Cement Embolism After Kyphoplasty.

Kyphoplasty is used for the treatment of vertebral compression fractures. The procedure involves inflating a balloon at the compression site; then, polymethylmethacrylate (PMMA) cement is added into the space created by the balloon, where it polymerizes, achieving stabilization, with possible expansion of the vertebral angle. The process is guided by X-rays. Complications are rare, especially when compared to vertebroplasty, and one rare complication is pulmonary cement embolism (PCE). Although many cases are likely undetected due to a lack of symptoms, symptomatic cases require treatment, as they can sometimes prove fatal. We present a case of a patient who underwent kyphoplasty and later presented with a PCE. The PCE was diagnosed using X-rays and computed tomography (CT).

Clinical and Radiological Features of Menetrier's Disease: A Case Report and Review of the Literature.

We present a case report describing the diagnosis and management of a patient who presents with a rare diagnosis of Menetrier's disease. This condition poses a diagnostic challenge to clinicians due to its nonspecific clinical presentation and is oftentimes misdiagnosed for more common gastric disorders. Menetrier's disease is characterized by gastric mucosal hypertrophy and subsequent protein loss, resulting in gastric symptoms and widespread edema. While the etiology remains unclear, notable associations have been observed with Helicobacter pylori (H. pylori) infection and overexpression of transforming growth factor-alpha (TGF-a). The management often involves supportive measures with medical and surgical interventions for refractory cases and when necessary. This report includes a comprehensive review of the literature on the clinical presentation, diagnostic approach, and management of this rare disease. By documenting such cases in the medical literature, we aim to enhance the clinician's ability to recognize and manage this disorder, thereby preventing the development of more severe manifestations such as gastric carcinoma.

Marchiafava-Bignami disease: Case presentation and radiological imaging.

Marchiafava-Bignami disease (MBD) is a rare vitamin B deficiency classically associated with alcoholism. MBD damages the corpus callosum and presents with nonspecific neurological symptoms. Radiological imaging is critical for diagnosing MBD and commencing subsequent treatment, which often consists of vitamin B supplementation. We present a case of MBD in a 56-year-old male with alcohol use disorder, epilepsy, schizophrenia, post-traumatic stress disorder, and cardiovascular risk factors. The patient presented with general neurological symptoms, and there were several potential diagnoses to consider based on the patient's history. Radiological imaging was necessary for diagnosis. This case demonstrates the role radiological imaging plays in the workup of MBD.

Radiological Diagnosis and Surgical Treatment of Gallstone Ileus.

We report on the diagnosis and treatment of a patient who presented with a small bowel obstruction due to gallstone ileus. This condition is an infrequent complication of cholelithiasis that presents with non-specific and intermittent findings, including bloating, early satiety, constipation, nausea, and vomiting. Contrast-enhanced CT features the classic imaging finding, called Rigler's triad, which includes small bowel distension, gas in the gallbladder, and an ectopic gallstone. Laparoscopic enterolithotomy is employed to prevent further erosion through the gallbladder wall and into the adjacent gastrointestinal structures. The early diagnosis and treatment of gallstone ileus results in decreased morbidity and mortality.

Inferior mesenteric vein thrombophlebitis secondary to acute diverticulitis.

Inferior mesenteric vein thrombophlebitis is an uncommon condition. Most cases of portal-mesenteric thrombophlebitis affect either the portal vein or superior mesenteric vein; it is not known why the inferior mesenteric vein is less affected. Thrombophlebitis typically occurs following inflammatory intra-abdominal processes, such as diverticulitis. Diverticulitis is a common condition in the Western world, with several common complications, such as fistula formation and bowel wall perforation. However, although diverticulitis is a common cause of portal-mesenteric thrombophlebitis, thrombophlebitis is still a rare complication of diverticulitis. We present a case of diverticulitis complicated with interior mesenteric vein thrombophlebitis with gas extension into the portal vein.

Mercury poisoning from artisanal gold mining equipment.

Artisanal and small-scale gold mining uses mercury to isolate gold from ore. Although uncommon in the United States, it is more common in poor and undeveloped countries. This practice requires heating mercury, which vaporizes into an odorless gas that can be inspired and absorbed into the blood. Inspired mercury vapors place individuals at risk of acute mercury toxicity and its subsequent chronic sequelae. We report a case of incidentally detected mercury foreign bodies in a 56-year-old male with a prior history of accidental mercury poisoning due to prior contact with artisanal gold mining equipment.

Primary adrenal leiomyosarcoma.

Primary adrenal leiomyosarcoma is a very rare mesenchymal tumor that arises from smooth muscle cells in the wall of the central adrenal vein or its branches (1). Less than 50 cases have been published in the English literature (2). The tumors are aggressive and often metastasize. This report describes a case of primary adrenal leiomyosarcoma that presented as intermittent left flank pain of 6 months duration in an otherwise healthy 58-year-old Caucasian female. The patient was initially imaged with an abdominal ultrasound, which revealed a left suprarenal mass. A follow-up CT of the abdomen and pelvis confirmed a malignant appearing left adrenal mass. A subsequent PET-CT demonstrated increased metabolic activity within the adrenal mass without evidence of metastasis. Biopsy proven metastasis eventually was detected on surveillance CT studies over the course of 2.5 years. Since this is such a rare malignancy, documenting its imaging findings with multiple modalities is of importance to add to the medical literature and help further characterize its imaging features.

Herpes simplex virus-1 encephalitis secondary to whole brain radiation therapy for metastatic renal cell carcinoma.

Herpes simplex virus-1 (HSV-1) infection is the most common cause of encephalitis. This virus commonly lays dormant in neural ganglia, specifically the trigeminal ganglia, following retrograde axonal transport from the site of infection. States of immunosuppression can activate the virus to cause active infection. There are several causes of immunosuppression that can cause viral reactivation. Sporadic case reports have demonstrated HSV-1 encephalitis following brain radiotherapy, although no clear relationship between this treatment and HSV-1 encephalitis has been elucidated. HSV1 encephalitis that arises during immunocompromized states has an atypical presentation for encephalitis, potentially obfuscating the diagnosis and delaying subsequent treatment. The main diagnostic criteria, including CSF analysis, brain imaging, and clinical presentation, all commonly present atypically during states of immunosuppression. For these reasons, it is imperative for physicians to be aware of this rare sequelae in appropriate populations, such as patients undergoing brain radiotherapy. We present a case of an atypical presentation of HSV-1 encephalitis in a patient who recently completed radiotherapy for brain metastases secondary to renal cell carcinoma.

Lipoma lead point intussusception in an adult: A case report.

Intussusception has been considered a rare phenomenon in adults, with most cases occurring secondary to lead points. Most adult cases of intussusception occur secondary to lead points. Lead point intussusceptions typically require surgical intervention, whereas non-lead point intussusceptions are often transient and resolve without surgery. Therefore, accurate identification of the etiology of the intussusception guides subsequent treatment. Lipomas are an uncommon type of lead point. We present a case of intussusception secondary to a lipomatous lead point and describe the radiological diagnosis and surgical management.

A Rare Complication of Noncompliance Status Post-Transhiatal Esophagectomy and Esophago-Gastroanastomosis.

Gastropleural fistulas are a complication of peptic ulcers in hiatal hernias, trauma, infections, surgical complications, and malignancy. Presenting symptoms may include gastric and chest pain with respiratory failure in the setting of pneumonitis, hydropneumothorax, or tension pneumothorax. We describe a 57-year-old male with a history of transhiatal esophagectomy and esophago-gastroanastomosis who presented in the setting of dyspnea and dark orogastric tube output. Upper endoscopy revealed multiple gastric ulcers with a dominant ulceration communicating with an adjacent space, and a fistulous tract was demonstrated on computed tomography chest, confirming a gastropleural fistula, a rare life-threatening condition.

MR imaging of epilepsy: strategies for successful interpretation.

MR imaging plays a pivotal role in the evaluation of patients with epilepsy. With its high spatial resolution, excellent inherent soft tissue contrast, multiplanar imaging capability, and lack of ionizing radiation, MR imaging has emerged as a versatile diagnostic tool in the evaluation of patients with epilepsy. MR imaging not only identifies specific epileptogenic substrates but also determines specific treatment and predicts prognosis. Employing appropriate imaging protocols and reviewing the images in a systematic manner helps in the identification of subtle epileptogenic structural abnormalities. With future improvements in software, hardware, and post-processing methods, MR imaging should be able to throw more light on epileptogenesis and help physicians to better understand its structural basis.

MR imaging of epilepsy: strategies for successful interpretation.

MR imaging plays a pivotal role in the evaluation of patients with epilepsy. With its high spatial resolution, excellent inherent soft tissue contrast,multiplanar imaging capability, and lack of ionizing radiation, MR imaging has emerged as a versatile diagnostic tool in the evaluation of patients with epilepsy. MR imaging not only identifies specific epileptogenic substrates but also determines specific treatment and predicts prognosis. Employing appropriate imaging protocols and reviewing the images ina systematic manner helps in the identification of subtle epileptogenic structural abnormalities. With future improvements in software, hardware, and post-processing methods, MR imaging should be able to throw more light on epileptogenesis and help physicians to better understand its structural basis.