Paradoxical cerebral arterial gas embolism: Computed tomography findings.

Computed tomography scan findings are described in cerebral arterial gas embolism in two patients with right to left intracardiac shunts by accidental injection of air during intravenous therapy. Although imaging may not be necessary to diagnose the condition, the patient may be referred to CT scan as a case of stroke. Cerebral arterial gas embolism should be considered in the differential diagnosis of stroke, particularly in case of right-to-left shunts. CT findings described are classical and diagnostic of the condition.

Giant renal capsular leiomyoma: study of two cases.

Leiomyomas of the renal parenchyma and of the capsule are rare. These tumours are normally small asymptomatic and often detected incidentally. Large renal leiomyomas can present with pain or as an abdominal mass, but they are rare. The imaging features of these tumours have been poorly described in the literature. A radiological distinction from other renal neoplasms is often difficult to make owing to the similarity of imaging findings. We report two patients with renal leiomyomas who presented with pain and an abdominal mass. Both patients underwent nephrectomy and histological evaluation confirmed the diagnosis of leiomyoma.

Echinococcosis of the rib with epidural extension: a rare cause of paraplegia.

Skeletal echinococcosis is a relatively rare entity and that of the rib is exceptional. Less than 50 cases of costal echinococcosis have been reported in the literature so far. Accurate pre-operative diagnosis aids in appropriate management and helps to eradicate the disease. This also prevents the dissemination of parasite and further complications. We report a case of echinococcosis of the rib with epidural extension in a young adult who presented with paraparesis and back pain. His laboratory investigations were within normal limits. Plain radiographs of the dorsal spine, CT scan of thorax and MRI of dorsal spine were performed. The imaging features were suggestive of echinococcosis involving the rib with epidural extension. The cyst was completely resected. Histopathology of the resected specimen confirmed the diagnosis of echinococcosis.

Imaging features and guided drainage in emphysematous pyelonephritis: a study of 11 cases.

AIM: The purpose of the present study is to evaluate the role of image-guided drainage in emphysematous pyelonephritis (EPN). MATERIALS AND METHODS: We reviewed 11 patients with EPN treated either by ultrasonography (three patients) or computed tomography (CT)-guided drainage (eight patients). There were eight male and three female patients in our study with ages ranging from 24 to 75 years, mean 56.3 years. All the patients underwent plain radiography, ultrasonography and plain CT of the abdomen. Contrast-enhanced CT was performed in seven patients. RESULTS: Seven of 11 patients, were successfully treated with per cutaneous drainage. One patient died within 24 h (case 2), due to septicaemia. Three patients subsequently required nephrectomy. Replacement of the drainage catheter was required in one patient. The catheter was kept in situ, for an average of 17 days. The catheter drained pus and gas in all patients. The quantity of pus ranged from 300 to 2000 cm(3). All 10 patients improved symptomatically within 24 h of drainage, with improved urine output and serum creatinine levels within 48 h. CONCLUSION: CT-guided drainage of EPN has established itself as a safe, quick and life-saving palliative treatment of choice as opposed to conventional emergency nephrectomy. Excluding the patient who died, the success rate of our study was 70%.

Case report: Aneurysmal bone cyst of the ethmoid bone.

Aneurysmal bone cysts (ABCs) are benign, slow growing expansile lesions usually found in long bones or vertebrae. Plain radiography reveals expansion of bone and cortical thinning. MRI may assist in diagnosis by virtue of its ability to demonstrate blood-fluid levels, which is a characteristic finding in these lesions. Very few cases of ABC of the paranasal sinuses have been reported in the literature. We present MRI findings of ABC of the ethmoid sinus in a 19-year-old male.

Persistent mullerian duct syndrome with teratoma in an ectopic testis: imaging features.

The persistent mullerian duct syndrome represents a rare form of male pseudohermaphroditism, secondary to mullerian inhibiting factor (MIF) deficiency. We describe imaging findings in a 30-year-old male (46 XY karyotype) with bilateral cryptorchidism and mullerian duct anomalies (presence of uterus and fallopian tubes). Grade-III teratoma with yolk sac tumour was detected in one of the undescended testis, lying in the pelvic cavity. The other testis was in the inguinal canal. The rest of the wolffian duct structures (e.g. prostate, seminal vesicles) were nearly normal. Very few reports of imaging findings of this entity have been published thus far, probably because of the rarity of entity, incidental detection of most of the cases at surgery and relatively asymptomatic clinical presentation.

Iatrogenic gastric fistula due to inappropriate placement of intercostal drainage tube in a case of traumatic diaphragmatic hernia.

A 26-year-old, 30 weeks primigravida presented with a gastric fistula through a left intercostal drain, which was inserted for drainage of suspected haemopneumothorax following minor trauma. It was confirmed to be a diaphragmatic hernia, with stomach and omentum as its contents. On exploratory laparotomy, disconnection of the tube and fistulous tract, with reduction of herniated contents and primary suturing of stomach was carried out. Diaphragmatic reconstruction with polypropylene mesh was also carried out. Post-operative recovery was uneventful with full lung expansion by 3rd postoperative day. Patient was asymptomatic at follow-up 6 months.

Giant cell tumour of talar body.

Giant cell tumour (osteoclastoma) of talar bone is a rare entity and is seen more commonly in the third decade of life. We report this disease entity in a 17-years-old girl. The patient presented with painful swelling of the left ankle with an osteolytic lesion in the talus on conventional radiographs. Intralesional curettage and autologous bone grafting was performed following which patient's pain and swelling disappeared. Complete range of movement at the ankle joint was regained with minimal restriction at the subtalar joint. There is no evidence of relapse at six months follow up.