History: 55 year old female with abdominal pain. This is the typical appearance of cholelithiasis (gallstones) on CT. There are multiple types of gallstones, including cholesterol stones (the most common type) and pigment stones. Ultrasound is usually the imaging method of choice to diagnose cholelithiasis, however, they can be seen on CT up to 80% … Continue reading
History: 40 year old male with abdominal pain. The differential diagnosis in this case includes both cecal bascule and cecal volvulus. A volvulus is a rotational twist of the colon or small bowel on its own axis, which eventually will lead to ischemia and necrosis of the bowel by impairing arterial inflow and venous outflow. … Continue reading
History: 55 year old male with left flank mass on physical exam. The diagnosis in this case was metastatic extraskeletal osteosarcoma, which is a malignant mesenchymal soft tissue tumor that contains components of cartilage, bone, and osteoid. Unfortunately, these tumors have a poor prognosis, with an approximately 25% 5 year survival rate. Notice the pleural … Continue reading
History: 50 year old male with a recent surgical intervention in the cervical esophagus. This patient was status post resection of his Zenker diverticulum a few days prior to the esophagram. When esophageal perforation is the clinical question, it is essential that the first portion of the esophagram be completed with water soluble contrast such … Continue reading
History: 50 year old male presents with difficulty swallowing, halitosis, and hoarseness. The differential diagnosis of a barium filled sac in the cervical esophagus essentially includes two types of diverticula. The first, and the diagnosis in this case, is a Zenker diverticulum. A Zenker diverticulum is a mucosal herniation through weak areas in the cricopharyngeal … Continue reading
History: 50 year old male with chest pain and shortness of breath has an incidental finding. The differential diagnosis for a calcified mass projecting over the left upper quadrant of the abdomen includes prior granulomatous disease such as histoplasmosis or tuberculosis, arterial calcifications such as a splenic artery aneurysm, splenic infarction, and splenic cyst. Less … Continue reading
History: 25 year old female with acute lower abdominal pain, nausea and vomiting. Given the history, this is essentially diagnostic of appendicitis. Take a look again at the image. The appendix has a target appearance, which also aids in the diagnosis. The target appearance is caused by edema within the various layers of the appendix … Continue reading
History: 48 year old man with history of ERCP 3 weeks ago for gallstone pancreatitis presents with severe abdominal pain. This is was post endoscopic retrograde cholangiopancreatography pancreatitis. Note in the picture above, the patient has two calcified gallstones near the neck of the gallbladder. Recently it has been suggested that the terminology describing these cases … Continue reading
History: 60 year old male with chest pain. Typical appearance of a large esophageal hiatal hernia containing stomach gas and liquid contents. There are two main types of esophageal hiatal hernias, sliding and paraesophageal.
History: 48 year old male presents with abdominal pain, nausea and vomiting and a new right groin mass. This patient was also found to have a small bowel obstruction secondary to the right femoral hernia.