ABSTRACT
RESUMEN Los estudios imagenológicos permiten evaluar de forma global la cavidad abdominal. Las malformaciones vasculares intraabdominales son entidades poco frecuentes, la mayoría cursa de forma asintomática. Se expone el uso de los medios diagnóstico de imágenes en la detección de una malformación arterio-venosa asintomática de páncreas, en paciente con otra sintomatología. Paciente de 31años, kenyana, que acude a la emergencia del Hospital Cubano de Catar, aquejando dolor en bajo vientre y fosa iliaca derecha (FID), reacción peritoneal, leucograma negativo y proteína C reactiva elevada. Se descartaron patologías ginecológicas, gastrointestinales y urinarias. Se indicó ultrasonido y posteriormente TAC con contraste endovenoso (EV) abdomino-pélvico, que demostró mioma uterino sub-seroso e imagen tumoral hiper-vascularizada en proceso uncinado de páncreas, compatible con malformación arterio-venosa. Fue remitida a las especialidades de ginecología, cirugía y gastroenterología. Sugerimos tener siempre presente enfermedades poco frecuentes en el curso de patologías comunes. Publicar imágenes de patologías raras, ofrece patrón de comparación para futuros diagnósticos.
ABSTRACT Imaging studies allow a global assessment of the abdominal cavity. Intra-abdominal vascular malformations are rare entities, most of which are asymptomatic. The use of diagnostic imaging technique in the detection of an asymptomatic arterio-venous malformation of the pancreas in a patient with other symptoms is exposed. 31-year-old Kenyan patient who came to the emergency department at the Cuban Hospital in Qatar with pain in the lower abdomen and right iliac fossa (RIF), peritoneal reaction, negative leukogram and elevated C-reactive protein. Gynecological, gastrointestinal and urinary pathologies were ruled out. An ultrasound and later CT abdominal-pelvic with intravenous contrast (IV) were indicated, which demonstrated subserous uterine myoma and hyper-vascularized tumor image in the uncinate process of pancreas, compatible with arterio-venous malformation. She was referred to the specialties of gynecology, surgery and gastroenterology. We suggest always keeping in mind rare diseases during common pathologies. Publish images of rare pathologies, offers a comparison pattern for future diagnoses.
RESUMO Estudos de imagem permitem a avaliação geral da cavidade abdominal. Malformações vasculares intra-abdominais são raras, a maioria das quais ocorrem assintomáticamente. O uso de imagens de diagnóstico significa na detecção de uma malformação arterio-venosa assintomática do pâncreas em pacientes com outros sintomas. Um paciente queniano de 31 anos, que foiao pronto-socorro do Hospital Cubano do Catar, sofrendo de dorna barriga inferior e fossa ilínica direita (FID), reação peritoneal, leucograma negativo e proteína C-reativa elevada. Foram descartadas patologias ginecológicas, gastrointestinais e urinárias. Foram indicadas ultrassonografia e tomografia computadorizada com contraste intravenoso abdomino-pélvico (EV), que demonstrou imagem de tumor uterino sub-seroso e hiper-vascularizada em processonãocinado do pâncreas, compatível com malformação arterio-venosa. Ela foi encaminhada para as especialidades de ginecologia, cirurgia e gastroenterologia. Sugerimos sempre ter em mente doenças raras no curso de patologias comuns. A publicação de imagens de patologias raras oferece um padrão de comparação para diagnósticos futuros.
ABSTRACT
OBJECTIVE: The purpose of this study was to improve the use of 64-channel multidetector computed tomography using lower doses of ionizing radiation during follow-up procedures in a series of patients with endovascular aortic aneurysm repair. METHODS: Thirty patients receiving 5 to 29 months of follow-up after endovascular aortic aneurysm repair were analyzed using a 64-channel multidetector computed tomography device by an exam that included pre-and postcontrast with both arterial and venous phases. Leak presence and type were classified based on the exam phase. RESULTS: Endoleaks were identified in 8/30 of cases; the endoleaks in 3/8 of these cases were not visible in the arterial phases of the exams. CONCLUSION: The authors conclude that multidetector computed tomography with pre-contrast and venous phases should be a part of the ongoing follow-up of patients undergoing endovascular aortic aneurysm repair. The arterial phase can be excluded when the aneurism is stable or regresses. These findings permit a lower radiation dose without jeopardizing the correct diagnosis of an endoleak.