MRI and CT of adenomatous tumours of the middle ear

We report three adenomatous middle-ear tumours, an adenoma, an adenocarcinoma and a semimalignant adenomatous tumour, with special attention to CT and MRI findings. In all cases we found small intratympanic masses in which the ossicles were embedded. All showed contrast enhancement and similar signal intensity as brain tissue on T1- and T2-weighted images. The biological nature of the tumours was not reflected by the imaging or operative findings.

Iatrogenic and accidental colon injuries--what to do?

PURPOSE

This study was designed to formulate management guidelines for a variety of rare iatrogenic and accidental injuries to the colon and rectum.

METHODS

This review collates the available evidence in the literature.

RESULTS

Both investigative and therapeutic maneuvers involving the colon, particularly endoscopy and radiographic contrast studies, are the most common cause of significant injury although the incidence is low. Even less common are injuries produced, at open surgery and minimally invasive surgery, by foreign bodies, enemas, or compressed air. The mechanisms and management of these injuries are discussed in detail.

CONCLUSIONS

Evidence exists to support that a nonoperative approach is safe for the majority of injuries, particularly when the colon is "clean" at the time of injury. Adequate resuscitation, observation, and repeated reassessment are mainstays of a conservative policy. Operation is essential for progression of abdominal signs. Patients with established peritonitis at the time of presentation or with an unprepared bowel are best served by prompt operation.