Anterior Abdominal Wall Scar Endometriosis: Case Series And Review Of Imaging Modalities

Pelvik veya abdominal skar dokusuna endometriozis ekimi oldukça nadir gözlenen bir durumdur. En sık olarak sezaryen operasyonları sonrasında uterus endometrial kavitesi içindeki endometrial stem hücrelerinin dış dokulara ekilmesi sonucunda gelişmektedir. Hastalar genellikle asemptomatiktir ancak siklik ağrı veya ele gelen kitle şikayeti ile başvurabilirler. Skar hattı yakınında klasik yerleşim yeri, klinik hikaye ve görüntüleme bulguları ile birleştirildiğinde tanı koyulması olasıdır. Ultrasonografi ile incelemede lezyon genellikle solid, hafif hipoekoik vasıfta, kas ile izoekoik özelliktedir. Kanama veya sıvı varlığı lezyonu heterojenleştirebilmektedir. Bilgisayarlı tomografik incelemede lezyonda en belirgin özellik, yoğun kontrast tutulumu olmakta iken manyetik rezonans görüntülemede ise kan ürünlerine hassasiyet ön plana çıkmaktadır.Implantation of endometriosis to pelvic and abdominal scar tissue is a very rare occurrence. Most commonly observed after cesarean sections due to implantation of uterine endometrial stem cells to outside tissues. Patients are often asymptomatic but may present with cyclic pain and mass. Imaging diagnosis is possible when classical implantation site near the scar tissue, clinical history and imaging findings are combined. In ultrasound imaging the lesion is often solid, mildly hypoechoic and often isoechoic to surrounding muscle. Presence of bleeding and fluid may cause the lesion to appear more heterogeneous. On computed tomography imaging the most pronounced finding is avid contrast enhancement of the lesion whereas in magnetic resonance imaging sensitivity to blood products

Anatomic Variations of the Intrahepatic Bile Ducts: Analysis of Magnetic Resonance Cholangiopancreatography in 1,011 Consecutive Patients

Objectives: The aim of the study was to evaluate the frequency of anatomic variations of the hepatic duct bifurcation using magnetic resonance cholangiopancreatography (MRCP). Methods: A total of 1,160 consecutive patients, referred to our department for MRCP due to suspected pancreatobiliary disease or before liver transplantation, were reviewed retrospectively. A total of 149 patients with less than optimal results due to imaging limitations or secondary differentiations of bile duct anatomy were excluded from the study. The final study population was composed of 1,011 cases. Results: Of the 1,160 patients, 149 were excluded from the analysis. Typical biliary anatomy was observed in 79.4% of cases, but female potential living liver donors more frequently presented an anatomic variation. Typical anatomy was present in 75.7% of the females and 85.3% of the males (p < 0.05). Out of the remaining 1,011 patients, 208 (20.57%) were diagnosed with different levels of various anatomic variations of the intra-and extrahepatic biliary ducts. Of the 208 cases with diagnosed variations, 204 (98.07%) and 4 (1.92%) turned out to have 1 and 2 different variations, respectively. The trifurcation variant was observed in 81 cases (8.01%), while 73 subjects (7.23%) had an aberrant right biliary duct draining into the common hepatic duct. A right dorsocaudal branch draining into the left hepatic duct was present in 42 cases (4.15%). Four cases (0.4%) had 2 different variations and 8 (0.8%) had uncommon anatomic variations. Conclusions: Typical intrahepatic biliary anatomy is present in about 80% of the inhabitants of the Aegean region of Turkey, but anatomic variants seem to be more frequent in females as compared to males. Trifurcation was the most common anatomic variation in our study population. The presence of an aberrant right hepatic duct emptying into the common hepatic duct was the second most common observation amongst our findings. (C) 2014 S. Karger AG, Base