Case 307: Heterotopic Pancreas in Jejunal Mesentery.

A 45-year-old woman presented to the emergency department with acute worsening of prolonged unexplained nausea, nonbilious vomiting, and mild upper abdominal pain of 4 years duration. Her bowel habits were regular, and there was no history of diarrhea or fresh or altered blood in her stool. On further inquiry, there was no history of facial flushing, excessive diaphoresis, or asthmalike symptoms.

Case 307.

A 45-year-old woman presented to the emergency department with acute worsening of prolonged unexplained nausea, nonbilious vomiting, and mild upper abdominal pain of 4 years duration. Her bowel habits were regular, and there was no history of diarrhea or fresh or altered blood in her stool. On further inquiry, there was no history of facial flushing, excessive diaphoresis, or asthmalike symptoms.

Anastomotic Leaks After Small- and Large-Bowel Surgery: Diagnostic Performance of CT and the Importance of Intraluminal Contrast Administration.

Objective: The objective of our study was to evaluate the diagnostic performance of CT in the identification of anastomotic leaks.

Materials And Methods: This was a study of patients who underwent bowel surgery and a subsequent postoperative CT examination performed specifically for investigating for an anastomotic leak. The study group included patients with surgically confirmed anastomotic leaks (n = 59), and the control group included patients without anastomotic leaks (n = 48) confirmed by either repeat surgery or uneventful clinical follow-up for at least 6 months.

How Well Are We Respecting Patient Privacy in Medical Imaging? Lessons Learnt From a Departmental Audit.

Rationale And Objectives: Preservation of patient privacy and dignity are basic requirements for all patients visiting a hospital. The purpose of this study was to perform an audit of patients' satisfaction with privacy whilst in the Department of Medical Imaging (MI) at the Civic Campus of the Ottawa Hospital.

Materials And Methods: Outpatients who underwent magnetic resonance imaging (MRI), computed tomography (CT), ultrasonography (US), and plain film (XR) examinations were provided with a survey on patient privacy.

Beyond ureterolithiasis: gamut of abnormalities affecting the ureter.

Nephrolithiasis is the most common condition involving the ureters. However, various other entities can affect the ureters, albeit less frequently. Imaging plays a crucial role in diagnosis, management, and follow-up of ureteral pathology.

Case 221: Hereditary Leiomyomatosis and Renal Cell Cancer Syndrome.

History A 24-year-old woman presented to the emergency department with a history of acute urinary retention, gross hematuria, and left flank pain for 2 days. Past history was unrevealing. Her last menstrual period occurred 2 weeks prior to presentation.

Current updates on the molecular genetics and magnetic resonance imaging of focal nodular hyperplasia and hepatocellular adenoma.

Unlabelled: Focal nodular hyperplasia (FNH) and hepatocellular adenomas (HCAs) constitute benign hepatic neoplasms in adults. HCAs are monoclonal neoplasms characterised by an increased predilection to haemorrhage and also malignant transformation. On the other hand, FNH is a polyclonal tumour-like lesion that occurs in response to increased perfusion and has an uneventful clinical course.

Impact of an in-house emergency radiologist on report turnaround time.

Background: One of the many challenges facing emergency departments (EDs) across North America is timely access to emergency radiology services. Academic institutions, which are typically also regional referral centres, frequently require cross-sectional studies to be performed 24 hours a day with expedited final reports to accelerate patient care and ED flow.

Objective: The purpose of this study was to determine if the presence of an in-house radiologist, in addition to a radiology resident dedicated to the ED, had a significant impact on report turnaround time.

Complications of minimally invasive procedures of the abdomen and pelvis: a comprehensive update on the clinical and imaging features.

Minimally invasive gastrointestinal, genitourinary, and gynecological procedures are widely used in the clinical practice for diagnostic and therapeutic purposes. Complications both minor and major are not uncommon with these procedures. Imaging plays an important role in the detection and optimal management of these complications.

Looking back, moving forward: an analysis of complaints submitted to a Canadian tertiary care radiology department and lessons learned.

Purpose: We present an analysis of various types and strata of complaints received in a geographically isolated tertiary care center over a 2.5-year period.

Methods: Research ethics board approval was obtained.

What is hiding in the hindgut sac? Looking beyond rectal carcinoma.

Objectives: Although rectal cancer is by far and large the most common pathology involving the rectum that needs imaging, there are many other important but less common pathological conditions affecting anorectal region. The objective of this pictorial review is to discuss the cross-sectional imaging features of less common anorectal and perirectal diseases.

Results: Although a specific histological diagnosis cannot usually be made due to considerable overlap in the imaging appearances of anorectal diseases, this review illustrates the cross-sectional imaging findings with emphasis on magnetic resonance imaging (MRI) that can help in narrowing down the differentials to a reasonable extent.

Small bowel obstruction in the emergency department: MDCT features of common and uncommon causes.

Small bowel obstruction is a common condition encountered by the radiologist in the emergency department. Though intestinal adhesions and obstructed hernias are the most common causes of acute small bowel obstruction, a variety of uncommon and rare conditions can cause acute and subacute bowel obstruction. Imaging plays a key role in the workup of bowel obstruction by identifying the cause, level, and degree of bowel obstruction.

Imaging of acute abdomen in pregnancy.

The approach to imaging in pregnancy is unique, as it is essential to minimize radiation exposure to the fetus. Ultrasonography and magnetic resonance imaging are the chief modalities for evaluation of the pregnant patient with abdominal pain. Use of computed tomography should not be delayed when there is a need for early diagnosis.

Imaging of tuberculosis of the abdominal viscera: beyond the intestines.

There is an increasing incidence of both intra- and extra-thoracic manifestations of tuberculosis, in part due to the AIDS epidemic. Isolated tubercular involvement of the solid abdominal viscera is relatively unusual. Cross-sectional imaging with ultrasound, multidetector computed tomography (CT), and magnetic resonance imaging (MRI) plays an important role in the diagnosis and post treatment follow-up of tuberculosis.

Spectrum of imaging manifestations in non-neoplastic gastric pathologies.

This article illustrates a wide spectrum of non-neoplastic gastric pathologies on cross-sectional imaging. Salient features of inflammatory, infectious, vascular, traumatic, and miscellaneous conditions of the stomach have been discussed and imaging clues to reach an accurate diagnosis are stressed upon.

The mysterious organ. Spectrum of focal lesions within the splenic parenchyma: cross-sectional imaging with emphasis on magnetic resonance imaging.

Incidental splenic lesions are frequently encountered at imaging performed for unrelated causes. Splenic cysts, hemangiomas, and lymphomatous involvement are the most frequently encountered entities. Computed tomography and sonography are commonly used for initial evaluation with magnetic resonance imaging reserved as a useful problem-solving tool for characterizing atypical and uncommon lesions.

Triphasic CT in the diagnosis of acute mesenteric ischaemia.

Objective: To evaluate the yield of each phase in a triphasic CT protocol used to diagnose acute mesenteric ischaemia (AMI).

Methods: Retrospective analysis of patients who underwent CT to exclude AMI was conducted. From 218 patients, 80 were randomly selected for analysis: 39 with proven AMI; 41 controls.

Neoplastic stomach lesions and their mimickers: spectrum of imaging manifestations.

This review illustrates a wide spectrum of gastric neoplasms with emphasis on imaging findings helpful in characterizing various gastric neoplasms. Both the malignant and benign neoplasms along with focal gastric masses mimicking tumour are illustrated. Moreover, imaging clues to reach an accurate diagnosis are emphasized.

The abdominal wall lumps and bumps: cross-sectional imaging spectrum.

This article focuses on the cross-sectional imaging spectrum of abnormalities that affect the abdominal wall, with emphasis on magnetic resonance imaging (MRI). Cross-sectional imaging is valuable for diagnosing and evaluating the extent of abdominal-wall masses. With the increasing use of MRI, it is often possible to reach a diagnosis or narrow the differential diagnosis, thereby guiding effective management.

Current concepts in the imaging of uterine sarcoma.

Recent advances in genetics and pathology have improved our understanding of diagnosis and staging of uterine sarcomas. The major types of uterine sarcomas include leiomyosarcoma, low-grade endometrial stromal sarcoma, undifferentiated endometrial sarcoma, adenosarcoma and carcinosarcoma. The distinctive biological behavior and poor overall survival of uterine sarcoma create challenges in the management of these tumors.

Uncommon primary pelvic retroperitoneal masses in adults: a pattern-based imaging approach.

There is a broad spectrum of primary pelvic retroperitoneal masses in adults that demonstrate characteristic epidemiologic and histopathologic features and natural histories. These masses may be classified into five distinct subgroups using a pattern-based approach that takes anatomic distribution and certain imaging characteristics into account, allowing greater accuracy in their detection and characterization and helping to optimize patient management. The five groups are cystic (serous and mucinous epithelial neoplasms, pelvic lymphangioma, tailgut cyst, ancient schwannoma), vascular or hypervascular (solitary fibrous tumor, paraganglioma, pelvic arteriovenous malformation, Klippel-Trénaunay-Weber syndrome, extraintestinal GIST [gastrointestinal stromal tumor]), fat-containing (lipoma, liposarcoma, myelolipoma, presacral teratoma), calcified (calcified lymphocele, calcified rejected transplant kidney, rare sarcomas), and myxoid (schwannoma, plexiform neurofibroma, myxoma).

"What is inside this right lower quadrant sac?" Spectrum of computed tomography abnormalities that affect the cecum.

The current pictorial is a comprehensive review of the various cecal pathologies, including both those that solely involve the cecum and those in which the cecum may be secondarily involved. The various cecal abnormalities will be categorized as inflammatory, infectious, vascular, neoplastic, congenital, and foreign bodies. Emphasis will be placed on the imaging features that, when coupled with the clinical history, help to reach a diagnosis or to narrow the differential diagnosis.