Subject(s)
Pneumopericardium , Prosthesis Implantation/adverse effects , Sick Sinus Syndrome/therapy , Aged , Chest Pain/physiopathology , Female , Humans , Pacemaker, Artificial , Pneumopericardium/diagnosis , Pneumopericardium/etiology , Pneumopericardium/physiopathology , Pneumopericardium/therapy , Tomography, X-Ray Computed , Treatment Outcome , Watchful WaitingABSTRACT
We report two cases of elderly patients presenting with life-threatening complications due to inadvertent accidental ingestion of blister pill packs (BPPs). The first patient presented with obstruction followed by anemia and finally perforation of the small bowel. The second presented with rapidly lethal mediastinitis due to a large perforation of the lower esophagus. The responsible BPPs were identified by multidetector computed tomography and the best result in their characterization was obtained through maximal intensity projections and volume rendering reformations.
Subject(s)
Drug Packaging/instrumentation , Esophageal Perforation/diagnostic imaging , Foreign Bodies/diagnostic imaging , Image Processing, Computer-Assisted , Intestinal Perforation/diagnostic imaging , Multidetector Computed Tomography , Aged, 80 and over , Esophageal Perforation/etiology , Esophageal Perforation/surgery , Fatal Outcome , Female , Foreign Bodies/complications , Foreign Bodies/surgery , Humans , Intestinal Obstruction/diagnostic imaging , Intestinal Obstruction/etiology , Intestinal Obstruction/surgery , Intestinal Perforation/etiology , Intestinal Perforation/surgery , Intestine, Small/diagnostic imaging , Intestine, Small/injuries , Intestine, Small/surgery , Male , Mediastinitis/diagnostic imaging , Mediastinitis/etiology , Mediastinum/diagnostic imaging , Mediastinum/surgeryABSTRACT
We report a rare case of small bowel obstruction of a 45-year-old female which was caused by internal hernia of the terminal ileum and cecum through the foramen of Winslow. The patient presented to the emergency department with acute abdominal pain, distention, and nausea, suggesting an intestinal obstruction. The complete unambiguous preoperative diagnosis was achieved by a 64-row multi-detector computed tomography. This report enlightens the utility and performances of high-quality computed tomography multiplanar reconstructions combined with vascular volume rendering analysis for the diagnosis of internal hernia.
