Cardiac metastasis of tongue squamous cell carcinoma complicated by pulmonary embolism: A case report

Cardiac metastasis is known as a rare complication of head and neck malignancy

Papillomavirus and anal carcinoma

Human papilloma virus (HPV; 16 and 18) is known to play an important etiologic role in cervical dysplasia, but its relationship with anal carcinoma is still unclear. Surgical samples from 80 female patients treated for anal epidermoid carcinoma in the Polyclinic of Surgery in Geneva between 1976 and 1989 were retrospectively studied. Of these, HPV detection was performed in 41 whose DNA was preserved well enough to allow such an analysis. Seventeen (42%) samples contained HPV, with a high percentage of high risk HPV (15/41, 36%). Thirty-eight of the 80 patients had a cervical smear, of which 18% revealed cervical carcinoma. When compared with epidemiological data, the results of this study suggest that genital HPV infection predisposes not only to cervical cancer, but also to anal carcinoma, possibly by means of contiguous contamination

Douleurs abdominales aiguës hautes : quelle imagerie ?

The aim of this article is to review the imaging modalities to be performed in patients with acute diffuse upper abdominal pain. Conventional radiography, ultrasound and computerized tomography (CT) are most often used in this setting. The choice of the initial imaging technique will depend from the localization of the pain and the probability of a particular pathology in the involved area

Ultrasound of local complications in hand surgery: a pictorial essay

Early detection of local complications (venipuncture complications, nerve lesions, infections, arthritis, and tenosynovitis, tendon adhesions and re-tears, complications related to orthopaedic hardware) after hand surgery is required for prompt treatment. Ultrasound has proven to be a valuable imaging modality for detecting and assessing a variety of disorders of the wrist and hand. The purpose of this pictorial essay is to present a wide range of complications after wrist and hand surgery assessed by ultrasound

Réactions aux produits de contraste iodés : quelles mesures préventives ?

Les réactions aiguës aux produits de contraste iodés sont rares mais importantes en clinique au vu de leur utilisation quotidienne. Une réaction est définie comme aiguë lorsqu'elle survient dans l'heure suivant l'injection. Un antécédent de réaction au produit de contraste et un terrain allergique semblent accroître le risque mais l'identification des patients à risque reste difficile. L'efficacité des mesures préventives (notamment l'administration de stéroïdes et/ou d'antihistaminiques) doit être encore mieux démontrée. Des guidelines sont proposées dans cet article. En plus de l'administration d'une prémédication, il faut également s'assurer du bien-fondé de l'indication à l'examen radiologique, utiliser un produit de contraste à faible osmolarité, et assurer la surveillance et la sécurité du patient pendant et après la procédure.-----The incidence of acute iodine contrast media reactions, appearing within the first hour after the procedure, is low but clinically important due to their daily use. Previous adverse reactions to iodinated contrast media, asthma and a history of allergic reaction are the most recognized risk factors, but the identification of patients at risk remains difficult. The efficacy of preventive measures such as corticosteroid and/or antihistaminic administration rests on low-level evidence. Practical recommendations are presented in this article. Rather than relying on the sole administration of a premedication, the importance of other measures must be stressed: assessing the relevance of the indication to the radiologic exam, use of low osmolarity contrast media, and ensuring a proper monitoring of the patient during and after the procedure

Asymptomatic Urolithiasis Complicated by Nephrocutaneous Fistula

Asymptomatic spontaneous nephrocutaneous fistula is a rare and severe complication of chronic urolithiasis. We report a case of 56-year-old woman with a nephrocutaneous fistula (NFC) which developed from a superinfected urinoma following calyceal rupture due to an obstructing calculus in the left ureter. The patient was clinically asymptomatic and came to the emergency department for a painless left flank fluctuating mass. This urinoma was superinfected, with a delayed development of renal abscesses and perirenal phlegmon found on contrast-enhanced uro-computed tomography (CT), responsible for left renal vein thrombophlebitis and left psoas abscess. Thereafter, a 99 mTc dimercaptosuccinic acid (DMSA) scintigraphy revealed a nonfunctional left kidney, leading to the decision of left nephrectomy. Chronic urolithiasis complications are rare and only few cases are reported in medical literature. A systematic medical approach helped selecting the best imaging modality to help diagnosis and treatment. Indeed, uro-CT scan and renal scintigraphy with 99 mTc-DMSA are the most sensitive imaging modalities to investigate morphological and functional urinary tract consequences of NFC, secondary to chronic urolithiasis

Douleurs abdominales basses: quelle imagerie ?

Nowadays, we need to counterbalance the excellent diagnostic yield of the abdominal CT Scan, with the significant risks of X irradiation. The Low Dose CT Scan allows confirmation of a diagnosis of appendicitis or nephrolithiasis with comparable precision and a much lower irradiation dose. In the case of appendicitis, the ultrasound is particularly useful, provided that the patient's BMI is <30. If there is suspicion of diverticulitis, the standard CT Scan remains the first line test. The Ultrasound is the first choice exam for a woman in childbearing age presenting with an acute abdominal pain

Successful treatment of a ruptured mycotic aneurysm of the ileocolic artery with transcatheter embolization and antibiotic therapy

We report a case of mycotic aneurysm of the ileocolic artery due to Streptococcus bovis endocarditis and acute septicemia complicated by active hemorrhage, that was treated successfully with transcatheter embolization and subsequent intravenous antibiotic treatment. This case suggests that a mycotic aneurysm can be treated successfully by percutaneous embolization in an emergent situation (active bleeding, septicemia) even without previous antibiotic therapy

Bleeding Meckel's diverticulum diagnosis: an unusual indication for computed tomography

Despite the wide use of modern investigation techniques, the diagnosis of complications related to Meckel's diverticulum (MD) remains difficult. Arteriography is commonly indicated for acute bleeding, and radionuclide scans may help in identifying the site of intestinal hemorrhage. In contrast, computed tomography (CT) is usually considered little use in the diagnosis of bleeding MD. We present the case of a young patient with massive gastrointestinal hemorrhage, in whom the diagnosis of MD bleeding was preoperatively made with contrast-enhanced CT after two negatives arteriographies