ABSTRACT
Bilateral adrenal hemorrhage (BAH) is a rare condition that can lead to acute adrenal insufficiency and death if not recognized and treated promptly. We report the case of a 30-year-old male who presented to the emergency department with acute abdominal pain, nausea, and vomiting. On emergency room admission, the first abdominal CT revealed normal adrenal glands without enlargement, but with the development of hypotension and hypoglycemia, a second CT performed four days later showed enlargement due to hemorrhage in both adrenals. The diagnosis of BAH associated with acute adrenal insufficiency was retained. Prompt treatment with intravenous and oral corticosteroids resulted in successful conservative management. We describe the clinical, biological, radiological and etiological features of this condition based on a review of the literature.
Subject(s)
Abdomen, Acute , Adrenal Gland Diseases , Adrenal Insufficiency , Male , Humans , Adult , Adrenal Gland Diseases/diagnosis , Adrenal Gland Diseases/diagnostic imaging , Adrenal Insufficiency/complications , Adrenal Insufficiency/diagnosis , Adrenal Insufficiency/drug therapy , Hemorrhage/etiology , Hemorrhage/complications , Abdominal Pain/diagnosis , Abdominal Pain/etiology , Acute DiseaseABSTRACT
A case of leiomyosarcoma of the superficial femoral vein detected in the follow-up of a non resolving deep venous thrombosis is presented. A short review of the literature focused on this unusual entity is presented.
Subject(s)
Femoral Vein , Leiomyosarcoma/complications , Vascular Neoplasms/complications , Venous Thrombosis/etiology , Aged , Humans , MaleABSTRACT
To determine the clinical feasibility and applicability of phosphorus-31 magnetic resonance (MR) spectroscopy and to assess its potential for characterization of human hepatic tissue, one-dimensional chemical shift imaging (CSI) was performed in 37 patients with various malignant hepatic neoplasms (30 metastases from a variety of primary tumors and seven hepatocellular carcinomas) and seven healthy volunteers. Tumors were grouped according to the percentage of the analyzed section that was occupied by tumor: less than 50% (group A) or more than 50% (group B). In group B, all phosphomonoester/beta-adenosine triphosphate ratios were significantly higher than normal (P less than .001). Hepatocellular carcinomas and metastases from various primary neoplasms could not be differentiated on the basis of spectral characteristics and metabolite ratios. Limitations of one-dimensional surface coil CSI prevented separation of spectra of small tumors and tumors deep within the liver parenchyma from spectra of normal liver parenchyma.
Subject(s)
Liver Neoplasms/diagnosis , Magnetic Resonance Spectroscopy , Adenosine Triphosphate/analysis , Adult , Aged , Aged, 80 and over , Carcinoma, Hepatocellular/chemistry , Carcinoma, Hepatocellular/diagnosis , Humans , Liver/chemistry , Liver/pathology , Liver Neoplasms/chemistry , Liver Neoplasms/secondary , Magnetic Resonance Spectroscopy/methods , Middle Aged , Organophosphates/analysis , PhosphorusABSTRACT
Narrowing of the pulmonary arteries was created surgically in twelve dogs. In six of the dogs the narrowing was central (main pulmonary artery), and in the remaining six the narrowing was located peripherally at the hilar level of the right pulmonary artery beyond the pericardial reflection. MRI and angiography were performed in all dogs. MRI clearly delineated the site of the pulmonary band and the caliber of the pulmonary artery at the site of the band in all dogs (N = 6). MRI was not able to visualize any of the stenosis of the right pulmonary arteries at the hila, beyond the pericardial reflection. In addition, optimal imaging planes to depict each segment of the central pulmonary arteries were determined. The capability to image in oblique planes is essential in evaluating the morphology of the central pulmonary arteries.
