Obstructive jaundice caused by a portal cavernoma

A 69-year-old Japanese man was admitted to our hospital because of acute cholangitis with biliary obstruction. The cause of obstruction was either compression by a portal cavernoma or cavernous transformation. Multidetector row computed tomography (MDCT) and abdominal ultrasonography (US) revealed a portal cavernoma around the common bile duct. Magnetic resonance cholangiopancreatography (MRCP) and endoscopic retrograde cholangiography (ERC) demonstrated characteristic short, smooth narrowing of the bile duct. Endoscopic US and intraductal US demonstrated collateral vessels around the bile duct and were helpful for ruling out a neoplastic lesion. Thus, a combination of imaging modalities was useful for diagnosing this hepatobiliary complication, portal biliopathy.     

Computed tomography of obstructive jaundice secondary to duodenal hematoma

Duodenal hematoma is an unusual condition, usually secondary to blunt abdominal trauma. Even more unusual is the rare development of obstructive jaundice and the attendant computed tomography findings. Nontraumatic causes of duodenal hematoma are also discussed.     

Obstructive jaundice due to multiple myeloma of the pancreatic head: CT evaluation

Extraskeletal spread of multiple myeloma is common and may cause jaundice due to hepatic infiltration. Less commonly, involvement of the pancreas may cause obstructive jaundice. We present a patient with multiple myeloma who became jaundiced. Computed tomography revealed an obstructing pancreatic mass. Aspiration biopsy yielded clumps of atypical plasma cells. The mass and the patient's jaundice responded satisfactorily to local radiation treatment.     

Obstructive jaundice and advanced gastric carcinoma--correlation with its histopathology

One hundred twenty-nine patients with far advanced or recurrent gastric carcinoma underwent computed tomography (CT) of the abdomen. There were three histologic types: differentiated (n = 41), undifferentiated (n = 68), and unclassified (n = 20). Eighteen patients who had developed obstructive jaundice were retrospectively studied to elucidate the nature of obstruction with histologic correlation. In differentiated carcinomas tumor tended to grow in an expansive fashion. A fairly large, well-defined lymph adenopathy was observed on CT. The extrahepatic bile duct surrounded by lymph nodes appeared as "doughnut sign" in six of eight patients. Undifferentiated gastric carcinoma had tendency to extend infiltratively. Bile duct obstruction was only a part of diffuse spreading. In spite of the presence of obstructive jaundice, no discrete mass was demonstrated around the extrahepatic bile duct on CT. In none of nine patients was present "doughnut sign". The significance of lymph node dissection along the extrahepatic bile duct in patients with differentiated gastric carcinoma was emphasized. The region of hepatoduodenal and pancreatico-duodenal lymph nodes should be carefully evaluated in interpretation of abdominal CT.     

Neonatal hepatic calcification secondary to transplacental infection

Transplacentally acquired infections which cause prenatal and neonatal hepatitis can cause hepatic calcification in the newborn. Three cases are reported in which congenital toxoplasmosis and herpes simplex viral infections were causes of neonatal hepatic calcification. Autopsies performed in 2 of the cases revealed extensive dystrophic hepatic calcifications.     

Obstructive migration of renal calculi following cyst aspiration

The authors report 3 cases of ureteral obstruction secondary to puncture of peri-pelvic renal cysts which had been obstructing and dilating the renal pelvis. In each case, non-obstructive calculi passed from the upper collecting system into the ureter or infundibulum within 72 hours of decompression, causing acute renal colic and marked obstruction.     

经皮肝穿刺胆道引流及支架置入治疗梗阻性黄疸

胆道梗阻是指良性或恶性病变所致的梗阻性黄疸,如不及时治疗可引起肝功能衰竭和继发感染等严重并发症.外科手术创伤大,且大部分病人失去手术机会.经皮肝穿刺胆道引流及支架置入治疗梗阻性黄疸作为介入放射学的一项新技术,自上个世纪90年代开展以来,我们先后对32例梗阻性黄疸病人进行了治疗,取得了较好的疗效,现报道如下.     

Enchondroma with secondary aneurysmal bone cyst

An enchondroma with complex cystic changes of the proximal femur is described in a 13-year-old male. The case illustrates a unique presentation of an enchondroma and reinforces the importance of considering the presence of secondary aneurysmal bone cysts in both benign and malignant lesions of bone.     

Causes of jaundice during hepatic artery infusion chemotherapy

Jaundice develops in many patients with liver metastases from colorectal adenocarcinoma during hepatic arterial infusion chemotherapy (HAIC). The usual cause is thought to be hepatotoxicity from the chemotherapeutic agent or biliary obstruction from progressive neoplastic disease. The authors evaluated the abdominal computed tomography and ultrasound examinations performed on 49 patients who were jaundiced during long-term HAIC. In only one patient was diffuse intrahepatic biliary dilatation caused by an obstructing mass in the porta. Two patients had metastatic hepatic lesions causing focal biliary obstruction. Intrahepatic dilatation without an obstructing mass occurred in 20 patients. Percutaneous or endoscopic cholangiograms were commonly interpreted prospectively as showing extrinsic compression by metastases, but no mass was confirmed on imaging studies. Seven patients had focal intrahepatic ductal dilatation from stricture without an associated mass. The remaining 19 patients had normal-caliber ducts; their jaundice was caused by chemical hepatitis. This series suggests that the most common causes of jaundice in these patients are chemical hepatitis and common bile duct stricture, complications of intraarterial chemotherapy, rather than neoplastic obstruction. Stricture formation may be confused with extrinsic compression on direct cholangiograms.     

恶性梗阻性黄疸的ERCP与CT对照分析

本文对比分析了８２例恶性梗阻性黄疸（包括胆管癌４５例，转移性癌２６例，胰头癌６例及壶腹周围癌５例）的ＥＲＣＰ与ＣＴ表现，主要发现：恶性胆管梗阻部位多位于肝外胆管近侧段；肝外胆管近侧段梗阻所致的肝内胆管重度扩张的发生率，远多于远侧段阻塞，在反映肝内胆管扩张程度、扩张范围方面ＣＴ优于ＥＲＣＰ，而显示病灶肿块直接征象方面ＥＲＣＰ优于ＣＴ。     

阻塞性黄疸阴黄、阳黄证的MRI表现

目的:分析阻塞性黄疸阴黄证和阳黄证的影像学特征,以探讨MRI在阻塞性黄疸中医辨证分型中的应用价值。方法:79例中阴黄证30例,阳黄证49例。分别观察分析阻塞性黄疸阴黄证、阳黄证的MRI表现。结果:阴黄与阳黄证MRI特征差异有统计学意义:①扩张程度方面,阴黄证以重度(19/30)和中度(8/30)扩张为主,阳黄证以轻度(21/49)和中度(28/49)为主,显著性检验χ2=19.694,P<0.005;②在胆管的扩张形态方面,阴黄证患者以软藤状扩张为主(21/30),阳黄证以枯枝状为主(35/49),显著性检验χ2=24.244,P<0.005。结论:MRI扫描利于阻塞性黄疸的定位、定性诊断,为阴黄、阳黄的辨证提供客观依据。     

Foot drop secondary to peroneal intraneural cyst arising from tibiofibular joint

An 11-year-old boy presented to our outpatient clinic with a three-month history of pain over the fibular head area and gait difficulty. Surgical exploration revealed a mass arising from the superior tibiofibular joint invading the peroneal nerve along the articular branch of the common peroneal nerve. The pathogenesis of the intraneural ganglion of the peroneal nerve may be an articular origin and superior tibiofibular joint is the central point. Level of evidence V.     

Pulmonary arterial embolism secondary to hydatid cyst of the liver.

Complications may develop after spontaneous or traumatic rupture of hydatid cysts. A rare complication is pulmonary embolism after rupture of such a cyst into the venous system. The authors present the pulmonary radiologic findings for a patient whose pulmonary complaints gradually increased after surgical removal of a hepatic hydatid cyst.     

Giant liponecrotic cyst secondary to augmentation mammoplasty with autologous fat injection

A 28-year-old woman was referred to our mammography unit for evaluation of bilateral palpable lumps in her breasts. She had undergone a bilateral augmentation mammoplasty with autologous fat injections obtained by a trochanteric liposuction 8 months previously. In this case report, we present mammographic and sonographic findings of a giant liponecrotic cyst secondary to breast augmentation by fat injection.