Biliary drainage by ultrasound-guided puncture of the left hepatic duct

Percutaneous transhepatic biliary drainage under ultrasonic guidance was performed in 38 patients with obstructive jaundice due to malignancy (49 intubations). The method was used for palliation in 33 patients and for pre-operative drainage because of cholangitis in five patients. Puncture of the left lobar ducts was the method of choice (35 patients). Only in cases of poor visualisation of the left biliary ducts was right-sided drainage performed (three patients). Combined left- and right-sided drainage was necessary in nine patients. All attempts with ultrasound-guided punctures were successful. There were no complications related to the punctures. Delayed complications were cholangitis (10 patients) and bleeding (one patient). The advantages of the method compared with conventional percutaneous transhepatic biliary drainage and the advantages of the left liver lobe drainage are outlined.     

Many Faces of Thoracic Histoplasmosis—Pictorial Essay

Histoplasmosis is primarily a pulmonary fungal infection with a vast array of radiological manifestations, which can mimic a number of thoracic diseases. This article reviews various presentations of histoplasmosis on chest imaging.     

Splenic infarction and spontaneous rupture of the spleen after therapeutic embolization

Patients with major hematologic disorders who have hypersplenism and alterations in their immune mechanism are subject to a higher incidence of bacterimia after embolization procedures. In certain instances, these infectious complications can be fatal. Medical splenectomy for hematologic disorders is sometimes complicated by massive splenic infarction and spontaneous rupture; spontaneous rupture appears to be a function of both infarct size and underlying infectious complications. Prophylactic measures can be employed to avoid these complications after interventional splenic embolization.     

Suprasellar seeding of a benign choroid plexus papilloma of the fourth ventricle with local recurrence

A suprasellar location of a benign choroid plexus papilloma is reported. Local recurrence within the fourth ventricle was also present, 8 years after apparently complete removal. Imaging and histological findings were similar to those of the initial lesion. At surgery, the suprasellar lesion had no connection with the ventricular system. Seeding of choroid plexus papillomas is discussed, and the pertinent literature reviewed. Received: 2 September 1999/Accepted: 10 December 1999     

Technical note: Percutaneous transhepatic removal of biliary endoprostheses using a snare

A method using a snare for the percutaneous transhepatic removal of occluded or malpostioned biliary endoprostheses is described. This technique was used in two patients. In one, the snared endoprosthesis was pulled into the duodenum, while in the second patient the prosthesis was pulled out through transhepatic tract without complications.     

Radiation-Induced Complications after Breast Cancer Radiation Therapy: a Pictorial Review of Multimodality Imaging Findings

The purpose of this pictorial essay is to illustrate the multimodality imaging findings of a wide spectrum of radiation-induced complications of breast cancer in the sequence of occurrence. We have classified radiation-induced complications into three groups based on the time sequence of occurrence. Knowledge of these findings will allow for the early detection of complications as well as the ability to differentiate tumor recurrence.     

Calcified thrombus of the inferior vena cava in transposition of the great vessels

Calcified thrombus of the inferior vena cava (IVC) in children is an entity usually not associated with significant complications. The possibility of pulmonary embolism from the soft thrombus, however, has been suggested but never reported. We give an account of a child with transposition of the great vessels who suffered embolization from a calcified thrombus in the IVC that entered the systemic circulation.     

隐源性大咯血的DSA表现及栓塞治疗

目的 探讨隐源性大咯血的支气管动脉造影表现及病理基础，支气管动脉栓塞效果。方法 隐源性大咯血定义为胸片和CT未发现明显病灶或原有病灶与咯血部位不一致，无法解释咯血原因。选择隐源性大咯血患19例，进行支气管动脉造影观察血管异常情况，进行支气管动脉栓塞观察术后即时止血率及长期随访止血率。结果 全部病例支气管动脉造影均可见血管异常，为支气管动脉增粗、分支增生、增多、扭曲，部分伴有出血灶，并可见支气管动脉畸形；经支气管动脉栓塞后即时止血效果及长期止血效果好，未见咯血部位恶性肿瘤发生，均为良性病变。结论 隐源性大咯血病理改变为支气管动脉因炎症感染损伤所致出血或肺血管畸形所致出血，支气管动脉造影和支气管动脉栓塞为一种安全可靠，有时是唯一的诊断、治疗方法，未见与技术操作有关的严重合并症。