IgG4-related disease of the hepatobiliary tract : 2 case reports and review of the literature.

IgG4-related disease is a rare inflammatory disorder that may mimic many infectious, malignant, and autoimmune conditions. The biliary tract is frequently involved, but hepatic lesions are rarely seen. Diagnosis is often delayed due to the absence of specific clinical and radiological signs, and the lack of an accurate diagnostic marker. Differential diagnosis includes cholangiocarcinoma, primary sclerosing cholangitis and intrinsic or metastatic liver disease. Corticosteroids are the cornerstone of therapy but treatment has not been standardized and relapse is common. Based on two cases of IgG4-related hepatobiliary disease, we review the current literature on this pathological entity.

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.

Can bone marrow edema be seen on STIR images of the ankle and foot after 1 week of running?

PURPOSE: To evaluate whether initiation of running in sedentary individuals would lead to bone marrow edema on MR images, within the time span of 1 week. MATERIALS AND METHODS: The feet of 10 healthy volunteers were imaged by MR imaging before and after running during 30 min a day for 1 week. The images were evaluated by consensus of 2 musculoskeletal radiologists who graded the presence of bone marrow edema on a 4-point scale. Edema scores and number of bones involved before and after running were compared statistically. RESULTS: Edema was present on the baseline images in 3 subjects. After running edema showed an increase or was present in 5 subjects. The changes after running were statistically significant. Bones involved were the talus, calcaneus, navicular bone, cuboid bone, and 5th metatarsal. CONCLUSION: Edema patterns can be seen in the feet of asymptomatic individuals. During initiation of running an increase of edema or development of new edema areas can be seen.