The accuracy of computed tomography in the diagnosis of retroperitoneal blood in the presence of abdominal aortic aneurysm.

The use of computed tomography (CT) in the management of patients who are hemodynamically stable with symptoms suggestive of ruptured abdominal aortic aneurysm and in hemodynamically unstable patients without palpable or known aortic aneurysms was analyzed in a retrospective study. One hundred forty-two CT scans were performed; 48 patients had abdominal aortic aneurysms and 35 had no evidence of rupture or retroperitoneal blood. Ten patients had CT scans that showed evidence of rupture, and three patients had CT scans that were thought to be indeterminate for rupture, probably inflammatory. Forty patients underwent laparotomy. Excluding the three patients with inflammatory aneurysms, the results of CT scanning were compared with the findings at laparotomy. The sensitivity of CT scanning for the diagnosis of retroperitoneal blood in the presence of abdominal aortic aneurysm was 77% and the specificity was 100%, with an overall accuracy of 92%. An algorithm for the management of the patient with symptoms suggestive of a ruptured aneurysm is presented.

Fetal ventriculomegaly and brain atrophy in a woman with intrauterine cytomegalovirus infection. A case report.

Fetal ventriculomegaly and brain atrophy occurred in a woman with intrauterine cytomegalovirus infection.

Percutaneous needle biopsy of deep pelvic masses: a posterior approach.

The classical approach for the fine-needle aspiration biopsy of deep pelvic masses has been through the lower anterior abdominal wall. With this approach, and using either CT or sonographic guidance, bowel or bladder may be unavoidably traversed to reach the mass. We have been using a posterior approach through the sciatic notch, which is a safe and simple procedure, with good results. The biopsy is done with the patient in a prone position, using a 22-gauge biopsy needle. With this technique we have successfully biopsied various neoplastic pelvic entities.

The oblique coronal view in sonography of the retroperitoneum.

The abdominal aorta and inferior vena cava can be seen easily from the right flank on a longitudinal coronal-oblique sonogram, using the liver as an acoustic window. With this view, tortuosity of the abdominal aorta can be shown, just as it appears on frontal aortography in 70% of cases, and similar to aortography in 27% of cases. The proximal renal and common iliac arteries can be demonstrated in 73% and 82% of cases, respectively, when aneurysms are absent, and in 45% and 82% of patients when aortic aneurysms are present. Enlarged posterior abdominal lymph nodes may be detected with accuracy, sensitivity, and specificity of 90% when compared to computed tomography (CT). Prominent gonadal vessels and anomalous or duplicated venae cavae can be displayed longitudinally, just as they might appear on venography. The coronal oblique view from the right flank, and occasionally from the left flank, can be a valuable addition to the standard views obtained during abdominal sonography. It is also a valuable supplement to CT in the differentiation of paraaortic vessels from enlarged lymph nodes.

Posterior hepatodiaphragmatic interposition of the colon: ultrasonographic and computed tomographic appearance.

High posterior hepatodiaphragmatic interposition of the colon is an unusual normal variant that may mimic posterior hepatic lesions, posterior retroperitoneal masses, or a disrupted right diaphragm on sonography. The correct diagnosis of this entity may be suggested on plain abdominal films, and is made easily with computed tomography.

CT diagnosis of congenital lobar emphysema.

Congenital lobar emphysema can be diagnosed by conventional chest films, but it may be difficult to determine which is the affected lobe or the etiology. This report presents the computed tomographic (CT) appearance of this entity and also emphasizes the significant role CT may have in its diagnosis.

Sonographic findings in myoglobinuric renal failure and their clinical implications.

Myoglobinuria, which occurs more frequently than previously believed, may lead to acute tubular necrosis and renal failure. It may be recurrent and can result in permanent renal damage. Three cases of myoglobinuria with acute renal failure and abnormal sonograms are reported.

Spontaneous regression of infantile hemangioendotheliomatosis of the liver: demonstration by ultrasound.

Ultrasonic and computed tomographic appearances of infantile hepatic hemangioendotheliomas are described. Ultrasonic documentation of spontaneous regression is demonstrated.

Focal hepatic fatty metamorphosis secondary to trauma.

Focal fatty metamorphosis of the liver is an entity that has recently been well described. This abnormality should be included in the differential computed tomographic (CT) diagnosis of lesions of decreased attenuation. In this paper, we report three cases in which blunt liver trauma (of varying degrees) resulted in focal fatty metamorphosis that was documented by CT.

Lymphangioma of the thymus in a child.

Computed tomographic (CT) evaluation of a rare thymic tumor in a child is described. The CT characteristics, pre- and postcontrast enhancement, are described and correlated with ultrasound and plain radiographic findings. Correlation is made between the CT results and the thymic lymphangioma with a subsequently identified abdominal lymphangioma.