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Mayer P, Wackenthaler A, Christmann PY, Habersetzer F, de Marini P, Héroin L. An unusual complication of acute biliary pancreatitis: an incidental discovery of hemobilia. Endoscopy 2023; 55:E631-E632. [PMID: 37040893 PMCID: PMC10089801 DOI: 10.1055/a-2058-8527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/13/2023]
Affiliation(s)
- Pierre Mayer
- Department of Hepatology and Gastroenterology, Pôle Hépato-digestif, Nouvel Hôpital Civil, Hôpitaux Universitaires de Strasbourg (HUS), Strasbourg, France
- IHU-Strasbourg (Institut Hospitalo-Universitaire), Strasbourg, France
| | - Antoine Wackenthaler
- Department of Radiology, Nouvel Hôpital Civil, Hôpitaux Universitaires de Strasbourg (HUS), Strasbourg, France
| | - Pierre-Yves Christmann
- Department of Hepatology and Gastroenterology, Pôle Hépato-digestif, Nouvel Hôpital Civil, Hôpitaux Universitaires de Strasbourg (HUS), Strasbourg, France
- IHU-Strasbourg (Institut Hospitalo-Universitaire), Strasbourg, France
| | - François Habersetzer
- Department of Hepatology and Gastroenterology, Pôle Hépato-digestif, Nouvel Hôpital Civil, Hôpitaux Universitaires de Strasbourg (HUS), Strasbourg, France
- IHU-Strasbourg (Institut Hospitalo-Universitaire), Strasbourg, France
- Inserm U1110, Institute for Viral and Liver Diseases, LabEx HepSYS, University of Strasbourg, Faculty of Medicine, Strasbourg, France
| | - Pierre de Marini
- Department of Interventional Radiology, Nouvel Hôpital Civil, Hôpitaux Universitaires de Strasbourg (HUS), Strasbourg, France
| | - Lucile Héroin
- Department of Hepatology and Gastroenterology, Pôle Hépato-digestif, Nouvel Hôpital Civil, Hôpitaux Universitaires de Strasbourg (HUS), Strasbourg, France
- IHU-Strasbourg (Institut Hospitalo-Universitaire), Strasbourg, France
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Leyendecker P, Ritter S, Riou M, Wackenthaler A, Meziani F, Roy C, Ohana M. Acute adrenal infarction as an incidental CT finding and a potential prognosis factor in severe SARS-CoV-2 infection: a retrospective cohort analysis on 219 patients. Eur Radiol 2020; 31:895-900. [PMID: 32852586 PMCID: PMC7450155 DOI: 10.1007/s00330-020-07226-5] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 07/27/2020] [Accepted: 08/21/2020] [Indexed: 01/20/2023]
Abstract
Objectives To retrospectively investigate the incidence of acute adrenal infarction (AAI) in patients who underwent chest CT for severe SARS-CoV-2 infection and to correlate findings with prognosis. Methods The local ethics committee approved this retrospective study and waived the need of informed consent. From March 9 to April 10, 2020, all patients referred to our institution for a clinical suspicion of COVID-19 with moderate to severe symptoms underwent a chest CT for triage. Patients with a/parenchymal lesion characteristics of COVID-19 involving at least 50% of lung parenchyma and b/positive RT-PCR for SARS-CoV-2 were retrospectively included. Adrenal glands were reviewed by two independent readers to look for AAI. Additional demographics and potential biological markers of adrenal insufficiency were obtained. Correlations with ICU stay and mortality were sought. Results Out of the 219 patients with critical (n = 52) and severe lung (n = 167) parenchyma lesions, 51 (23%) had CT scan signs of AAI, which was bilateral in 45 patients (88%). Four patients had an acute biological adrenal gland insufficiency (8%). Univariate analysis in AAI+ patients demonstrated a higher rate of ICU stay (67% vs. 45%, p < 0.05) and a longer stay (more than 15 days for 31% for AAI+ vs. 19%, p < 0.05) compared with AAI− patients. Mortality rate was similar (27%, p = 0.92). Conclusions Acute adrenal infarction on initial chest evaluation of severe COVID-19 is frequent (51/219, 23%) and might be a sign of poorer prognosis. Key Points • Acute adrenal infarction on initial chest CT evaluation of severe COVID-19 is frequent (51/219). • AAI might be a factor of poorer prognosis, with increased rate of ICU hospitalization and length of stay.
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Affiliation(s)
- Pierre Leyendecker
- Service de Radiologie B, Nouvel Hôpital Civil, Hôpitaux Universitaires de Strasbourg, 1, place de l'hôpital, BP 426, 67091, Strasbourg Cedex, France.
| | - Sébastien Ritter
- Service de Radiologie B, Nouvel Hôpital Civil, Hôpitaux Universitaires de Strasbourg, 1, place de l'hôpital, BP 426, 67091, Strasbourg Cedex, France.,Hôpital Louis Pasteur de Colmar, Service de radiologie, Colmar, France
| | - Marianne Riou
- Service de Pneumologie, Nouvel Hôpital Civil, Hôpitaux Universitaires de Strasbourg, Strasbourg, France.,Service de Physiologie et Explorations fonctionnelles, Nouvel Hôpital Civil, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Antoine Wackenthaler
- Service de Radiologie B, Nouvel Hôpital Civil, Hôpitaux Universitaires de Strasbourg, 1, place de l'hôpital, BP 426, 67091, Strasbourg Cedex, France
| | - Ferhat Meziani
- Service de Médecine Intensive et Réanimation, Nouvel Hôpital Civil, Hôpitaux Universitaires de Strasbourg, Strasbourg, France.,INSERM (French National Institute of Health and Medical Research), UMR 1260, Regenerative Nanomedicine (RNM), FMTS, Strasbourg, France.,Faculté de Médecine, Strasbourg, France
| | - Catherine Roy
- Service de Radiologie B, Nouvel Hôpital Civil, Hôpitaux Universitaires de Strasbourg, 1, place de l'hôpital, BP 426, 67091, Strasbourg Cedex, France.,Faculté de Médecine, Strasbourg, France
| | - Mickaël Ohana
- Service de Radiologie B, Nouvel Hôpital Civil, Hôpitaux Universitaires de Strasbourg, 1, place de l'hôpital, BP 426, 67091, Strasbourg Cedex, France.,Faculté de Médecine, Strasbourg, France.,iCube, Université de Strasbourg/CNRS UMR 7357, Telecom Physique Strasbourg, Illkirch, France
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