Deoxyguanosine kinase deficiency and recurrent spontaneous pneumothorax: a case report.

Background: Deoxyguanosine kinase deficiency is mainly manifested by hepatic and neurological damage, hence it belongs to the hepatocerebral form of mitochondrial deoxyribonucleic acid depletion syndrome. The association between deoxyguanosine kinase deficiency and recurrent spontaneous pneumothorax has not currently been reported.

Case Presentation: A 12-year-old Russian boy with deoxyguanosine kinase deficiency, a recipient of a liver transplant with amyotrophy secondary to his mitochondriopathy, presented with recurrent spontaneous bilateral pneumothorax refractory to drainage and surgery.

Mass-forming intrahepatic cholangiocarcinoma presenting with painful obstructive hemobilia.

We report a very rare case of acute obstructive hemobilia caused by bleeding of a mass-forming intrahepatic cholangiocarcinoma in a 75-year old man. The prompt complete emergency diagnosis was made by ultrasound and confirmed by MDCT. The features of hemobilia and intrahepatic cholangiocarcinoma are briefly reviewed.

A rare case of early onset type of abdominal trocar site hernia (TSH) with atypical externalizing in two-step: multidetector row CT diagnosis.

We report a rare case of early onset type Trocar Site Hernia (TSH) producing in the right lower abdominal quadrant of a 64-year old obese woman. The patient was admitted in the emergency room for abdominal pain producing four days after laparoscopic adnexectomy. The hernia atypically externalized in two-steps creating two superposed concentric small bowel strangulating hernias producing through two distinctive superposed orifices.

Extensive propagation of a pancreatic pseudocyst along the lower limb through the sciatic foramen.

The extremely rare extensive propagation of a giant retroperitoneal pancreatic pseudocyst into the posterior compartment of the lower limb as far as the knee is reported. The extension was found producing through the sciatic foramen and the full diagnosis was made by MDCT. A complete healing was progressively obtained in the 78-year old female after a six months period of sequential multidisciplinary therapeutic approach comprising combined medical and surgical intra-abdominal and external drainage.

Extra-abdominal lumbar abscesses caused by retroperitoneal gastrointestinal perforations through the lumbar triangle of Petit: report of two cases diagnosed by CT.

Extra-abdominal abscesses of gastrointestinal origin developing within the lumbar subcutaneous tissues are extremely rare. We report two cases of retroperitoneal bowel perforation presenting spontaneously at admission with a lumbar abscess trespassing the lumbar triangle of Petit, a classical "locus of minus resistencia" of the posterior abdominal wall. The first case was caused by perforation of a retrocecal appendicitis--being concomitantly responsible of a necrotizing fasciitis of the thigh--and in the second case perforation was caused by left colonic diverticulitis.

Small bowel obstruction due to an internal herniation through a defect of the broad ligament.

We report on a case of internal hernia through a defect of the broad ligament of the uterus. Early diagnostic may be possible with multidetector CT and lead to early treatment. MDCT can help achieving early preoperative diagnostic and allows early laparoscopic treatment with prompt recovery.

Intraabdominal counter clockwise gastric volvulus incarcerated through a defect of the lesser omentum: CT diagnosis.

We report the probably first case of incarcerated intra-abdominal gastric volvulus protruding through a defect of the pars flaccida of the lesser omentum. The 79-year-old woman presented with acute symptoms of upper gastrointestinal occlusion. Plain film radiographs, endoscopy and attempts at opacifying the upper alimentary tract failed to make the correct diagnosis.

Carcinoid tumor of the small intestine: MDCT findings with pathologic correlation.

Background: MDCT currently frequently represents the first choice modality for imaging in acute or subacute abdominal conditions implicating the small bowel. As a consequence, the MDCT features of intestinal carcinoid tumors and of their peculiar metastatic spread have to be known by abdominal radiologists.

Patients And Methods: These features are described and illustrated in the retrospective review of seven proven cases of small intestine carcinoids diagnosed and treated in our institution.

MDCT diagnosis of ruptured tubal pregnancy with massive hemoperitoneum.

We report a case of ruptured tubal pregnancy with massive life-threatening hemoperitoneum. The 38 year-old woman presented with gynaecologic haemorrhage, pelvic pain and hypovolemic shock. Without any ambiguity, the diagnosis was directly made during contrast enhanced Multidetector Computed Tomography (MDCT).

Giant splenic artery aneurysm presenting as unusual cause of obstructive jaundice.

Giant splenic aneurysms larger than 8 cm (GSAA) are rare and often asymptomatic but present an increased risk of dramatic rupture, a life-threatening complication. The management of these aneurysms is especially challenging. We probably report the first case of GSAA revealed by clinical mechanical jaundice due to direct compression of the biliary tree.

Emphysematous epididymitis as presentation of unusual seminal vesicle fistula secondary to sigmoid diverticulitis: case report.

This case report describes a sigmoid diverticulitis with torpid development, long-term symptoms of bladder irritability, and an emphysematous epididymitis caused by a direct seminal vesicle fistula. The diagnosis was suggested by scrotal ultrasound visualizing gas in the scrotum; the complex pelvic fistulous tract was specifically delineated by multislice computed tomography. This may be the first reported case of seminal vesicle fistula directly related to colonic diverticulitis and causing emphysematous epididymitis.

Spiral CT and multidetector-row CT diagnosis of perforation of the small intestine caused by ingested foreign bodies.

The aim of this retrospective study was to emphasize the performances of spiral CT (HCT) and multidetector-row CT (MDCT) as very effective imaging modalities for the diagnosis of intestinal perforations caused by calcified alimentary foreign bodies. Eight sites of perforations of the ileum by ingested foreign bodies were found in seven patients--one patient presenting with two separate sites of perforation. The diagnosis was successfully made by HCT in four patients and MDCT in the remaining three.

Complicated Meckel's diverticulum diagnosed preoperatively in three cases by complementing CT with detailed us studies.

The clinical and imaging features of Meckel's diverticulum of the adult are reviewed through the report of three complicated cases, one presenting with perforation, the second with intestinal bleeding, and the third with intestinal occlusion due to phytobezoar impaction. Intradiverticular heterotopy of gastric mucosa was the responsible common denominator for the first two cases. Intradiverticular calcified entheroliths were also found in the second case.

US and CT diagnosis of a twisted lipomatous appendage of the falciform ligament.

Pathologic conditions of the falciform ligament leading to surgical intervention are extremely uncommon. We report a case of twisted lipomatous appendage of this ligament, demonstrated by US and CT. To our knowledge, there have been no previous reports of this entity.

[Diagnosis of non-hiatal diaphragmatic hernia using helical computed tomography].

The authors report the cases of two patients with non traumatic quiescent diaphragmatic hernias who presented with delayed but classical acute gastrointestinal complications. Their only predisposing factor was previous surgery of the left upper quadrant. The diagnosis, suspected on chest radiographs, was promptly performed by helical CT with multiplanar reconstructions (MPVR) and maximal intensity projections (MIP).

[Diagnosis using spiral computed tomography of an internal hernia through the uterine broad ligament].

Internal hernia is an uncommon cause of intestinal obstruction producing only 1% of all acute small bowel obstructions. Hernias involving a defect of the broad ligament of the uterus are particularly uncommon. We report a case successfully diagnosed by spiral CT with multiaxial reconstruction.

Hazards of laparoscopic adrenalectomy for Conn's adenoma. When enthusiasm turns to tragedy.

A 74-year-old man with primary aldosteronism had a small tumor (27 x 23 mm) of his right adrenal gland successfully removed by a transperitoneal laparoscopy. Despite absence of malignancy in the resected tumor and complete relief of all symptoms in the immediate postoperative period, recurrence occurred 6 months later. The tumor behaved as a carcinoma spread in the peritoneal cavity, and the patient eventually died with peritoneal carcinomatosis.

[Strangulated intestinal Spigelian hernia].

Spigelian hernia, an uncommon hernia of the anterior abdominal wall, has serious complications in a high percentage of cases. The diagnosis is often difficult because the symptoms can be insidious or simulate those of more classical lower quadrant abdominal diseases. Furthermore, the clinical findings are often nonspecific.