Publications by authors named "Filomena Pezzullo"

A multispecialty trauma team must provide care for pelvic gunshot wounds (PGW) due to the high risk of associated morbidity and mortality, the high density of organs that might be wounded within the pelvis, and the potential consequences of these complicated injuries. We present a case of a 59-year-old woman hemodynamically stable with firearm injury to the left buttock. CT examination showed free air in the peritoneal cavity and in the retroperitoneum and a focal contrast extravasation within the uterine fundus.

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Article Synopsis
  • Traumatic vascular injuries involve damage to arteries and veins, making up 3% of all trauma cases, and often lead to serious issues like hemorrhage and ischemia.
  • These injuries frequently affect the lower extremities and can occur alone or alongside other severe injuries, representing 1-2% of emergency department admissions and around 50% of arterial injuries.
  • The effectiveness of treatment largely depends on the patient's environment and the timing of care, with computed tomography angiography (CTA) serving as a crucial tool for diagnosis and assessment, despite challenges in prioritizing injuries in complex trauma cases.
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Purpose: To identify CT prognostic signs of poor outcomes in acute obstructive colonic cancer (AOCC).

Methods: Demographic, clinical, laboratory, radiological and surgical data of 65 consecutive patients with AOCC who underwent emergency surgery were analyzed. CT exams were reviewed to assess diameters of cecum, ascending, transverse, descending, and sigmoid proximal to the tumor; colon segments' CD/L1-VD ratios, continence of the ileocecal valve, small bowel overdistension, presence of small bowel feces sign and cecal pneumatosis.

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Cesarean scar pregnancies (CSPs) are a type of ectopic pregnancy that occur when an embryo implants within the fibrous scar tissue of a previous cesarean surgery. If not promptly detected and treated, CSPs can result in serious maternal complications, such as uterine rupture and hemorrhage. TVUS (transvaginal ultrasonography) represents the imaging of choice for the diagnosis of CSPs; however, recent studies proposed a complementary role of MRI due to its capability in soft tissue characterization that may impact the therapeutical decision-making process.

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  • Transdiaphragmatic fistulae are rare conditions that create abnormal connections between different organ systems, specifically between the thorax and organs like the liver or pancreas.
  • Symptoms are often vague and include pain, cough, and elevated lab values, making initial diagnosis challenging with basic imaging like chest X-rays and ultrasounds.
  • Contrast-enhanced CT scans are essential for identifying these fistulae, with further imaging options like MRI available if initial results are unclear, as accurate diagnosis is key for effective treatment.
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  • This study explored the challenges of performing benign nephrectomy on patients with xanthogranulomatous pyelonephritis (XGP), a type of renal inflammatory disease characterized by severe urinary infections and complications like fistulization.
  • Researchers retrospectively analyzed data from 18 patients diagnosed with XGP over four years, finding that the mean patient age was 63 and that women were more affected (72.22%).
  • Preoperative CT scans had a high accuracy rate of 94.44% for diagnosing renal inflammatory diseases, but only 66.67% of suspected XGP cases were correctly identified before surgery.
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Unlabelled: Primary aortic occlusion (PAO) is defined as acute occlusion in the absence of aortic atherosclerosis or aneurysm. PAO is a rare disease with acute onset and can determine massive parenchymal ischemia and distal arterial embolization. The aim of our study was to focus on the assessment of clinical characteristic, CT signs, medical and surgical treatment, complication rates and the overall survival of PAO.

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Gastrointestinal bleeding is a potentially life-threatening abdominal emergency that remains a common cause of hospitalisation. Although 80-85% of cases of gastrointestinal bleeding resolve spontaneously, it can result in massive haemorrhage and death. The presentation of gastrointestinal bleeding can range from asymptomatic or mildly ill patients requiring only conservative treatments to severely ill patients requiring immediate intervention.

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Septic shock is a medical emergency that represents one of the most important underlying causes for presentation to the Emergency Department. Sepsis is defined as organ dysfunction, life-threatening event caused by a deregulated inflammatory host response to infection, with a mortality risk ranging from 10 to 40%. Early sepsis identification is the cornerstone of management and diagnostic imaging can play a pivotal role in this clinical context.

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High-resolution ultrasound is the most common imaging technique used to supplement the physical examination of scrotum and penis with great accuracy in assisting the diagnosis of the various pathologies of male genital system, with the highest diagnostic potential in emergency conditions. Technical advancements in real-time high-resolution, color flow Doppler sonography and contrast enhanced ultrasonography (CEUS) have led to an increase in the clinical applications of scrotal and penile sonography. In this pictorial review we focus on common and uncommon male genitalia emergency with special emphasis on the role of ultrasound assessment and its specific findings to improve diagnostic accuracy.

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Acute aortic syndromes are life-threatening medical conditions that include classic acute aortic dissection (AAD), aortic intramural hematoma, penetrating aortic ulcer, and even aortic pseudoaneurysm and traumatic aortic injury. The European Society of Cardiology has designed a multiparametric diagnostic algorithm to provide stepwise diagnosis. All patients with AAD should receive aggressive medical therapy to control blood pressure and heart rate.

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BACKGROUND Secondary neurolymphomatosis is a rare clinical condition that may be observed in patients with hematologic malignancies. Clinical findings can overlap with other conditions. Diagnosis can be obtained by magnetic resonance imaging (MRI) and imaging with positron emission tomography (PET) and confirmed by biopsy.

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Purpose: To prospectively evaluate image quality and diagnostic efficacy of a low radiation-high contrast (LR-HC) CT Enterography (CTE) in active Inflammatory Bowel Disease (IBD).

Materials And Methods: Eighty-five (36M; 49F; 17-75 yrs) patients with active IBD underwent contrast-enhanced CTE and were stratified in two groups according to age (< or ≥45 yrs): Group A (N = 45; 32 ± 9 yrs; 58 ± 10 kg) and Group B (N = 40; 58 ± 10 yrs; 61 ± 13 kg). Each group received a different amount of radiation (Noise Index, NI) and non-ionic iodinated contrast media (LOCM) as follows: Group A (NI = 15; 2.

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Objective: The purpose of this study was to prospectively evaluate the safety and effectiveness of radiofrequency ablation (RFA) by using a multiple-electrode switching system to treat unresectable medium-large (3.1-6.0 cm) HCC nodules.

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