No abstract

PurposeTo evaluate the feasibility of ultrasound in detecting spontaneous pneumomediastinum in the neonatal intensive care unit (NICU) and illustrate the ultrasound features.MethodsAmong neonates with abnormal mediastinal radiolucency suspected on chest radiography, those referred for ultrasound examination within 2 days were included. Anterior mediastinal ultrasound was performed using a linear transducer (5–12 MHz) to determine the presence and location of abnormal air in the mediastinum. Clinical data for the neonates were also reviewed.ResultsOn ultrasound, pneumomediastinum appeared as thick linear/curvilinear echogenic lines, some with posterior shadowing located between the anterior chest wall and thymus, in lateral margins of the thymus, between the thymus and the great vessels, and in the middle of the thymic parenchyma.ConclusionsUsing ultrasound, pneumomediastinum was easily visualized, and localization of the abnormal air accumulation was possible. Ultrasound may be used as a radiation-free supplementary imaging modality for neonates with abnormal mediastinal air.

Schwannoma is a benign, solitary, slow-growing neoplasm of the peripheral nerve sheath. These tumors are rarely found in the external genital system, and only a few cases of vulvar schwannoma have been reported. Herein, we report a case of a vulvar schwannoma. A 37-year-old woman presented with a 3-cm-sized painless mass of the vulva which had been present for 3 years. Magnetic resonance imaging (MRI) of the pelvis showed an isolated finding of a 4.6-cm-sized round mass with a well-defined margin in the midline vulvar area. Simple excision of the tumor was undertaken, and histological examination with immunohistochemical testing demonstrated a vulvar schwannoma. Although benign schwannoma only rarely occurs in the vulva and other external areas of female genitalias, we suggest that it should be considered a differential diagnosis for patients that present a vulvar enlargement or mass. Simple surgical resection and follow-up is the most convenient treatment.

Only two cases of gastric intramural hematoma (IMH) caused by endoscopic mucosal resection (EMR) have been reported to date. This is the first reported case of gastric IMH caused by EMR, treatment of which required hemoclipping and transcatheter arterial embolization. The patient had a normal coagulation profile and no relevant medical history. About 8 h after completing the EMR, the patient vomited approximately 150 mL fresh blood and complained of abdominal pain. Endoscopy showed a 3 × 7 cm hematoma with active surface bleeding in the gastric antrum. Hemoclipping of the bleeding site on the surface and transcatheter arterial embolization of the left gastric artery were performed. Thereafter, conservative management including administration of a proton pump inhibitor was performed, and the lesion resolved. A review of relevant previous cases and this case suggested vessel damage secondary to the submucosal injection itself to be a reasonable causative mechanism for the gastric IMH.

Developmental venous anomaly (DVA) is a common congenital venous malformation characterized by dilated medullary veins in caput medusa configuration and a draining vein. Despite the high incidence of DVAs, they are benign anatomic variations and rarely cause symptoms. Here, we report computed tomography and magnetic resonance imaging findings with perfusion images of acute infarction from underlying DVA in a 63-year-old female patient who presented with acute onset of neurologic symptoms and recovered without any neurologic deficit. Index terms