The purpose of this study is to report the computed tomography (CT) features of cecal volvulus and to determine the accuracy of CT in distinguishing the three pathophysiological types of cecal volvulus. The CT studies of ten patients with surgically confirmed cecal volvulus were reviewed. For each patient, CT findings were looked for and recorded. The precise location of the cecum within the abdomen, the presence of an ileocecal twist, and the clockwise or counterclockwise direction of the whirl sign were specifically analyzed. All these results were confronted to the surgical diagnosis retrospectively correlated with the three types of cecal volvulus. According to our classification based on the analysis of the location of the cecum within the abdomen and the presence or the absence of a whirl sign on CT scans, the cecal volvulus was defined as the axial torsion type in four (40%) patients, loop type in four (40%) patients, and cecal bascule type in two (20%). For each patient, the result was in full accordance with the type of cecal volvulus diagnosed at surgery. CT is not only a valuable diagnostic technique in diagnosing cecal volvulus and its complications, but it is also useful in distinguishing the three pathophysiological types of cecal volvulus.
MP has typical CT appearance and is associated with underlying neoplastic disease in 56% of patients. Such levels of association might suggest that MP may be considered as a paraneoplastic condition. Hence, incidental depiction of MP on CT in a patient without known neoplastic disease should incite radiologists to further scrutinize CT examination for presence of synchronous neoplastic lesions.
In cases of SBO, although some CT features of bezoars and small-bowel feces overlap, a well-defined mass mottled with gas bubbles associated with an encapsulating wall, the newly described "floating fat-density debris" sign, and a lesion in the stomach that appears similar to the obstructing mass is typical of a small-bowel bezoar; an isolated amorphous mass mottled with gas bubbles is typical of small-bowel feces.
• Complex regional pain syndrome is painful, disabling and often refractory to treatment. • Sixty-seven percent of patients had lasting pain relief (2 years) after radiofrequency neurolysis. • Retrospective study showed a significantly higher success rate for radiofrequency neurolysis. • CT guidance is mandatory for a successful and safe procedure.
Letter: innovative use of the alfapump system to treat a small hepatocellular carcinoma We demonstrate herein that the treatment of small HCC by RFA in patients with large ascites is feasible by removing ascites using the AP system, although AP is not currently labeled for this particular use and is still investigational for the treatment of RA. We hope that clinicians with expertise in the use of the AP system will report their experience and their unusual cases, to enable evaluation of the feasibility of this innovative device, and of the clinical benefit for the patient.
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