scholarly journals Volumetric Computed Tomography Angiography in the Evaluation of Mediastinal Fluid Collections following Congenital Cardiac Surgery

2013 ◽  
Vol 2013 ◽  
pp. 1-6
Author(s):  
Arno A. W. Roest ◽  
Joost Roelofs ◽  
Mark G. Hazekamp ◽  
Marry E. B. Rijlaarsdam ◽  
Jacob Geleijns ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Cardiac Surgery ◽  
Case Report ◽  
Radiation Dose ◽  
Essential Role ◽  
Fluid Collection ◽  
Congenital Cardiac Surgery ◽  
Imaging Tool ◽  
Fluid Collections ◽  
Accurate Imaging

We present 3 patients with 4 causes of mediastinal fluid collection after congenital cardiac surgery in this extended case report. Volumetric computed tomography played an essential role in diagnosing causes and extent, relevant to subsequent management. Recent advances in volumetric computed tomography allow fast and accurate imaging of cardiovascular and extravascular structures in children with acceptable radiation dose, providing a powerful imaging tool for the evaluation of complications after congenital cardiac surgery.

Diagnostic Accuracy of Intra-abdominal Fluid Collection Characterization in the Era of Multidetector Computed Tomography

2012 ◽  
Vol 78 (2) ◽  
pp. 185-189 ◽  
Author(s):  
Brian C. Allen ◽  
Huiman Barnhart ◽  
Mustafa Bashir ◽  
Christopher Nieman ◽  
Steven Breault ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Multidetector Ct ◽  
Imaging Finding ◽  
Fluid Collection ◽  
Ct Guided ◽  
High Attenuation ◽  
Institutional Review ◽  
Imaging Characteristics ◽  
Fluid Collections ◽  
Ct Density

The purpose of this study was to test the hypothesis that with improved technology, the presence of abscess in a postoperative fluid collection may be prospectively made. This is an Institutional Review Board-approved, Health Insurance Portability and Accountability Act-compliant retrospective review of computed tomography (CT)-guided intra-abdominal fluid collection drainages. The diagnostic CT scans of 95 consecutive patients performed on 16- and 64-multidetector CT (MDCT) were reviewed by four readers with varying abdominal imaging expertise. Readers were asked to determine fluid content, to document whether infection was present, and to rate reader confidence for infection. A fifth radiologist reviewed the collections for imaging characteristics. The gold standard for presence of infection was microbiological Gram stain and culture. The logistic regression model showed that both fluid collections containing gas or high attenuation fluid (average CT density 20 or greater Hounsfield units) are significant predictors of infection ( P = 0.001). The average sensitivity over the four readers for determining presence of infection was 83.4 per cent and specificity was 39.3 per cent. Even in the era of MDCT, the ability to predict whether or not a fluid collection is infected or not, based on imaging findings alone, is limited. Presence of gas is a strong indicator of infection, but no imaging finding is characteristic of a sterile fluid collection.

Iatrogenic diaphragmatic hernia in an infant following cardiac surgery: the culprit in a case of unresolved respiratory distress: Case report and review of the literature

2019 ◽  
Vol 29 (2) ◽  
pp. 238-240
Author(s):  
Erica N. Heinrichs ◽  
Michelle S. Miller
Keyword(s):  
Cardiac Surgery ◽  
Case Report ◽  
Respiratory Distress ◽  
Diaphragmatic Hernia ◽  
Rare Complication ◽  
Review Of The Literature ◽  
Congenital Cardiac Surgery ◽  
Pediatric Intervention

AbstractAcquired diaphragmatic hernia is a rare complication of pediatric intervention or surgery. In this study, we report an infant with iatrogenic diaphragmatic hernia following neonatal complex congenital cardiac surgery, and then we review the associated literature.

scholarly journals Subdural fluid collection and hydrocephalus following cervical schwannoma resection: hydrocephalus resolution after spinal pseudomeningocele repair: case report

2016 ◽  
Vol 25 (6) ◽  
pp. 762-765 ◽  
Author(s):  
Nicola Benedetto ◽  
Federico Cagnazzo ◽  
Carlo Gambacciani ◽  
Paolo Perrini
Keyword(s):  
Cerebrospinal Fluid ◽  
Case Report ◽  
Clinical Symptoms ◽  
Obstructive Hydrocephalus ◽  
Fluid Collection ◽  
Flow Dynamics ◽  
Subdural Fluid Collection ◽  
Ventricular Dilation ◽  
Cerebrospinal Fluid Flow ◽  
Fluid Collections

The authors report the case of a 31-year-old man who developed neck pain and headache 2 months after the uncomplicated resection of a cervical schwannoma. MR imaging revealed infratentorial subdural fluid collections and obstructive hydrocephalus associated with cervical pseudomeningocele. The clinical symptoms, subdural fluid collections, and ventricular dilation resolved after surgical correction of the pseudomeningocele. This report emphasizes that hydrocephalus may be related to disorders of cerebrospinal fluid flow dynamics induced by cervical pseudomeningocele. In these rare cases, both the hydrocephalus and the symptoms are resolved by the simple correction of the pseudomeningocele.

scholarly journals Dropped Gallstones Causing a Perihepatic Abscess and Empyema

2015 ◽  
Vol 2015 ◽  
pp. 1-3 ◽  
Author(s):  
J. R. Robinson ◽  
J. K. Wright ◽  
S. K. Geevarghese
Keyword(s):  
Computed Tomography ◽  
Laparoscopic Cholecystectomy ◽  
Fluid Collection ◽  
Surgical Operation ◽  
Initial Operation ◽  
Iatrogenic Perforation ◽  
Abdominal Exploration ◽  
Night Sweats ◽  
Fluid Collections ◽  
Gallstone Spillage

Iatrogenic perforation of the gallbladder during laparoscopic cholecystectomy is a well-known occurrence; however, the consequences of spillage of gallstones in the peritoneum and particularly intrathoracic complications are less defined. We describe the delayed development of a perihepatic abscess and empyema in a patient five years following laparoscopic cholecystectomy secondary to dropped gallstones. A 53-year-old man with medical history significant for a laparoscopic cholecystectomy five years prior to acute cholecystitis presented with purulent cough, hemoptysis, night sweats, and right-upper quadrant (RUQ) pain. Computed tomography (CT) scan revealed 5.4 cm right-sided subpulmonic and 5.9 cm perihepatic fluid collections with an 8 mm focal radiopaque density within the perihepatic fluid collection. Open intra-abdominal exploration resulted in retrieval of a 1 cm intraperitoneal gallstone. Laparoscopic cholecystectomy is a common surgical operation during which gallstone spillage can occur, causing both intra-abdominal and intrathoracic complications, presenting even years after surgery. This necessitates an attempt to retrieve all free intra-abdominal gallstones during the initial operation.

scholarly journals Splenic injury following endoscopic drainage of a large pancreatic pseudocyst: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Krittin J. Supapannachart ◽  
Christopher R. Funk ◽  
Lauren M. Gensler ◽  
Matthew P. Butters
Keyword(s):  
Computed Tomography ◽  
Case Report ◽  
Pancreatic Pseudocyst ◽  
Left Kidney ◽  
Fluid Collection ◽  
Mass Effect ◽  
Pancreatic Pseudocysts ◽  
Endoscopic Drainage ◽  
Left Pleural Effusion ◽  
Splenic Hematoma

Abstract Background Many pancreatic pseudocysts spontaneously resolve, but larger or symptomatic pseudocysts may require procedural management. Though endoscopic ultrasound guided approaches are standard of care and have high success rates, complications can include bleeding, infection, and splenic perforation. This patient case report details an unusual series of complications of endoscopic cystogastrostomy that should encourage clinicians to evaluate for anatomic disruptions caused by mass effects of pancreatic pseudocysts prior to endoscopic pseudocyst drainage. Case presentation A 53-year-old African American male with a past medical history notable for alcohol use disorder, chronic pancreatitis, and insulin dependent diabetes presented with a 4-day history of left upper quadrant abdominal pain. Computed tomography imaging with contrast revealed enlargement of a known pancreatic pseudocyst to 15.9 × 10.4 cm. Due to pseudocyst size and the patient’s symptoms, endoscopic cystogastrostomy stent placement was performed. However, postprocedurally, he developed leukocytosis to 19,800 cells/m3 (from 14,100 cells/m3 preoperatively) as well as acute hypoxemic respiratory failure with a large left pleural effusion. Postprocedural computed tomography with contrast demonstrated a new large subcapsular splenic hematoma in communication with a new subdiaphragmatic fluid collection. Due to suspicion of endoscopic procedural complication, he underwent open laparotomy which revealed grade 4 splenic laceration, septic splenic hematoma, and a subdiaphragmatic abscess. Conclusions While endoscopic drainage of pancreatic pseudocyst was technically successful, this case demonstrates complications from mass effect of a large pancreatic pseudocyst which putatively tore the splenorenal ligament, leading to excessive separation of the left kidney and spleen. If anatomic disruptions caused by mass effect from a pancreatic pseudocyst are recognized through preprocedural abdominal imaging, such cases may be considered for early open repair versus cystogastrostomy.

scholarly journals Optimal management of peripancreatic fluid collection with postoperative pancreatic fistula after distal pancreatectomy: Significance of computed tomography values for predicting fluid infection

PLoS ONE ◽  
2021 ◽  
Vol 16 (11) ◽  
pp. e0259701
Author(s):  
Koki Maeda ◽  
Naohisa Kuriyama ◽  
Yuki Nakagawa ◽  
Takahiro Ito ◽  
Aoi Hayasaki ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Pancreatic Fistula ◽  
Distal Pancreatectomy ◽  
Fluid Collection ◽  
Intervention Group ◽  
Postoperative Pancreatic Fistula ◽  
Optimal Management ◽  
Duration Of Hospitalization ◽  
Pancreatic Fistulas ◽  
Fluid Collections

Peripancreatic fluid collections have been observed in most patients with postoperative pancreatic fistula after distal pancreatectomy; however, optimal management remains unclear. This study aimed to evaluate the management and outcomes of patients with postoperative pancreatic fistula and verify the significance of computed tomography values for predicting peripancreatic fluid infections after distal pancreatectomy. We retrospectively investigated 259 consecutive patients who underwent distal pancreatectomy. Grade B postoperative pancreatic fistula patients were divided into two subgroups (B-antibiotics group and B-intervention group) and outcomes were compared. Predictive factor analysis of peripancreatic fluid infection was performed. Clinically relevant postoperative pancreatic fistulas developed in 88 (34.0%) patients. The duration of hospitalization was significantly longer in the B-intervention (n = 54) group than in the B-antibiotics group (n = 31; 41 vs. 17 days, p < 0.001). Computed tomography values of the infected peripancreatic fluid collections were significantly higher than those of the non-infected peripancreatic fluid collections (26.3 vs. 16.1 Hounsfield units, respectively; p < 0.001). The outcomes of the patients with grade B postoperative pancreatic fistulas who received therapeutic antibiotics only were considerably better than those who underwent interventions. Computed tomography values may be useful in predicting peripancreatic fluid collection infection after distal pancreatectomy.

scholarly journals Ascending aorta pseudoaneurysm simulating mediastinal lymphoma in computed tomography, a possible diagnostic error: a case report

2020 ◽  
Vol 14 (1) ◽  
Author(s):  
Marcello Chiocchi ◽  
Luigi Spiritigliozzi ◽  
Federica Di Tosto ◽  
Leonardo Benelli ◽  
Francesca D’Errico ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Cardiac Surgery ◽  
Case Report ◽  
Rare Complication ◽  
Laboratory Data ◽  
Aortic Pseudoaneurysm ◽  
Computed Tomographic ◽  
Imaging Results ◽  
Mediastinal Lymphoma ◽  
Ascending Aortic Pseudoaneurysm

Abstract Background An ascending aortic pseudoaneurysm is a severe and rare complication following cardiothoracic surgery. This case report demonstrates its possible misinterpretation and the consequent importance of multidisciplinary evaluation. Case presentation We present a case of an 18-year-old Caucasian man with Marfan syndrome who developed an ascending aortic pseudoaneurysm about 1 year after undergoing cardiac surgery with the Bentall procedure. Computed tomographic examination of the thoracic aorta and positron emission tomography–computed tomography initially suggested a lymphomatous pathology. However, these imaging results were in contrast to the transesophageal echocardiogram and the laboratory data that showed negative results for hematological pathology. A second computed tomographic scan redirected the diagnosis toward a pseudoaneurysm. Conclusion This case demonstrates the utility of close communication and interdisciplinary consultation between cardiovascular radiologists and the cardiac surgery team, which are mandatory in order to maximize their diagnostic skills in identifying postoperative complications.

Myocardial Rupture Secondary to Ventricular Septal Hematoma: A Case Report and Review of Contemporary Literature

2019 ◽  
Vol 10 (6) ◽  
pp. 793-795
Author(s):  
Maruti Haranal ◽  
Chee Chin Hew ◽  
Jeffrey Jeswant Dillon
Keyword(s):  
Cardiac Surgery ◽  
Case Report ◽  
Ventricular Septal Defect ◽  
Literature Search ◽  
Septal Defect ◽  
Contemporary Literature ◽  
Myocardial Necrosis ◽  
Congenital Cardiac Surgery ◽  
Patch Closure ◽  
Myocardial Rupture

Interventricular septal hematoma following congenital cardiac surgery is an uncommon entity. Literature search reveals few cases of interventricular septal hematoma complicating pediatric cardiac surgery. We report a case of interventricular septal hematoma following patch closure of ventricular septal defect, with associated myocardial necrosis and myocardial rupture.

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