共查询到19条相似文献,搜索用时 62 毫秒
1.
肝内胆汁瘤一例 总被引:1,自引:0,他引:1
患者 女 ,32岁。上腹包块 1个月伴疼痛入院。查体 :剑突下偏右可扪及一包块约 10cm× 10cm ,边界不清 ,活动差。既往史 :1个半月前患者因车祸行肝破裂修补术 ,当时外院CT报告肝挫裂伤。临床拟诊 :炎性包块。CT扫描 :相当于肝裂处见一囊状低密度灶 ,推挤相邻肝左、右叶并向下延伸推挤胆囊、胰腺向后下方 ,囊壁光滑 ,囊内为均匀液体密度 ,大小约为 8.8cm× 8.1cm× 6 .1cm(图 1)。CT诊断 :肝内胆汁瘤。手术所见 :右肝脏面有一约 10cm× 8cm大小囊性包块 ,内容物为混浊有“渣”性胆汁 ,无明显管道与肝内或肠内相通 ,壁较… 相似文献
2.
目的:探讨医源性肝包膜下胆汁瘤(HSB)的临床及 CT 表现。方法收集本院资料齐全、经穿刺确诊的医源性 HSB 患者7例,检索文献报道的医源性 HSB 病例18例,对其临床及 CT 表现特点进行回顾性分析。结果25例医源性 HSB 中,发生于腹腔镜胆囊切除术后9例,经皮经肝胆道引流术后5例,经皮经肝胆道取石术后4例,开腹胆囊切除术后2例,其他手术5例。CT 表现为肝脏包膜下水样密度影,局限性或弥漫性分布,呈新月形或囊袋状,部分病例伴有肝脏体积缩小,肝表面受压凹陷。结论肝胆手术,特别是腹腔镜及介入手术后,CT 显示肝脏包膜下局限性或弥漫性积液,应考虑 HSB 可能,需及早穿刺确诊并置管引流。 相似文献
3.
4.
患者 女 ,19岁。半年内晕厥 4次 ,均为活动后发作伴胸闷、气急 ,持续约 1分钟后自行好转。查体 :肺动脉瓣区可闻及Ⅲ级SM杂音 ,粗糙 ,向四周传导 ,与体位无关 ;心电图 :右房、右室增大 ;超声心动图 :肺动脉内占位 ,不除外粘液瘤。MRI检查 (图 1~ 3 ) :右室、右房增大 ,于肺动脉瓣平面起向上直达右肺动脉主干近段腔内见血管铸形异常信号 ,T1WI呈中等信号 ,T2 WI呈不均匀高信号 ,除内侧与肺动脉壁部分相贴外 ,其前、后及外侧尚可见血管流空影 ,肿块边缘不光整。MRI诊断 :首先考虑肺动脉主干内肿瘤。手术所见 :右室前壁、肺动… 相似文献
5.
肝内胆汁瘤因病因不同可分为外伤性胆汁瘤、医源性胆汁瘤和自发性胆汁瘤,临床表现缺乏特征性,影像学检查是主要的诊断途径.我们在两年内接诊了4名最终分别诊断为外伤性、自发性和医源性胆汁瘤的患者,现按时间顺序报告各自的超声影像表现及介入性超声的诊治结果. 相似文献
6.
7.
8.
9.
10.
11.
胆汁瘤α-氰基丙烯酸正丁酯封堵1例 总被引:1,自引:0,他引:1
临床资料患者男,75岁.“结肠癌术后26个月,胆汁瘤引流3个月来院复查”.患者于26个月前因升结肠癌肝转移行右半结肠切除术,术后肝转移瘤行肝动脉化疗栓塞(TACE)9次,微波消融(MWA)2次,其后发现胆汁瘤,大小11.5 cm×6.8 cm,多次CT复查大小无变化,1年后行胆汁瘤穿刺引流,引流出草绿色胆汁样液体约300 ml,其后每日引流量约100 ml,7 d后引流液浑浊,患者出现发烧症状,行引流液细菌培养,培养出金黄色葡萄球菌和阴沟肠杆菌,给予敏感抗生素治疗后出院.胆汁瘤外引流近3个月,囊腔消失,但引流量逐渐增多,每日约300 ml,遂决定行胆汁瘤栓塞.经引流管造影,见有2个瘘口与胆管相通. 相似文献
12.
13.
Nguyen Lan Hieu Vu Ngoc Tu Le Hoan Hoang Bui Hai Doan Tien Luu Nguyen Ngoc Cuong Thieu Thi Tra My Tran Ngoc Minh Pham Thuan Manh 《Radiology Case Reports》2022,17(6):1986
Primary pulmonary artery sarcoma is a rare tumor that mimics pulmonary embolism. Patients may present with cough, dyspnea, chest pain, and weight loss. The diagnosis is challenging. Herein, we report a case of 29-year-old female patient who had presented with dyspnea, fatigue for 2 weeks. Computed tomography pulmonary angiography scan suggests pulmonary embolism. We decided to perform surgical embolectomy. The histopathological results, however demonstrated primary pulmonary artery intimal sarcoma. The patient died 1-month post-surgery because of respiratory and circulatory failure. 相似文献
14.
Tran Thanh Tri Pham Ngoc Thach Ho Phi Duy Luu-Nguyen An Thuan Phan Tuan Kiet Nguyen Minh Duc 《Radiology Case Reports》2023,18(3):895
Although post-traumatic intrahepatic pseudoaneurysms are rare in adults and even more uncommon in children, this serious complication can result in life-threatening bleeding. Most case studies have recommended surgical or endovascular interventions for preventing rupture or managing the bleeding from a ruptured intrahepatic pseudoaneurysm. Some studies also reported pseudoaneurysms could resolve without intervention and advised conservative therapy. In this case study, we describe a 19-month-old boy diagnosed with an intrahepatic pseudoaneurysm, upper gastrointestinal bleeding from the biliary tract, and hematoma infection. The patient received successful conservative treatment. After 36 days, the patient was discharged without signs of gastrointestinal bleeding and the steady shrinkage of the hematoma surrounding the pseudoaneurysm. The pseudoaneurysm and hematoma vanished at follow-up 18 months after the trauma. Conservative treatment may be considered a viable option, particularly for cases of post-traumatic intrahepatic pseudoaneurysms in children. 相似文献
15.
Daouda Diarra Siham Salam Abdoulfatihi Salihou Boubacar Traore Dalale Laoudiyi Kamilia Chbani Lahcen EL Ouzidane 《Radiology Case Reports》2022,17(6):2203
Post-traumatic hepatic biloma is a rare complication of closed trauma of the abdomen. Generally, biloma occurs spontaneously or secondary to traumatic or iatrogenic injury to the biliary system. It can lead to significant morbidity and mortality if not diagnosed promptly and properly managed. A 4-year-old child was admitted to the emergency room with abdominal pain following a traffic accident. Clinical examinations suspected closed abdominal trauma without biological signs of icteric cholestasis. Abdominal CT scan performed within 24 hours showed a focus of hepatic laceration, and follow-up imaging at 5 days showed post-traumatic intrahepatic cystic formations. This case report aims to emphasize the importance of imaging including ultrasound, CT, MRI, MRI cholangiopancreatography (MRCP), or hepatobiliary cholescintigraphy to establish the diagnosis and guide the therapeutic gestures. 相似文献
16.
17.
18.
Background: Pulmonary hypertension is a rare complication of sarcoidosis. The pathogenesis of sarcoidosis-related pulmonary hypertension is multifactorial, and patients with sarcoidosis-related pulmonary hypertension can have variable treatment responses and prognoses. While selexipag (Nippon Shinyaku / Kyoto / Japan) was recently approved in Japan for the treatment of pulmonary hypertension, the risk of cerebral infarction has not been clearly reported. Case report: A 63-year-old Asian female with a diagnosis of ocular and cutaneous sarcoidosis developed shortness of breath and was referred to our department to rule out cardiac sarcoidosis. Swan–Ganz catheterization was performed, and she was diagnosed with pulmonary arterial hypertension and started on selexipag. A few days after starting treatment, she presented with hemiplegia and was diagnosed with cardiogenic cerebral embolism by using magnetic resonance imaging. As there was no evidence of pre-existing intracardiac thrombosis, we suspected unusual cerebral embolism. Echocardiography revealed a deep venous thrombus and a bubble study revealed a right-left shunt through a patent foramen ovale. Conclusions: The initiation of selexipag improved pulmonary blood flow and caused cerebral embolism, which was an unusual and unexpected event. This report highlights the importance of confirming the presence of patent foramen ovale and a deep venous thrombus before starting treatment for pulmonary hypertension. 相似文献