Asunto(s)

RESUMEN

Congenital diverticulum is a very rare congenital heart disease. 3D virtual and physical models from ultrasound scan data provide a spatial visualization and better understanding of congenital heart disease to the parents and support possible surgical procedures.

Asunto(s)

RESUMEN

Calyceal diverticulum (CD) is a rare anatomic anomaly with an incidence of 0.2% to 0.6% in the patients undergoing renal imaging. They are considered benign lesions and malignancy is exceedingly rare. For diagnosis it is suggested to perform a multiphasic contrast-enhanced computed tomography (CT) evidencing a diverticulum of the pelvicalyceal system with thin-walled cavities communicating with the central collecting system. However, they can be usually mistaken as kidney cancers leading to unjustified nephrectomy. Here, we present a case of a 34-year-old patient who underwent surgery in 2022 due to suspected kidney cancer and histopathological analysis surprisingly reported a CD.

Asunto(s)

Asunto(s)

Asunto(s)

Asunto(s)

RESUMEN

PURPOSE: To describe an anatomical variant that should be consider in patients with hearing loss. METHODS: An 8-year-old girl underwent to temporal bone computed tomography for the evaluation of bilateral conductive hearing loss and further assessment of possible enlarged vestibular aqueduct or high jugular bulb on brain magnetic resonance imaging (MRI). RESULTS: CT of temporal bone showed a cystic cavity with bony sclerotic margins extending from the right jugular foramen to the vestibular aqueduct. Bony dehiscence of the jugular foramen with the right carotid canal was also noted. On brain MRI, there was no evidence of enlargement of the endolymphatic duct and sac on T2 thin-section gradient echo sequence. Time of flight MR angiography did not show arterial flow in the cavity. Contrast enhanced MR venography confirmed the presence of a high right jugular bulb with a diverticulum extending into the vestibular aqueduct due to jugular bulb-vestibular aqueduct dehiscence. CONCLUSION: Knowledge of high jugular bulb-vestibular aqueduct dehiscence is important in the assessment of patients with otologic symptoms such as vertigo, tinnitus and hearing loss.

Asunto(s)

Asunto(s)

Asunto(s)

RESUMEN

Background: Intestinal diverticulum is an abnormality resulting in the formation of a blind-ended saccular pouch that canbe acquired either congenital, true (involving all intestinal layers) or false (involving the mucosa and submucosa), withextraluminal and intraluminal type. In humans, the acquired is more frequent, the colon is the most affected segment followed by duodenum; and majority cases of duodenal diverticula remains asymptomatic, but biliary obstruction, recurrentacute pancreatitis, hemorrhagic ulcer, proximal intestinal obstruction and perforation may occur. The aim of this report isto present a case of a congenital disease in dogs, prone to misdiagnosis due to non-specific clinical signs.Case: An 8-month-old male Boxer was evaluated due to recurrent hyporexia, vomiting, melena and syncope over threemonths with signs of a possible intestinal obstruction. Physical examination showed no abnormalities except for palemucous membranes. Complete blood count revealed anemia and leukocytosis. Platelets and biochemical profiles werenormal. Abdominal ultrasound examination indicated a dilated duodenum, measuring approximately 3.36 cm in diameter,with heterogeneous fluid content and hyperechoic structures with acoustic shadow, peristalsis appeared decreased andnon-progressive. The gastrointestinal positive contrast study was performed to better evaluate abnormalities detected atultrasonography. Images after 30 min of contrast administration demonstrated a marked distension of the duodenum, filledwith contrast and a mildly filled stomach displaced to the left. Sixty min after contrast administration a marked distensionof the entire duodenum, with tortuous aspect and filled with contrast was seen. The caudal duodenal flexure was connectedto a large barium filled saccular structure that measured approximately 7 cm in diameter...

Asunto(s)

RESUMEN

Background: Intestinal diverticulum is an abnormality resulting in the formation of a blind-ended saccular pouch that canbe acquired either congenital, true (involving all intestinal layers) or false (involving the mucosa and submucosa), withextraluminal and intraluminal type. In humans, the acquired is more frequent, the colon is the most affected segment followed by duodenum; and majority cases of duodenal diverticula remains asymptomatic, but biliary obstruction, recurrentacute pancreatitis, hemorrhagic ulcer, proximal intestinal obstruction and perforation may occur. The aim of this report isto present a case of a congenital disease in dogs, prone to misdiagnosis due to non-specific clinical signs.Case: An 8-month-old male Boxer was evaluated due to recurrent hyporexia, vomiting, melena and syncope over threemonths with signs of a possible intestinal obstruction. Physical examination showed no abnormalities except for palemucous membranes. Complete blood count revealed anemia and leukocytosis. Platelets and biochemical profiles werenormal. Abdominal ultrasound examination indicated a dilated duodenum, measuring approximately 3.36 cm in diameter,with heterogeneous fluid content and hyperechoic structures with acoustic shadow, peristalsis appeared decreased andnon-progressive. The gastrointestinal positive contrast study was performed to better evaluate abnormalities detected atultrasonography. Images after 30 min of contrast administration demonstrated a marked distension of the duodenum, filledwith contrast and a mildly filled stomach displaced to the left. Sixty min after contrast administration a marked distensionof the entire duodenum, with tortuous aspect and filled with contrast was seen. The caudal duodenal flexure was connectedto a large barium filled saccular structure that measured approximately 7 cm in diameter...(AU)

Asunto(s)

RESUMEN

INTRODUCTION: Sigmoid sinus diverticulum has been considered the most common cause of pulsatile tinnitus; the mechanism underlying sigmoid sinus diverticulum formation is unclear. To the best of our knowledge, no previous studies have assessed whether the formation of sigmoid sinus diverticulum is related to compression of the internal jugular vein by the styloid process. OBJECTIVE: To discuss the relationship between the styloid process and the formation of sigmoid sinus diverticulum. METHODS: The medical records of nine patients diagnosed with venous pulsatile tinnitus caused by sigmoid sinus diverticulum were reviewed between April 2009 and May 2019. All patients underwent high-resolution computed tomography of the temporal bones, computed tomography venogram of the head and neck, magnetic resonance venography, and brain magnetic resonance imaging. The length and medial angulation of the styloid process were measured, and compression of the internal jugular vein was recorded. RESULTS: The study population consisted of nine female right-sided pulsatile tinnitus patients with a mean age of 53.8±4.6 years. The mean lengths of the styloid process were 3.9±0.6cm on the right side and 4.1±0.7cm on the left side. The mean medial angulation of the styloid process was significantly smaller on the right side than the left side (65.3°±1.2° vs. 67.8°±1.7°, p<0.05). In addition, computed tomography venogram of the head and neck demonstrated the left internal jugular vein was compressed by the styloid process in eight of the nine patients. CONCLUSION: The formation of sigmoid sinus diverticulum with venous pulsatile tinnitus may be related to compression of the contralateral internal jugular vein by the styloid process. However, accumulation of data in additional cases is required to verify this suggestion.

Asunto(s)

Asunto(s)

Asunto(s)

Asunto(s)

Asunto(s)

RESUMEN

BACKGROUND Kommerell diverticulum with a right-sided aortic arch is a rare congenital anatomical condition most often observed in adults. A possible etiology of the subclavian artery's anomalous origin would be an abnormality in regression of the fourth primitive aortic arch during embryonic development. CASE REPORT We report on the case of a 16-year-old female patient presenting with complaints of occasional tachycardia and mild non-specific dyspnea after anxiety crises. Physical examination revealed lower amplitude of the pulses in the left upper limb compared to the right upper limb, and difference in blood pressure (BP) values of 80×60 mmHg, and 100×60 mmHg, respectively. Different radiological imaging modalities were performed to elucidate a possible vascular abnormality. Multislice detector computed tomography angiography of the thoracic aorta and supra-aortic trunks showed a right-sided aortic arch and an aberrant origin of the left subclavian artery with a retroesophageal course and dilation of its emergence (Kommerell diverticulum), as well as duplicity of the right vertebral artery (RVA). Considering the actual small diameter of the diverticulum and the absence of dysphagia or severe external esophageal compression analyzed by the esophagogram, vascular surgery was not indicated. Since complications have been described in the literature, the patient must be kept under observation in the future. CONCLUSIONS Congenital vascular alterations, including Kommerell diverticulum with right-sided aortic arch and the aberrant origin of the left subclavian artery, should be suspected in otherwise asymptomatic young patients with few clinical manifestations. Investigation with different imaging methods helps to clarify the vascular abnormalities, to support a possible surgical procedure indication, and to monitor the patients in follow-up.

Asunto(s)

Asunto(s)

RESUMEN

ABSTRACT Introduction: The urinary bladder diverticula (BD) secondary to benign prostatic hyperplasia (BPH) is a complication that can lead to urinary stasis, stone, urinary tract infection (UTI) and tumors. It's role in acute urinary retention (AUR) is not totally understood. Objectives: To determine the effect of BD size on AUR rates in patients with BPH candidates to surgery. Subjects and Methods: We performed a retrospective cohort study of 47 patients with BPH and BD who underwent BPH surgery associated to complete bladder diverticulectomy from 2006 to 2016. We analyzed risk factors for AUR in patients with BD using univariate, multivariate and correlation analysis. Results: There was a difference in the size of the diverticula, with 6.8 cm vs. 4.5 cm among patients with and without AUR respectively (p=0.005). The ROC curve showed a correlation between the size of BD and the risk of AUR. The value of 5.15 cm presented a sensitivity of 73% and a specificity of 72%. The area under the curve was 0.75 (p=0.01). Comparing groups with BD >5.0 cm vs. ≤5.0 cm, the AUR incidence was 74% and 27.8% respectively with an OR of 2.65 (1.20-5.85) (p=0.005). In the multivariate analysis, only the size of the diverticula reached statistical significance (p=0.012). Conclusions: The diameter of BD is an independent risk factor for AUR in patients with BPH and BD who are candidates to surgery. A diameter greater than 5.15 cm increases the risk of AUR.

Asunto(s)

RESUMEN

BACKGROUND Jejunal diverticulosis is a rare clinical condition, and the majority of patients are asymptomatic. However, some patients can develop serious complications, including perforation. We report the case of a 74-year-old female patient with a perforated jejunal diverticulum who presented with an 'acute abdomen' and with pneumoperitoneum on X-ray radiography. CASE REPORT A 74-year-old female patient presented to the emergency department with a 24-hour history of acute onset of diffuse abdominal pain associated with nausea and vomiting. Physical examination showed signs of generalized peritonitis. The chest radiograph showed a pneumoperitoneum. An emergency laparotomy was performed, and a perforated jejunal diverticulum was identified. Resection of the involved jejunal segment and a primary jejunal anastomosis were performed. CONCLUSIONS Perforated jejunoileal diverticula should be included in the differential diagnosis for elderly patients who present with an acute abdomen. A delay in the diagnosis can be fatal in this group of patients. Although radiographic signs, such as pneumoperitoneum, are unusual in these cases, this finding should provide a diagnostic clue for the physician.

Asunto(s)