Influence of C-reactive protein levels and age on the value of D-dimer in diagnosing pulmonary embolism.

Background: Recently, the number of performed CT-angiographies to diagnose pulmonary embolism (PE) rised markedly, while the incidence of PE hardly increased. This low yield of CT-angiography leads to more patients exposed to radiation and higher costs.

Aim: The diagnostic value of age, C-reactive protein (CRP) and D-dimer in PE was investigated.

[A woman with right-sided lower abdominal pain due to intussusception of the appendix].

A 38-year-old woman presented with mild abdominal pain in the right inferior quadrant. Ultrasonography and CT scan suggested intussusception in the ileocoecal region. At exploratory laparotomy an invagination ofthe appendix through the appendicial base into the coecum was found.

A solitary Peutz-Jeghers type polyp in the jejunum of a 19 year-old male.

A 19-year old male presented with melena and anemia. A duodenoscopy revealed no abnormalities, but a small bowel X-ray series demonstrated a large jejunal polyp. This 4 cm large polyp was visualised during peroperative small bowel endoscopy and was subsequently surgically removed.

[An 80-year-old woman with dyspnoea caused by cardiac myxoma].

An 80-year-old woman presented with general malaise and dyspnoea that has persisted for 2 months. Physical examination, laboratory tests, chest X-ray and ECG were normal, but tachycardia was not. A CT scan of the thorax performed due to suspicion of pulmonary embolism revealed a lesion in the right atrium and no other abnormalities.