Interventional Radiology
Successful arterial embolization of a giant pseudoaneurysm of the gastroduodenal artery secondary to chronic pancreatitis with literature review by Miriam Klauß et al. |
Published: 2012 Feb Issue: 6(2) :: Pages: 9-16
| Abstract: We report a case of an uncommon giant pseudoaneurysm of the gastroduodenal artery secondary to chronic pancreatitis. It presented with a perfused volume of 17.3 cm³ close to the branch-off of the right hepatic artery. Superselective transcatheter embolization including interlocking detachable coils and a mixture of Ethibloc and Lipiodol was our technique of choice. Following the procedure, the patient was in hemodynamically stable condition. At that time, he was free of any clinical symptoms and showed no further signs of bleeding or ischaemia. Additionally, we present an overview of the relevant literature.
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Pediatric Radiology
Paucity of biliary ducts: A rare etiology of neonatal cholestasis by Steven Cornell Figiel et al. |
Published: 2012 Feb Issue: 6(2) :: Pages: 29-38
| Abstract: We report a case of a newborn with cholestasis that was diagnosed as nonsyndromic Alagille syndrome. The main feature of the disease is a paucity of biliary ducts. There are two known types of the disease: the syndromic type which is associated with other congenital defects and the nonsyndromic type without other anomalies detected at birth. We describe the case and discuss its clinical and radiologic findings. We also discuss the various etiologies of cholestasis that are included in the differential diagnosis.
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Thoracic Radiology
Pulmonary Embolism Following 2-Octyl-Cyanoacrylate/Lipiodol Injection for Obliteration of Gastric Varices: An Imaging Perspective by Adam Daniel Singer et al. |
Published: 2012 Feb Issue: 6(2) :: Pages: 17-22
| Abstract: Bleeding from esophageal and gastric varices remains a significant cause of morbidity and mortality for patients with liver cirrhosis. Currently, therapeutic strategies for gastric variceal bleeding include transjugular intrahepatic portosystemic shunt, cyanoacrylate sclerotherapy and hepatic transplantation. Though relatively safe and efficacious, endoscopic sclerotherapy using cyanoacrylate has known complications including infection, bleeding, and distal embolization. This case report describes a patient who became febrile and tachycardic following sclerotherapy and subsequently had an abnormal chest radiograph that prompted further evaluation for pulmonary embolization of the sclerosant. The focuses of this report are the computed tomographic and radiographic findings associated with 2-octyl-cyanoacrylate/lipiodol pulmonary embolization.
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Nuclear Medicine / Molecular Imaging
False Positive GI Bleed on Tc-99m RBC Scintigraphy Due to Ileal Varices by Paul Ning-Chuan Chen et al. |
Published: 2012 Feb Issue: 6(2) :: Pages: 23-28
| Abstract: Tc-99m labeled RBC scintigraphy is commonly employed in the evaluation of acute gastrointestinal bleeding. On Tc-99m RBC studies gastrointestinal bleeding is seen as an initial focus of increased radiotracer activity that on subsequent images increases in intensity and changes position in a pattern that conforms to segments of bowel. We report a case of a patient with multiple episodes of hematochezia that presented with lower gastrointestinal hemorrhage. A Tc-99m labeled RBC scan was performed and the findings suggested a GI bleed. However, subsequent angiography revealed prominent ileal varices simulating an acute bleed. Although most varices fill promptly and should not be misinterpreted as a focus of hemorrhage, slow filling varices can simulate an acute bleed and lead to a false positive interpretation.
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OB/GYN
MRgFUS treatment of uterine fibroid in a nulliparous woman with acute retention of urine by Vinay Nyapathy et al. |
Published: 2012 Feb Issue: 6(2) :: Pages: 1-8
| Abstract: Uterine fibroids are the most common tumors of the female reproductive tract. Although most fibroids are asymptomatic, about 25% are associated with symptoms that can have a significant impact on patient`s quality of life, including prolonged or excessive menstrual bleeding, pelvic pain or bulkiness, dyspareunia, increased urinary frequency, and infertility. Various treatment options available for symptomatic uterine fibroids include hysterectomy, myomectomy (abdominal or laparoscopic), uterine artery embolization, MR-guided Focused Ultrasound (MRgFUS), and hormonal therapy, which also is sometimes used as adjuvant to other therapies. MRgFUS is a non-invasive treatment approach for symptomatic uterine fibroids. The following case report demonstrates successful treatment of a fibroid that is hyper-intense on T2WIs by MRgFUS with immediate alleviation of pressure symptoms on the urinary bladder.
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