Severe non-cardiovascular thoracic trauma: diagnostic clues on computed tomography.

OBJECTIVE: About 60% of multiple trauma patients have thoracic trauma, and thoracic trauma results in the death of 10% of these patients. Computed tomography (CT) is the most sensitive and specific imaging modality for the diagnosis of acute disease, and it helps in the management and prognostic evaluation of patients with high-impact trauma. This paper aims to show the practical points that are key for diagnosing severe non-cardiovascular thoracic trauma by CT. CONCLUSION: Knowing the key features of severe acute thoracic trauma on CT is crucial to avoid diagnostic errors. Radiologists play a fundamental role in the accurate early diagnosis of severe non-cardiovascular thoracic trauma, because the patient's management and outcome will depend largely on the imaging findings.

Traumatismo torácico grave no cardiovascular: claves diagnósticas en tomografía computarizada / Severe non-cardiovascular thoracic trauma: diagnostic clues on computed tomography

Objetivo: El traumatismo torácico ocurre en aproximadamente el 60% de los pacientes politraumatizados y es causa de muerte en un 10%. La tomografía computarizada (TC) es la prueba de imagen más sensible y específica en el diagnóstico de patología aguda y contribuye en el manejo y valoración del pronóstico en los pacientes con un traumatismo de alto impacto. El objetivo de este artículo es mostrar puntos clave y prácticos para el diagnóstico con TC de patología no cardiovascular en el traumatismo torácico grave.ConclusiónEl conocimiento de los aspectos clave en la TC de patología aguda en el traumatismo torácico grave es crucial para evitar errores diagnósticos. El radiólogo tiene un papel fundamental en el diagnóstico correcto y precoz de dicha patología, ya que de ello dependerá en gran parte el manejo y evolución de los pacientes.(AU)

Objective: About 60% of polytrauma patients present thoracic traumatic injuries, accounting for approximately 10% of trauma-related deaths. Computed tomography (CT) is the most sensitive and specific imaging modality for the diagnosis of acute injuries, and it improves management and prognostic evaluation of patients with high-impact trauma. This paper aims to show practical clues that are key for diagnosing severe non-cardiovascular thoracic trauma by CT.ConclusionKnowing the key features of severe acute thoracic trauma on CT is crucial to avoid diagnostic errors. Radiologists play a fundamental role in the accurate early diagnosis of severe non-cardiovascular thoracic trauma, because the patient's management and outcome will depend largely on the imaging findings.(AU)

Follow-up care for survivors of lymphoma who have received curative-intent treatment.

OBJECTIVE: This evidence summary set out to assess the available evidence about the follow-up of asymptomatic survivors of lymphoma who have received curative-intent treatment. METHODS: The medline and embase databases and the Cochrane Database of Systematic Reviews were searched for evidence published between 2000 and August 2015 relating to lymphoma survivorship follow-up. The evidence summary was developed by a Working Group at the request of the Cancer Care Ontario Survivorship and Cancer Imaging programs because of the absence of evidence-based practice documents in Ontario for the follow-up and surveillance of asymptomatic patients with lymphoma in complete remission. RESULTS: Eleven retrospective studies met the inclusion criteria. The proportion of relapses initially detected by clinical manifestations ranged from 13% to 78%; for relapses initially detected by imaging, the proportion ranged from 8% to 46%. Median time for relapse detection ranged from 8.6 to 19 months for patients initially suspected because of imaging and from 8.6 to 33 months for those initially suspected because of clinical manifestations. Only one study reported significantly earlier relapse detection for patients initially suspected because of clinical manifestations (mean: 4.5 months vs. 6.0 months, p = 0.042). No benefit in terms of overall survival was observed for patients depending on whether their relapse was initially detected because of clinical manifestations or surveillance imaging. SUMMARY: Findings in the present study support the importance of improving awareness on the part of survivors and clinicians about the symptoms that might be associated with recurrence. The evidence does not support routine imaging for improving outcomes in this patient population.

Diagnóstico de atresia de la arteria coronaria principal izquierda mediante tomografía computarizada volumétrica cardíaca de 320 detectores / Diagnosis of atresia of the main left coronary artery using 320-detector volumetric cardiac computed tompography

La ausencia congénita del tronco coronario izquierdo es una de las anomalías de arterias coronarias más raras. Presentamos un caso en el que se sospechó este diagnósticomediante angiografía coronaria, confirmándose mediantetomografíacomputarizada (TC) volumétricacardíaca adquirida en un solo latido (AU)

The congenital absence of the left coronary trunk is one of the rarest anomalies of the coronary artery. We present a case in which this anomaly was suspected at cardiac catheterization and confirmed at volumetric cardiac computed tomography (CT) with a single heart beat (AU)

[Diagnosis of atresia of the main left coronary artery using 320-detector volumetric cardiac computed tomography [corrected]]. / Diagnóstico de atresia de la arteria coronaria principal izquierda mediante tomografía computarizada volumétrica cardíaca de 320 detectores.

The congenital absence of the left coronary trunk is one of the rarest anomalies of the coronary artery. We present a case in which this anomaly was suspected at cardiac catheterization and confirmed at volumetric cardiac computed tomography (CT) with a single heart beat.

Lumbalgia secundaria a dilatación del plexo venoso epidural lumbar por compresión de la vena cava inferior / Low back pain secondary to lumbar epidural venous plexus dilatation due to compression of the inferior vena cava

Se presenta el caso de un paciente que acudió al Servicio de Urgencias, con una lumbalgia subaguda radiada a ambos miembros inferiores, en el que se hizo el diagnóstico por ecografía y tomografía computarizada abdominal de una masa adenopática retroperitoneal que comprimía la vena cava inferior. Una resonancia magnética de la columna lumbar, además de la masa retroperitoneal, mostró una dilatación y tortuosidad de los vasos del plexo venoso epidural lumbar a la que se atribuyó la lumbalgia y la radiculalgia que presentaba el paciente. El diagnóstico anatomopatológico de la masa retroperitoneal fue de linfoma no Hodgkin folicular. La dilatación del plexo venoso epidural lumbar puede ser causa de dolor lumbar y radicular

We present the case of a patient presenting at the emergency department with subacute low back pain radiating to both lower limbs in whom ultrasonography and abdominal computed tomography diagnosed a retroperitoneal adenopathic mass compressing the inferior vena cava. Magnetid resonance imagin of the lumbar spine showed the retroperitoneal mass and also showed dilatation and tortuosity of the vessels of the lumbar epidural venous plexus, which was considered responsible for the radiating low back pain. Histological study defined the retroperitoneal mass as follicular non-Hodgkin's lymphoma. The dilatation of the lumbar epidural venous plexus can cause lumbar and radicular pain

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