ABSTRACT
Thin-slice CT findings were reviewed in three patients with biliary stricture due to blunt abdominal trauma. In all cases, the stricture was located at the suprapancreatic portion of the common bile duct. Central enhancement with a low attenuation rim at the bile duct between the stricture and the papilla of Vater was apparent in all cases. Ancillary findings such as focal renal laceration (1 case) and left rib fracture (1 case) were also seen. These CT findings may help in the diagnosis of biliary injury for patients with blunt abdominal trauma.
Subject(s)
Bile Ducts/injuries , Tomography, X-Ray Computed/methods , Wounds, Nonpenetrating/diagnostic imaging , Accidents, Traffic , Aged , Constriction, Pathologic , Female , Humans , Male , Middle AgedABSTRACT
A 25-year-old, 7-weeks pregnant woman was admitted to the Nagaoka Red Cross Hospital in a state of confusion, following fever, headache and vomiting. Brain CT and MRI showed swelling in the bilateral thalami, basal ganglia and splenium of corpus callosum, and thrombosis of the internal cerebral veins and straight sinus. Initial treatment by intravenous heparin and glycerol was successful, and she regained her consciousness, leaving antegrade amnesia and childish character change. Her free protein S antigen was 32% (normal 60-127) and subsequently rose to 70% after delivery. She was diagnosed as having secondary protein S deficiency associated with pregnancy. Because warfarin can be teratogenic, subcutaneous heparin injection was prescribed in order to prevent thrombosis and the patient subsequently had a successful delivery. This was the first case in Japanese of successful delivery after subcutaneous heparin treatment in a patient with cerebral venous thrombosis.
Subject(s)
Delivery, Obstetric , Fibrinolytic Agents/administration & dosage , Heparin/administration & dosage , Intracranial Thrombosis/etiology , Pregnancy Complications , Protein S Deficiency/complications , Adult , Brain/diagnostic imaging , Female , Humans , Injections, Subcutaneous , Intracranial Thrombosis/diagnosis , Magnetic Resonance Imaging , Pregnancy , RadiographyABSTRACT
A 15-year-old girl presented with headache in the left retro-orbital area associated with double vision. She had a history of migraine headaches since the age of 9, and her mother also had suffered from migraine. The patient had experienced a similar episode at the age of 13, which resolved without any treatment in a day. On examination, two days after the onset of diplopia the patient had left ptosis and paresis of inwards and downwards in the left eye. Her pupils were isocoric, and the light reflex was prompt. MRI of the brain showed thickening and enhancement of the left third nerve through the cistern portion, especially at the oculomotor midbrain exit. No cavernous sinus involvement was noted. Results of the hemogram, ESR, and CSF were normal. The oculomotor palsy resolved spontaneously within six days. A follow-up MRI two months later demonstrated a marked lessening of enhancement at the oculomotor nerve but did not completely disappeared. These serial MRI abnormalities are thought to be important and typical findings seen in the patients of ophthalmoplegic migraine.
