1
|
Cirimele V, D'Amone G, Ricci M, Casati R, Ragone R, Redi A, Faiella E. A rare cause of right-upper quadrant abdominal pain: Epiploic appendagitis of the hepatic flexure. Radiol Case Rep 2023; 18:3434-3437. [PMID: 37502488 PMCID: PMC10369382 DOI: 10.1016/j.radcr.2023.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 07/03/2023] [Indexed: 07/29/2023] Open
Abstract
Epiploic appendagitis (EA) is an uncommon cause of acute abdominal pain that may mimic other causes of acute abdomen. Epiploic appendages are outpouching of fat tissue located on the external wall of the colon, being more numerous in the descending and sigmoid colon that account for up to 80% of EA cases. We present the case of a 59-year-old woman with right upper quadrant pain. Abdominal ultrasound and contrast-enhanced computed tomography suggested the diagnosis of epiploic appendagitis of the right colonic flexure. Our case highlights the fact that epiploic appendagitis may occur in unusual locations and must be included in the differential diagnosis of acute abdominal pain, in order to avoid unnecessary medical and surgical treatment.
Collapse
|
2
|
Indiran V, Jagannathan K. Colonic diverticulitis on sonography: Dome sign. ABDOMINAL RADIOLOGY (NEW YORK) 2022; 47:3638-3639. [PMID: 35857065 DOI: 10.1007/s00261-022-03613-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 07/02/2022] [Accepted: 07/05/2022] [Indexed: 01/18/2023]
Affiliation(s)
- Venkatraman Indiran
- Department of Radiodiagnosis, Sree Balaji Medical College and Hospital, 7 Works Road, Chromepet, Chennai, Tamilnadu, 600044, India.
- IVR Scans, 1, Nellipet Cross Street, Chromepet, Chennai, Tamilnadu, 600044, India.
| | - Kokilavani Jagannathan
- VK General Health and Diabetic Care Clinic, 27A Nemilichery High Road, Bharathipuram, Chromepet, Chennai, Tamilnadu, 600044, India
| |
Collapse
|
3
|
Simonetti I, Trovato P, Granata V, Picone C, Fusco R, Setola SV, Mattace Raso M, Caracò C, Ascierto PA, Sandomenico F, Petrillo A. Imaging Assessment of Interval Metastasis from Melanoma. J Pers Med 2022; 12:jpm12071033. [PMID: 35887530 PMCID: PMC9315548 DOI: 10.3390/jpm12071033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 06/22/2022] [Accepted: 06/23/2022] [Indexed: 11/26/2022] Open
Abstract
Interval metastasis is a particular metastatic category of metastatic localizations in the lymph nodes in patients with melanoma. Interval nodes are generally located at nonregional lymphatic stations placed along the pathway of the spread of melanoma, such as the epitrochlear lymph node station, the popliteal fossa, and the retroareolar station. Imaging techniques for evaluation of patients with interval metastasis from melanoma diseases include ultrasound (US), computed tomography (CT), magnetic resonance imaging (MRI), lymphoscintigraphy (LS), and positron emission tomography (PET). A literature review was conducted through a methodical search on the Pubmed and Embase databases. The evaluation of lymph node metastases represents a critical phase in the staging and follow-up of melanoma patients. Therefore, a thorough knowledge of the imaging methods available and the interactions between the clinician and the radiologist are essential for making the correct choice for individual patients, for a better management, and to improve treatment and survival.
Collapse
Affiliation(s)
- Igino Simonetti
- Radiology Division, Istituto Nazionale Tumori-IRCCS-Fondazione G. Pascale, 80131 Napoli, Italy; (I.S.); (C.P.); (S.V.S.); (M.M.R.); (A.P.)
| | - Piero Trovato
- Radiology Division, “ASL Napoli II Nord”, 33939 Naples, Italy;
| | - Vincenza Granata
- Radiology Division, Istituto Nazionale Tumori-IRCCS-Fondazione G. Pascale, 80131 Napoli, Italy; (I.S.); (C.P.); (S.V.S.); (M.M.R.); (A.P.)
- Correspondence:
| | - Carmine Picone
- Radiology Division, Istituto Nazionale Tumori-IRCCS-Fondazione G. Pascale, 80131 Napoli, Italy; (I.S.); (C.P.); (S.V.S.); (M.M.R.); (A.P.)
| | - Roberta Fusco
- Medical Oncology Division, Igea SpA, 80013 Napoli, Italy;
- Italian Society of Medical and Interventional Radiology (SIRM), SIRM Foundation, 20122 Milan, Italy
| | - Sergio Venanzio Setola
- Radiology Division, Istituto Nazionale Tumori-IRCCS-Fondazione G. Pascale, 80131 Napoli, Italy; (I.S.); (C.P.); (S.V.S.); (M.M.R.); (A.P.)
| | - Mauro Mattace Raso
- Radiology Division, Istituto Nazionale Tumori-IRCCS-Fondazione G. Pascale, 80131 Napoli, Italy; (I.S.); (C.P.); (S.V.S.); (M.M.R.); (A.P.)
| | - Corrado Caracò
- Melanoma, Cancer Immunotherapy and Development Therapeutics Unit, Istituto Nazionale Tumori-IRCCS-Fondazione G. Pascale, 80131 Naples, Italy; (C.C.); (P.A.A.)
| | - Paolo A. Ascierto
- Melanoma, Cancer Immunotherapy and Development Therapeutics Unit, Istituto Nazionale Tumori-IRCCS-Fondazione G. Pascale, 80131 Naples, Italy; (C.C.); (P.A.A.)
| | | | - Antonella Petrillo
- Radiology Division, Istituto Nazionale Tumori-IRCCS-Fondazione G. Pascale, 80131 Napoli, Italy; (I.S.); (C.P.); (S.V.S.); (M.M.R.); (A.P.)
| |
Collapse
|
4
|
Yan H, Wu YC, Wang X, Liu YC, Zuo S, Wang PY. Appendico-vesicocolonic fistula: A case report and review of literature. World J Clin Cases 2022; 10:3241-3250. [PMID: 35647117 PMCID: PMC9082718 DOI: 10.12998/wjcc.v10.i10.3241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Revised: 12/30/2021] [Accepted: 02/23/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Appendico-vesicocolonic fistulas and appendiceal-colonic fistulas are two kinds of intestinal and bladder diseases that are rarely seen in the clinic. To our knowledge, no more than 4 cases of appendico-vesicocolonic fistulas have been publicly reported throughout the world, and no more than 100 cases of appendiceal-colonic fistulas have been reported. Although the overall incidence is low, an early diagnosis is difficult due to their atypical initial symptoms, but these diseases still require our attention.
CASE SUMMARY Here, we report a case of a 77-year-old male patient diagnosed with an appendico-vesicocolonic fistula combined with an appendiceal-colonic fistula. The main manifestations were diarrhea and urine that contained fecal material. The diagnosis was confirmed by multiple laboratory and imaging examinations. A routine urinalysis showed red blood cells and white blood cells. Abdominal and pelvic computed tomography scans showed close adhesions between the bowels and the bladder, and fistulas could be seen. Colonoscopy and cystoscopy and some other imaging examinations clearly showed fistulas. The preoperative diagnoses were a colovesical fistula and an appendiceal-colonic fistula. The fistulas were repaired by laparoscopic surgical treatment. The diseased bowel and part of the bladder wall were removed, followed by a protective ileostomy. The postoperative diagnosis was an appendico-vesicocolonic fistula combined with an appendiceal-colonic fistula, and the pathology suggested inflammatory changes. The patient recovered well after surgery, and all his symptoms resolved.
CONCLUSION The final diagnosis in this case was a double fistula consisting of an appendico-vesicocolonic fistula combined with an appendiceal-colonic fistula.
Collapse
Affiliation(s)
- Han Yan
- Department of General Surgery, Peking University First Hospital, Beijing 100032, China
| | - Ying-Chao Wu
- Department of General Surgery, Peking University First Hospital, Beijing 100032, China
| | - Xin Wang
- Department of General Surgery, Peking University First Hospital, Beijing 100032, China
| | - Yu-Cun Liu
- Department of General Surgery, Peking University First Hospital, Beijing 100032, China
| | - Shuai Zuo
- Department of General Surgery, Peking University First Hospital, Beijing 100032, China
| | - Peng-Yuan Wang
- Department of General Surgery, Peking University First Hospital, Beijing 100032, China
| |
Collapse
|
5
|
Mitrovic M, Velickovic D, Micev M, Sljukic V, Djuric P, Tadic B, Skrobic O, Djokic Kovac J. Encapsulated Omental Necrosis as an Unexpected Postoperative Finding: A Case Report. ACTA ACUST UNITED AC 2021; 57:medicina57090865. [PMID: 34577788 PMCID: PMC8470421 DOI: 10.3390/medicina57090865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Revised: 08/18/2021] [Accepted: 08/20/2021] [Indexed: 11/16/2022]
Abstract
Postsurgical fat necrosis is a frequent finding in abdominal cross-sectional imaging. Epiploic appendagitis and omental infarction are a result of torsion or vascular occlusion. Surgery or pancreatitis are conditions that can have a traumatic and ischemic effect on fatty tissue. The imaging appearances may raise concerns for recurrent malignancy, but percutaneous biopsy and diagnostic follow-up assist in the accurate diagnosis of omental infarction. Herein we describe a case of encapsulated omental necrosis temporally related to gastric surgery. Preoperative CT and MRI findings showed the characteristics of encapsulated, postcontrast nonviable tumefaction in the epigastrium without clear imaging features of malignancy. Due to the size of the lesion and the patient’s primary disease, tumor recurrence could not be completely ruled out, and the patient underwent surgery. Histopathological analysis confirmed the diagnosis of steatonecrosis of the omentum.
Collapse
Affiliation(s)
- Milica Mitrovic
- Center for Radiology and Magnetic Resonance Imaging, Clinical Centre of Serbia, Pasterova No. 2, 11000 Belgrade, Serbia; (M.M.); (J.D.K.)
| | - Dejan Velickovic
- Department of Stomach and Esophageal Surgery, Clinic for Digestive Surgery, Clinical Centre of Serbia, Koste Todorovica Street No. 6, 11000 Belgrade, Serbia; (D.V.); (V.S.); (O.S.)
- Department for Surgery, Faculty of Medicine, University of Belgrade, Dr Subotica No. 8, 11000 Belgrade, Serbia
| | - Marjan Micev
- Department for Pathology, Clinic for Digestive Surgery, Clinical Centre of Serbia, Dr Subotica No. 8, 11000 Belgrade, Serbia;
| | - Vladimir Sljukic
- Department of Stomach and Esophageal Surgery, Clinic for Digestive Surgery, Clinical Centre of Serbia, Koste Todorovica Street No. 6, 11000 Belgrade, Serbia; (D.V.); (V.S.); (O.S.)
- Department for Surgery, Faculty of Medicine, University of Belgrade, Dr Subotica No. 8, 11000 Belgrade, Serbia
| | - Petar Djuric
- Center for Nephrology, University Hospital Zvezdara, Dimitrija Tucovica No. 161, 11000 Belgrade, Serbia;
| | - Boris Tadic
- Department for Surgery, Faculty of Medicine, University of Belgrade, Dr Subotica No. 8, 11000 Belgrade, Serbia
- Department for HBP Surgery, Clinic for Digestive Surgery, Clinical Centre of Serbia, Koste Todorovica Street No. 6, 11000 Belgrade, Serbia
- Correspondence: ; Tel.: +381-62-388-288
| | - Ognjan Skrobic
- Department of Stomach and Esophageal Surgery, Clinic for Digestive Surgery, Clinical Centre of Serbia, Koste Todorovica Street No. 6, 11000 Belgrade, Serbia; (D.V.); (V.S.); (O.S.)
- Department for Surgery, Faculty of Medicine, University of Belgrade, Dr Subotica No. 8, 11000 Belgrade, Serbia
| | - Jelena Djokic Kovac
- Center for Radiology and Magnetic Resonance Imaging, Clinical Centre of Serbia, Pasterova No. 2, 11000 Belgrade, Serbia; (M.M.); (J.D.K.)
- Department for Radiology, Faculty of Medicine, University of Belgrade, Dr Subotica No. 8, 11000 Belgrade, Serbia
| |
Collapse
|