COVID-19 associated spontaneous hemorrhagic cholecystitis.

Hemorrhagic cholecystitis is a rare disorder associated with considerable morbidity and mortality. The clinical presentation of hemorrhagic cholecystitis is non-specific and imaging findings can be difficult to accurately interpret without a high level of suspicion. Most recent reports of hemorrhagic cholecystitis have been associated with concurrent therapeutic anticoagulation. Here, we report imaging findings of a case of acute, spontaneous hemorrhagic cholecystitis in a 67-year-old male patient admitted for hypoxic respiratory failure secondary to COVID-19 pneumonia.

Fluoroscopic Swallowing Examination: Radiologic Findings and Analysis of Their Causes and Pathophysiologic Mechanisms.

Dysphagia is a common symptom in the general population, and its prevalence increases with patient age. The deterioration of swallowing function has many acute and chronic causes, including cerebrovascular and neuromuscular diseases, radiation, and surgery. In an elderly population, diagnosis and treatment of swallowing abnormalities is a high priority because it improves the patient's quality of life and helps them to avoid medical complications. Fluoroscopic swallowing examinations and modified barium swallow studies are the most used and most reliable diagnostic procedures to evaluate swallowing disorders. Functional anomalies include disturbances of the oral preparatory, oral propulsory, and pharyngeal phases of swallowing as premature spillage from the mouth, nasal regurgitation, delayed initiation of pharyngeal swallowing, incomplete displacement of the hyolaryngeal complex, abnormal epiglottic tilt, incomplete laryngeal closure, and pharyngeal dysmotilities. Anatomic abnormalities of the pharynx include diverticula, benign strictures, and tumors. The abnormalities diagnosed on the basis of fluoroscopic examination have a variety of treatment strategies, and the choice of treatment depends on the cause of the anomaly and its pathophysiologic characteristics. The radiologist's interpretation of these characteristics is crucial to therapeutic decision making and achieving the best patient outcomes. Online supplemental material is available for this article. ©RSNA, 2021.

Simultaneous 111In-WBC and 99mTc-SC SPECT/CT Clearly Delineates Infection Sites.

A 22-year-old man sustained a complex left ankle fracture following a motor vehicle collision and underwent external and internal fixation with transfixation-pinning. Several weeks after surgery, the patient presented with clinical concerning for infection at the fracture sites. Initial radiographic evaluation of the left lower extremity showed no evidence of osteomyelitis. The patient underwent SPECT/CT with a novel imaging protocol, using simultaneous acquisition of 111In-WBC and 99mTc- SC SPECT/CT, which clearly delineated the infection sites along the orthopedic hardware track and adjacent soft tissues. This new combined SPECT/CT protocol offers advantages of shorter scanning time, easy patient positioning, expedited diagnostic workup, and more accurate localization of infection sites compared to the conventional protocol of separately acquiring 111In-WBC and 99mTc- SC SPECT/CT images.