Computed tomography of miscellaneous regional and diffuse small bowel disorders.

This article reviews the computed tomography (CT) findings of miscellaneous regional and diffuse small bowel disorders. CT technique and potential pitfalls are discussed. Several categories of regional and diffuse small bowel conditions are reviewed, with representative CT images.

Intramural vesicular fat--an uncommon CT finding.

We present a case of a 75-year-old male who presented with lower back pain found to have an incidental finding of intramural vesicular fat on an unenhanced computed tomography of the pelvis. This relatively uncommon finding of a normal entity should not be mistaken for other causes of pathology within the urinary bladder.

Radiographic demonstration of a wireless capsule pH monitor in the esophagus.

Monitoring of esophageal pH is a major component of the evaluation of gastroesophageal reflux disease. A recent innovation has led to the replacement of the intraluminal probe by a wireless capsule. This capsule is attached to the esophageal wall and transmits the appropriate data to a patient-worn receiver.

Complications of abdominal and pelvic procedures: computed tomographic diagnosis.

The postprocedural period is a critical time in which serious complications can manifest. Localization of suspected complications following abdominal and pelvic procedures can be difficult on clinical evaluation alone. For example, abdominal pain after a colonoscopy may vary in etiology and can result from simple colonic spasm to colonic perforation, hemoperitoneum, or even splenic rupture.

Hepatic leiomyomas in two adult patients with AIDS: intravenous contrast-enhanced CT and MR imaging.

Multiple opportunistic infections and neoplasms have been described in the AIDS population over the past 20 years. Four cases of AIDS-related hepatic smooth muscle tumors (leiomyomas) have been described, and of these, three were in children. The fourth case was in a single patient with two hepatic lesions.

Esophageal actinomycosis: a case report and review of the literature.

A 37-year-old African-American male with acquired immunodeficiency syndrome (AIDS) presented with recurrent chest pain. An upper gastrointestinal endoscopy had been performed two months previously and esophageal biopsy revealed extensive candidal infection with ulceration. He temporarily responded to fluconazole.

The northern exposure sign: a newly described finding in sigmoid volvulus.

Objective: Previous studies of sigmoid volvulus have focused on the migration and dilatation of the sigmoid with respect to both fixed and mobile landmarks in the abdomen. None has specifically referred to the relationship of this colonic segment to the more proximal large intestine. We analyzed findings on abdominal radiographs, all of which had been obtained with the patient supine, of sigmoid volvulus, with particular attention to the juxtaposition of the sigmoid colon with the transverse colon.

Cholangiographic demonstration of the cholecystohepatic duct of Luschka.

The cholecystohepatic duct of Luschka is demonstrated. This anomaly directly connects the gallbladder to the bile ducts, draining a portion of the right lobe of the liver. The pertinent embryology is reviewed.

A study on biliary ductal system and bile fistula in the American alligator, Alligator mississippiensis.

The anomalous arrangement of bile ducts in the Crocodylia has not been fully appreciated. A clear understanding of biliary anatomy is necessary in order to create complete bile drainage in these reptiles. The object of this study was to clarify the anatomy of the bile ductal system and to establish total bile fistulas in the American alligator, Alligator mississippiensis.

Acute thermal injury of the esophagus.

Acute thermal injury to the esophagus has not been reported previously in the radiographic literature. We present a case of a young adult who developed an intramural "blister" that ultimately communicated with the esophageal lumen. A double-contrast esophagogram outlined the resulting mucosal flap.

Cardiophrenic varices in portal hypertension: evaluation with CT.

Purpose: To determine the prevalence and appearance of cardiophrenic angle (CPA) varices at computed tomography (CT) in patients with portal hypertension (PHT).

Materials And Methods: A retrospective review was performed of 148 consecutive contrast material--enhanced abdominal CT scans of patients with PHT. The paracardiac region was assessed for tubular structures suggestive of varices.

Imaging of percutaneous tube gastrostomies: spectrum of normal and abnormal findings.

Enteral alimentation is a crucial component of care for the malnourished patient who cannot eat. Until recently, long-term alimentation was delivered through nasogastric tubes or gastrostomy tubes placed at surgery. In the past few years, percutaneous endoscopic gastrostomy (PEG) has almost completely supplanted these traditional methods.

Idiopathic localized dilatation of the ileum in adults: findings on barium studies.

Objective: Idiopathic localized dilatation of the ileum is a rare entity characterized by a sharply demarcated segmental dilatation of the small bowel that is in line with the lumen. It is probably congenital in origin. Although more commonly diagnosed in children, it presents in adults as occult gastrointestinal (GI) bleeding or less often with abdominal pain.

Inflammatory fibroid polyp of the esophagus in an HIV-infected individual: case study.

We report an unusual case of a large esophageal inflammatory fibroid polyp in a man infected with the human immunodeficiency virus complaining of dysphagia. Barium studies and computed tomography demonstrated a long, submucosal-appearing, distal esophageal mass which extended into a hiatal hernia. Inflammatory fibroid polyps should be considered in the differential diagnosis of submucosal and polypoid esophageal masses, although distinctive radiographic features are not found.

Double anal canal: complication of rectal fecalith.

Fecaliths and stercoraceous ulcerations are well-known complications of chronic constipation. The authors present the case of a double anal canal in an elderly man. This anorectal fistula (complex anal fistula) developed as a complication of an impacted rectal fecalith with resultant stercoraceous ulceration.