Lebereigene Tumoren – Hepatozelluläres und das Cholangiozelluläre Karzinom

2021 ◽  
Vol 78 (10) ◽  
pp. 585-588
Author(s):  
Savas Deniz Soysal ◽  
Otto Kollmar
Keyword(s):  
Abdomen Ct

Zusammenfassung. Lebertumoren werden häufig als Zufallsbefund in der Sonographie entdeckt. Weiterführende Diagnostik sind das MRT mit Gadolinium-Kontrastmittel oder das 3-Phasen-Abdomen-CT. Auf eine Biopsie bei einem Leberrundherd kann bei genauer Kenntnis der radiologischen und klinischen Präsentation verzichtet werden. Patienten mit Lebereigenen Tumoren und / oder unklaren Befunden sollten in einem Leberzentrum vorgestellt werden. Nur die chirurgisch-onkologische R0-Resektion ist kurativ.

Einfluss der Richtung des Topogramms auf die Strahlendosis und die Bildqualität in Thorax- und Abdomen-CT-Untersuchungen

2016 ◽  
Vol 188 (S 01) ◽  
Author(s):  
S Suntharalingam ◽  
A Wetter ◽  
N Guberina ◽  
A Ringelstein ◽  
J Theysohn ◽  
...  
Keyword(s):  
Abdomen Ct

scholarly journals A very persistent chicken bone: two separate perforations from the same foreign object 2 months apart

2019 ◽  
Vol 12 (5) ◽  
pp. e228050
Author(s):  
Andrew James Brown ◽  
Thomas Whitehead-Clarke ◽  
Vera Tudyka
Keyword(s):  
Small Bowel ◽  
Bowel Perforation ◽  
Linear Structure ◽  
Small Bowel Resection ◽  
Emergency Laparotomy ◽  
Small Bowel Perforation ◽  
Chicken Bone ◽  
Abdomen Ct ◽  
Distal Migration ◽  
The Right

A 56-year-old man presented acutely with abdominal pain and raised inflammatory markers. Initial CT images demonstrated acute inflammation in the right upper quadrant surrounding a high-density linear structure. The appearance was of a chicken bone causing a contained small bowel perforation. This was managed conservatively with intravenous antibiotics and the patient was discharged 10 days later. The same patient returned to the hospital 2 months later, once again with an acute abdomen. CT imaging on this occasion showed distal migration of the chicken bone as well as free gas and fluid indicative of a new small bowel perforation. The patient underwent an emergency laparotomy, washout and small bowel resection. No foreign body was found at laparotomy or in the histopathology specimen. The postoperative course was complicated by an anastomotic leak. A further CT on that admission demonstrated that the chicken bone had migrated to the rectum!

scholarly journals COVID-19: No benefit of chest inclusion in acute abdomen CT

2020 ◽  
Author(s):  
C. Brennan ◽  
B. Morrissey ◽  
S. Dubois-Marshall ◽  
D. McAteer ◽  
A. Qadir ◽  
...  
Keyword(s):  
Acute Abdomen ◽  
Abdomen Ct

scholarly journals Perforated diverticulitis in a patient with very proximal jejunal diverticula

2020 ◽  
Vol 2 (3) ◽  
Author(s):  
Constantinos Avgoustou ◽  
Dimitrios Velecheris
Keyword(s):  
Abdominal Distension ◽  
Perforated Diverticulitis ◽  
Jejunal Loop ◽  
Emergency Laparotomy ◽  
Rebound Tenderness ◽  
Cardiac Arrythmias ◽  
Cardiopulmonary Support ◽  
Abdomen Ct ◽  
Fluid Levels ◽  
Jejunal Diverticulitis

Background: We report a case of an elderly with peritonitis due to perforated jejunal diverticulitis, and we highlight the diagnostic evaluation and treatment alternatives. Case presentation: A 92-year-old woman was transferred to the Emergency Dept. with abdominal pain and vomiting for the past 12 hours. Physical examination revealed diffuse pain, abdominal distension, rebound tenderness and bowel silence. She was febrile, tachycardic, tachypneic, hypotensive and anuric. Blood gas estimation showed metabolic acidosis. She fulfilled the criteria of septic shock. At presentation, she was mildly malnourished. From her medical history, she had cardiac arrythmias, hypertension and diabetes mellitus under proper medication, and laparoscopic cholecystectomy. Laboratory investigations revealed Hct 44.6%, WBC 12.500/dL, glucose 300 mg/dL, creatinine 2.8 mg/dL, CRP 405 mg/L, and electrolyte deficit. Abdominal X-ray showed gastric, small intestinal and colonic gas, with no pneumoperitoneum or air-fluid levels. Chest/abdomen CT showed thickening of proximal jejunal loop and adjacent mesentery, and an extraluminal air bubble, suggesting possible perforation. The patient was given intense resuscitation and broad-spectrum antibiotics and underwent emergency laparotomy. Results: Four jejunal diverticula, sized 1-3 cm, were confined to a segment 12 cm long, located 6 cm from the Treitz ligament; the proximal diverticula was inflamed and perforated. The adjacent mesentery was inflamed and thickened; the bowel lumen remained open. We performed one-layer full-thickness suturing of the perforated diverticulum and omental patch closure. The patient was transferred intubated to ICU. E. Coli was isolated from peritoneal fluid cultures and antibiotic therapy was adjusted to antibiogram. The patient had a first bowel movement at day 5 and was extubated at day 21. She needed mild cardiopulmonary support and was discharged at day 30. Conclusions: Jejunal diverticulitis is a challenging disorder since its rarity makes diagnosis difficult and, thus delayed. The perforation of jejunal diverticulitis requires emergent surgery and poses technical dilemmas.

scholarly journals Adrenal incidentaloma: prevalence and referral patterns from routine practice in a large UK university teaching hospital

2021 ◽  
Author(s):  
Fahmy W F Hanna ◽  
Sarah Hancock ◽  
Cherian George ◽  
Alexander Clark ◽  
Julius Sim ◽  
...  
Keyword(s):  
Teaching Hospital ◽  
Imaging Modality ◽  
Temporal Trends ◽  
Adrenal Incidentaloma ◽  
University Teaching ◽  
Routine Practice ◽  
Anatomical Site ◽  
Referral Patterns ◽  
Referral Rates ◽  
Abdomen Ct

Abstract Context Adrenal incidentalomas are increasingly being identified during unrelated imaging. Unlike AI clinical management, data on referral patterns in routine practice are lacking. Objective To identify factors associated with AI referral Design We linked data from imaging reports and outpatient bookings from a large UK teaching hospital. We examined; (i) AI prevalence and (ii) pattern of referral to endocrinology, stratified by age, imaging modality, scan anatomical site, requesting clinical specialty and temporal trends. Patients Utilising key radiology phrases to identify scans reporting potential AI, we identified 4,097 individuals from 479,945 scan reports (2015-19). Main Outcome Measures Prevalence of AI and referral rates Results Overall, AI lesions were identified in 1.2% of scans. They were more prevalent in abdomen CT and MRI scans (3.0% and 0.6%, respectively). Scans performed increased 7.7% year-on-year from 2015-19, with a more pronounced rise in the number with AI lesions (14.7% pa). Only 394/4097 patients (9.6%) had a documented endocrinology referral code within 90 days, with medical (11.8%) more likely to refer than surgical (7.2%) specialties (p<0.001). Despite prevalence increasing with age, older patients were less likely to be referred (p<0.001). Conclusions While overall AI prevalence appeared low, scan numbers are large and rising; the number with identified AI are increasing still further. The poor AI referral rates, even in centres such as ours where dedicated AI multi-disciplinary team meetings and digital management systems are used, highlights the need for new streamlined, clinically-effective systems and processes to appropriately manage the AI workload.

Renal tumors segmentation in abdomen CT Images using 3D-CNN and ConvLSTM

2022 ◽  
Vol 72 ◽  
pp. 103334
Author(s):  
Li Kang ◽  
Ziqi Zhou ◽  
Jianjun Huang ◽  
Wenzhong Han
Keyword(s):  
Ct Images ◽  
Renal Tumors ◽  
Abdomen Ct ◽  
3D Cnn

How much is the effective dose from medical imaging in pediatric patients in the neurosurgery department?

2021 ◽  
Author(s):  
B. Zeinali-Rafsanjani ◽  
S. Haseli ◽  
R. Jalli ◽  
M. Saeedi-Moghadam
Keyword(s):  
Medical Imaging ◽  
Ionizing Radiation ◽  
Ct Scan ◽  
Effective Dose ◽  
Pediatric Patients ◽  
Ct Scans ◽  
Imaging Data ◽  
Plain Radiographs ◽  
Brain Ct ◽  
Abdomen Ct

Medical imaging with ionizing radiation in pediatric patients is rising, and their radiation sensitivity is 2–3 times more than adults. The objective of this study was to estimate the total effective dose (ED) of all medical imaging by CT scan and plain radiography in patients in pediatric neurosurgery department. Patients with at least one brain CT scan and recorded dose length product (DLP) were included. Patients’ imaging data were collected from the picture-archiving-and-communicating system (PACS) using their national code to find all their medical imaging. Total ED (mSv) from CT scans and plain radiographs were calculated. A total of 300 patients were included, of which 129 were females and 171 males with a mean age of 5.45 ± 4.34 years. Mean DLPs of brain, abdomen, and chest CT were 329.16, 393.06, 284.46 mGy.cm. The most frequent CT scans in these children were brain CT scans with ED range of 0.09 to 47.09 mSv. Total ED due to all CT scans and plain radiographs were in the range of 0.38 to 63.41 mSv. Although the mean DLP of each brain, chest, and abdomen CT of patients was in the range of DRLs reported by previous studies, the patients with numerous CT scans received more radiation doses than mean ED (6.21 mSv between all age groups). The most frequent CT scan was the brain, and the most frequent plain radiographs were chest and lower extremities. It can be concluded that reducing the number of CT scans or plain radiographs by appropriate physical exams or replacing them with modalities that do not use ionizing radiation can reduce ED.

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