GASTROINTESTINAL COMPLICATIONS OF ACCIDENTAL INGESTION OF FOREIGN OBJECTS.

Ingestion of foreign objects is common and most of the time, they pass without major problems. However sometimes they could cause significant morbidity or even mortality. Most of the time they cause pain in the pharyngeal or oesophageal area. In these instants, diagnosing the problem is straightforward, limiting the use of radiographic diagnosis. However the intraperitoneal complications include stomach or bowel perforation, obstruction, abscedation, septicemia or even hemorrhage or thrombosis of the abdominal veins. Because of the considerable risks, accompanied by the accidental ingestion of a metallic object, the preferred technique for screening is still Computed Tomography. However not all of these objects are radio-opaque and therefore could not always be diagnosed radiographically. In this article we will describe several cases of complications, due to the accidental ingestion of foreign objects. Also we will describe certain patient related risk factors significantly increasing, not only the amount, but also the severity of those complications. Diverticulosis seems the most common risk factor amongst the patients described and so it could be one of the more common triggers causing (recidivating) diverticulitis attacks. But because not all of the ingested foreign objects are radiopaque or still in the gastrointestinal tract, such a theory is difficult to prove.

Imaging features of peripheral neurogenic tumors.

Peripheral nerve sheath tumors (PNST) include schwannoma, neurofibroma and malignant peripheral sheath tumors. All neurogenic tumors share the same imaging characteristics, including fusiform shape, low attenuation on CT, fascicular sign, split fat sign and associated muscle atrophy. The aim of this article is to give a comprehensive overview of peripheral nerve tumors and to discuss the imaging characteristics that distinguish these masses.

MR features of peripheral nerve sheath tumors: can a calculated index compete with radiologist's experience?

The aims of this study were, firstly, to provide a formula (neurogenic index) based on MR characteristics used in daily routine for predicting whether a soft tissue tumor is neurogenic or not, secondly, to test prospectively the performance of this formula, and thirdly, to compare this performance with that of radiologists experienced in MR imaging of soft tissue tumors. Retrospectively, MR images of 70 neurogenic and 70 non-neurogenic soft tissue tumors were evaluated in random order by two teams of two observers each. A neurogenic index (NI) was calculated based on those MR parameters that showed no or minor interobserver variability. Subsequently, three investigators in concert used the NI in a validation group of 15 neurogenic and 22 nonneurogenic soft tissue tumors. The same team, based on their own experience, tried to differentiate in the same validation group neurogenic from non-neurogenic soft tissue tumors. This was expressed in a subjective score (SS). Sensitivity, specificity, and predictive values were calculated. NI comprised spread (intra- or extracompartmental), distribution, fluid-fluid levels, homogeneity on T2-weighted images (WI), highest signal intensity (SI) on T1WI, lowest SI on T2WI, and delineation on T2WI. In the validation group, NI had a sensitivity of 88.6%, a specificity of 52.0%, a positive predictive value (PPV) of 54.1%, and a negative predictive value (NPV) of 84.6% for neurogenic tumors. The subjective score SS was superior and had a sensitivity of 93.3%, a specificity of 77.2%, a PPV of 73.7%, and a NPV of 94.4%. Our NI was less accurate than the SS; however, the low number of false-negative diagnoses for neurogenic tumors warrants continued efforts in development of neural networks.

Amyloidoma of the skull base.

We report a case of a primary amyloidoma of the skull base. Plain radiography and CT showed a lytic, highly destructive lesion with multiple scattered calcifications within. MR imaging revealed that the tumor was isoto hypointense to muscle on T1-weighted images and extremely hypointense on T2-weighted images. In contrast to two previous reports, marked enhancement after the administration of contrast material was absent. Bone amyloidomas are very rare and are frequently misinterpreted as chondrosarcomas.

[Restrictive dermopathy]. / Restriktive Dermopathiey.

Restrictive dermopathy is a rare, fatal, autosomal recessive, congenital skin disease. Rigidity of translucent thin skin, which is thus highly vulnerable and tears, spontaneously causes intra-uterine fetal akinesia or hypokinesia deformation sequence (FADS), characteristic dysmorphic facies with fixed open mouth in O position, and generalized joint contractures (arthrogryposis). Polyhydramnios and pulmonary hypoplasia are distinctive manifestations, leading to respiratory insufficiency and premature delivery at about 31 weeks of gestation. We report on a case of a prematurely born infant who presented with the typical morphological features and describe the light- and electron-microscopical findings as described in the literature.

[Choriocarcinoma of the uterine cervix and cervical pregnancy]. / Chorionkarzinom der Cervix uteri und zervikale Schwangerschaft.

Case report of a 20-year-old women with a chorionic carcinoma of the uterine cervix. Subsequently, the aspects of the disease of chorionic carcinoma and cervical pregnancy are discussed, including epidemiology, aetiology, diagnosis and management. Finally, the conclusions of this discussion are compared with the case report.