[Multi slice computerized tomography of the heart and coronary arteries]

Due to the recent technological progress, multislice computerized tomography [MSCT] allows visualizing the heart and coronary arteries. Multislice computed tomography is non invasive and provides high quality images.Its main limits are arythmia, tachycardia and coronary calcifications. But the main drawback with MSCT is the radiation dose. Report of usefuluess and indications of multislice CT scanner. Review of literature. Although the indications of MSCT did not reach a guideleness level yet, some trends can be stated. The advantages and limitations of MSCT in cardiac exploration are summarized in this article. The indications are mainly based on the excellent negative predictive value of MSCT regarding coronary artery disease. Hence, patients at low to moderate risk of coronary artery disease mostly benefit of the technique. MSCT can be an alternate examination in case of non feasible or non contributive ischemic test. MSCT is highly contributive in the ostial analysis, in detecting abnormal congenital coronary anomalies or in analysing bypass grafts. MSCT remains limited in patients with heavily calcified coronary arteries, and in patients with stented distal arteries. Multislice CT scanner should not be considered as equivalent to invasive coronary angiography bu it is a additional diagnostic tool

[Extra - cardiac findings on coronary computed tomography scanning]

Multi-detector-row computed tomography [MDCT] has emerged as method for non-invasive imaging of the heart. To investigate the frequency of the non cardiac findings in cardiac imaging with MDCT. Atotal of 191 patients underwent cardiac imaging with 64-slice MDCT over a period of 8 months. The detected abnormalities were classified in major [implying an immediate workup and treatment or at least a further investigation] and minor abnormalities. Extra cardiac abnormalities were detected on 69 examinations [36%]. Major abnormalities were found in 17% of the patients, and the minor abnormalities in 25,6%. The scan revealed 4 cases of lung carcinomas, all at a still surgical stage. There were a significant number of non cardiac findings in cardiac MDCT. To avoid missing clinically important findings, we should carefully evaluate all the organs included in the scan

Chontirosarcoma of sinonasal cavity: a case report and brief literature review

Chondrosarcomas are slow-growing malignant tumors that usually arise from cartilaginous structures. it may occur in the head and neck region with a predilection for the maxillofacial skeleton, where it has been reported to occur particularly in the mandible anti maxilla. Ghondrosarcomas of the sinonasal tract is very rare. Report a new case. We present the case of a 43-year-old man presenting with an incidental finding of a chondrosarcoma of the maxillary and ethmoid sinus with nasal extension. The tumor was completely resected using a transnasal endoscopic approach. Treatment has followed by a radiation therapy and the patient was considered free of disease at her 5 years follow-up. Surgery is the mainstay treatment of chondrosarcomas. In selected patients, complete resection can be achieved using transnasal endoscopic approach

[Rupture of hydatid cyst of the liver into the duodenum. A case report]

Rupture of hydatid cyst in the digestif tract is a rare complication even in endemic areas. Authors report a case of a hydatid cyst of the left hepatic lobe ruptured in the duodenum. Was discovered at the occasion of epigastric pain and vomiting. Ct-scan revealed presence of air in a calcified hydatid cyst of the left liver lobe and a fistulous tract between the cyst and the duodenum. Endoscopy confirmed the diagnosis by the visualisation of a fistulous orifice of the anterior aspect of the first duodenum with a protrusion of hydatid membrane. Patient was treated surgically and had a partial cysto-pericystectomy and Suture of duodenum

[Spontaneous intrahepatic porto-cava shunt associated with chronic pericarditis. A case report]

Introduction: Spontaneous intrahepatic portosystemic shunts are rare vascular anomalies that consist of a communiation between the portal system and the systemic venous circulation. We report a case of a porto-caval shunt associated with chronic pericarditis

Case report: A 47-year-old patient with post pericarditis cirrhosis and without encephalopathy and hypoglycaemia. The shunt was tubular in its initial segment and aneurismal just before joining the vena cava

Discussion: Spontaneous intrahepatic portosystemic shunt is a rare anomaly. Diagnosis can ve made by Doppler ultrasound and helical CT

misleading renal tumour

Hydatid cyst of the kidney is uncommon and still constitutes about 3% of cases of hydatid disease. The diagnosis can be made by ultrasonbography, Ct-scan and in some difficult cases by MR1. We report a case of a renal hydatid cyst in a 47-year-old man mimicking at imaging, even at MRI, a hypo vascular renal tumour

[Gastrointestinal bleeding caused by rupture of an aneurysm of the hepatic artery]

Gastrointestinal bleeding secondary to a rupture of an aneurysm of the hepatic artery is rare. We report a case of an 81-year-old man, who was admitted with hematemesis and melena. Gastroduodenoscopy revealed an abundant bleeding from the posterior wall of the duodenal bulb. CT-scan showed an aneurysm arising from the hepatic artery. Ultrasound, computed tomography and angiography are the methods of choice for gastrointestinal bleeding diagnosis if endoscopy is inconclusive

[Management of complications of percutaneous nephrolithotomy with ballistic lithotripsy. A report of 82 consecutive PCNL]

In this paper, authors assessed the complication rate of percutaneous nephrolithotomy [PCNL] through a consecutive series of 82 PCNL performed on 80 patients with renal calculi [48 men and 32 women]. Patients' mean age was 42 years. Stones were located in the pelvis or lower calyx in 75% of cases with a diameter exceeding 20 mm in 56%. 11 Patients had intraoperative problems one ureteral false passage, one renal perforation by a ureteral stent, three cases of hemorrage, three cases of punctate perforations of excretory cavities. In one case, nephrostomy tube fell and could not be replaced. 6 patients had post operative complications: three patients had postoperative fever, one patient developed acute pyelonephritis and two patients had transient urinary leakage after nephrostomy tube removal. After reviewing the literature, authors conclude to the low complication rate of PCNL