ABSTRACT
Contexte et objectif. Le pancréas étant un organe profond, son exploration clinique est parfois limitée et peu performante. Le diagnostic de ces pathologies repose principalement sur le dosage des enzymes pancréatiques (la lipasémie notamment) et l'imagerie médicale. L'objectif de la présente étude était de décrire le profil scanographique des tumeurs pancréatiques. Méthodes. Il s'agissait d'une série des cas documentaires menée dans 3 Services de radiologie à Kinshasa de janvier 2016 à juin 2021, ayant retenu 86 comptes rendus de tomodensitométrie (TDM) abdominale des patients avec pathologie pancréatique. Toutes les images archivées ont été relues par spécialistes en imagerie. Résultats. 66 cas de tumeurs pancréatiques ont été colligés. Le sexe masculin était prépondérant (sex-ratio H/F=1,6) avec un âge moyen de 55,7 ± 14,7 ans (16 à 92 ans). Le syndrome de cholestase (50 %) et la douleur abdominale (épigastrique) étaient les indications les plus retrouvées. Les contours étaient lobulés dans plus de la moitié des cas (56,1 %). Le canal de Wirsung était dilaté dans la plupart des tumeurs. Les tumeurs étaient résécables dans 26 % des cas. Conclusion. La TDM abdominale contribue au diagnostic des pathologies pancréatiques. Elles affectent le plus souvent des sujets âgés du sexe masculin et sont dominées par les tumeurs qui sont généralement diagnostiquées au stade non-résécable
Context and objective. The pancreas being a deep organ, its clinical exploration is sometimes limited and inefficient. The diagnosis of pancreatic pathologies is mainly based on the dosage of pancreatic enzymes (lipasemia in particular) and medical imaging. The objective of the present study was to describe the scanographic profile of pancreatic tumors in 3 radiology departments in Kinshasa. Methods. It was a retrospective serial case study conducted in 3 radiology departments in Kinshasa from January 2016 to June 2021, having retained 86 reports of abdominal computed tomography (CT) scan of patients with pancreatic pathology. Results. 66 cases of pancreatic tumors were involved. Male patients were predominant (sex-ratio M/F=1.6) and the mean age of 55.7 ± 14.7 years (range: 16 to 92 years). Cholestasis syndrome (50 %) and abdominal (epigastric) pain were the most common indications. In tumors, the contours were lobulated (56.1 %). The Wirsung duct was dilated in most tumors. The tumors were resectable in 26 % of cases. Conclusion. The abdominal CT-scan contributes to the diagnosis of pancreatic pathologies. These pathologies mostly affect male elderly subjects, are predominantly tumoral and generally diagnosed in late unresectable stage.
Subject(s)
Humans , Male , Female , Pancreatic Neoplasms , Tomography, X-Ray Computed , Disease Progression , Diagnosis , Neoplasm MetastasisABSTRACT
Postoperative intestinal obstruction,also known as postoperative small bowel obstruction(PSBO),is the most common acute abdomen after abdominal operations. The key to the treatment is accurate determination of therapeutic strategy.While avoiding unnecessary operation,delayed operation will cause intestinal obstruction and endanger the patients. PSBO diagnosis was improved owing to the progress of imaging techniques. Contrast enhanced CT can reach 90% in the diagnostic accuracy of intestinal strangulation,necessity of emergency operation and elucidation of etiology. Intestinal decompression via small intestinal decompression tube and subsequent gastrografin challenge can promote resolution of PSBO,increase the success rate of nonoperative management,avoid operation delay,and shorten the length of hospital stay.Operation is indicated for repeated episode of PSBO to eliminating the cause and avoiding recurrence. Elective operation is preferred over emergency. Laparoscopic operation is indicated for simple adhesions,but laparotomy is indicated for complex one. Meticulous operation,either laparoscopic or laparotomic,intestinal protection and eliminating foreign material and tissue debris are the keys to the prophylaxis of PSBO.
ABSTRACT
Se presenta el caso de una adolescente con colitis isquémica, patología poco frecuente en este grupo etario, que se agrava ante la presencia del lupus eritematoso sistémico (LES). Una paciente de 20 años, con diagnóstico de LES desde los 6 años, consultó por fiebre, dolor abdominal en el flanco y la fosa ilíaca derecha, y diarrea de 48 hs de evolución. Se asumió como gastroenteritis aguda pero, ante la persistencia del dolor, la aparición de vómitos incoercibles y la distensión abdominal, se decidió su internación. La radiografía de abdomen mostró asas distendidas, abundante materia fecal, sin niveles hidroaéreos. La ecografía mostró erosiones y ulceraciones, edema y hemorragia en la submucosa del colon descendente. La tomografía computarizada (TC) evidenció una lesión isquémica en el colon derecho. La colitis isquémica es una patología grave, infrecuente en los jóvenes. Los signos y síntomas, la TC de abdomen y la colonoscopia son los elementos de elección para el diagnóstico.
We present the case of an adolescent with ischemic colitis, an infrequent pathology in this age group, worsened in the presence of systemic lupus erythematosus (SLE). The patient, aged 20, was diagnosed SLE at 6. She consulted for fever, abdominal pain in the side and right iliac fossa and diarrhea lasting 48 hours. It was assumed as acute gastroenteritis but given the persistent pain, incoercible vomiting and abdominal distension she was hospitalized. The abdominal X-ray showed distended loops, abundant feces, without airfluid levels. The ultrasound showed erosions and ulcerations, edema and bleeding in the descending colon submucosal layer. The CT scan evidenced an ischemic lesion in the right colon. Ischemic colitis is a severe condition, infrequent in young individuals. Signs, symptoms, abdominal CT scan and colonoscopy are the elements of choice for the diagnosis.
Subject(s)
Female , Humans , Young Adult , Colitis, Ischemic/etiology , Lupus Erythematosus, Systemic/complications , Lupus Erythematosus, Systemic/diagnosisABSTRACT
La pancreatitis aguda como complicación de parotiditis es infrecuente y ha sido reportada esporádicamente en adolescentes en asociación post vacunación. Paciente femenino, 15 años de edad, presentó malestar general, fiebre >39ĈC, aumento de volumen en región submaxilar, diagnosticándose parotiditis. Una semana después, se asocian nauseas, vómitos y dolor abdominal en epigastrio, irradiado en banda. Examen físico: febril, deshidratada, aumento de volumen en región submaxilar y retroauricular bilateral, abdomen doloroso en epigastrio y flancos. Hallazgos de laboratorio: elevación de amilasas, lipasas, transaminasas y leucocitosis, ingresa con diagnósticos de pancreatitis aguda por parotiditis. Ultrasonido abdominal (USA) normal. La tomografía abdominal evidencia edema peri pancreático (estadio B de Balthazar). Evolucionó tórpidamente las siguientes 24 horas, asociándose hematemesis. Ingresó a terapia intensiva, recibió antibioticoterapia endovenosa con Meropenem y Ciprofloxacina, nutrición parenteral y cuidados propios de su estado. Es egresada cuatro días después en condiciones satisfactorias.
Acute pancreatitis as a complication of mumps is rare and has been sporadically reported in association with teens post vaccination. Female patient, 15 years old, presented with general malaise, fever> 39 Ĉ C, increased volume in submaxillary region diagnosing mumps. A week later, nausea, vomiting and abdominal pain in epigastrium were associated, like band. Physical Examination: febrile, dehydrated, increased volume in bilateral auricular and submaxillary region, abdomen and flank pain in epigastrium. Laboratory findings: elevated amylase, lipase, transaminases, and leukocytosis, admitted with a diagnosis of acute pancreatitis mumps. Abdominal ultrasound (U.S.): normal. Abdominal CT evidenced peripancreatic edema (Balthazar stage B). Torpidly evolve in the following 24 hours, associated hematemesis. Admitted to intensive care, she received intravenous antibiotics with Meropenem and Ciprofloxacin, parenteral nutrition and care of their own state. She graduated after four days in a satisfactory condition.
ABSTRACT
No abstract available.
ABSTRACT
Intestinal malrotation is a constellation of a wide spectrum of embryologic failures of rotation and fixation of the gut, resulting in a narrow-based attachment of the mesentery and the presence of abnormal peritoneal (Ladd's) band. These abnormalities predispose to midgut volvulus, intestinal obstruction and internal herniation. We experienced a case of intestinal malrotation complicated by midgut volvulus in a 4-year-old girl who presente with abdominal pain, abdominal distension and melena. The diagnosis was made by abdominal CT scan, which showed "whirl sign." The diagnosis was confirmed by surgery. A brief review of literature ensues.
Subject(s)
Adolescent , Child, Preschool , Female , Humans , Abdominal Pain , Acidosis , Acidosis, Renal Tubular , Alkalies , Anemia, Hemolytic , Atrophy , Biopsy , Chest Pain , Diagnosis , Exanthema , Fever , Fibrosis , Hospitalization , Hypergammaglobulinemia , Hypokalemia , Intestinal Volvulus , Leukopenia , Liver Diseases , Lupus Erythematosus, Systemic , Lymphopenia , Melena , Mesentery , Molecular Weight , Multiple Myeloma , Nephrotic Syndrome , Neutrophils , Potassium , Prednisolone , Proteinuria , Thyroid Diseases , Tomography, X-Ray ComputedABSTRACT
Intestinal malrotation is a constellation of a wide spectrum of embryologic failures of rotation and fixation of the gut, resulting in a narrow-based attachment of the mesentery and the presence of abnormal peritoneal (Ladd's) band. These abnormalities predispose to midgut volvulus, intestinal obstruction and internal herniation. We experienced a case of intestinal malrotation complicated by midgut volvulus in a 4-year-old girl who presente with abdominal pain, abdominal distension and melena. The diagnosis was made by abdominal CT scan, which showed "whirl sign." The diagnosis was confirmed by surgery. A brief review of literature ensues.