scholarly journals Usefulness of Plain Computed Tomography with Swallowing of GastrografinTM for the Diagnosis of a Late-Onset Iatrogenic Diaphragmatic Hernia following Biopsy of a Diaphragmatic Tumor: Report of a Case

2018 ◽  
Vol 12 (2) ◽  
pp. 271-276
Author(s):  
Yoh Asahi ◽  
Shohei Honda ◽  
Tadao Okada ◽  
Hisayuki Miyagi ◽  
Makoto Kaneda ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Diaphragmatic Hernia ◽  
Late Onset ◽  
Epigastric Pain ◽  
Contrast Study ◽  
Mixed Germ Cell Tumor ◽  
Left Diaphragm ◽  
Granulomatous Lesions ◽  
Chest X Ray ◽  
Diaphragmatic Tumor

Although diaphragmatic hernia (DH) may be congenital, posttraumatic, or iatrogenic, DHs after diaphragmatic surgery are rarely reported in the literature. This report describes the rare case of a 14-year-old girl complicated by iatrogenic DH following the biopsy of granulomatous lesions of the left diaphragm, when a mediastinal mixed germ cell tumor was extirpated. Plain computed tomography (CT) with swallowing of GastrografinTM was useful for the diagnosis of this disorder. The patient presented to our hospital with frequent epigastric pain and vomiting 11 months after the original surgery. Chest X-ray, a gastrointestinal contrast study, and plain CT with swallowing of GastrografinTM revealed the left DH with gastric content. At laparotomy, the diaphragmatic defect, 3 × 3 cm in diameter, was repaired using nonabsorbable sutures after hernia reduction. The patient showed a rapid recovery with complete resolution of symptoms. We should consider the presence of iatrogenic DH in patients who develop epigastralgia after procedures involving the diaphragm, even at 11 months after the original surgery. Furthermore, plain CT with swallowing of GastrografinTM is useful for the diagnosis of this disorder.

scholarly journals DIAPHRAGMATIC RUPTURE AN EMERGENCY CASE REPORT

2020 ◽  
Vol 2 (2) ◽  
pp. 93
Author(s):  
IFADA INDRIYANI ◽  
WIDIASTUTI WIDIASTUTI ◽  
THARINA LAWEI ◽  
DARMAWAN ISMAIL
Keyword(s):  
Computed Tomography ◽  
Case Report ◽  
Ct Scan ◽  
Diaphragmatic Rupture ◽  
Early Assessment ◽  
Emergency Case ◽  
X Ray ◽  
Left Diaphragm ◽  
Computed Tomography Scanning ◽  
Chest X Ray

<p class="Abstract"><strong><em> ABSTRACT</em></strong></p><p class="TextAbstract"><strong><em>Introduction:</em></strong><em> Diaphragmatic rupture is a major challenge for the radiologist to be confirmed as an emergency diagnosis. The prevalence of the injury is 5% of abdominal blunt force trauma cases. Left-sided injury is more common with left-to-right ratio 3:1. Chest X-Ray is a conventional modality as an early assessment of abdominal trauma and computed tomography is a standard reference to confirm this diagnosis.</em></p><p class="TextAbstract"><strong><em>Case Report:</em></strong><em> A 70 yo man complained about chest pain after falling from 4 meter-height tree. Chest X-Ray revealed bowel gas appearance in the left thorax cavity with no appearance of left diaphragm. Contrasted abdominal CT showed gaster and intestine in the left thorax cavity. The patient underwent left diaphragm thoracotomy confirming the existence of gaster, ileum, and spleen in the pleural cavity. Those organs were returned to the abdomen and the left diaphragm repaired. Following-up after discharge obtained remarkable outcomes.</em></p><p class="TextAbstract"><strong><em>Discussion:</em></strong><em> Confirming the diagnosis of diaphragmatic rupture is a challenge for the radiologist because it can be asymptomatic until life-threatening complications manifest such as respiratory disorders and visceral incarceration.</em></p><p class="TextAbstract"><strong><em>Conclusion</em></strong><em>: With the improvement of imaging technology, the radiologist is able to confirm a diaphragmatic rupture to get a better prognosis. </em></p><p class="TextAbstract"><em> </em></p><p class="TextAbstract"><strong><em>Key words: </em></strong><strong><em>diaphragmatic rupture</em></strong><strong><em>; trauma</em></strong><strong><em>; </em></strong><strong><em>chest X-</em></strong><strong><em>ray</em></strong><strong><em>; computed tomography</em></strong></p><p class="TextAbstract"><strong> </strong></p><p class="TextAbstract" align="center"><strong>ABSTRAK</strong></p><p class="TextAbstract" align="center"><strong> </strong></p><p class="TextAbstract"><strong>Pendahuluan</strong> : Konfirmasi diagnosis emergensi ruptur diafragma masih menjadi tantangan bagi spesialis radiologi. Prevalensi ruptur diafragma sebesar 5% dari kasus trauma tumpul abdomen dan perlukaan diafragma pada sisi kiri lebih umum terjadi dibandingkan sisi kanan dengan rasio 3:1. Foto X-Ray dada merupakan modalitas konvensional sebagai penilaian awal trauma abdomen dan <em>computed tomography scanning</em> (CT scan) merupakan standar pemeriksaan untuk mendiagnosis kasus tersebut.</p><p class="TextAbstract"><strong>Laporan Kasus </strong>: Seorang laki-laki berusia 70 tahun mengeluhkan nyeri dada setelah jatuh dari pohon setinggi 4 meter. X-ray dada menunjukkan gambaran gas usus di sebelah kiri rongga thorax dan tidak tampak gambaran diafragma kiri. CT scan abdomen dengan kontras menunjukkan gambaran lambung dan usus di sebelah kiri rongga thorax. Pasien tersebut kemudian ditatalaksana dengan thorakotomi diafragma kiri untuk mengkonfirmasi adanya lambung, ileum dan lien pada rongga pleura. Organ-organ tersebut kemudian dikembalikan ke dalam abdomen dan diafragma kiri direparasi. Kondisi klinis pasien setelah penatalaksanaan tersebut menunjukkan perbaikan.</p><p class="TextAbstract"><strong>Diskusi</strong> : Konfirmasi diagnosis ruptur diafragma merupakan tantangan bagi spesialis radiologi karena kasus tersebut bisa tidak bergejala sampai timbulnya komplikasi yang mengancam jiwa seperti gangguan respirasi dan perlekatan organ visceral.</p><p class="TextAbstract"><strong>Kesimpulan : </strong>Dengan adanya perkembangan teknologi<strong> </strong>pencitraan, spesialis radiologi dapat mengkonfirmasi ruptur diafragma sehingga memberikan prognosis yang lebih baik.</p><p class="TextAbstract"> </p><p class="TextAbstract"><strong>Kata Kunci : ruptur diafragma</strong><strong><em>; </em></strong><strong>trauma;<em> </em></strong><strong><em>chest X-ray, computed tomography</em></strong></p>

Computed tomography of late-onset epilepsy

1982 ◽  
Vol 18 (3) ◽  
pp. 442
Author(s):  
Y S Kim ◽  
J Y Im ◽  
Y G Joo ◽  
S K Park
Keyword(s):  
Computed Tomography ◽  
Late Onset

scholarly journals Faecopneumothorax due to missing diaphragmatic hernia: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Resul Nusretoğlu ◽  
Yunus Dönder
Keyword(s):  
Computed Tomography ◽  
Diaphragmatic Hernia ◽  
Colon Resection ◽  
Emergency Laparotomy ◽  
Hernia Sac ◽  
Case Presentation ◽  
Abdominal Tenderness ◽  
History Of ◽  
Diaphragmatic Hernias ◽  
Tomography Scan

Abstract Background Diaphragmatic hernias may occur as either congenital or acquired. The most important cause of acquired diaphragmatic hernias is trauma, and the trauma can be due to blunt or penetrating injury. Diaphragmatic hernia may rarely be seen after thoracoabdominal trauma. Case presentation A 54-year-old Turkish male patient admitted to the emergency department with abdominal pain and dyspnea ongoing for 2 days. He had general abdominal tenderness in all quadrants. He had a history of a stabbing incident in his left subcostal region 3 months ago without any pathological findings in thoracoabdominal computed tomography scan. New thoracoabdominal computed tomography showed a diaphragmatic hernia and fluid in the hernia sac. Due to respiratory distress and general abdominal tenderness, the decision to perform an emergency laparotomy was made. There was a 6 cm defect in the diaphragm. There were also necrotic fluids and stool in the hernia sac in the thorax colon resection, and an anastomosis was performed. The defect in the diaphragm was sutured. The oral regimen was started, and when it was tolerated, the regimen was gradually increased. The patient was discharged on the postoperative 11th day. Conclusions Acquired diaphragmatic hernia may be asymptomatic or may present with complications leading to sepsis. In this report, acquired diaphragmatic hernia and associated colonic perforation of a patient with a history of stab wounds was presented.

scholarly journals Efficacy of chest X-ray in the diagnosis of COVID-19 pneumonia: comparison with computed tomography through a simplified scoring system designed for triage

2021 ◽  
Vol 52 (1) ◽  
Author(s):  
Akın Çinkooğlu ◽  
Selen Bayraktaroğlu ◽  
Naim Ceylan ◽  
Recep Savaş
Keyword(s):  
Computed Tomography ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Scoring System ◽  
Imaging Modality ◽  
Ground Glass Opacity ◽  
Initial Presentation ◽  
X Ray ◽  
Chest X Ray

Abstract Background There is no consensus on the imaging modality to be used in the diagnosis and management of Coronavirus disease 2019 (COVID-19) pneumonia. The purpose of this study was to make a comparison between computed tomography (CT) and chest X-ray (CXR) through a scoring system that can be beneficial to the clinicians in making the triage of patients diagnosed with COVID-19 pneumonia at their initial presentation to the hospital. Results Patients with a negative CXR (30.1%) had significantly lower computed tomography score (CTS) (p < 0.001). Among the lung zones where the only infiltration pattern was ground glass opacity (GGO) on CT images, the ratio of abnormality seen on CXRs was 21.6%. The cut-off value of X-ray score (XRS) to distinguish the patients who needed intensive care at follow-up (n = 12) was 6 (AUC = 0.933, 95% CI = 0.886–0.979, 100% sensitivity, 81% specificity). Conclusions Computed tomography is more effective in the diagnosis of COVID-19 pneumonia at the initial presentation due to the ease detection of GGOs. However, a baseline CXR taken after admission to the hospital can be valuable in predicting patients to be monitored in the intensive care units.

scholarly journals Diagnosing gastric volvulus in chest X-ray: report of three cases

2020 ◽  
Vol 2020 (7) ◽  
Author(s):  
Narendra Pandit ◽  
Abhijeet Kumar ◽  
Tek Narayan Yadav ◽  
Qamar Alam Irfan ◽  
Sujan Gautam ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Acute Abdomen ◽  
Gastric Volvulus ◽  
X Ray ◽  
Pain Abdomen ◽  
Life Threatening ◽  
Chest X Ray ◽  
High Index Of Suspicion ◽  
Specific Symptoms ◽  
Prompt Diagnosis

Abstract Gastric volvulus is a rare abnormal rotation of the stomach along its axis. It is a surgical emergency, hence requires prompt diagnosis and treatment to prevent life-threatening gangrenous changes. Hence, a high index of suspicion is required in any patients presenting with an acute abdomen in emergency. The entity can present acutely with pain abdomen and vomiting, or as chronic with non-specific symptoms. Chest X-ray findings to diagnose it may be overlooked in patients with acute abdomen. Here, we report three patients with gastric volvulus, where the diagnosis was based on the chest X-ray findings, confirmed with computed tomography, and managed successfully with surgery.

scholarly journals Incidental renal tumours on low-dose CT lung cancer screening exams

2016 ◽  
Vol 24 (2) ◽  
pp. 104-109 ◽  
Author(s):  
Paul F Pinsky ◽  
Barbara Dunn ◽  
David Gierada ◽  
P Hrudaya Nath ◽  
Reginald Munden ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Lung Cancer ◽  
Renal Cancer ◽  
Low Dose ◽  
Lung Cancer Screening ◽  
National Lung Screening Trial ◽  
Renal Tumours ◽  
Chest X Ray ◽  
Low Dose Computed Tomography ◽  
Lung Screening

Introduction Renal cancer incidence has increased markedly in the United States in recent decades, largely due to incidentally detected tumours from computed tomography imaging. Here, we analyze the potential for low-dose computed tomography lung cancer screening to detect renal cancer. Methods The National Lung Screening Trial randomized subjects to three annual screens with either low-dose computed tomography or chest X-ray. Eligibility criteria included 30 + pack-years, current smoking or quit within 15 years, and age 55–74. Subjects were followed for seven years. Low-dose computed tomography screening forms collected information on lung cancer and non-lung cancer abnormalities, including abnormalities below the diaphragm. A reader study was performed on a sample of National Lung Screening Trial low-dose computed tomography images assessing presence of abnormalities below the diaphragms and abnormalities suspicious for renal cancer. Results There were 26,722 and 26,732 subjects enrolled in the low-dose computed tomography and chest X-ray arms, respectively, and there were 104 and 85 renal cancer cases diagnosed, respectively (relative risk = 1.22, 95% CI: 0.9–1.5). From 75,126 low-dose computed tomography screens, there were 46 renal cancer diagnoses within one year. Abnormalities below the diaphragm rates were 39.1% in screens with renal cancer versus 4.1% in screens without (P < 0.001). Cases with abnormalities below the diaphragms had shorter median time to diagnosis than those without (71 vs. 160 days, P = 0.004). In the reader study, 64% of renal cancer cases versus 13% of non-cases had abnormalities below the diaphragms; 55% of cases and 0.8% of non-cases had a finding suspicious for renal cancer (P < 0.001). Conclusion Low-dose computed tomography screens can potentially detect renal cancers. The benefits to harms tradeoff of incidental detection of renal tumours on low-dose computed tomography is unknown.

scholarly journals Laparoscopic Repair of a Diaphragmatic Hernia Associated with Radiofrequency Ablation for Hepatocellular Carcinoma: Lessons from a Case and the Review of the Literature

2014 ◽  
Vol 99 (4) ◽  
pp. 384-390 ◽  
Author(s):  
Ryohei Nomura ◽  
Hiromi Tokumura ◽  
Makoto Furihata
Keyword(s):  
Computed Tomography ◽  
Hepatocellular Carcinoma ◽  
Radiofrequency Ablation ◽  
Diaphragmatic Hernia ◽  
Laparoscopic Repair ◽  
Laparoscopic Approach ◽  
Review Of The Literature ◽  
Gastrografin Enema ◽  
History Of ◽  
Segment Viii

Abstract We describe the case of a patient with a diaphragmatic hernia associated with radiofrequency ablation for hepatocellular carcinoma who was successfully treated by laparoscopic surgery. A 62-year-old man with a long history of hepatitis C-induced liver cirrhosis was admitted to our institution because of recurrent postprandial periumbilical pain. Eight years earlier, he had undergone radiofrequency ablation for hepatocellular carcinoma at hepatic segment VIII. Computed tomography, gastrografin enema examination revealed transverse colon obstruction because of a diaphragmatic hernia. We diagnosed diaphragmatic hernia associated with the prior radiofrequency ablation treatment. The patient underwent laparoscopic repair of the diaphragmatic hernia. Though the patient experienced the recurrence once, relaparoscopic treatment has improved the patient's conditions. Thus, diaphragmatic hernia can develop as a complication of radiofrequency ablation treatment. A laparoscopic approach is safe, feasible, and minimally invasive, even in patients with cirrhosis who develop iatrogenic diaphragmatic hernia as a complication of radiofrequency ablation treatment.

Life-threatening presentation of a parahiatal hernia after esophagectomy: a case report and review of the literature

2021 ◽  
Vol 14 (6) ◽  
pp. e242158
Author(s):  
Camille Plourde ◽  
Émilie Comeau
Keyword(s):  
Small Bowel ◽  
Transverse Colon ◽  
Acute Abdominal Pain ◽  
Haemodynamic Instability ◽  
Acute Setting ◽  
X Ray ◽  
Left Diaphragm ◽  
Life Threatening ◽  
Chest X Ray ◽  
Obstructive Shock

A woman presented to our hospital with acute abdominal pain 7 months following an oesophagectomy. A chest X-ray revealed a new elevation of the left diaphragm. CT demonstrated a large left diaphragmatic hernia incarcerated with non-enhancing transverse colon and loops of small bowel. She deteriorated rapidly into obstructive shock and was urgently brought to the operating room for a laparotomy. The diaphragmatic orifice was identified in a left parahiatal position, consistent with a parahiatal hernia. Incarcerated necrotic transverse colon and ischaemic loops of small bowel were resected, and the diaphragmatic defect was closed primarily. Because of haemodynamic instability, the abdomen was temporarily closed, and a second look was performed 24 hours later, allowing anastomosis and definitive closure. Parahiatal hernias are rare complications following surgical procedures and can lead to devastating life-threatening complications, such as an obstructive shock. Expeditious diagnosis and management are required in the acute setting.

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