Introduction: Ectopic spleen is a very rare clinical entity, characterized by the absence of one or more of the ligaments, in which the spleen is located outside of its normal position. The spleen can be found anywhere in the abdomen or pelvis owing to its long, vascular pedicle. Ectopic spleens are found more commonly in women. Patients are often asymptomatic and the diagnosis can be accidental. Case presentation:A female patient at the age of 67 years was undergone on CT investigation after a clinical finding of a suspicious hernia on the anterior abdominal wall. The patient complains of pain in the lower abdomen. A post contrast CT scans clearly reveal of an ectopic spleen in the pelvis with normal enhancement and no signs of infarction or torsion. There was a long splenic pedicle containing tortuous vessels.Discussion: Clinical manifestations of ectopic spleen vary from asymptomatic to complications related to torsion. Imaging findings of the ectopic spleen are the absence of the spleen in its normal position and a mass located anywhere in the abdomen or pelvis with enhancement pattern of a normal splenic tissue. The treatment choice of an ectopic spleen is splenopexy. Splenectomy is required only in case of infarction, which can be diagnosed radiologically. Conclusion:This diagnosis should be considered whenever there are mobile abdominal or pelvic mass, signs, and symptoms of an abdominal discomfort, or an acute abdomen or during investigations of chronic intermittent abdominal pain. CT is the most used methods for diagnosis which revealed the absence of the spleen in its normal position, and a homogeneous mass with contrast enhancement located in the pelvis.
Automatic pancreas segmentation in 3D radiological scans is a critical, yet challenging task. As a prerequisite for computer-aided diagnosis (CADx) systems, accurate pancreas segmentation could generate both quantitative and qualitative information towards establishing the severity of a condition, and thus provide additional guidance for therapy planning. Since the pancreas is an organ of high inter-patient anatomical variability, previous segmentation approaches report lower quantitative accuracy scores in comparison to abdominal organs such as the liver or kidneys. This paper presents a novel approach for automatic pancreas segmentation in magnetic resonance imaging (MRI) and computer tomography (CT) scans. This method exploits 3D segmentation that, when coupled with geometrical and morphological characteristics of abdominal tissue, classifies distinct contours in tight pixel-range proximity as "pancreas" or "non-pancreas". There are three main stages to this approach: (1) identify a major pancreas region and apply contrast enhancement to differentiate between pancreatic and surrounding tissue; (2) perform 3D segmentation via continuous max-flow and min-cuts approach, structured forest edge detection, and a training dataset of annotated pancreata; (3) eliminate non-pancreatic contours from resultant segmentation via morphological operations on area, structure and connectivity between distinct contours. The proposed method is evaluated on a dataset containing 82 CT image volumes, achieving mean Dice Similarity coefficient (DSC) of 79.3 ± 4.4%. Two MRI datasets containing 216 and 132 image volumes are evaluated, achieving mean DSC 79.6 ± 5.7% and 81.6 ± 5.1% respectively. This approach is statistically stable, reflected by lower metrics in standard deviation in comparison to state-of-the-art approaches.
Introduction: Congenital left diaphragmatic hernia of Bochdalek rarely occurs in adults. There are fewer than 100 cases of left-sided Bochdalek hernia reported in adults in the literature. Most of them are asymptomatic. Bochdalek hernias typically arise on the left side, contain fat or omentum, stomach, part of colon transverse, predominantly and small intestinal loops.Aim: The aim of this paper is to present a rare case of Bochdalek hernia in adults and to point out the important role of Computed tomography (CT) in reaching the exact diagnosis of this abnormality.Case report: We presented a rare case of a 46-year old female with left-sided Bochdalek diaphragmatic hernia, came to the Clinic of Surgery complaining of abdominal pain in the lower abdomen. The chest radiograph showed features suggestive of left-sided diaphragmatic hernia, which was confirmed using Multi-Dimensional Computed Tomography (MDCT). Conclusion:Bochdalek hernia in adults occurs most frequently when the patients are undergoing CT for reasons that appear to be unrelated to the hernia
The stomach is a very rare location of metastatic deposits. We present a case of a gastric metastatic deposit from primary colon cancer. Computed tomography (CT) indicated primary colon cancer, but also revealed the presence of cancer in the region of the gastric greater curvature and gastric antrum. With the progression of primary cancer and the creation of an extraluminal tumor mass, the process progresses in the manner that the primary transversal colon tumor merges into the metastatic deposit located in the stomach. The patient underwent subtotal gastrectomy and D2 lymphadenectomy, as well as partial resection of the transversal colon, thus the tumor mass of the stomach and the one in the transversal colon being removed in a single act. Pathohistological analysis of the tumor mass and immunohistochemical tests revealed a primary neoplastic infiltrative process in the colon metastasizing into the stomach.
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