Unusual MRI abnormality in patients with nonketotic hyperglycaemia-associated seizures.

Nonketotic hyperglycaemia (NKH) is a metabolic disorder typically observed in individuals with inadequately managed or undiagnosed diabetes mellitus (DM). Seizures are a common clinical presentation in NKH, and they tend to respond better to glucose correction than anticonvulsant therapy. MRI scans may reveal both subcortical T2/fluid-attenuated inversion recovery (FLAIR) imaging hypointensity and cortical changes, including cortical grey matter T2/FLAIR imaging hyperintensity and cortical or leptomeningeal enhancement, although cortical abnormalities are less frequently observed. These alterations are reversible when the underlying metabolic disturbance is effectively addressed. We suggest the role of iron accumulation as a mechanism for subcortical T2 hypointensity using T2* weighted imaging. Our cases substantiate the significance of subcortical T2/FLAIR hypointensity as a fundamental feature of this condition. In the appropriate clinical context, the recognition of these MRI abnormalities can help prevent misdiagnosis and facilitate timely treatment.

An unusual complication of acute appendicitis: isolated superior mesenteric venous pylephlebitis.

Septic thrombophlebitis of the portal vein or one of its tributaries is referred to as pylephlebitis. It is unusual to have superior mesenteric venous thrombophlebitis. It frequently arises as a result of an infection in the portal venous system's drainage area, such as appendicitis or diverticulitis. Preoperative diagnostic imaging can help in the early diagnosis of acute phase pylephlebitis. A case of acute appendicitis complicated by an intra-abdominal abscess and superior mesenteric venous pylephlebitis is presented. Appendicectomy, abscess drainage, and antibiotic and anticoagulant treatment resulted in a full recovery. After two months, follow-up imaging revealed that the superior mesentric vein had been completely canalised.

Unusual case of small bowel intussusception in adult revealing a Peutz-Jeghers syndrome.

Peutz-Jeghers syndrome is a rare genetic disorder characterized by hyperpigmented mucocutaneous macules, hamartomatous polyps of the small intestine, and family history. These hamartomatous polyps can cause intermittent abdominal pain, chronic anemia, or even intussusception. Imaging has an important role in the diagnosis of this syndrome but also in the identification of complications and periodic surveillance. Here, we present a demonstrative case of a Peutz-Jeghers syndrome associated with intussusception in a 16-year-old patient.

Cystic mass of the right iliac fossa: don't forget about lymphatic malformation.

Lymphatic malformation or cystic lymphangioma is a benign tumour of the lymphatic vessels. It is more commonly reported among children and has polymorphic clinical presentations. The diagnosis is based on imaging but requires histological confirmation. The treatment of choice is surgical excision for the abdominal and symptomatic localization. We report the case of a 30-year-old female who consulted for right iliac fossa pain mimicking an acute appendicitis. The physical examination revealed a slight tenderness in the right iliac fossa without fever or palpable mass. Though the biological screening was normal, the imaging exploration has revealed the presence of a multiloculated cyst located in the right iliac fossa at the ascending colon and measuring 15 cm. The mass matches with lymphatic malformation. Therefore, a laparoscopy was performed, and complete resection of the cystic tumor was accomplished with right hemicolectomy. The histologic exam has confirmed the diagnosis. Colonic lymphatic malformation is a rare and benign tumour, requiring a complete surgical excision to minimise any recidivism. The definitive diagnosis remains histological.

An unusual cause of obstructive jaundice: Lemmel's syndrome.

Lemmel's syndrome is a rare and misdiagnosed cause of obstructive jaundice. The cause of the obstacle is a duodenal diverticulum located at the periampullary generating a compression effect on the common bile duct with secondary dilation of the extra- and intra-hepatic bile ducts. Late diagnosis of this entity is common and may lead to unnecessary further investigations and therapeutic delay. There are only few case reports of this rare condition. We report a case of 77-year-old female presenting with obstructive jaundice due to Lemmel's syndrome. The diagnosis was made on a set of clinical, biological and radiological arguments with good improvement after medical treatment.

Hydatid pulmonary embolism: An exceptional complication of hydatid disease.

We present an extremely rare case of a young man with hydatid pulmonary embolism caused by a direct invasion of the pulmonary artery by a hydatid cyst. Even if it is a benign parasitic disease, it can lead to serious complications such as arterial, systemic, or multivisceral dissemination or being responsible for an anaphylactic shock. Because of the clinical polymorphism, the diagnosis can be delayed. Therefore, it is necessary to know when conduct a chest CT angiography which is the gold standard for the positive diagnosis.

[Plexiform cervical neurofibroma: about a case]. / Neurofibfrome plexiforme cervical: à propos d'un cas.

Plexiform neurofibroma is a rare benign tumor of the peripheral nerves involving the conjunctiva cells of the perineurium. It is pathognomonic of neurofibromatosis type1 (NF1 or Von Recklinghausen disease). MRI is a great help in the diagnosis of this pathology. Anatomopathological confirmation is sometimes necessary, in particular in patients with no signs of NF1. We here report the case of a little girl with cervical plexiform neurofibroma revealing neurofibromatosis type 1.

[Rare digestive tumors: gastrointestinal stromal tumors (GISTs): about a case of small bowel location and literature review]. / Tumeurs digestives rares: tumeur gastro-intestinale stromale (GIST): à propos d'un cas de localisation grêlique et revue de littérature.

Gastrointestinal stromal tumors (GISTs) are a rare group of mesenchymal tumors mainly occurring in the gastrointestinal tract. Previously, GISTs were classified as smooth muscle tumors also known as leiomyomas, leiomyosarcomas or leiomyoblastomas. However, since the advent of immunohistochemistry, GISTs have been diagnosed on the basis of the identification of c-kit-positive cells. We here report a case of stromal tumor of the small intestine in order to analyze it in the light of literature data and imaging results, which may suggest prebiopsy diagnosis as well as its therapeutic and prognostic peculiarities.

[Mirizzi's syndrome: a rare cause of biliary tract obstruction: about a case and review of the literature]. / Le syndrome de Mirizzi: une cause rare de l'obstruction des voies biliaires: à propos d'un cas et revue de littérature.

Mirizzi's syndrome is a rare complication of chronic vesicular lithiasis with prevalence ranging from 0.7% to 1.4% among patients who have undergone cholecystectomy. It is characterized by cholestatic icterus associated with compression of the common bile duct due to lodged calculus in the vesicular neck or in the cystic duct. The disease can evolve toward the erosion through the common hepatic duct wall and, therefore, it can cause the formation of a gallbladder-biliary fistula. We here report a case of Mirizzi's syndrome type I in order to highlight the role of preoperative diagnosis which is made easier by endoscopic retrograde cholangiography or by cholangio-MRI, allowing to avoid iatrogenic bile duct injuries. We conducted a review of the available literature on various aspects of this syndrome, including its pathogenesis, diagnosis and management.

[Giant congenital intrapericardial left atrial appendage aneurysm: about a case and review of the literature]. / Anévrysme congénital géant intra péricardique de l'auricule gauche: à propos d'un cas avec revue de la littérature.

Left atrial appendage aneurysm is a very rare heart anomaly. It may be congenital or acquired, secondary to inflammatory or degenerative processes. Most cases are asymptomatic. The prevalence of these lesions in pediatric age has been very rarely reported. As it can cause potentially fatal arrhythmias or thrombus, surgery is required immediately after diagnosis. This study reports the case of a 14-year-old boy with rapidly progressive dyspnea, palpitations, sensation of repetitive dizziness and fainting, in whom congenital left atrial appendage aneurysm was detected. Diagnosis was based on coronary CTA data. The patient was successfully treated with surgical resection of the aneurysm.