CT Findings of Patients with Small Bowel Obstruction due to Bezoar: A Descriptive Study

Purpose. The aim of this study was to present the computed tomography (CT) findings of bezoars that cause obstruction in the small bowel and to emphasize that some CT findings can be considered specific to some bezoar types. Materials and Methods. The records of 39 patients who underwent preoperative abdominal CT and subsequent operation with a diagnosis of intestinal obstruction due to bezoars were retrospectively analyzed. Results. In total, 56 bezoars were surgically removed from 39 patients. Bezoars were most commonly located in the jejunum (n=26/56, 46.4%). Sixteen (41.0%) patients had multiple bezoar locations in the gastrointestinal tract. Common CT findings in all patients were a mottled gas pattern and a focal ovoid or round intraluminal mass with regular margins and a heterogeneous internal structure. Furthermore, some CT findings were determined to be specific to bezoars caused by persimmons. Conclusions. Preoperative CT is valuable in patients admitted with signs of intestinal obstruction in geographic regions with a high bezoar prevalence. We believe that the correct diagnosis of bezoars and the identification of their number and location provide a great advantage for all physicians and surgeons. In addition, some types of bezoars have unique CT findings, and we believe that these findings may help to establish a diagnosis

The comparison of high and standard definition computed tomography techniques regarding coronary artery imaging

Objective: The aim was to compare coronary high-definition CT (HDCT) with standard-definition CT (SDCT) angiography as to radiation dose, image quality and accuracy. Material and Methods: 28 patients with history of coronary artery disease scanned by HDCT (Discovery CT750 HD) and SDCT (Somatom Definition AS). The scan modes were both axial prospective ECG-triggered. The vessel diameters and vessel attenuation values of totally 280 measurements from 140 coronary arteries were analyzed by two experienced radiologists. All data was analyzed by intraclass correlation test. Image quality graded by motion and stair step artifacts (grade 1, poor, to grade 4, excellent), accuracy of vessel inner and outer diameters were compared between the two CT units using the independent samples t-test and Mann-Whitney U test. Results: The intraclass correlation coefficient (ICC) of measured vessel attenuation values in SDCT between the two radiologists was exceedingly good. The ICC was higher in HDCT. The radiation dose of HDCT was higher than that of SDCT. The mean tube current was 180 (mA) in HDCT and 147(mA) in SDCT with the same tube voltage (kVp). There was no significant difference between image quality. Conclusion: HDCT has a higher radiation dose but has much more atenuation and the spatial resolution which improve measurement accuracy for imaging coronary arteries

Short pancreas: evaluation with multi-detector row CT.

PURPOSE: The purpose of this study was to analyze the length variations of the pancreas using computed tomography (CT) and establish a database for short pancreas. METHODS: We retrospectively reviewed CT examinations of 228 adults and rated pancreatic lengths qualitatively on a scale of 1-3 using transverse images. 1, normal pancreas length; 2, mildly short pancreas; and 3, markedly short pancreas. The length of the pancreas from head to tail was also measured using the curved line tool through the midline of the organ on curved planar reconstructed (CPR) images. The pancreatic neck-tail length and the abdominal radius were measured on transverse images, and the ratio of pancreatic neck-tail length to abdominal radius was calculated to avoid the effect of body mass differences. All data were analyzed statistically. RESULTS: The pancreas length was normal (group 1) in 180 (78.9%) patients, mildly short (group 2) in 38 (16.7%), and markedly short (group 3) in 10 (4.4%). The average pancreatic length on CPR evaluation was 207.5 ± 19.1 mm in group 1, 168.9 ± 8.5 mm in group 2, and 135.1 ± 10.7 mm in group 3. There were statistically significant differences between three groups. Although it was not statistically significant, percentage of diabetes mellitus was higher in group 3 (20%) than other two groups (13.2% in group 2, and 8.9% in group 1). CONCLUSIONS: CT examination of the pancreas is an effective imaging method to classify the pancreatic length and to detect short pancreas. We suggest that pancreatic length variations should be reported on routine abdominal CT examinations

A neck mass with brachial plexus injury: Pott's disease

Tuberculous osteomyelitis of the spine is most commonly seen in lower thoracic and lumbar vertebrae. Cervical spine tuberculosis is a very rare condition, and it represents a very small part of all patients with Pott's disease. We present a case with thoraco-cervical Pott's disease, with left-sided neck mass and left ann and hand weakness and numbness. The patient had a paraspinal abscess under the sternocleidomastoid muscle that was compressing the brachial plexus. (C) 2009 Elsevier Inc. All rights reserved

Absence of Middle Hepatic Vein Combined with Retro-Aortic Left Renal Vein: a Very Rare Case Report

The hepatic and renal veins drain into the inferior vena cava. The upper group of hepatic veins consists of three veins which extend to the posterior face of the liver to join the inferior cava. The left renal vein passes anterior to the aorta just below the origin of the superior mesenteric artery. We detected a variation in the hepatic and renal veins in a multislice CT angiogram of a nine-year-old male patient in the Radiology Department of Afyon Kocatepe University Medical School. The upper group hepatic veins normally drains into the inferior vena cava as three separate trunks, namely the right, left and middle. In our case, we found that only the right and left hepatic veins existed and the middle hepatic vein was absent. Furthermore, the left renal vein, which normally passes anterior to the abdominal aorta, was retro-aortic. Left renal vein variations are of great importance in planning retroperitoneal surgery and vascular interventions. Knowledge of a patient's hepatic vein and renovascular anatomy and determining their variations and anomalies are of critical importance to abdominal operations, transplantations and preoperative evaluation of endovascular interventions

Extracranial carotid Doppler ultrasound evaluation of cerebral blood flow volume in COPD patients

Objective: Doppler ultrasound of extracranial internal carotid artery (ICA) and vertebral artery (VA) were performed and total cerebral blood flow volume (tCBFV) was evaluated in chronic obstructive pulmonary disease (COPD) patients. CBFV changes due to blood gas changes were also evaluated

Effect of sildenafil citrate on postprandial gallbladder motility

Objective: Sildenafil stimulates the nitric oxide-cyclic guanosine monophosphate (NO-cGMP) pathway through inhibition of type 5 phosphodiesterase. NO-cGMP pathway causes smooth muscle relaxation. The aim of this study is to evaluate the effects of sildenafil on gallbladder motility