Contrast-enhanced acquisition: images at the time of admission show eccentric hyperdense (60 HU) rim of wall thickening if the descending aorta, c/w intramural hematoma (IMH)

ASVIDE ◽  
2018 ◽  
Vol 5 ◽  
pp. 243-243
Author(s):  
Paul Schoenhagen
Author(s):  
Mohamed M. Harraz ◽  
Ahmed H. Abouissa

Abstract Background Although gall bladder perforation (GBP) is not common, it is considered a life-threating condition, and the possibility of occurrence in cases of acute cholecystitis must be considered. The aim of this study was to assess the role of multi-slice computed tomography (MSCT) in the assessment of GBP. Results It is a retrospective study including 19 patients that had GBP out of 147, there were 11 females (57.8%) and 8 males (42.1%), aged 42 to 79 year (mean age 60) presented with acute abdomen or acute cholecystitis. All patients were examined with abdominal ultrasonography and contrast-enhanced abdominal MSCT after written informed consent was obtained from the patients. This study was between January and December 2018. Patients with contraindications to contrast-enhanced computed tomography (CT) (pregnancy, acute kidney failure, or allergy to iodinated contrast agents) who underwent US only were excluded. Patients with other diagnoses, such as acute diverticulitis of the right-sided colon or acute appendicitis, were excluded. The radiological findings were evaluated such as GB distention; stones; wall thickening, enhancement, and defect; pericholecystic free fluid or collection; enhancement of liver parenchyma; and air in the wall or lumen. All CT findings are compared with the surgical results. Our results revealed that the most important and diagnostic MSCT finding in GBP is a mural defect. Nineteen patients were proved surgically to have GBP. Conclusion GBP is a rare but very serious condition and should be diagnosed and treated as soon as possible to decrease morbidity and mortality. The most accurate diagnostic tool is the CT, MSCT findings most specific and sensitive for the detection of GBP and its complications.


Diagnostics ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. 784
Author(s):  
Shinji Okaniwa

The most important role of ultrasound (US) in the management of gallbladder (GB) lesions is to detect lesions earlier and differentiate them from GB carcinoma (GBC). To avoid overlooking lesions, postural changes and high-frequency transducers with magnified images should be employed. GB lesions are divided into polypoid lesions (GPLs) and wall thickening (GWT). For GPLs, classification into pedunculated and sessile types should be done first. This classification is useful not only for the differential diagnosis but also for the depth diagnosis, as pedunculated carcinomas are confined to the mucosa. Both rapid GB wall blood flow (GWBF) and the irregularity of color signal patterns on Doppler imaging, and heterogeneous enhancement in the venous phase on contrast-enhanced ultrasound (CEUS) suggest GBC. Since GWT occurs in various conditions, subdividing into diffuse and focal forms is important. Unlike diffuse GWT, focal GWT is specific for GB and has a higher incidence of GBC. The discontinuity and irregularity of the innermost hyperechoic layer and irregular or disrupted GB wall layer structure suggest GBC. Rapid GWBF is also useful for the diagnosis of wall-thickened type GBC and pancreaticobiliary maljunction. Detailed B-mode evaluation using high-frequency transducers, combined with Doppler imaging and CEUS, enables a more accurate diagnosis.


2013 ◽  
Vol 57 (1) ◽  
pp. 293
Author(s):  
Jip L. Tolenaar ◽  
Kevin M. Harris ◽  
Gilbert R. Upchurch ◽  
Vincenzo Rampoldi ◽  
Arturo Evangelista ◽  
...  

2015 ◽  
Vol 16 (1) ◽  
pp. 53-55
Author(s):  
Sohely Sultana ◽  
Mohammad Faisal Ibn Kabir ◽  
Tarana Yasmin ◽  
Shyamal KR Roy ◽  
Asish Sarkar ◽  
...  

A 52 year old female reported to surgery department of Bangabandhu Sheikh Mujib Medical University (BSMMU) with dysphasia and exertional chest pain. With detailed history and examination she was diagnosed as a case of epigastric mass and undergone X-ray chest. The report revealed enlarged mediastinal shadow with suspicion of thoracic aortic aneurysm. X-ray chest was followed by contrast enhanced CT scan which revealed a large partially thrombosed aneurysmal dilatation of the aortic arch with sharp kinking (bend) at distal end of aneurysm and beginning of descending aorta. Then the patient was referred to cardiac surgery for immediate management. But the patient refused to have a surgery. Then two months later the patient again presented with chest pain and admitted in DMCH. But the patient died.DOI: http://dx.doi.org/10.3329/jom.v16i1.22405 J MEDICINE 2015; 16 : 53-55


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