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1.
Hai-Yu Cui Cheng-Hang Jiang Jie Dong Yang Wen You-Wei Chen 《World Journal of Clinical Cases》2021,9(1):236-244
BACKGROUNDHemosuccus pancreaticus is a very rare but severe form of upper gastrointestinal hemorrhage. The most common etiology is peripancreatic pseudoaneurysm secondary to chronic pancreatitis. Due to the rarity of gastroduodenal artery pseudoaneurysms, most of the current literature consists of case reports. Limited knowledge about the disease causes diagnostic difficulty.CASE SUMMARYA 39-year-old man with a previous history of chronic pancreatitis was hospitalized due to hematemesis and melena for 2 wk, with a new episode lasting 1 d. Two weeks prior, the patient had visited a local hospital for repeated hematemesis and melena. Esophagogastroduodenoscopy indicated hemorrhage in the descending duodenum. The patient was discharged after the bleeding stopped, but hematemesis and hematochezia recurred. Bedside esophago-gastroduodenoscopy showed no obvious bleeding lesion. On admission to our hospital, he had hematemesis, hematochezia, left middle and upper abdominal pain, severe anemia, and elevated blood amylase. After admission, intermittent hematochezia was observed. Abdominal contrast-enhanced computed tomography revealed a pseudoaneurysm in the pancreas head. Angiography confirmed the diagnosis of gastroduodenal artery pseudoaneurysm. The pseudoaneurysm was successfully embolized with a coil and cyanoacrylate. No bleeding was observed after the operation. After discharge from the hospital, a telephone follow-up showed no further bleeding signs.CONCLUSIONHemosuccus pancreaticus caused by gastroduodenal artery pseudoaneurysm associated with chronic pancreatitis is very rare. This diagnosis should be considered when upper gastrointestinal bleeding and abdominal pain are intermittent. Abdominal enhanced computed tomography and angiography are important for diagnosis and treatment. 相似文献
2.
There are only a few case reports in the literature describing the migration of metallic surgical clips into the common bile
duct. Diagnosis of this postcholecystectomy complication is usually made during ERCP. We describe the identification on CT
scan of a migratory surgical clip in the common bile duct in a patient with biliary colic.
Received: 12 January 1995/Accepted: 14 February 1995 相似文献
3.
Recently, the term ``serous cystadenoma' has been adopted in the pathological community to qualify the so-called microcystic
adenoma of the pancreas. This change in terminology was based on the emergence of a new type of serous cystadenoma of the
pancreas, i.e., the macrocystic variant. We report one case of pathologically proven macrocystic serous cystadenoma of the
pancreas for which the diagnosis of mucinous cystadenoma was suggested preoperatively. This rare but benign macrocystic variant
exhibits radiological features similar to those of mucinous cystadenoma. In addition, inflammatory changes and foci of hemorrhage
within the tumor may simulate mucinous cystadenocarcinoma.
RID="ID="<e5>Correspondence to:</e5> P. Soyer
Received: 25 August 1997/Accepted: 8 October 1997 相似文献
4.
Heterotopic pancreas of the stomach: CT findings correlated with pathologic findings in six patients 总被引:4,自引:0,他引:4
Background: The purpose of this study was to characterize the computed tomographic (CT) findings of heterotopic pancreas of the stomach.
Methods: CT scans of six surgically proven cases of heterotopic pancreas of the stomach were reviewed. Three were dynamic spiral CT
scans, with both arterial dominant and late phase scans. In other three, both unenhanced and contrast-enhanced scans were
obtained by using conventional techniques. Particular attention was given to the enhancement of the heterotopic pancreas.
Pathologic and surgical findings were correlated with CT findings.
Results: The locations were in the gastric antrum in five cases and in the mid-body in one. Size ranged from 1 cm to 3 cm (mean =
2.1 cm). Three cases showed homogeneous, strong enhancement similar to the pancreas and consisted mainly of pancreatic acini
with the same histologic features as the normal pancreas. Two cases showed poor enhancement and consisted mainly of ducts
and hypertrophied muscle; pancreatic acini were a minor component. In one case appearing as a cystic lesion on CT, a pseudocyst
was found with many ducts and some nests of pancreatic acini.
Conclusions: Heterotopic pancreas of the stomach showed a diverse spectrum of CT findings. Good understanding of these CT findings may
be helpful in making a correct diagnosis.
Received: 24 March 1999/Accepted: 19 May 1999 相似文献
5.
Added value of CT criteria compared to the clinical SAP score in patients with acute pancreatitis 总被引:7,自引:0,他引:7
A. R. van den Biezenbos P. M. Kruyt K. Bosscha M. S. van Leeuwen M. A. M. Feldberg Y. T. van der Schouw H. G. Gooszen 《Abdominal imaging》1998,23(6):622-626
Background: To assess the added value of established computed tomography (CT) scores versus the Simplified Acute Physiology (SAP) score
in predicting outcome in patients with acute pancreatitis.
Methods: Contrast-enhanced CT was performed in 45 patients with acute pancreatitis. The Balthazar score, CT severity index (CTSI),
and Schr?der score were assessed, and the SAP score was calculated. The predictive values of CT score and SAP score for mortality,
need for one or more interventions, and length of hospital stay were compared. The added value of the SAP score to the CT
scores was assessed by using ROC (receiver operating curve) analysis.
Results: The positive predictive values of the higher Balthazar, CTSI, Schr?der, and SAP scores, reflecting severe disease, were 50%,
41%, 41%, and 48%, respectively, for mortality, 85%, 84%, 84%, and 83%, respectively, for need for one or more interventions,
and 55%, 66%, 66%, and 65%, respectively, for longer hospital stay. The negative predictive values of the lower Balthazar,
CTSI, Schr?der and SAP scores were 84%, 92%, 92%, and 42%, respectively, for mortality, 44%, 69%, 69%, and 45%, respectively,
for need for one or more interventions, and 44%, 69%, 69%, and 55%, respectively, for longer hospital stay. When CT scores
were added to the SAP score, there was no improvement in discriminating power for mortality.
Conclusion: To identify patients with severe outcome, there is no clear benefit using established CT scores as opposed to the SAP score.
However, the Balthazar score and CTSI are better than the SAP score in predicting a favorable outcome.
Received: 29 July 1997/Accepted: 10 September 1997 相似文献
6.
Detection of pancreatic adenocarcinoma: relative value of arterial and late phases of spiral CT 总被引:11,自引:0,他引:11
Background: Spiral computed tomography (CT) allows the pancreas to be imaged during peak contrast levels owing to the capability of fast
data acquisition. The objective of this study was to evaluate the relative value of the arterial and late phases of spiral
CT for detecting pancreatic adenocarcinomas.
Methods: Twenty-two patients with pathologically proved pancreatic adenocarcinomas underwent two-phase spiral CT. The CT scans were
performed with 5 mm collimation and 5 mm/s table speed. Images during the arterial and late phases were obtained at 30- and
180-second delays, respectively. The images of the arterial phase were compared with those of the late phase in terms of tumor
conspicuity from surrounding pancreatic parenchyma and tumor detectability by means of a 3-point grading system: 1 (poor),
2 (fair), and 3 (good).
Results: In terms of tumor conspicuity from surrounding pancreatic parenchyma, 16 lesions (73%) were good, 5 lesions (23%) were fair,
and 1 lesion (4%) was poor during the arterial phase, whereas 6 lesions (27%) were good, 9 lesions (41%) were fair, and 7
lesions (32%) were poor during the late phase (p= 0.0007). The arterial phase was superior to the late phase in 16 patients (73%) and equal in 6 patients (27%). For tumor
detectability, 18 lesions (82%) were good, 3 lesions (14%) were fair, and 1 lesion (4%) was poor during the arterial phase,
whereas 10 lesions (45%) were good, 7 lesions (32%) were fair, and 5 lesions (23%) were poor during the late phase (p= 0.0033). For detectability, the arterial phase was superior to the late phase in 14 patients (64%) and equal in 8 patients
(36%).
Conclusion: The arterial phase of spiral CT is superior to the late phase, which is equivalent to conventional CT for detecting pancreatic
adenocarcinoma.
Received: 1 August 1995/Accepted: 12 September 1995 相似文献
7.
Yama N Akiba H Tamakawa M Oouchi A Sakata K Koito K Hareyama M Morita K 《Abdominal imaging》2000,25(2):132-133
Midgut malrotation is a relatively rare congenital malformation that arises from an error of rotation and fixation of the
midgut. We report a case of spontaneously reduced duodenal malrotation diagnosed by computed tomography and roentgenography
after the ingestion of barium.
Received: 4 December 1998/Revision accepted: 14 July 1999 相似文献
8.
A case study of a patient who presented with abdominal pain and a palpable mesogastric mass is discussed. Ultrasound and
computed tomography (CT) demonstrated that the palpable mass was jejunojejunal intussusception of the small intestine. The
lead point of the intussusception was a lipoma that appeared in the CT scan as a small intramural mass with an attenuation
coefficient of fat.
Received: 23 May 1995/Accepted: 20 June 1995 相似文献
9.
Angiomyolipoma of the liver: significance of CT and MR dynamic study 总被引:20,自引:0,他引:20
T. Ahmadi Y. Itai M. Takahashi H. Onaya T. Kobayashi Y. O. Tanaka Y. Matsuzaki N. Tanaka Y. Okada 《Abdominal imaging》1998,23(5):520-526
Angiomyolipoma is a benign mesenchymal tumor that has been reported frequently in the kidney but rarely in the liver. In
the present study, we present four cases of hepatic angiomyolipoma with different radiologic appearances, discuss differential
diagnosis, and review previously reported cases. One of our cases was followed for 8 years. Computed tomography (plain, enhanced,
and dynamic study), magnetic resonance imaging (T1-weighted spin echo, T2-weighted spin echo, and dynamic study), ultrasonography,
and angiography were performed in all cases. Although different radiologic appearances were observed in the tumors, based
on different proportions of fat, blood vessels, and muscle, three cases were diagnosed as angiomyolipoma. In one case, it
was quite difficult to make radiologic diagnosis; hepatocellular carcinoma with fatty metamorphosis in part was most likely
suspected, but histopathological examination revealed angiomyolipoma with few fat elements. In the present study, early and
prolonged enhancement of the lesion with the special pattern of time density/intensity curve was significant for angiomyolipoma,
and we suggest that preoperative radiologic diagnosis of the lesion is possible in most of the cases. However, it can be quite
difficult to distinguish angiomyolipoma from some hepatocellular carcinomas with fatty metamorphosis.
Received: 25 April 1997/Accepted: 25 June 1997 相似文献
10.
Fascioliasis: US, CT, and MRI findings with new observations 总被引:2,自引:0,他引:2
Kabaalioğlu A Cubuk M Senol U Cevikol C Karaali K Apaydin A Sindel T Lüleci E 《Abdominal imaging》2000,25(4):400-404
Background: The purpose of this study is to describe the ultrasonographic (US), computed tomographic (CT), and magnetic resonance imaging
(MRI) findings in fascioliasis and to emphasize the impact of radiology in diagnosis.
Methods: Radiologic findings in 23 consecutive patients with fascioliasis were prospectively recorded. All patients had at least one
US and CT examination, and 10 of them were studied by MRI. All diagnoses were confirmed by serologic methods. In the first
three cases, initial diagnosis was reached by microscopic demonstration of the parasites' eggs in bile obtained by US-guided
gallbladder aspiration.
Results: In the hepatic phase of fascioliasis, multiple, confluent, linear, tractlike, hypodense, nonenhancing hepatic lesions were
detected by CT. On US, the parasites could be clearly identified in the gallbladder or common bile duct as floating and nonshadowing
echogenic particles. MRI showed the lesions as hypo- or isointense on T1-weighted images and as hyperintense on T2-weighted
images.
Conclusions: CT findings in the hepatic phase and US findings in the biliary phase are characteristic of fascioliasis. Because clinical
and laboratory findings of fascioliasis may easily be confused with several diseases, radiologists should be familiar with
the specific radiologic findings of the disease to shorten the usual long-lasting diagnostic process.
Received: 15 December 1999/Accepted: 26 January 2000 相似文献
11.
We report a case of mycotic aneurysm of the ileocolic artery due to Streptococcus bovis endocarditis and acute septicemia complicated by active hemorrhage, that was treated successfully with transcatheter embolization
and subsequent intravenous antibiotic treatment. This case suggests that a mycotic aneurysm can be treated successfully by
percutaneous embolization in an emergent situation (active bleeding, septicemia) even without previous antibiotic therapy.
Received: 19 November 2000/Revision accepted: 27 December 2000 相似文献
12.
Benign cystic peritoneal mesothelioma (BCPM) is a rare tumor, primarily affecting young women; approximately 130 cases have
been described mainly in the pathological and surgical literature. We present imaging findings of a giant BCPM in a male patient
and discuss the radiological differential diagnosis with a brief review of the literature.
Received: 3 June 1997/Accepted: 9 July 1997 相似文献
13.
Transcatheter arterial embolization in the treatment of symptomatic cavernous hemangiomas of the liver: a prospective study 总被引:10,自引:0,他引:10
Background: This prospective study evaluated the clinical and radiologic results of transcatheter arterial embolization (TAE) for the
treatment of symptomatic cavernous hemangiomas of the liver. The technique, its complications, and effectiveness also were
analyzed.
Methods: Eight patients (five male, three female; mean age ± SD = 47.75 ± 8.59 years) with symptomatic cavernous hemangiomas of the
liver were treated by TAE with polyvinyl alcohol particles or gelfoam and steel coils (single session) followed by supportive
treatment. Tumor characterization (including the extent and number of lesions) was done on triple-phase helical computed tomography
or gadolinium-enhanced dynamic magnetic resonance imaging.
Results: The lesions were located in the right lobe in five patients, left lobe in one, and both lobes in two. The largest diameter
of the lesions was 6–18 cm (9.28 ± 5.13 cm). The treatment response was assessed on follow-up ultrasound and color Doppler
and/or contrast-enhanced helical computed tomography. There were no treatment-related deaths and morbidity was minimal. Embolization
was the only method of treatment in seven patients; however, one patient had surgery after TAE because the symptoms were only
partly relieved. Indications for embolization were abdominal pain (eight patients), rapid tumor enlargement (four of eight),
and recurrent jaundice (one of eight). Symptomatic improvement was documented in all patients after embolization. Symptoms
did not worsen in any patient. The mean size of the tumor did not show any statistically significant change on follow-up radiologic
examinations. However, in one patient, the tumor significantly regressed in size after embolization.
Conclusion: TAE of hepatic cavernous hemangioma is a useful procedure in the therapy of symptomatic hemangiomas.
Received: 13 July 2000/Revision accepted: 27 December 2000 相似文献
14.
Two cases of rare lymphoepithelial cyst (LEC) of the pancreas are presented. Although the histogenesis of this lesion is
not known, it can be histologically differentiated from other pancreatic and retropancreatic cysts. The importance of its
recognition is in the distinction from cystic neoplasm of the pancreas.
Received: 24 October 1996/Accepted: 27 November 1996 相似文献
15.
Extrahepatic arterioportal venous fistula: multidetector CT and volume-rendered angiographic imaging
We present a case of unsuspected extrahepatic arterial–main portal venous fistula diagnosed by multiphase computed tomography
with three-dimensional volume-rendered computed tomographic angiography. To our knowledge, this entity has not been reported
previously in the literature, and it represents an example of pathology that may only be detected and clarified with multiphase
imaging with three-dimensional rendering. This finding has great clinical importance in patient management.
Received: 9 January 2001/Accepted: 24 January 2001 相似文献
16.
Helical CT anatomy of pancreatic arteries 总被引:3,自引:0,他引:3
J. S. Sim B. I. Choi J. K. Han M. J. Chung J. W. Chung J. H. Park M. C. Han 《Abdominal imaging》1996,21(6):517-521
Background: To assess the frequency of visualization of pancreatic arteries in the arterial phase of helical computed tomography (CT).
Methods: The visibility of pancreatic and peripancreatic arteries in helical CT images was evaluated in 20 consecutive patients who
had no evidence of pancreatic disease. CT examinations were performed by using a continuously rotating CT scanner and intravenous
injection of contrast media. The scans were taken 35 s after the start of injection and with a table speed of 3 mm/s. Images
were reconstructed in 3-mm section increments.
Results: Frequently visualized arteries were the gastroduodenal, anterior and posterior superior pancreaticoduodenal, and right gastroepiploic
arteries. Infrequently visualized arteries were the dorsal pancreatic, pancreatica magna, caudal pancreatic, transverse pancreatic,
and common, anterior, and posterior inferior pancreaticoduodenal arteries.
Conclusion: Helical CT enabled us to recognize small pancreatic arteries, and the evaluation of these arteries should be considered in
the staging of pancreatic carcinoma.
Received: 6 June 1995/Accepted: 22 July 1995 相似文献
17.
Adequate distention of the gastrointestinal tract is essential for the best quality image in abdominal computed tomography.
We introduce a new technique for per-rectal administration of contrast material with the use of an automatic injector. With
this technique, more contrast material can be inserted and thus adequately distend the colon, including the proximal colon.
Received: 15 September 2000/Revision accepted: 27 December 2000 相似文献
18.
胰腺肿瘤的磁共振成像诊断——与CT、B超对比研究 总被引:2,自引:0,他引:2
目的:评价磁共振成像在胰腺肿瘤诊断的价值。方法:本文通过对25例有手术病理的胰腺病变进行MR检查,采用自旋回波T1和T2加权像对病变进行判断,并与CT和B超对比分析。结果:这三种影像方法对胰腺癌的诊断准确率均为72.7%。胰腺癌的MR表现,无论在T1还是T2加权像上其信号改变无特点,且78%的胰腺癌信号强度与正常的肝组织和胰腺接近,故MR无法区别胰腺癌或胰腺其它病变。但在T1加权像上,由于MR的组织分辨率高,因而无论是显示胰周脂肪,肠系膜上动静脉有无受侵,还是肝门、脾门、脾静脉有无受侵均较CT显示更佳。结论:我们认为MR对于胰腺肿瘤的诊断尚需进一步探讨,但对于判断肿瘤侵犯的范围则有较大的应用价值 相似文献
19.
P. Soyer N. Devine E. Somveille G. Rebibo C. Rambert A. Scherrer 《Abdominal imaging》1996,21(4):324-328
Background: The purpose of this study was to determine the prevalence of hepatic pseudolesions seen around the falciform ligament on
computed tomography (CT) of the abdomen obtained with intravenous administration of contrast material.
Methods: We first retrospectively reviewed the CT scans of six patients in whom hepatic pseudolesions were seen around the falciform
ligament. The abdominal CT scans of 587 patients were then prospectively analyzed for the presence of hepatic pseudolesions
around the falciform ligament to determine the prevalence of this finding on CT examinations.
Results: CT scans in the first six patients showed two types of hepatic pseudolesion around the falciform ligament. In three patients,
hepatic pseudolesions were focal spared areas in fatty liver. In three patients, hepatic pseudolesions were developed in nonfatty
liver. Prospectively, hepatic pseudolesions were found on five of 587 CT examinations (prevalence = 1%). A single hepatic
pseudolesion was found in segment 4 on two examinations. Two hepatic pseudolesions (one in segment 4 and one in segment 3)
were found together on three CT examinations.
Conclusion: Hepatic pseudolesions around the falciform ligament are seldom seen on CT scan. However, recognition of these pseudolesions
is crucial because they may be interpreted as true tumors.
Received: 28 February 1995/Accepted: 29 March 1995 相似文献
20.
Santorinicele in pancreas divisum: diagnosis with secretin-stimulated magnetic resonance pancreatography 总被引:1,自引:0,他引:1
A Santorinicele, or cystic dilatation of the dorsal pancreatic duct at the minor papilla, is seen in a small number of patients with pancreas divisum and may indicate obstruction at the minor papilla, a risk factor for pancreatitis. We present a case of a Santorinicele that was diagnosed with secretin-stimulated magnetic resonance pancreatography and treated with minor papillotomy. Received: 13 July 2000/Accepted: 23 August 2000 相似文献