RESUMEN
PURPOSE: The purpose of our work was to assess the value of abdominal sonography (US) and computed tomography (CT) in the preoperative diagnosis of appendiceal mucocele. MATERIAL: and methods. We retrospectively reviewed 10 cases of mucocele of the appendix, 7 cases without pseudomyxoma peritonei, and 3 cases with pseudomyxoma peritonei. All cases were investigated radiologically by plain film and US, barium enema was performed in 3 cases and CT in 5 cases. RESULTS: Mucoceles of the appendix are rare and their clinical presentation is not specific. US confirms the appendicular involvement, but often poses the differential diagnosis with acute inflammation, abscess or localized appendicular peritonitis. CT appears as a mandatory examination since it allows accurate preoperative diagnosis period. In this series, the diagnosis was made preoperatively in the 5 cases where CT had been performed. CONCLUSION: US is useful to confirm the abnormal pattern of the appendix but does not allow accurate diagnosis of mucocele. CT is more specific and accurate for diagnosis of mucocele of the appendix.
Asunto(s)
Apéndice , Enfermedades del Ciego/diagnóstico , Mucocele/diagnóstico , Tomografía Computarizada por Rayos X/normas , Ultrasonografía/normas , Dolor Abdominal/etiología , Absceso/diagnóstico , Enfermedad Aguda , Adulto , Apendicitis/diagnóstico , Sulfato de Bario , Enfermedades del Ciego/complicaciones , Enfermedades del Ciego/cirugía , Medios de Contraste , Diagnóstico Diferencial , Enema , Femenino , Fiebre/etiología , Humanos , Masculino , Persona de Mediana Edad , Mucocele/complicaciones , Mucocele/cirugía , Peritonitis/diagnóstico , Estudios Retrospectivos , Sensibilidad y EspecificidadRESUMEN
We report 4 cases of pathologically proven abdominal actinomycosis. US and CT demonstrated an infiltrative abdominal mass with ill-defined margins and heterogeneous enhancement after IV contrast. The ileo-cecal region was involved in one case; the mass appeared following cholecystectomy and recurred 3 years after surgical resection in one case; and no predisposing factor was identified in the 2 other cases. In one of these, recurrence was observed 12 years after the first episode. Actinomycosis must be included in the differential diagnosis of invasive abdominal lesions with "malignant" appearance.
Asunto(s)
Abdomen , Actinomicosis/diagnóstico por imagen , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , RadiografíaRESUMEN
Hydatic cysts of the liver can rupture into the thorax. The aim of this work was to demonstrate how abdominal access can be used in most cases. We report 44 cases of hydatic cysts which ruptured into the thorax among a series of 1411 hydatic cysts of the liver operated between 1974 and 1995. Abdominal ultrasound and chest x-ray provided the diagnosis preoperatively in 35/42 operated cases (one case of spontaneous elimination of a hydatic membrane via a cutaneous orifice and one case of preoperative death). Thoracophrenolaparotomy was used in 12 cases, thoracotomy with laparotomy in 6, thoracotomy alone in 5 and laparotomy alone in 19. Pulmonary resections were performed in 18 cases. No procedure could be performed in one patient who died at the beginning of surgery. A breach in the diaphragm was repaired in 41 cases. The dome of the cyst was resected in 29 cases and complete pericystectomy was performed in 12. There were 7 post-operative deaths. There were no deaths in the abdominal access patients. All emergency problems were controlled with abdominal access. Thoracic access was reserved for specific cases.