RESUMO
Abdominal scanning with Tc-99m labeled red blood cells serendipitously demonstrated collateral flow in a patent umbilical vein in a patient with unsuspected advanced cirrhotic liver disease and portal hypertension. Knowledge of this was crucial in planning the optimal surgical approach in this patient, referred for resection of a bladder carcinoma. Furthermore, the nuclide study was helpful in clarifying several questions posed by a prior abdominal pelvic CT scan.
Assuntos
Eritrócitos , Tecnécio , Veias Umbilicais/diagnóstico por imagem , Circulação Colateral , Humanos , Masculino , Pessoa de Meia-Idade , Cintilografia , Tomografia Computadorizada por Raios X , Veias Umbilicais/anormalidades , Grau de Desobstrução VascularRESUMO
Misinterpretation of the diaphragmatic crura on axial computed tomography images is a recognized pitfall in diagnosis. The right diaphragmatic crus is generally longer and thicker than the left. The authors observed a case in which the left crus was thicker than the right, causing diagnostic difficulty. Obtaining scans at full expiration and full inspiration clarified the situation. Confirmation of respiratory variation in crural thickness was obtained in ten patients. The crura increased in thickness on inspiration, compared with the size on expiration.
Assuntos
Músculos/anormalidades , Respiração , Diafragma/anormalidades , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
A retrospective analysis was made of all abdominal computed tomography scans performed because of clinical suspicion of an abscess at our institution over a 12-month period. Of 130 patients examined, 45 patients had had abdominal surgery within the previous 2-week period. Of these patients, 14 were found to have abscesses on computed tomography, with three known false-negative studies. An additional nine patients had sterile postoperative collections. Nine patients had had an abdominal abscess previously diagnosed, and five of these had a residual abscess. A total of seven abscesses were found by computed tomography in 76 patients who had had no surgery in the previous 2 weeks, with one known false-negative study. High-risk categories of nonoperative patients were identified. Only one positive study occurred in a patient without a high clinical index of suspicion for an intraabdominal abscess, although a total of 50 patients fell into this low-risk, nonoperative category. The cost-effectiveness of computed tomography studies in such low-risk patients is questioned.
Assuntos
Abdome , Abscesso/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Estudos de Avaliação como Assunto , Feminino , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Estudos RetrospectivosRESUMO
Blunt trauma to the chest may result in the formation of a traumatic lung cyst. The lesion itself is innocuous and requires no special treatment. Though it is important that traumatic lung cyst not be mistaken for a more serious complication of trauma requiring aggressive management, this distinction may be difficult to make on plain chest radiographs. However, in the setting of blunt chest trauma, the computed tomography appearance of a thin-walled cystic cavity completely surrounded by lung parenchyma is diagnostic of traumatic lung cyst.
