Vellingkilgore2441

Epiploic appendagitis is a condition resulting from ischemia or necrosis involving the appendage epiploica either due to torsion or spontaneous thrombosis of the venous outflow. It is one of the myriad causes of acute abdominal pain and can masquerade clinically as appendicitis, omental infarction, sclerosing mesenteritis and even diverticulitis. Epiploic appendagitis of the vermiform appendix is a rare entity, clinically indistinguishable from appendicitis. We present a 45-year-old male patient with 4-day duration of right iliac fossa pain and tenderness, with strong clinical suspicion of acute appendicitis. CT scan of the abdomen and pelvis demonstrated Epiploic appendagitis of the vermiform appendix, whilst the appendix remained uninflamed. The patient was thus discharged with conservative management without having to go undergo needless surgery, thereby avoiding the potential complications thereof.Inflammatory myofibroblastic tumors (IMT) are rare soft tissue tumors of intermediate malignant potential with tendency for local recurrence. Although they can occur at all age groups, occurrence in infants is extremely unusual and their imaging characteristics are not well described. A 3-month-old female infant presented with gradually progressive abdominal distention without any fever or weight loss. She had a large ill-defined homogenous hypodense lesion of size 8.4 × 11.4 × 11.3 cm (APxTraxSag) in the abdomen showing mild delayed post contrast enhancement. She underwent exploratory laparotomy with gross total excision of mesenteric mass, histopathology of which was suggestive of IMT. She had recurrence within 6 months of complete resection with a well-defined heterogeneously enhancing lesion of size 1.8 × 1.8 × 2.3cm (APxTraxSag) in right paravesical region abutting the bladder without invasion with a similar lesion of size 4.4 × 2.1 × 3 cm (APxTraxSag) in left subdiaphragmatic region abutting superior surface of spleen (no invasion). Since, surgery in our patient would have entailed splenectomy and partial cystectomy, systemic therapy with ceritinib (anaplastic lymphoma kinase [ALK] inhibitor) was planned for her with which she had a near complete response after 2 months. A high index of suspicion is required to differentiate IMT from other common causes of mesenteric masses in children and role of radiologist is quintessential in this regard. Local recurrence with abutment but without invasion of surrounding structures points to the intermediate malignant pathology of IMT and may provide a clue to diagnosis. Systemic therapy is effective in patients who are ALK positive and destructive surgery should be avoided.Pneumothorax is an extremely common entity that is typically readily diagnosed and treated. Standard treatment for a small pneumothorax in an otherwise healthy patient is oxygen and observation. For many cases of pneumothorax (those that are larger, more symptomatic, occur in patients with underlying lung disease, or occur in patients who live far from an emergency facility), treatment includes needle aspiration or chest tube placement. We report the clinical presentation and imaging appearance of a 47-year-old female who had a trocar traverse the heart during pleural chest tube placement. Based on this case, policies in the emergency department were reviewed and quality measures were improved.Tuberous sclerosis complex (TSC) is a rare autosomal dominant disease characterized by multiple tumors throughout the body. Supratentorial hamartomas (or tubers), are a very common CNS feature of TSC. Cerebellar tubers are much less common in TSC. We present an interesting case of cerebellar tuber in a 14-year-old patient with TSC, highlighting clinical and diagnostic criteria for TSC and review the unique features of cerebellar tubers, differentiating these lesions from their more common supratentorial counterparts. This case serves as an educational tool to improve awareness of cerebellar tubers in patients with tuberous sclerosis.Stent-graft placement is an important treatment for traumatic renal artery dissection, but it may occasionally be technically difficult to advance a catheter through the lesion of the dissection due to severe stenosis of the true rumen. A triple-coaxial (triaxial) system, which consists of a small microcatheter, a large microcatheter, and a 4-Fr. selleck chemical catheter, has recently become available, and it contributes to super-selective catheterization. We thought this system may be useful for passing catheters through the dissection. We herein report a 30-year-old male patient with traumatic renal artery dissection, who was successfully treated by stent-graft placement using the triaxial system.Primary synovial chondromatosis is a rare benign neoplastic process, in which cartilaginous nodules are produced in the subsynovial tissue. It has 3 main subtypes (intra-articular, tenosynovial and bursal). We present the case of a 61-year-old female, with a mass involving her right thumb for at least 5 years, which had recently increased in size. X-ray showed a soft tissue mass, without calcification or any underlying bony abnormality. Ultrasound and MRI showed a 6-cm mass surrounding the right flexor pollicis longus tendon of the right thumb. The patient went on to have surgical resection and was given a diagnosis of tenosynovial chondromatosis.Rendu Osler Weber syndrome is a rare disorder, in which arteriovenous malformations are a hallmark feature. We describe the case of a 77-year-old female patient who presented with dyspnea, recurrent epistaxis, and signs of right ventricular heart failure, along with hypoxia and severe anemia. Several imaging modalities facilitated diagnostic workup. The computed tomography revealed an area of pulmonary arteriovenous malformation. Visceral involvement, along with clinical criteria and medical history, established the diagnosis of Rendu Osler Weber syndrome. The patient was scheduled for embolization of the PAVM soon after the diagnosis. Proper imaging, guided by clinical suspicion can be extremely helpful in diagnosing and treating this rare entity.The anomalies of the celiac artery have been reported and reviewed in literature. Hence, it is not uncommon to clinically encounter its various types. This report presents the case of a 76-year-old male who underwent laparoscopic distal gastrectomy. Preoperative abdominal contrast-enhanced computed tomography showed an anomaly of the celiac artery, which was extremely rare, with various other anomalies of the artery.