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A prospective study assessing the efficacy of abdominal computed tomography scan without bowel preparation in diagnosing intestinal wall and luminal lesions in patients presenting to the emergency room with abdominal complaints 被引量:2
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作者 Michal Mizrahi Yoav Mintz +5 位作者 Avraham Rivkind David Kisselgoff Eugene Libson Mayer Brezis Eran Goldin Oren Shibolet 《World Journal of Gastroenterology》 SCIE CAS CSCD 2005年第13期1981-1986,共6页
AIM: To evaluate the positive predictive value of abdominal non-prepared computed tomography (CT) for diagnosing intestinal lumen or wall lesions in patients presenting to the emergency room (ER) with abdominal compla... AIM: To evaluate the positive predictive value of abdominal non-prepared computed tomography (CT) for diagnosing intestinal lumen or wall lesions in patients presenting to the emergency room (ER) with abdominal complaints.METHODS: For 1-year we prospectively evaluated all ER patients hospitalized after abdominal CT scan detected either intraluminal or intestinal wall lesions. These patients underwent colonoscopy serving as gold standard. Patients with prior abdominal pathology or CT findings of appendicitis or diverticulitis were excluded.RESULTS: Five hundred and sixty-eight abdominopelvic CT scans were performed in the ER, 96 had positive colonic findings. Sixty-two patients were excluded, 46 because of diverticulitis or appendicitis, 16 because of prior abdominal pathology. Of the remaining 34 patients, 14 did not undergo colonoscopy during hospitalization.Twenty eligible patients were included in the study. The positive predictive value of the CT scans performed in the ER was calculated to be 45% (95% CI 25-67).CONCLUSION: CT findings correlated with colonoscopic findings only in approximately half of the cases. Relying on non-prepared CT scan findings in planning patient management and colonoscopy may lead to unnecessary diagnostic work-ups. 展开更多
关键词 abdominal computed tomography Intestinal lesions Emergency room
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Virtual nonenhanced abdominal dual-energy MDCT:Analysis of image characteristics 被引量:4
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作者 Jacob Sosna Shmuel Mahgerefteh +3 位作者 Liran Goshen Galit Kafri Galit Aviram Arye Blachar 《World Journal of Radiology》 CAS 2012年第4期167-173,共7页
AIM: To evaluate abdominal and pelvic image characteristics and artifacts on virtual nonenhanced (VNE) images generated from contrast-enhanced dual-energy multidetector computed tomography (MDCT) studies. METHODS: Had... AIM: To evaluate abdominal and pelvic image characteristics and artifacts on virtual nonenhanced (VNE) images generated from contrast-enhanced dual-energy multidetector computed tomography (MDCT) studies. METHODS: Hadassah-Hebrew University Medical Institutional Review Board approval was obtained; 22 patients underwent clinically-indicated abdominal and pelvic single-source dual-energy MDCT (Philips Healthcare, Cleveland, OH, USA), pre- and post-IV administration of Omnipaque 300 contrast (100 cc). Various solid and vascular structures were evaluated. VNE images were generated from the portal contrast-enhanced phase using probabilistic separation. Contrast-enhanced-, regular nonenhanced (RNE)-, and VNE images were evaluated with a total of 1494 density measurements. The ratio of iodine contrast deletion was calculated. Visualization of calcifications, urinary tract stones, and image artifacts in VNE images were assessed. RESULTS: VNE images were successfully generated in all patients. Significant portal-phase iodine contrast deletion was seen in the kidney (61.7%), adrenal gland (55.3%), iliac artery (55.0%), aorta (51.6%), and spleen (34.5%). Contrast deletion was also significant in the right atrium (RA) (51.5%) and portal vein (39.3%), but insignificant in the iliac vein and inferior vena cava (IVC). Average post contrast-to-VNE HU differences were significant (P < 0.05) in the: RA -135.3 (SD 121.8), aorta -114.1 (SD 48.5), iliac artery -104.6 (SD 53.7), kidney -30.3 (SD 34.9), spleen -9.2 (SD 8.8), and portal vein -7.7 (SD 13.2). Average VNE-to-RNE HU differences were significant in all organs but the prostate and subcutaneous fat: aorta 38.0 (SD 9.3), RA 37.8 (SD 16.1), portal vein 21.8 (SD 12.0), IVC 12.2 (SD 11.6), muscle 3.3 (SD 4.9), liver 5.7 (SD 6.4), spleen 22.3 (SD 9.8), kidney 40.5 (SD 6.8), and adrenal 20.7 (SD 13.5). On VNE images, 196/213 calcifications (92%) and 5/6 renal stones (84%) were visualized. Lytic-like artifacts in the vertebral bodies were seen in all studies. CONCLUSION: Iodine deletion in VNE images is most significant in arteries, and less significant in solid organs and veins. Most vascular and intra-abdominal organ calcifications are preserved. 展开更多
关键词 abdominal computed tomography Dual-energy computed tomography Pelvic computed tomography Virtual nonenhanced computed tomography
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Sclerosing epithelioid fibrosarcoma of the pancreas:A case report
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作者 Meng-Qing Sun Li-Na Guo +3 位作者 Yan You Yan-Yu Qiu Xiao-Dong He Xian-Lin Han 《World Journal of Clinical Cases》 SCIE 2024年第26期5983-5989,共7页
BACKGROUND A sclerosing epithelioid fibrosarcoma(SEF)is a rare malignant fibroblastic soft tissue tumor that rarely occurs in intra-abdominal organs.A case of a SEF in the pancreatic head is reported herein,including ... BACKGROUND A sclerosing epithelioid fibrosarcoma(SEF)is a rare malignant fibroblastic soft tissue tumor that rarely occurs in intra-abdominal organs.A case of a SEF in the pancreatic head is reported herein,including its clinical manifestations,preoperative imaging features,gross specimen and pathological findings.CASE SUMMARY A 33-year-old male patient was admitted to Peking Union Medical College Hospital in December 2023 due to a one-year history of intermittent upper abdominal pain and the discovery of a pancreatic mass.The patient underwent an enhanced computed tomography scan of the abdomen,which revealed a welldefined,round mass with clear borders and calcifications in the pancreatic head.The mass exhibited progressive,uneven mild enhancement,measuring approximately 6.6 cm×6.3 cm.The patient underwent laparoscopic pylorus-preserving pancreaticoduodenectomy.Postoperative pathological examination revealed that the lesion was consistent with a SEF.At the 3-month postoperative follow-up,the patient did not report any short-term complications,and there were no signs of tumor recurrence.CONCLUSION SEFs are rare malignant fibrous soft tissue tumors.SEFs rarely develop in the pancreas,and its preoperative diagnosis depends on imaging findings,with confirmation depending on pathological examination and immunohistochemistry.Currently,only four cases of pancreatic SEF have been reported in studies written in English.This case is the first reported case of a pancreatic SEF by a clinical physician. 展开更多
关键词 Sclerosing epithelioid fibrosarcoma of the pancreas abdominal malignant fibroblastic soft tissue tumor abdominal enhanced computed tomography Laparoscopic pancreaticoduodenectomy Case report
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Transverse mesocolic hernia with intestinal obstruction as a rare cause of acute abdomen in adults:A case report
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作者 Chun Zhang Deng-Fang Guo +3 位作者 Feng Lin Wen-Feng Zhan Jian-Yuan Lin Gui-Fang Lv 《World Journal of Clinical Cases》 SCIE 2023年第27期6613-6617,共5页
BACKGROUND Internal hernia is a rare cause of acute abdomen and intestinal obstruction in adults.Internal abdominal hernias include paraduodenal,perigastric,foramen of Winslow,intersigmoid,and post-anastomotic hernias... BACKGROUND Internal hernia is a rare cause of acute abdomen and intestinal obstruction in adults.Internal abdominal hernias include paraduodenal,perigastric,foramen of Winslow,intersigmoid,and post-anastomotic hernias and can be congenital or acquired.Internal hernias occur in 1%-2%of patients,and transmesocolic hernias are extremely rare.This report presents a patient with a transverse mesocolic hernia with a preoperative diagnosis of small intestinal obstruction.CASE SUMMARY A 45-year-old Chinese woman was admitted to the hospital with middle and upper abdominal pain for 2 d,abdominal distension,and vomiting.After abdominal computed tomography,she was diagnosed with an internal abdominal hernia complicated by small intestinal obstruction and underwent emergency laparoscopic surgery.The patient recovered well and was discharged 6 d postoperatively.CONCLUSION Transmesocolic hernias must be considered in adult patients with signs and symptoms of intestinal obstruction,even without a history of abdominal trauma or surgery. 展开更多
关键词 Internal hernia Transmesocolic hernias abdominal computed tomography Small bowel obstruction Laparoscopic surgery Case report
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Hepatic portal venous gas: Physiopathology, etiology, prognosis and treatment 被引量:32
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作者 Bassam Abboud Jad El Hachem +1 位作者 Thierry Yazbeck Corinne Doumit 《World Journal of Gastroenterology》 SCIE CAS CSCD 2009年第29期3585-3590,共6页
Hepatic portal venous gas (HPVG), an ominous radiologic sign, is associated in some cases with a severe underlying abdominal disease requiring urgent operative intervention. HPVG has been reported with increasing freq... Hepatic portal venous gas (HPVG), an ominous radiologic sign, is associated in some cases with a severe underlying abdominal disease requiring urgent operative intervention. HPVG has been reported with increasing frequency in medical literature and usually accompanies severe or lethal conditions. The diagnosis of HPVG is usually made by plain abdominal radiography, sonography, color Doppler flow imaging or computed tomography (CT) scan. Currently, the increased use of CT scan and ultrasound in the inpatient setting allows early and highly sensitive detection of such severe illnesses and also the recognition of an increasing number of benign and non-life threatening causes of HPVG. HPVG is not by itself a surgical indication and the treatment depends mainly on the underlying disease. The prognosis is related to the pathology itself and is not influenced by the presence of HPVG. Based on a review of the literature, we discuss in this paper the pathophysiology, risk factors, radiographic findings, management, and prognosis of pathologies associated with HPVG. 展开更多
关键词 Hepatic portal venous gas Bowel ischemia/necrosis DIVERTICULITIS Gastric pathologies Ulcerativecolitis abdominal computed tomography scan Crohn'sdisease Liver transplantation Chemotherapy
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Rare squamous cell carcinoma of the jejunum causing perforated peritonitis: A case report
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作者 Lin Xiao Lie Sun +1 位作者 Ji-Xin Zhang Yi-Sheng Pan 《World Journal of Gastrointestinal Oncology》 SCIE 2022年第11期2295-2301,共7页
BACKGROUND Adenocarcinoma has the highest incidence among malignant tumors of the small intestine(SI).Squamous cell carcinoma(SCC)often occurs in organs covered with squamous epithelium.Primary or metastatic SCC origi... BACKGROUND Adenocarcinoma has the highest incidence among malignant tumors of the small intestine(SI).Squamous cell carcinoma(SCC)often occurs in organs covered with squamous epithelium.Primary or metastatic SCC originating from the SI is very rare,with very few cases reported in the literature.CASE SUMMARY This case report involves a 69-year-old man who developed abdominal pain after lunch.After admission,an abdominal computed tomography scan revealed perforation of the alimentary canal and multiple abnormal low-density lesions in the liver.During laparotomy,an approximately 4 cm×3 cm-sized solid tumor was found in the jejunum,located 30 cm from the Treitz ligament,with a perforation.An intestinal segment of approximately 15 cm was removed,including the perforated portion.The pathological result was SCC.In combination with liver imaging,a diagnosis of SI SCC with multiple liver metastases was considered.The patient died from hepatic failure 1 mo after the operation.CONCLUSION SI tumors are very rare compared to those originating in other digestive organs.Due to its insidious onset,the diagnosis of this disease is usually delayed.Clinicians must pay close attention to digestive symptoms such as persistent abdominal pain and melena. 展开更多
关键词 Squamous cell carcinoma Jejunal perforation PERITONITIS abdominal computed tomography scan Case report
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Imaging of unilateral adrenal hemorrhages in patients after blunt abdominal trauma: Report of two cases
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作者 Asli Tanrivermis Sayit Emrah Sayit +1 位作者 Hediye Pinar Gunbey Kerim Asian 《Chinese Journal of Traumatology》 CAS CSCD 2017年第1期52-55,共4页
Adrenal hemorrhage following blunt abdominal trauma is extremely rare. Most of the lesions are uni- lateral and right sided. Although often asymptomatic, life-threatening adrenal insufficiency may develop in the bilat... Adrenal hemorrhage following blunt abdominal trauma is extremely rare. Most of the lesions are uni- lateral and right sided. Although often asymptomatic, life-threatening adrenal insufficiency may develop in the bilateral adrenal gland hemorrhage. Isolated adrenal injuries are very rare. They are often asso- ciated with other organ injuries. The mortality rates of patients range from 7% to 32%. In this report, we present the computed tomography and magnetic resonance imaging findings of unilateral adrenal hemorrhages in two natients with a historv of fall from a height. 展开更多
关键词 Adrenal glands computed tomography Magnetic resonance imaging Blunt abdominal trauma
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