Pneumoperitoneum and Chilaiditi syndrome: navigating a diagnostic conundrum.

Chilaiditi sign represents a rare condition marked by the interposition of the bowel between the diaphragm and liver, mimicking pneumoperitoneum on radiological imaging. The syndrome manifests with gastrointestinal symptoms and is often confused with more serious conditions. This case report presents a rare instance of Chilaiditi syndrome, initially misdiagnosed as pneumoperitoneum based on chest X-ray findings. The patient, a 61-year-old woman, arrived at the emergency department complaining of acute epigastric pain. Initial tests, including a chest X-ray, suggested pneumoperitoneum, but a subsequent contrast-enhanced abdominal CT-scan revealed the interposition of the right colon between the liver and diaphragm, characteristic of Chilaiditi sign. The patient's symptoms, including abdominal pain and diarrhea, were consistent with Chilaiditi syndrome. The patient was treated successfully with intravenous antibiotics and fluids, showing significant improvement within 48 hours. The report highlights the importance of differentiating Chilaiditi syndrome from other acute abdominal conditions to avoid unnecessary surgical intervention.

Pelvic and Lumbar Pain Revealing Bone Sarcoidosis: A Case Report.

A 54-years-old woman suffered from a bilateral pelvic and lumbar pain. She had a systemic investigation shows a diffuse bone lesions. A biopsy of iliac bone was done and revealed sarcoidosis. Bony manifestations of sarcoidosis are rare and challenging to diagnose. Our report shows that MRI with diffusion weighted sequences is a simple and non invasive technique to evaluate bone infiltration. It helps to distinguish inflammatory disease from metastatic lesions and to guide the osseous biopsy. Moreover, fluorodeoxyglucose PET scan, are useful in establishing the extent of damage and measuring disease activity.

Unusual sites of hydatid disease: report of two cases of dumbbell formations.

Hydatidosis is a zoonosis caused by Echinococcus granulosus. Humans are accidentally contaminated by ingesting the parasite´s eggs mainly released through the faeces from infected dogs. Hydatidosis affects the bone in 0.5 to 2% of cases, with 44% of these cases involving in the spine. Vertebral hydatidosis is rare and it represents the most frequent and most dangerous form of bone involvement. This manifestation is extremely delicate, difficult to correctly identify and manage. The authors report two cases of vertebral hydatidosis revealed by medullar compression and increasing lumbar-radicular pain and functional impotence of lower limbs. Imaging showed multicystic bony lesions in lumbar spine. The extension into the spinal canal and to the perivertebral soft tissue were involved in both cases. We present those two cases to highlight the role of radiological exploration for diagnosis especially with magnetic resonance imaging (MRI) and the importance of monitoring this dangerous pathology.

Οbstructive tracheal neοplasm: Primary tracheοbrοnchial nοn-hοdgkin lymphοma.

The trachea is an unusual site οf primary malignancy. Very few cases οf primary tracheal lymphοma with central airway οbstructiοn have been repοrted sο far. Cοmmοn cοmplaints are dyspnea and cοugh that cοuld mimic a partially refractοry asthma in sοme cases. In this article; we will present the case οf a 63-year-οld wοman diagnοsed with a tracheal lymphοma causing life-threatening airway οbstructiοn, this was cοnfirmed by brοnchοscοpy biοpsy and histοpathοlοgical exminatiοn. The mοrtality depends οn the prοgressiοn οf the disease, the οbstructiοn οf the airway. Hοwever, this entity has a gοοd prοgnοsis if diagnοsed immediately and treated with specific chemοtherapy. This case will shοw that the diagnοsis οf tracheal lymphοma shοuld be kept in mind within the differential diagnοsis οf central airway οbstructiοn.