RESUMO
We report a case of hepatic hemangiomatosis coexistent with a giant hepatic hemangioma diagnosed in the context of the study for SARS-CoV-2 infection. Computed tomography showed irregular contours of the left hepatic lobe with a lesion that compromised the whole lobe, with peripheral uptake and a centripetal tendency in the late phase, compatible with bulky cavernous hemangioma, as well as another lesion with the same characteristics in segment VI. Magnetic resonance imaging of the abdomen showed multiple hepatic hemangiomas observed in both lobes involving all segments, some of them smaller than 1 cm, which were hyperintense in the T2-weighted sequences and showed progressive contrast enhancement. This case illustrates the incidental diagnosis of this condition during the study for another pathology, the radiological features that are important to differentiate from other tumoral findings, and the possible management strategies to follow.
RESUMO
La enfermedad fistulosa perianal es una entidad inflamatoria crónica que afecta el canal anal y los espacios perianales. Las fístulas anales presentan gran morbilidad y recurrencia. Para definir el tipo de tratamiento quirúrgico o médico, evitar recurrencias y complicaciones como la incontinencia fecal, es importante una adecuada caracterización y clasificación de las fístulas mediante la resonancia magnética (RM). Actualmente la RM es el estudio imaginológico con mayor sensibilidad diagnóstica debido a su alta resolución anatómica para definir las estructuras del canal anal y demostrar el trayecto fistuloso con sus complicaciones (abscesos y trayectos secundarios).
Fistulous perianal disease is an inflammatory entity that affects the anal canal and perianal spaces. Anal fistulas represent important morbidity and recurrence for patients. For the planning of surgical treatment, preventing recurrences and complications like fecal incontinence, a proper characterization and classification of fistulas with magnetic resonance must be done. Currently, magnetic resonance is the imaging modality with greatest diagnostic sensitivity due to its high anatomical resolution in defining structures like the anal canal and fistulous tracts with its complications (abscesses, secondary paths).
