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Pediatrics in Review Dec 2017Necrotizing enterocolitis (NEC) is a frequently encountered condition in the premature neonate, which can have devastating effects. The signs and symptoms of NEC are... (Review)
Review
Necrotizing enterocolitis (NEC) is a frequently encountered condition in the premature neonate, which can have devastating effects. The signs and symptoms of NEC are variable and can be confused with those of sepsis. An abdominal radiograph is often obtained for diagnosis, and findings that indicate NEC include pneumatosis and portal venous gas. The treatment of NEC includes gastrointestinal rest, gastric decompression, broad-spectrum intravenous antibiotics, and systemic support. A finding of pneumoperitoneum signifies intestinal perforation, which requires surgical intervention. Long-term sequelae of NEC include short-gut syndrome, intestinal stricture, and neurodevelopmental delays. The presentation of intestinal stricture can be puzzling. It can appear at presentation as a bowel obstruction or, conversely, as increased stool output or diarrhea. The clinician should have a high level of suspicion for intestinal stricture in a patient with a history of NEC.
Topics: Child; Enterocolitis, Necrotizing; Humans; Infant, Newborn; Radiography, Abdominal
PubMed: 29196510
DOI: 10.1542/pir.2017-0002 -
BMJ Case Reports Jan 2018A 35-year-old man stopped breathing after injecting a large dose of heroin. He subsequently received cardiopulmonary resuscitation from friends. He arrived to accident...
A 35-year-old man stopped breathing after injecting a large dose of heroin. He subsequently received cardiopulmonary resuscitation from friends. He arrived to accident and emergency department with Glasgow Coma Scale of 13. On examination, he had distended and tense abdomen. CT Thorax, Abdomen, and Pelvis confirmed massive tension pneumoperitoneum. A 14 Fr intravenous cannula was inserted through the umbilicus to relieve the intra-abdominal pressure. An emergency laparotomy showed petechia along the anterior gastric wall, haematoma of lesser omentum but showed no evidence of gastrointestinal perforation or organ injury. Air leak test performed by insufflating air into the stomach via nasogastric tube and abdomen filled with normal saline showed no leak. On-table oesophagogastroduodenoscopy showed mild oesophagitis and petechia of cardiac gastric mucosa. He was treated with intravenous antibiotics and discharged on the fifth postoperative day with adequate analgesia.
Topics: Abdominal Cavity; Adult; Analgesia; Anti-Bacterial Agents; Cannula; Cardiopulmonary Resuscitation; Decompression, Surgical; Drug Overdose; Heroin; Humans; Laparotomy; Male; Peritonitis; Pneumoperitoneum; Radiography, Abdominal; Tomography, X-Ray Computed; Treatment Outcome
PubMed: 29386215
DOI: 10.1136/bcr-2017-223069 -
European Journal of Vascular and... Jan 2022
Topics: Aged, 80 and over; Aortic Aneurysm, Abdominal; Asymptomatic Diseases; Endovascular Procedures; Foreign-Body Migration; Humans; Male; Postoperative Complications; Radiography, Abdominal; Stents; Tomography, X-Ray Computed
PubMed: 34844832
DOI: 10.1016/j.ejvs.2021.10.028 -
Computers in Biology and Medicine Jul 2022The construction of three-dimensional multi-modal tissue maps provides an opportunity to spur interdisciplinary innovations across temporal and spatial scales through...
The construction of three-dimensional multi-modal tissue maps provides an opportunity to spur interdisciplinary innovations across temporal and spatial scales through information integration. While the preponderance of effort is allocated to the cellular level and explore the changes in cell interactions and organizations, contextualizing findings within organs and systems is essential to visualize and interpret higher resolution linkage across scales. There is a substantial normal variation of kidney morphometry and appearance across body size, sex, and imaging protocols in abdominal computed tomography (CT). A volumetric atlas framework is needed to integrate and visualize the variability across scales. However, there is no abdominal and retroperitoneal organs atlas framework for multi-contrast CT. Hence, we proposed a high-resolution CT retroperitoneal atlas specifically optimized for the kidney organ across non-contrast CT and early arterial, late arterial, venous and delayed contrast-enhanced CT. We introduce a deep learning-based volume interest extraction method by localizing the 2D slices with a representative score and crop within the range of the abdominal interest. An automated two-stage hierarchal registration pipeline is then performed to register abdominal volumes to a high-resolution CT atlas template with DEEDS affine and non-rigid registration. To generate and evaluate the atlas framework, multi-contrast modality CT scans of 500 subjects (without reported history of renal disease, age: 15-50 years, 250 males & 250 females) were processed. PDD-Net with affine registration achieved the best overall mean DICE for portal venous phase multi-organs label transfer with the registration pipeline (0.540 ± 0.275, p < 0.0001 Wilcoxon signed-rank test) comparing to the other registration tools. It also demonstrated the best performance with the median DICE over 0.8 in transferring the kidney information to the atlas space. DEEDS perform constantly with stable transferring performance in all phases average mapping including significant clear boundary of kidneys with contrastive characteristics, while PDD-Net only demonstrates a stable kidney registration in the average mapping of early and late arterial, and portal venous phase. The variance mappings demonstrate the low intensity variance in the kidney regions with DEEDS across all contrast phases and with PDD-Net across late arterial and portal venous phase. We demonstrate a stable generalizability of the atlas template for integrating the normal kidney variation from small to large, across contrast modalities and populations with great variability of demographics. The linkage of atlas and demographics provided a better understanding of the variation of kidney anatomy across populations.
Topics: Adolescent; Adult; Female; Humans; Kidney; Male; Middle Aged; Radiography, Abdominal; Tomography, X-Ray Computed; Young Adult
PubMed: 35533459
DOI: 10.1016/j.compbiomed.2022.105555 -
The New England Journal of Medicine Jan 2019
Topics: Abdominal Pain; Fatigue; Fever; Humans; Leishmania infantum; Leishmaniasis, Visceral; Male; Middle Aged; Radiography, Abdominal; Spleen; Tomography, X-Ray Computed; Weight Loss
PubMed: 30673546
DOI: 10.1056/NEJMicm1803648 -
BMJ Case Reports Sep 2018
Topics: Abdominal Wall; Adenocarcinoma; Adult; Cystoscopy; Humans; Lymph Node Excision; Male; Radiography, Abdominal; Treatment Outcome; Urinary Bladder Neoplasms
PubMed: 30219781
DOI: 10.1136/bcr-2018-226207 -
CMAJ : Canadian Medical Association... Apr 2021
Topics: Accidents, Traffic; Adult; Bandages; Emergency Service, Hospital; First Aid; Hematoma; Humans; Motorcycles; Pubic Symphysis Diastasis; Radiography, Abdominal; Sacroiliac Joint; Tomography, X-Ray Computed
PubMed: 33903137
DOI: 10.1503/cmaj.201114-f -
The British Journal of Radiology 2016Post-transplant lymphoproliferative disease (PTLD) is a major cause of morbidity and mortality following both solid organ and haematopoietic stem cell transplantation.... (Review)
Review
Post-transplant lymphoproliferative disease (PTLD) is a major cause of morbidity and mortality following both solid organ and haematopoietic stem cell transplantation. PTLD has a broad range of manifestations with extranodal involvement more common in the abdomen than nodal involvement. Fludeoxyglucose positron emission tomography/CT (FDG-PET/CT) is sensitive and specific to detect PTLD and can upstage or detect occult PTLD compared with conventional CT imaging. As functional imaging, FDG-PET/CT also has a role in monitoring treatment response. In this pictorial essay, we will discuss the role of FDG-PET/CT in the diagnosis and staging of abdominal PTLD and describe the advantages of functional imaging in assessing response to therapy.
Topics: Abdomen; Fluorodeoxyglucose F18; Humans; Lymphoproliferative Disorders; Multimodal Imaging; Organ Transplantation; Positron-Emission Tomography; Postoperative Complications; Radiography, Abdominal; Radiopharmaceuticals; Stem Cell Transplantation; Tomography, X-Ray Computed
PubMed: 26544161
DOI: 10.1259/bjr.20150844 -
Diseases of the Colon and Rectum Oct 2019A healthy 65-year-old woman presents to the emergency department with a 12-hour history of sudden-onset severe lower abdominal pain. This is her first episode. She... (Review)
Review
A healthy 65-year-old woman presents to the emergency department with a 12-hour history of sudden-onset severe lower abdominal pain. This is her first episode. She reports nausea, vomiting, and anorexia. Her last colonoscopy was at age 60, and was normal, except for diverticulosis of the sigmoid colon. Physical examination is significant for fever, tachycardia, and generalized abdominal pain with rebound tenderness. Pertinent laboratory findings include a leukocytosis and metabolic acidosis. A CT scan is obtained and is consistent with freely perforated diverticulitis, including a thickened sigmoid colon, free fluid in the pelvis, and free air noted near the diaphragm (). The surgeon completes the patient evaluation, recommends initiation of intravenous fluid resuscitation and antibiotics, and plans to go immediately to the operating room for surgical resection.
Topics: Aged; Anastomosis, Surgical; Colon, Sigmoid; Colostomy; Disease Management; Diverticulitis, Colonic; Female; Humans; Intestinal Perforation; Laparoscopy; Radiography, Abdominal; Tomography, X-Ray Computed; Ultrasonography
PubMed: 31490823
DOI: 10.1097/DCR.0000000000001457 -
The New England Journal of Medicine Oct 2017
Topics: Adult; Decompression Sickness; Embolism, Air; Humans; Male; Portal Vein; Radiography, Abdominal; Skin; Tomography, X-Ray Computed; Vomiting
PubMed: 29045210
DOI: 10.1056/NEJMicm1615505