Bouveret syndrome is a rare disease-a cause of gastric outlet obstruction. It represents less than 3% of cases of gallstone ileus, which is already rare-0.3-0.5% of patients with cholelithiasis. Persistent inflammation provokes the development of the fistula between the gallbladder and the duodenum and, with an elevation of the intraluminal pressure, the wall ischemia starts, enabling the gallstone entrance in the bowel. The risk factors are female, gallstones larger than 2.5 cm, and elderly. Morbidity and mortality are between 15 and 33%. Herein, we present a case of a Bouveret syndrome diagnosed by a CT scan.
Umbilical hernias are common in patients with chronic liver disease, caused by increased intra-abdominal pressure. In some patients the hernia contents can be the dilated paraumbilical vein. Complications are ulceration of the skin and vascular rupture, with high mortality. It can also occur thrombosis of paraumbilical herniated vein. Imaging tests are essential for the diagnosis of the contents of the sac in order to assist the treatment. Hepatocellular carcinoma is the most common primary tumor of the liver. Affects three times more men than women. The main risk factor is chronic liver disease. The imaging methods are essential for early diagnosis and to decrease morbidity and mortality. The authors report a case of a Thrombosed vascular incarcerated umbilical hernia with an MRI and ultrasound imaging tests diagnosis.
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