RESUMO
Pancreatic duct disruption is a serious complication of acute or chronic pancreatitis. These ruptures may cause collections of pancreatic secretion leading to ascites but also to pleural or mediastinal effusions. Rupture into the bronchial tree, resulting in a pancreaticobronchial fistula, is also possible, but it is a rare complication. It should be considered if a patient with pancreatitis develops respiratory symptoms and requires cross-sectional imaging to identify pancreaticobronchial fistulae.
RESUMO
We report the CT, surgical and histopathologic findings of a rare case of Hepatic Angiosarcoma (HAS) diagnosed in a 85-year old women 65 years afterThorotrast (Th232) exposure for angiography. At the early arterial phase of dynamic MDCT, peripheral curvilinear and central nodular puddling of contrast produced in the 8 cm tumor.Then progressive contrast filling of the tumor was observed on the delayed scans. Associated pathognomonic signs related to previous Th232 exposure were also found comprising diffuse intrahepatic reticular bands of calcifications, numerous calcified epigastric lymph nodes and a calcified shrunken spleen. Emergency laparotomy was performed because of associated hemoperitoneum. With a delay of 65 years afterThorotrast exposure, this historical case probably represents, to our knowledge, the most delayed presentation of Th232 related HAS ever published.
Assuntos
Meios de Contraste/efeitos adversos , Hemangiossarcoma/induzido quimicamente , Hemangiossarcoma/diagnóstico por imagem , Neoplasias Hepáticas/induzido quimicamente , Neoplasias Hepáticas/diagnóstico por imagem , Dióxido de Tório/efeitos adversos , Idoso de 80 Anos ou mais , Carcinógenos , Diagnóstico Diferencial , Evolução Fatal , Feminino , Hemangiossarcoma/química , Hemangiossarcoma/patologia , Hemangiossarcoma/cirurgia , Humanos , Fígado/diagnóstico por imagem , Fígado/patologia , Fígado/cirurgia , Neoplasias Hepáticas/química , Neoplasias Hepáticas/patologia , Neoplasias Hepáticas/cirurgia , Tomografia Computadorizada Multidetectores/métodos , Dióxido de Tório/análiseRESUMO
We report a very rare case of acute obstructive hemobilia caused by bleeding of a mass-forming intrahepatic cholangiocarcinoma in a 75-year old man. The prompt complete emergency diagnosis was made by ultrasound and confirmed by MDCT. The features of hemobilia and intrahepatic cholangiocarcinoma are briefly reviewed.
Assuntos
Neoplasias dos Ductos Biliares/complicações , Ductos Biliares Intra-Hepáticos , Colangiocarcinoma/complicações , Hemobilia/etiologia , Idoso , Neoplasias dos Ductos Biliares/diagnóstico , Neoplasias dos Ductos Biliares/patologia , Ductos Biliares Intra-Hepáticos/patologia , Colangiocarcinoma/diagnóstico , Colangiocarcinoma/patologia , Humanos , Masculino , Tomografia Computadorizada MultidetectoresRESUMO
The clinical and imaging features of Meckel's diverticulum of the adult are reviewed through the report of three complicated cases, one presenting with perforation, the second with intestinal bleeding, and the third with intestinal occlusion due to phytobezoar impaction. Intradiverticular heterotopy of gastric mucosa was the responsible common denominator for the first two cases. Intradiverticular calcified entheroliths were also found in the second case. Obstruction due to a phytobezoar as observed in the third case is a very rare presentation. This report clearly emphasizes and encourages the approach of this difficult diagnosis by combined CT and US imaging.
