ABSTRACT
Acute mesenteric ischemia (AMI) is a life-threatening emergency with prognosis directly correlated with the delay in diagnosis and treatment. Clinical and laboratory findings are nonspecific and it is imperative to look for findings of AMI on CT and ultrasound examinations performed in patients with acute abdomen. Arterial and venous ischemia are different entities with different clinical and imaging features, treatment and prognosis. The main causes of AMI are arterial thromboembolic disease and low-flow state. Venous ischemia is less frequent. Due to its high reported sensitivity (90%), CT should be performed as a firstline imaging modality when AMI is suspected. CT and ultrasound imaging features of AMI include: bowel wall thickness and enhancement abnormalities, pneumatosis, portal venous gas, demonstration of intravascular thrombus, bowel dilatation and ascitis.
Subject(s)
Ischemia/diagnostic imaging , Vascular Diseases/diagnostic imaging , Humans , Ischemia/etiology , Mesenteric Ischemia , Tomography, X-Ray Computed , Ultrasonography , Vascular Diseases/etiologyABSTRACT
PURPOSE: To evaluate the role of imaging for follow-up after treatment of morbid obesity by laparoscopic adjustable gastric banding (LAGB). PATIENTS AND METHODS: Since 1996, more than 1,000 patients underwent gastric banding using 5 different types of devices. Our experience is based on a retrospective study (from September 1996 to September 2002) concerning 663 consecutive patients who underwent LAGB: 114 Lapband system (LB) and 549 Swedish adjustable gastric banding (SAGB). Upper gastrointestinal series were performed within 24-48 hours after surgery in all patients. Radiological examination was also used to detect complications and to adjust gastric band. RESULTS: The five types of gastric band are easily identified on plain films. Early and late complications are illustrated: pouch dilatation, slippage, band migration, rotation of the port, and system disconnection. Radiological criteria for adjustment of gastric band are explained on the basis of barium studies performed before and after any modification of the stoma size. CONCLUSION: In patients treated with LAGB for morbid obesity, radiology plays an important role in evaluating early and late complications.
Subject(s)
Gastroplasty/methods , Laparoscopy , Obesity, Morbid/surgery , Adult , Equipment Design , Follow-Up Studies , Gastroplasty/instrumentation , Humans , Obesity, Morbid/diagnostic imaging , RadiographyABSTRACT
The authors report a case of perforated diverticulitis with presence of a fistulous tract between a peridiverticular abscess and the uterus during pregnancy with favorable outcome under medical treatment. The purpose of this case report is to illustrate specific imaging findings and clinical management of diverticulitis during pregnancy.
Subject(s)
Diverticulitis/diagnosis , Pregnancy Complications/diagnosis , Sigmoid Diseases/diagnosis , Adult , Female , Humans , PregnancyABSTRACT
UNLABELLED: With the introduction of spiral scanning then multidetector technologies, the accuracy for diagnosing digestive tract diseases with CT has been highly improved, and CT is used more and more in the evaluation of patients with suspected gastrointestinal disorders. CT is able to demonstrate both the intramural and the extramural components of the disease, and has a major role in the preoperative staging and the follow-up. Improvements of CT protocols, such as CT-enteroclysis, or multiplanar 2D and 3D post-processing, including now techniques for "virtual endoscopy", lead to discuss new indications in which CT could now compete with conventional X-rays series and videoendoscopy. This precise study of the digestive wall, the peridigestive fat, the digestive tract blood supply, may be performed by MRI, under the condition of access to high level machines and standardized protocols. MR-enteroclysis and MR-virtual colonoscopy could be performed with much lower risk for the patient, in terms of radiation dose or contrast adverse effects. Endoluminal coils should give to MR an ultra-high resolution for analysing the different layers of the gastrointestinal wall. LEARNING OBJECTIVES: to review how to perform CT and MRI protocols for digestive tract imaging, to recognize the CT and MR patterns of the main digestive tract diseases, to discuss the value, limits and role of CT and MR in digestive tract diseases, to discuss the potential role of CT and MR new technological developments for digestive tract imaging in the upcoming future. CONCLUSION: CT is nowadays a modality of choice for digestive imaging. Improvements in technologies and indications, the necessary discussion of the risks and benefits for the patient should let the radiologists consider MRI in gastrointestinal disorders as an important part of the routine activity in clinical MRI.
