced abdominal CT scan showed that the low-density lesion previously found in the spleen was smaller than before. After percutaneous drainage of the splenic abscess and treatment with piperacillin/tazobactam based on the antibiotic sensitivity pattern, repeated abdominal CT scan revealed a significant reduction in the low-density lesion. The patient was discharged without recurrence or complications. A systematic review of organ abscess caused by S. anginosus bacteremia was performed. To our knowledge, there has been no report of splenic abscess caused by S. anginosus bacteremia secondary to urinary system tract infection, although urinary tract infections are also an important source.

scholarly journals Small intestine duplication cyst with recurrent hematochezia: a case report and literature review

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Zhicheng Zhang ◽  
Xiaowei Huang ◽  
Qian Chen ◽  
Demin Li ◽  
Qi Zhou ◽  
...  
Keyword(s):  
Small Intestine ◽  
Case Report ◽  
Literature Review ◽  
Ct Scan ◽  
Duplication Cyst ◽  
Abdominal Ct ◽  
Case Presentation ◽  
Abdominal Ct Scan ◽  
Capsule Endoscopes

Abstract Background Small intestine duplication cysts (SIDCs) are rare congenital anatomical abnormalities of the digestive tract and a rare cause of hematochezia. Case presentation We describe an adult female presented with recurrent hematochezia. The routine gastric endoscope and colonic endoscope showed no positive findings. Abdominal CT scan indicated intussusception due to the "doughnut" sign, but the patient had no typical symptoms. Two subsequent capsule endoscopes revealed a protruding lesion with bleeding in the distal ileum. Surgical resection was performed and revealed a case of SIDC measuring 6 * 2 cm located inside the ileum cavity. The patient remained symptom-free throughout a 7-year follow-up period. Conclusion SIDCs located inside the enteric cavity can easily be misdiagnosed as intussusception by routine radiologic examinations.

Comparative analysis of the radiation shield effect in an abdominal CT scan

2014 ◽  
Vol 64 (6) ◽  
pp. 929-935
Author(s):  
Seon-Chil Kim ◽  
Young-Jae Kim ◽  
Joon-Seok Lee ◽  
Kyung-Rae Dong ◽  
Woon-Kwan Chung ◽  
...  
Keyword(s):  
Comparative Analysis ◽  
Ct Scan ◽  
Radiation Shield ◽  
Abdominal Ct ◽  
Abdominal Ct Scan

Selective non-operative management of anterior abdominal stab wounds with emphasis on the value of follow-up abdominal CT scanning

Trauma ◽  
2017 ◽  
Vol 20 (3) ◽  
pp. 194-202
Author(s):  
El Yamani Fouda ◽  
Alaa Magdy ◽  
Sameh Hany Emile
Keyword(s):  
Ct Scan ◽  
Ct Scanning ◽  
Operative Management ◽  
Abdominal Ct ◽  
Management Group ◽  
Abdominal Ct Scan ◽  
Laparotomy Group ◽  
Abdominal Stab Wounds ◽  
Non Operative Management

Background and aim Selective non-operative management of patients with penetrating abdominal stabs is the preferred treatment strategy. The present study aimed to assess the efficacy and safety of non-operative management with emphasis on the value of follow-up abdominal CT scanning in management of patients with penetrating anterior abdominal stab. Patients and methods This is a retrospective chart review of stable patients with anterior abdominal stab wounds. Patients were divided in terms of initial decisions into two groups: laparotomy group and non-operative management group. Abdominal CT scan was performed for patients in the non-operative management group on admission and follow-up CT scanning was performed in cases of clinical and/or biochemical deterioration. Results The laparotomy group included 82 patients and 68.2% of them had unnecessary laparotomies. The non-operative management group comprised 97 patients and 90.7% of them did not require subsequent laparotomy. Abdominal CT scan had a sensitivity of 88.9% and specificity of 100% in detection of intra-abdominal injuries. Follow-up CT scanning detected bowel injuries missed by initial CT scan in three patients. The non-operative management group had significantly lower post-operative complication rate than the laparotomy group (4.1% vs. 18.3%), with a significantly shorter length of stay. Conclusions Non-operative management is the optimal management strategy for stable patients with penetrating anterior abdominal stab to decrease unnecessary laparotomy rates, hospital stay and costs. Follow-up abdominal CT scanning facilitated the decision making for patients selected for non-operative management and is highly sensitive in the diagnosis of patients who require subsequent exploration.

False-negative abdominal CT scan in a cocaine body stuffer

1999 ◽  
Vol 17 (7) ◽  
pp. 702-704 ◽  
Author(s):  
Janet G.H Eng ◽  
Steven E Aks ◽  
Rachel Waldron ◽  
Christopher Marcus ◽  
Stuart Issleib
Keyword(s):  
Ct Scan ◽  
False Negative ◽  
Abdominal Ct ◽  
Abdominal Ct Scan ◽  
Body Stuffer

EP.FRI.390 Improving care for patients with acute bowel obstruction: A closed loop audit

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Benjamin Clayphan ◽  
Anna Fairclough ◽  
Jeff Lim ◽  
Roderick Alexander
Keyword(s):  
Ct Scan ◽  
Patient Outcomes ◽  
Bowel Obstruction ◽  
Care Pathway ◽  
Imaging Modality ◽  
Ct Scans ◽  
Abdominal Ct ◽  
Retrospective Audit ◽  
Raising Awareness ◽  
Time To Diagnosis

Abstract Aims Acute Bowel Obstruction (ABO) accounts for 10% of emergency surgical admissions and when surgery is required mortality can exceed 10%. Early diagnosis is associated with improved patient outcomes and timely acquisition of abdominal CT scans can help prevent delays. The NCEPOD 2020 report on ABO identified ‘delays in imaging’ as a key area for improvement in the care of these patients, with these delays being exacerbated if an abdominal X-ray (AXR) was performed as well as an abdominal CT. This study looks at ways to expedite the diagnosis of patients presenting with ABO.   Methods A retrospective audit of 77 patients admitted from A&E or SAU with ABO from April 2019 to February 2020 was conducted. Imaging modality, time-to-CT scan and time-to-diagnosis was recorded. Results and recommendations were presented locally and an evidence based ABO care pathway was implemented and publicised. 20 patients were audited prospectively, post care pathway implementation.  Results 70.1% of patients from the initial audit received a CT-scan and 42% of these patients received an AXR before their eventual CT-scan. The average wait for a definitive radiological diagnosis was 27.8hr. After implementation of the pathway only 18% of patients audited received both modes of imaging and the average time to diagnosis has been reduced to 10.7hr.  Conclusions Raising awareness of the appropriate and timely use of CT-scans in the diagnosis of ABO has reduced the number of concomitant AXR for these patients, expediting the making of a definitive diagnosis and improving patient outcomes. 

Using chest CT scan and unsupervised machine learning for predicting and evaluating response to lumacaftor-ivacaftor in people with cystic fibrosis

2021 ◽  
pp. 2101344
Author(s):  
Alienor Campredon ◽  
Enzo Battistella ◽  
Clémence Martin ◽  
Isabelle Durieu ◽  
Laurent Mely ◽  
...  
Keyword(s):  
Machine Learning ◽  
Cystic Fibrosis ◽  
Ct Scan ◽  
Structural Changes ◽  
Clinical Status ◽  
Chest Ct ◽  
Ct Scans ◽  
Wall Thickening ◽  
Unsupervised Machine Learning ◽  
One Year

ObjectivesLumacaftor-ivacaftor is a cystic fibrosis transmembrane conductance regulator (CFTR) modulator known to improve clinical status in people with cystic fibrosis (CF). This study aimed to assess lung structural changes after one year of lumacaftor-ivacaftor treatment, and to use unsupervised machine learning to identify morphological phenotypes of lung disease that are associated with response to lumacaftor-ivacaftor.MethodsAdolescents and adults with CF from the French multicenter real-world prospective observational study evaluating the first year of treatment with lumacaftor-ivacaftor were included if they had pretherapeutic and follow-up chest computed tomography (CT)-scans available. CT scans were visually scored using a modified Bhalla score. A k-mean clustering method was performed based on 120 radiomics features extracted from unenhanced pretherapeutic chest CT scans.ResultsA total of 283 patients were included. The Bhalla score significantly decreased after 1 year of lumacaftor-ivacaftor (−1.40±1.53 points compared with pretherapeutic CT; p<0.001). This finding was related to a significant decrease in mucus plugging (−0.35±0.62 points; p<0.001), bronchial wall thickening (−0.24±0.52 points; p<0.001) and parenchymal consolidations (−0.23±0.51 points; p<0.001). Cluster analysis identified 3 morphological clusters. Patients from cluster C were more likely to experience an increase in percent predicted forced expiratory volume in 1 sec (ppFEV1) ≥5 under lumacaftor–ivacaftor than those in the other clusters (54% of responders versus 32% and 33%; p=0.01).ConclusionOne year treatment with lumacaftor-ivacaftor was associated with a significant visual improvement of bronchial disease on chest CT. Radiomics features on pretherapeutic CT scan may help in predicting lung function response under lumacaftor-ivacaftor.

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