This category contains 46 posts

Fatty Liver Disease – Foie Gras

History: 50 year old male with right upper quadrant pain Fatty liver disease is generally divided into two main categories, alcoholic liver disease and non-alcoholic fatty liver disease (NAFLD). More than 15 million people in the U.S. abuse or overuse alcohol. Almost all of them — 90%-100% — develop fatty livers. Fatty liver can occur after … Continue reading

Neutropenic Colitis (Typhlitis)

History: 50 year old female with right lower quadrant pain. Typhlitis is a necrotizing process of the cecum, occurring in neutropenic patients who are usually receiving combined chemotherapy. The atonic cecum is affected because of its poor arterial perfusion, the presence of colonic bacteria, and the milieu of immunosuppression. Other terms that have been used … Continue reading

Perforated Appendicitis MRI

History: 16 year old with abdominal pain This is a case of perforated appendicitis. Appendicitis usually occurs due to obstruction of the appendix at its origin from the cecum, in this case due to an appendicolith. This causes build up of secretions and mucus within the lumen of the appendix, which then dilates. The resultant … Continue reading

MRI for Pediatric Acute Appendicitis

History: 14 year old female with right lower qaudrant pain This is the appearance of pediatric appendicitis on MRI. Intravenous gadolinium contrast aids in visualization of the appendix (as seen in the third image above, the LAVA-Flex sequence MRI). MRI has recently been a hot topic of research in the diagnosis of pediatric appendicitis in … Continue reading

Left Ventricular Free Wall Rupture

History: 70 year old male with abdominal pain status post cholecystectomy This is a case of acute contained left ventricular free wall rupture diagnosed on a CT scan of the abdomen and pelvis obtained for abdominal pain. The patient had a myocardial infarction two days prior. The table below details the mechanical complications of myocardial … Continue reading

Normal Pediatric Upper GI

History: 1 day old infant with bilious emesis.  This is a normal upper GI study in a neonate. The patient is usually imaged first in the right lateral position and multiple images are obtained as contrast passes through to the duodenum and ligament of Treitz. The most common indication in the emergent setting is bilious … Continue reading

Solution to Unknown Case #39 – Pneumatosis Intestinalis with Pneumoperitoneum

This is a case of pneumatosis intestinalis with pneumoperitoneum. Pneumatosis intestinalis can be caused by many different entities. The most worrisome scenario is bowel ischemia. Small bowel ischemia is usually due to occlusion of either the superior mesenteric artery or superior mesenteric vein. Colonic ischemia is usually due to hypoperfusion. This patient underwent subtotal colectomy. … Continue reading

Unknown Case #39 – Female with Abdominal Pain

History: 70 year old female with abdominal pain.  What are the yellow and red arrows pointing to? What is your diagnosis? Share below! Find the answer to this case here.

Eel Chewed Through Colon

This is not one of my personal cases, but I found this at the link below the images and had to share it. History: China‘s southeastern Guangdong province admitted himself to a local hospital after he reportedly got a live eel stuck inside him. http://www.huffingtonpost.com/2013/04/09/eel-removed-from-man-stuck-colon-photo_n_3046785.html

Pediatric Foreign Body Ingestion – Battery

History: Child with reported swallowed foreign body.  This is a case of a swallowed battery, which is an urgent finding that needs to be reported immediately to the referring clinician for endoscopic removal. Read about distinguishing batteries from other similar appearing foreign bodies such as coins here. Below is a penny in the esophagus.