RESUMO
BACKGROUND: Persistent pneumoperitoneum after a laparoscopic operation can represent either residual postoperative pneumoperitoneum or free intraperitoneal gas released from the gastrointestinal tract. This animal study was conducted to better characterize the extent and duration of postoperative pneumoperitoneum as detected by computed tomography (CT). METHODS: Five pigs underwent cholecystectomy, four laparoscopically and one open. All pigs were followed serially with upright chest radiographs and abdominal CT scans beginning immediately postoperatively and continuing daily until resolution of pneumoperitoneum as detected by both imaging modalities. All radiographs and CT scans were reviewed by dedicated radiologists who reported the extent and duration of pneumoperitoneum in a blinded fashion. RESULTS: Pneumoperitoneum resolved on upright chest radiographs in all five pigs by or on postoperative day 1. Serial CT scans demonstrated that the laparoscopic group had either resolution of pneumoperitoneum or minimal persistence of free intraperitoneal gas by postoperative day 2. In contrast, the single pig in the open group had CT evidence of persistent pneumoperitoneum through postoperative day 6. CONCLUSIONS: In the pig model, small pockets of free intraperitoneal gas detected by CT scanning are expected to resolve by postoperative day 2 following laparoscopic surgery. Persistence of pneumoperitoneum beyond this interval is abnormal and may represent a perforated viscus. Whereas a prospective CT imaging study in humans is not ethically feasible, we believe that parallel conclusions between the pig and human may be drawn.
Assuntos
Laparoscopia/efeitos adversos , Pneumoperitônio/etiologia , Dor Abdominal/etiologia , Animais , Pneumoperitônio/diagnóstico por imagem , Suínos , Tomografia Computadorizada por Raios XRESUMO
Imaging plays a crucial role in the detection, characterization, and post-operative follow-up of renal masses. With rapidly advancing technology, imaging techniques are continuously evolving. This review will discuss the current modalities and techniques available for renal imaging, and recent developments.
Assuntos
Nefropatias/diagnóstico , Imageamento por Ressonância Magnética , Tomografia Computadorizada por Raios X , Angiografia , Diagnóstico Diferencial , Humanos , Nefropatias/diagnóstico por imagem , Ultrassonografia , UrografiaRESUMO
We report a case in which 99mTc-sestamibi SPECT was used to localize a middle mediastinum parathyroid adenoma that was not detected with planar sestamibi imaging on two previous occasions. Despite prior surgical exploration of the neck and mediastinum, the patient had a 20-yr history of hyperparathyroidism.
Assuntos
Adenoma/diagnóstico por imagem , Coristoma/diagnóstico por imagem , Doenças do Mediastino/diagnóstico por imagem , Glândulas Paratireoides , Neoplasias das Paratireoides/diagnóstico por imagem , Tecnécio Tc 99m Sestamibi , Tomografia Computadorizada de Emissão de Fóton Único , Adenoma/complicações , Humanos , Hiperparatireoidismo/etiologia , Masculino , Pessoa de Meia-Idade , Neoplasias das Paratireoides/complicações , Fatores de TempoRESUMO
Parathyroid scintigraphy is useful in detecting residual hyperplastic parathyroid tissue in patients who continue to have hyperthyroidism after "total parathyroidectomy." Typically, only the neck and mediastinum are imaged. The authors report a case in which images of the forearm were helpful in detecting hyperplastic autologous transplanted parathyroid tissue.
