Subject(s)
Biopsy/methods , Carcinoma, Hepatocellular/pathology , Hemangiosarcoma/pathology , Liver Neoplasms/pathology , Liver/diagnostic imaging , Adult , Aged , Carcinoma, Hepatocellular/diagnostic imaging , Catheterization, Peripheral , Diagnosis, Differential , Female , Hemangiosarcoma/diagnostic imaging , Humans , Liver Neoplasms/diagnostic imaging , Male , Middle Aged , Reproducibility of Results , UltrasonographyABSTRACT
Metastatic lesions of the umbilicus are more common than primary malignancies and are commonly referred to as Sister Mary Joseph nodules. Most arise from the stomach or the female genital tract. We describe an unusual case of renal cell carcinoma with peritoneal implants producing a Sister Mary Joseph nodule diagnosed by CT. To our knowledge, no report of a urinary tract malignancy with umbilical involvement has been described in the radiological literature.
Subject(s)
Abdominal Neoplasms/secondary , Carcinoma, Renal Cell/secondary , Kidney Neoplasms/pathology , Umbilicus , Abdominal Neoplasms/diagnostic imaging , Carcinoma, Renal Cell/diagnostic imaging , Female , Humans , Kidney/diagnostic imaging , Kidney Neoplasms/diagnostic imaging , Middle Aged , Peritoneal Neoplasms/diagnostic imaging , Peritoneal Neoplasms/secondary , Tomography, X-Ray Computed , Umbilicus/diagnostic imagingABSTRACT
The development of interventional uroradiologic techniques has had a major impact on the care of the urologic patient by allowing nonoperative treatment of many disease processes. This article will review percutaneous nephrostomy with emphasis on urologic calculi, interventional therapy for neoplasms and trauma of the urinary tract, diagnosis and treatment of renovascular hypertension, and the management of complications following renal transplantation.
Subject(s)
Radiology, Interventional , Urography/methods , Humans , Hypertension, Renovascular/diagnosis , Hypertension, Renovascular/therapy , Kidney Neoplasms/diagnosis , Kidney Neoplasms/therapy , Kidney Transplantation , Nephrostomy, Percutaneous , Urinary Tract/injuries , Urologic Diseases/diagnosis , Urologic Diseases/therapyABSTRACT
PURPOSE: To compare a technique of mechanical balloon declotting of thrombosed hemodialysis grafts with conventional pulsed-spray thrombolysis. MATERIALS AND METHODS: Forty patients had 53 episodes of graft thrombosis over a 19-month period. Twenty-nine grafts were randomly treated with thrombolysis with urokinase and 24 grafts with mechanical declotting by placement of crossed balloon catheters within the graft. Patency was determined by retrospective review of hemodialysis records. RESULTS: Successful hemodialysis for 1 week after the procedure was achieved in 21 (88%) of the 24 grafts treated mechanically and 26 (90%) of 29 grafts treated with thrombolysis. Continuous pulse oximetry showed no change in oxygen saturation in either group, and no clinical signs or symptoms of pulmonary embolism were noted. Average total procedure times were 2.2 hours for mechanical declotting and 3.5 hours for thrombolysis (P < .05). Probability of patency (mechanical vs thrombolysis) was 42% vs 45% at 3 months, 36% vs 25% at 6 months, and 8% vs 4% at 12 months. One major complication of ulnar artery embolization occurred in the thrombolysis group. CONCLUSION: Mechanical declotting of hemodialysis grafts is faster and as effective as thrombolysis.
Subject(s)
Angioplasty, Balloon , Arteriovenous Shunt, Surgical/adverse effects , Renal Dialysis , Thrombolytic Therapy , Thrombosis/therapy , Adult , Aged , Aged, 80 and over , Humans , Middle Aged , Thrombosis/drug therapy , Thrombosis/etiology , Vascular PatencyABSTRACT
A child with trisomy 21 had altered mental status and hyperammonemia at presentation and was found to have a congenital portosystemic shunt as a result of a congenital abnormality of the portal venous system. Anomalies of the portal venous system leading to portosystemic shunting, although they are infrequent, should be considered in the differential diagnosis of hyperammonemia.
Subject(s)
Ammonia/blood , Portal System/abnormalities , Amino Acids/analysis , Child, Preschool , Congenital Abnormalities/diagnosis , Congenital Abnormalities/metabolism , Diagnosis, Differential , Down Syndrome/metabolism , Humans , Male , Portal System/diagnostic imaging , Radiography , UltrasonographyABSTRACT
Richter's hernia can present as a diagnostic challenge because of its usually small size and eccentric bowel wall involvement with limited luminal compromise. This article describes a case of Richter's hernia in the femoral canal and illustrates its sonographic features.
