• Title/Summary/Keyword: abdominal ultrasound

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Endovascular embolization of persistent liver injuries not responding to conservative management: a narrative review

  • Simon Roh
    • Journal of Trauma and Injury
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    • v.36 no.3
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    • pp.165-171
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    • 2023
  • Trauma remains a significant healthcare burden, causing over five million yearly fatalities. Notably, the liver is a frequently injured solid organ in abdominal trauma, especially in patients under 40 years. It becomes even more critical given that uncontrolled hemorrhage linked to liver trauma can have mortality rates ranging from 10% to 50%. Liver injuries, mainly resulting from blunt trauma such as motor vehicle accidents, are traditionally classified using the American Association for the Surgery of Trauma grading scale. However, recent developments have introduced the World Society of Emergency Surgery classification, which considers the patient's physiological status. The diagnostic approach often involves multiphase computed tomography (CT). Still, newer methods like split-bolus single-pass CT and contrast-enhanced ultrasound (CEUS) aim to reduce radiation exposure. Concerning management, nonoperative strategies have emerged as the gold standard, especially for hemodynamically stable patients. Incorporating angiography with embolization has also been beneficial, with success rates reported between 80% and 97%. However, it is essential to identify the specific source of bleeding for effective embolization. Given the severity of liver trauma and its potential complications, innovations in diagnostic and therapeutic approaches have been pivotal. While CT remains a primary diagnostic tool, methods like CEUS offer safer alternatives. Moreover, nonoperative management, especially when combined with angiography and embolization, has demonstrated notable success. Still, the healthcare community must remain vigilant to complications and continuously seek improvements in trauma care.

Gastroduodenal intussusception of a gastrointestinal stromal tumor: a rare cause of acute pancreatitis

  • Pornpayom Numpraphrut;Sorachat Niltwat;Thammawat Parakonthun;Nonthalee Pausawasdi
    • Clinical Endoscopy
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    • v.55 no.3
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    • pp.447-451
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    • 2022
  • Patients with symptomatic gastrointestinal stromal tumor (GIST) typically present with gastrointestinal bleeding and abdominal pain. This report presents an unusual case of fundic GIST complicated by gastroduodenal intussusception, manifesting as acute pancreatitis. The patient presented with epigastric pain and pancreatic enzyme elevation; thus, he was diagnosed with acute pancreatitis. Computed tomography showed evidence of pancreatitis and a 4×4.7 cm well-defined hyperdense lesion in the 2nd part of the duodenum, compressing the pancreatic head and pancreatic duct. Esophagogastroduodenoscopy revealed invagination of the gastric folds into the duodenum, causing pyloric canal blockage consistent with gastroduodenal intussusception. Spontaneous reduction of the lesion during endoscopy revealed a 4 cm pedunculated subepithelial mass with central ulceration originating from the gastric fundus. Endoscopic ultrasound demonstrated a heterogeneous hypoechoic lesion originating from the 4th layer of the gastric wall. Laparoscopic-endoscopic intragastric wedge resection of the fundic lesion was subsequently performed, and surgical histology confirmed GIST.

Radiologic Evaluation of Intraabdomenal Masses in Childhood (소아복부 종괴의 방사선학적 고찰)

  • Kwon, Hyuk-Po;Byun, Woo-Mok;Hwang, Mi-Soo;Kim, Sun-Yang;Chang, Jae-Chun;Park, Bok-Hwan
    • Journal of Yeungnam Medical Science
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    • v.5 no.1
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    • pp.33-42
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    • 1988
  • The abdominal tumors in children are different from those of adult. These tumors are the third most common one, preceded by leukemia and brain tumors, in children under 15 years. X-ray examination is the most important method among diagnostic approaches. The role of diagnostic imaging is to identify the precise anatomic location and extent of pathologic process with the minimal number of imaging procedures. 23 cases of abdominal tumors were reviewed in respect of age incidence, site of origin, radiologic findings. The results are briefly summarized as follows : 1. Neuroblastoma was the most common(6 cases) and wi1m's tumor(5 cases), choledocal cyst(4 cases), ovarian mass(3 cases), hydronephrosis(2 cases), were descending order in frequency. 2. The most common site was retroperitoneum(60%). Kidney was the single most common site of origin. 3. Radiologic findings. The most common findings of plain radiography was ill defined soft tissue mass and this method was helpful in the presence of calcification especially in neuroblastoma. Ultrasonographic pattern was anechoic(cystic), echoic or mixed pattern, but this method provide less precise anatomical details, nevertheless ultrasonography wes paticullary useful imaging modality for the pediatric abdominal tumors. IVP findings were renal displacement, caliceopelvic system distortion or nonvisualization of kidney, these information was helpful in determining the location of tumors. CT scan showed homogenous or inhomogenous, cystic or solid, mass with their anatomic location. 4. Ultrasonography was the most widely used specific diagnostic method, but had limited value in detecting the anatomic location of tumors. CT scan was superior to ultrasound for determining the extent of tumors.

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Urachal Anomalies in Children (소아 요막관 기형)

  • Kang, Eun-Young;Lee, Cheol-Koo;Park, Kwan-Hyeon;Seo, Jeong-Meen;Lee, Suk-Koo
    • Advances in pediatric surgery
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    • v.11 no.2
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    • pp.150-156
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    • 2005
  • Failure of the urachus to regress completely results in anomalies that may be classified as patent urachus, urachal sinus, urachal cyst and bladder diverticula. The presenting symptoms of children with urachal anomalies are variable and uniform guidelines for diagnosis and treatment are lacking. The purpose of this study was to analyze our experience and develop conclusions regarding the presentation, diagnosis and treatment of urachal anomalies. We retrospectively analyzed the records of 32 patients who were admitted for urachal anomalies from March 1995 to February 2005. The age distribution of these patients at presentation ranged from 1 day to 14 years old (median age 1 month). There were 20 boys and 12 girls. The 32 cases comprised 13 cases of urachal sinus (40.6 %), 10 urachal cyst (31.3 %), and 9 patent urchus (28.1 %). In 30 patients ultrasonography was used for diagnosis and 2 patients with patent urachus were explored without using a diagnostic method. Twenty-three patients were confirmed by ultrasonography alone and 7 patients were examined using additional modalities, namely, computed tomography for 2 patients with an urachal cyst, magnetic resonance imaging for 1 patient with an urachal cyst, and fistulography for 3 patients with an urachal sinus. The presenting symptoms were umbilical discharge (14 patients), umbilical granuloma (8), abdominal pain and fever (3), fever (3), abdominal pain (2), and a low abdominal mass (2). Excision was performed in 29 patients, and 3 patients were conservatively managed. Urachal anomalies in children most frequently presented in neonates, and the most common complaint was umbilical discharge with infection. Urachal anomalies can be diagnosed by a physical examination and an appropriate radiographic test. Ultrasound was the most useful diagnostic method. Complete surgical excision of an urachal anomaly is recommended to avoid recurrence, and the rare development of carcinoma.

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Study on Fatty Liver Duagnosed by Abdominal Ultrasonography and Clinical Laboratory Findings (초음파로 진단된 지방간과 임상검사수치의 관련성에 관한 비교 연구)

  • Yang, Jeong-Hwa
    • Journal of radiological science and technology
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    • v.29 no.1
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    • pp.7-11
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    • 2006
  • This study obtained the following conclusions by making a comparative study on fatty liver diagnosed by abdominal ultrasonography and clinical laboratory findings. I surveyed the value of abdominal ultrasound in 400 patients without clinical symptoms at C Health Clinic Center, Seoul. 1. Compare with blood pressure was high(systolic/diastolic) in 7.5%/4.5% on persons who were diagnosed fatty liver. 2. At the time of the diagnosis, Total cholesterol level was increased in fatty liver patients, HDL-cholesterol level was high in fatty liver patients. And Trigryceride level was increased in fatty liver persons, LDL-cholesterol was high in fatty liver persons. 3. SGOT level was increased in 5.5% on patients who were diagnosed fatty liver, 0% on persons who were normal and SGPT level was high in 29.5% on people who were diagnosed fatty liver, 0% on patients who were diagnosed normal.

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Extraordinary Response of Metastatic Pancreatic Cancer to Chemotherapy (항암 치료에 좋은 반응을 보였던 전이성 췌장암 증례)

  • Shin, Dong Woo;Kim, Jinkook;Lee, Jong-chan;Kim, Jaihwan;Hwang, Jin-Hyeok
    • Journal of Digestive Cancer Research
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    • v.7 no.1
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    • pp.22-25
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    • 2019
  • A 58-year-old woman presented with right flank and back pain for one month. After undergoing an abdominal computed tomography (CT), she was referred to our hospital. The abdominal CT showed a hypodense pancreatic tail mass with multiple retroperitoneal lymph node metastases. Positron emission tomography-computed tomography (PET-CT) scan showed high 18F-FDG uptake in pancreatic tumor and enlarged lymph nodes. Endoscopic ultrasound fine needle aspiration (EUS-FNA) revealed adenocarcinoma, which stained strongly in hENT1 (human equilibrative nucleoside transporter 1) on immunohistochemistry. She received gemcitabine 1,000 mg/m2 + nanoparticle albumin-bound paclitaxel 125 mg/m2 as a palliative chemotherapy. Follow-up abdominal CT and PET-CT after 4 cycles of chemotherapy showed that both pancreatic mass and the metastatic retroperitoneal lymph nodes were nearly disappeared. We report a case of 58-year-old female with metastatic pancreatic cancer who had a dramatic response to palliative chemotherapy (gemcitabine plus nanoparticle albumin-bound paclitaxel).

Evaluation of Liver Function and Blood Exam including hs-CRP in Adults with Nonalcoholic Fatty Liver Findings (비알코올성 지방간 소견을 보이는 성인에 대한 간 기능 및 hs-CRP 혈액 검사 항목 평가)

  • Jeong-Mi, Park;Young-Hyun, Seo;Jong-Nam ,Song
    • Journal of the Korean Society of Radiology
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    • v.16 no.7
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    • pp.943-952
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    • 2022
  • As a test for diagnosing fatty liver, recently, ultrasound and blood exam are being performed simultaneously. In particular, in the case of high-sensitivity C-reactive protein in blood exam, it is used as an index indicating the level of inflammation in various parts of the body as well as cardiovascular diseases. Thus, this study was conducted to analyze the association between metabolic syndrome components, liver function, and high-sensitivity C-reactive protein levels according to the degree of nonalcoholic fatty liver, and use it as a clinical indicator for fatty liver diagnosis. Metabolic syndrome components, liver function and high-sensitivity C-reactive protein blood test values analyzed from 1,139 men and women over 20 years of age with nonalcoholic fatty liver in abdominal ultrasonography from March 2021 to August 2021 at the Korea Association of Health Promotion, Gwangju-Jeonnam Branch. Analyzed for all men and women, the blood test values for subjects with mild fatty liver were AST 30 U/L, ALT 32.1 U/L, γ-GTP 41.2 IU/L, and hs-CRP 0.14 mg/dL. These values were lower than the blood test values of subjects with moderate fatty liver (AST 38 U/L, ALT 47.6 U/L, γ-GTP 54.9 IU/L, hs-CRP 0.22 mg/dL) and was statistically significant (p<0.001). In this case of high-sensitivity C-reactive protein test, it is statistically significant, showing higher values in Subjects with moderate fatty liver than Subjects with mild fatty liver. thus, it is considered that hs-CRP can be used as clinical data for the prevention and management of fatty liver.

Primary Invasive Ductal Carcinoma Arising in Axillary Accessory Breast: A Case Report (겨드랑이 부유방 조직에서 발생한 원발성 유방암: 증례 보고)

  • Seo Young Park;Jeeyeon Lee;Ji Young Park;Gab Chul Kim;Jongmin Park;Jung Geun Cha;Hye Jung Kim
    • Journal of the Korean Society of Radiology
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    • v.85 no.2
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    • pp.421-427
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    • 2024
  • Ectopic breast tissue can develop along the mammary ridge from the axilla to the groin, and the most common site is the axillae. Primary carcinoma of ectopic breast tissue is extremely rare. We report a rare case of a 61-year-old woman with a palpable mass in her left axilla who had a history of surgical excision of accessory breast tissue in the same area. Mammography (MMG), including axillary tail view, ultrasound (US), and breast MRI were performed. We evaluated the extent and characteristics of the microcalcifications in the axillary tail view. A US-guided biopsy was done, and histopathology revealed an invasive ductal carcinoma. Enhanced abdominal CT revealed multiple hepatic masses consistent with metastases, and the patient received palliative chemotherapy. Herein, we present a rare case of breast cancer arising from accessory breast tissue in the axilla, best appreciated on the axillary tail view of the patient's MMG.

Comparison of endoscopic ultrasound-guided drainage and percutaneous catheter drainage of postoperative fluid collection after pancreaticoduodenectomy

  • Da Hee Woo;Jae Hoon Lee;Ye Jong Park;Woo Hyung Lee;Ki Byung Song;Dae Wook Hwang;Song Cheol Kim
    • Annals of Hepato-Biliary-Pancreatic Surgery
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    • v.26 no.4
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    • pp.355-362
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    • 2022
  • Backgrounds/Aims: Postoperative fluid collection is a common complication of pancreatic resection without clear management guidelines. This study aimed to compare outcomes of endoscopic ultrasound (EUS)-guided trans-gastric drainage and percutaneous catheter drainage (PCD) in patients who experienced this adverse event after pancreaticoduodenectomy (PD). Methods: Demographic and clinical data and intervention outcomes of 53 patients who underwent drainage procedure (EUS-guided, n = 32; PCD, n = 21) for fluid collection after PD between January 2015 and June 2019 in our tertiary referral center were retrospectively analyzed. Results: Prior to drainage, 83.0% had leukocytosis and 92.5% presented with one or more of the following signs or symptoms: fever (69.8%), abdominal pain (69.8%), and nausea/vomiting (17.0%). Within 8 weeks of drainage, 77.4% showed a diameter decrease of more than 50% (87.5% in EUS vs. 66.7% in PCD, p = 0.09). Post-procedural intravenous antibiotics were used for an average of 8.1 ± 4.3 days and 12.4 ± 7.4 days for EUS group and PCD group, respectively (p = 0.01). The EUS group had a shorter post-procedural hospital stay than the PCD group (9.8 ± 1.1 vs. 15.8 ± 2.2 days, p < 0.01). However, the two groups showed no statistically significant difference in technical or clinical success rate, reintervention rate, or adverse event rate. Conclusions: EUS-guided drainage and PCD are both safe and effective methods for managing fluid collection after PD. However, EUS-guided drainage can shorten hospital stay and duration of intravenous antibiotics use.

Primary Ureteral Transitional Cell Carcinoma in a Dog (개에서 발생한 원발성 요관 이행세포암종 증례)

  • Kim, Seong-soo;Lee, Jeo-soon;Yun, Soo-kyung;Kim, Su-yeon;Oh, Hyun-jung;Sohn, Jung-min;Jung, Sun-young;Kim, Bo-eun;Ji, Seo-yeoun;Kim, Dae-yong;Kim, Wan-hee;Yoon, Jung-hee;Choi, Min-cheol
    • Journal of Veterinary Clinics
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    • v.32 no.5
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    • pp.459-463
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    • 2015
  • A 14-year-old, castrated male mixed-breed dog weighing 9 kg was presented for hematuria and dysuria. Abdominal ultrasound showed unilateral hydronephrosis and hydroureter with focal thickening of the ureteral wall. Surgical exploration revealed an intraluminal mass arising from the proximal left ureter. Mass resection was performed. Histopathology of the ureteral mass was consistent with a papillary transitional cell carcinoma. The patient recovered well post-operatively, but was diagnosed with another tumor three months later, this time in the right kidney. Fine-needle aspiration cytology of the renal mass revealed an epithelial cell tumor with mesenchymal features.