[Inflammatory pseudotumors of the liver. Apropos of a pediatric case with radiological and ultrasonographic features and anatomopathological correlations]

Inflammatory pseudo-tumor of the liver (IPT) are benign encapsulated masses. IPT or inflammatory myofibroblastic tumor is a myofibroblastic proliferation with chronic inflammatory cell infiltration of unknown origin. A four-year-old girl, with cutaneous flushing of the face and biological inflammatory syndrome was referred for abdominal investigation. Ultrasound examination showed a 5-cm mass located in the anterior segment of the right hepatic lobe. After abdominal CT showing slightly vascular feature of this right hepatic mass, diagnosis was made through percutaneous US-guided fine needle biopsy. Surgical resection was performed and pathologic examination of the mass confirmed preoperative diagnosis. Clinical outcome was good.

[Chemical colitis caused by glutaraldehyde]

Glutaraldehyde disinfectant solution may be a cause of toxic chemical colitis. We report two cases. Ultrasonic features were studied in one case and mimic colonic ischemia, inflammatory and/or infectious colitis. These findings were colonic wall thickening especially mucosal (hypoechogenicity) and submucosal (hyperechogenicity) layers. This diagnosis should be discussed when one sees a patient with echographic findings of acute left-sided colitis just after uncomplicated colonic endoscopy.

[Tomographic study of the intra-abdominal digestive tract. Contributions of percutaneous echography and scanner in daily practice]

Endoscopy and radiological imaging are complementary. However the gastro-intestinal tract is routinely being imaged in CT and ultrasound, often performed for other indications. When an abnormality is discovered, several questions have to be addressed. Is the lesion due to a bowel abnormality? When bowel wall thickening is present, is it due to poor opacification or is it due to inflammation or tumor? Circumferential symmetrical thickening is more in favor of an inflammatory lesion, while focal asymmetrical thickening is more in favor of a neoplastic lesion. Inflammatory and lymphomatous lesion can have similar appearances. Guidelines to aid in diagnostic interpretation of gastrointestinal lesions are discussed, including features of appendicitis and obstruction.

[Isolated intramural hematoma of the sigmoid. A rare complication of anticoagulant treatment]

The authors report a case of intra-mural hematoma of the sigmoid associated with anticoagulant therapy. The small intestine is the site of predilection for intra-mural hematoma and the colonic site is very unusual. Our case was revealed by an obstructive syndrome. The diagnosis, suggested by the increased prothrombin time, was confirmed by ultrasonography and endoscopy. The treatment was symptomatic with nasogastric suction and correction of any hemostatic disorders.

[Hepatic steatosis in obesity in children]

The fatty liver infiltrations of the children are not uncommon and are often seen in particular diseases, mainly related to intoxication or metabolic diseases. The authors reported a case of heterogeneous fatty liver infiltration due to obesity with a good evolution after a hypocaloric diet.

[Acute pancreatitis and viral hepatitis A. Report of a case]

We are reporting the case of a patient with acute pancreatitis associated with viral A hepatitis with satisfactory recovery. To our knowledge, two similar cases have been reported.

[Müllerian cyst. Apropos of a case of the prostatic region]

One case of the unusual entity, prostatic müllerian duct cyst, is reported. Depending on their volume, they may, like in our case-report, or may not be symptomatic. Ultrasonography, C.T. scan and vasoseminal vesiculogram precised its midline location and its relationships with other adjacent anatomic structures. The endo-uretral approach to drainage was used successfully.

Ultrasound of the traumatized spleen: left butterfly sign in lesions masked by echogenic blood clots

Ultrasonic display of blood on both sides of the splenogastric ligament (left butterfly sign) in the left traumatized patient indicates hemoperitoneum within the lesser sac. Particular attention must be paid then to the splenic parenchyma, where isoechogenic blood clots can mask a hematoma. The association of subtile parenchymal changes and of a left butterfly sign are relevant of frank splenic lesions.

[Vesico-ureteral reflux. Ultrasonographic aspect of endoscopic treatment (excluding follow-up)]

Thirty four children, mean age 6 years, with reflux of 56 ureters were treated by an endoscopic approach. The technique, a recent innovation, attempts to reinforce the intravesical trajectory of the ureter by the injection of a Teflon disk below the vesical mucosa at the ureteral meatus level. The Teflon disk used is radiotransparent but could always be detected by ultrasound imaging, whatever its size, as a very reflecting image with a posterior cone shadow.

Acute fatty liver of pregnancy: CT evaluation. Case report

CT scans of two patients with acute fatty liver of pregnancy were reviewed in conjunction with the clinical evolution of this uncommon and potentially fatal disorder. In each of the CT scans, liver density measurements were less than those of the spleen. While the findings are non-specific, in the proper clinical context they are highly suggestive and may be the sole method of diagnosis, as these patients often have coagulation problems which rule out liver biopsy. It is an important diagnosis, as the high maternal and fetal mortality rates appear to be considerably reduced by early foetal delivery.

Outpatient peripheral angioplasty: survey of complications and patients' perceptions

We report our experience with a total of 79 peripheral angioplasties performed in 64 patients on an outpatient basis between July 1983 and April 1985. Review of the medical files and a telephone inquiry in 58 subjects (72 angioplasties) revealed no major complications, a low rate of minor complications (1.5%), and a high degree of patient satisfaction (99%).

[X-ray computed tomography in purulent pleurisy]

Complementary CT scan imaging during investigation of 18 cases of empyema showed it to be an essential examination, since it established the diagnosis in all cases, determined possible extension of the infectious process and possible causal lesion, defined the most effective approach for percutaneous drainage and evaluated efficacy of the later.

[Acute fatty liver of pregnancy. Apropos of 4 cases: contribution of x-ray computed tomography]

Acute fatty liver of pregnancy is a disease of the third trimester, generally considered to be rare and to have a grave prognosis. Histologically the characteristic fine droplet steatosis usually produces distinct vacuolization. Successful treatment depends on accurate diagnosis and early delivery. Computed tomography is of value in the diagnosis of fatty liver through liver and spleen attenuation value measurements. We reviewed 4 cases of acute fatty liver of pregnancy. Computed tomography was performed in two cases and was very helpful in the diagnosis of this condition.

[Ultrasonics in abdominal emergencies. Results of a series of 179 cases]

The study of a series of 179 emergency ultrasonic examinations showed a sensitivity of 97% and a specificity of 98%. Such results confirm the reliability of real-time sonography in the assessment of the acute abdomen, obstructive intestinal syndromes still requiring mainly conventional procedures. With this exception, the part of ultrasound in the diagnostic and the therapeutic strategies is essential. Associated to plain X-ray films, it enables one to curb down the number of other imaging procedures, such as IVP, angiography, or CT. Emergency ultrasound, particularly in traumatology, requires trained, competent radiologists. Performant machines should be available in admittance and intensive care wards.

[Vascular radiology without hospitalization. Apropos of 306 angiographies and/or peripheral percutaneous transluminal angioplasties done on an ambulatory basis]

A study on the safety of outpatient angiography and interventional radiology was undertaken. The authors reviewed the medical files of 286 patients and conducted a late telephone inquiry in 249 patients (87%) who underwent these procedures on an outpatient basis : arteriographies (221) or percutaneous transluminal angioplasties (76) and a few intravenous studies (9). The results revealed a high degree of satisfaction from the patients (98%), no major complications and a very low incidence of minor complications (3%).

[Radiographic aspect of enterocystoplasties using the Kock technic]

Normal radiologic images obtained during postoperative review examinations of patients with bladder epithelioma, treated by cystectomy and continent enterocystoplasty using the recently introduced Kock's technique, are described and a programme of radiologic follow up of these patients proposed.

[Yellow nail syndrome. Apropos of a case. A review of the main radiologic manifestations]

The authors report a case of "yellow nail syndrome" and emphasize the radiological features of this recently described entity which physiopathology has not yet been established. A new feature to be described: a non symptomatic pericardial effusion in association with long standing bilateral pleural effusions.

Ossification of the posterior longitudinal ligament after cervical irradiation

A case of ossification of the posterior longitudinal ligament (PLL) at the cervical level one year after cervical irradiation is reported. This condition is rare in Caucasian people. The cause is unknown. The particular circumstances of ossification occurrence in the case reported allow us to propose a new etiological hypothesis.