Differential diagnosis of endodontic-related inferior alveolar nerve paraesthesia with cone beam computed tomography: a case report.

AIM: To discuss the use of cone-beam computed tomography (CBCT) in the differential diagnosis of a case of labiomandibular paraesthesia caused by extrusion of endodontic sealer into the mandibular canal. SUMMARY: A 59-year-old woman suffering from a paraesthesia on the left posterior mandible and numbness on the left side of the lower lip was referred to an endodontic specialist 1 month after multiple root canal treatments. A panoramic radiograph revealed the presence of extruded root filling material beyond the apex of the mesial root of the mandibular left second molar and also beyond the apex of the first premolar. A cone beam computed tomography examination was undertaken, which confirmed the presence of radiopaque root canal filling material in the periapical area of the second molar, and revealed that the material was inside the mandibular canal. No extruded filling material was found inside the mental foramen beyond the apex of the first premolar tooth. KEY LEARNING POINTS: Small field of view CBCT (where possible) can be considered an effective radiographic diagnostic device when endodontic-related inferior alveolar nerve or mental foramen paraesthesia are suspected. CBCT is able to provide detailed three-dimensional images of the tooth, the root canal system and the surrounding tissue.

[Heterotopic splenic autotransplantation: a therapeutic option in splenic trauma]. / L'autotrapianto eterotopico di milza: un'alternativa terapeutica nel trauma splenico.

The Authors report two cases of splenectomy for trauma, followed by heterotopic autotransplantation of splenic tissue in omental pockets. A follow-up nuclear scan and ultrasonography showed function and growth of the splenic implants. The pertinent surgical literature is reviewed.

[Diagnostic considerations in a case of pericardial effusion with anomalous distribution]. / Considerazioni diagnostiche su di un caso di idropericardio a distribuzione anomala.

The authors report an atypical arrangement of pericardial effusion simulating an expansive mediastinal mass. Radiologic examination of the chest (standard, fluoroscopy and conventional tomography) failed to establish the correct diagnosis, its diagnostic aid was only related to demonstrate the lesion, without provided any additional anatomical and morphological features. The final and correct diagnosis was only obtained with CT and U.S. These latter imaging modalities have correctly located the lesion in pericardial space, and particularly they identified it like an loculated, completely fluid pericardial not corpusculated effusion. The authors remarked the value of CT and US techniques in the study of para and pericardial regions, especially of pericardial serosal surfaces. CT scan allow to localize the lesion, and to discriminate through densitometric values between cystic and solid masses; further more it provided information of possible extracardiac and/or mediastinal invasion. US provides the features of the fluid, its changes during systo-diastolic cycle, its mobility in different patient positions and the thickness of cardial wall. Nevertheless, at present, we consider both imaging modalities indispensable in the study of lesions occupying the cardiac-mediastinal border.

[Role of ultrasonic diagnosis in patients with clinically suspected acute intestinal invagination]. / Ruolo dell'esame ecografico nei pazienti con sospetto clinico di invaginazione intestinale acuta.

Acute intestinal intussusception is one of the commonest causes of abdominal emergency in infants. It strikes mainly infants 3 to 30 months old. Ileo-colic intussusception is the commonest form (75-95%), whereas ileo-ileo-colic, colono-colic and ileo-ileal intussusceptions are rather uncommon. Intussusception is primitive in 95% of cases and secondary in the extant 5%. Over the last 3 years we examined 25 infants with clinical suspicion of acute intestinal intussusception by means of plain abdominal radiographs and US. In 11 cases US diagnosed acute intestinal intussusception. US signs useful for diagnosis were: intussusception "pudding" on both transverse and longitudinal scans, and communicating intussusception "pudding" and bowel. US allowed intestinal intussusception to be diagnosed in 11 cases and ruled out in 14, with 100% reliability. In agreement with literature data, our results confirm US as the method of choice--versus conventional radiology--in the diagnosis of acute intestinal intussusception and stress the value of US studies in helping avoid surgery.