Retrograde jejunogastric intussusception is an unusual long term complication of gastro-jejunostomy or Billroth-II reconstruction. Acute and chronic forms have been well recognised with the acute form being fatal without timely surgical intervention. The imaging findings are diagnostic, and an established emergency imaging protocol would be very useful for clinical decision making, as the clinical features are usually ambiguous. We present the systematic imaging description in a case of retrograde (type II) jejunogastric intussusception with strangulation following gastric bypass procedure.
Few studies involving the Indian population have attempted to use multi-row detector CT to define the biological behavior of carcinoma gallbladder. The opinion whether the pathology is operable or non-operable can reasonably be given. This large-scale, single-center study gives insight about the epidemiology and biological behavior of carcinoma gallbladder.
We report an unusual case of 26 year old previously healthy man who presented with exertional breathlessness of 6 months duration with clinical findings suggestive of moderate aortic regurgitation (AR). There was no previous history suggestive of trauma or chest pain. Trans-thoracic and trans-esophageal echocardiography showed an ascending aortic aneurysm compressing the Left atrium and presence of moderate AR. A 64 slice cardiac CT with intraaortic endoscopic reconstruction further clarified the anatomy. This revealed an ascending aortic aneurysm, extending into the middle mediastinum with a clear rent in the ascending aorta, communicating with the aneurysm. More importantly, CT imaging also confirmed the absence of a dissection flap. The case demonstrates the usefulness of multimodality imaging in defining the morpho-anatomic features in such unusual situations.
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