Acute cholecystitis (AC) is a frequent complication of biliary cholelithiasis. Although ultrasound is the first diagnostic imaging procedure, frequently the initial imaging modality is computed tomography (CT). Therefore, familiarization of CT findings in AC and potential related complications are extremely important. This pictorial essay reviews a broad spectrum of complications related to AC and its key findings in CT.
El síndrome de Mounier-Kuhn o traqueobroncomegalia es una condición rara caracterizada por dilatación de la tráquea y del árbol bronquial, la cual se produce por la reducción y atrofia de las fibras elásticas de la tráquea y los bronquios, por lo que habrá mayor predisposición a infecciones respiratorias recurrentes y a la aparición de bronquiectasias cilíndricas. Presentamos el caso de una mujer de 71 años con antecedente de neumonía a repetición que consultó por disnea asociada a tos productiva mucopurulenta. La exploración física, los exámenes de laboratorio y la radiografía de tórax no fueron concluyentes. Se realizó broncoscopía, que demostró una alteración de la anatomía traqueobronquial con acentuada dilatación traqueal. En la tomografía computarizada de tórax se observó una gran dilatación traqueal asociada a múltiples divertículos en la pared posterior y anterior, hallazgos con los que se estableció el diagnóstico definitivo de síndrome de Mounier-Kuhn.
Gastric intramural pseudocyst in a heterotopic pancreas causing gastric outlet obstruction. Report of one case Heterotopic pancreas is a silent gastrointestinal malformation that may become clinically evident when complicated by inflammation and pseudocyst formation. We report a 26 year-old male presenting with vomiting, pain and abdominal distention. An abdominal CT scan showed an important gastric distention secondary to a 4-cm cystic lesion located in the antrum wall. An endosonography showed that the lesion obstructed the gastric outlet and was compatible with a pseudocyst. A cysto-gastrostomy was performed draining the cyst. Its high lipase and amylase content confirmed that it was a pancreatic pseudocyst. Six months later, the lesion appeared again and a subtotal gastrectomy was performed Histopathology confirmed ectopic pancreatic tissue.
Mesenteric panniculitis (MP) is a rare, benign, and nonspecific chronic fibrosing inflammation of the mesenteric adipose tissue. Abdominal pain is the most frequent presentation.The objective was to recognize ultrasound (US) features in MP. A retrospective 9-year review of computed tomography– (CT) or US-diagnosed cases of MP recorded in the radiology department was performed. The inclusion criteria included an US recorded in PACS imaging data base within 10 days before CT, to compare and evaluate the correlation of MP diagnosis.The prevalence of MP on CT was 2.8%. The 120 selected patients had an abdominal US 10 days before CT. Male-to-female ratio was 4:1. Fifty-three percent of MP was suggested by US. The US finding was increased volume with fatty mass in the mesentery root (98%). The fatty mesenteric mass had oval shape or convex anterior border in 94%, central abdominal location in 91%, and focal mesenteric increased echogenicity in 95%. Lateral bowel loop displacement was observed in 59%. Detection of lymph nodes was less frequent (55%).In conclusion, MP is an entity to be considered in the differential diagnosis of abdominal pain. Knowledge and recognition of the US findings of MP and central abdominal compression may improve detection during the abdominal US examination.
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