Pseudoaneurysm due to chronic pancreatitis is uncommon, but it can cause recurrent and massive hemorrhage. Because of high morbidity and mortality associated with the pseudoaneurysm, early detection and treatment is essential. Surgical ligation or resection of the aneurysm has a high mortality and therefore, transcatheter embolization is preferably carried out. We report a case in which gastroduodenal artery pseudoaneurysm caused by chronic pancreatitis was successfully treated by transcatheter embolization using Gelfoam and Gianturco spring coils.
Aneurysm ; Aneurysm, False* ; Arteries* ; Gelatin Sponge, Absorbable ; Hemorrhage ; Ligation ; Mortality ; Pancreatitis, Chronic*

The classical Roentgenographic features of tuberculosis of the spine such as narrowing of the intervertebraldisc, collapse of the vertebral bodies, with or without the shadow of a cold abscess, present a specific pictureof the actural pathological process. However, the diagnosis of tuberculosis is not confirmed unless proven bybiopsy, or the finding of the tubercle bacillus. 120 cases of proven spinal tuberculosis, at Kwangju ChristianHospital during the period form Jan 1973 through Aug. 1980, were studied and analysed. The results were asfollows; 1. The ratio of male to female was 1:1.1. The age preference was under 30 years old. 2. The most frequentsite of involvement was the lumbar spine(44.1%) and next the thoracic(39.2%0. 3. The incidence of lytic type was50.8%, mixed type 36.7%, and sclerotic type 12.5%. 4. Associated pulmonary tuberculous lesions were observed in 94patients (78.3%). 5. The central type, with wedging or collapse of the vertebral body, was more common in theyounger age group and the intrevertebral articular type in older patients. 6. The incidences of typical radiologicfindings were : Collapse of vertebral body(90%), cold abscess (78.3%) and narrowing of intervertebral space(70%).7. Associated kyphosis was observed in 37 cases (30.8%). Among these 37 cases the range of angulation was between21 to 40 degrees in 40%.
Abscess ; Bacillus ; Diagnosis ; Female ; Gwangju ; Humans ; Incidence ; Kyphosis ; Male ; Spine ; Tuberculosis ; Tuberculosis, Spinal

PURPOSE: The purposes of this study were to evaluate the plain radiologic findings of the childhood intussusception and to evaluate the role of plain abdominal films in predicting the success of air or barium reduction. SUBJECTS AND METHODS: We retrospectively reviewed 140 cases with the diagnosis of intussusception in children. The radiological signs that included soft tissue mass, dilatation of small bowel suggesting obstruction, crescent sign, and target sign were evaluated in terms of frequency. The relationship between radiological findings and outcome of reduction was analyzed. The site of soft tissue mass or crescent sign seen on plain radiographs was correlated with the position of the apex of the intussusceptum seen at the beginning of barium enema. The degree of dilated small bowel was evaluated by calculating the proportion of air-filled small bowel occupying peritoneal cavity and measuring the maximal diameter of dilated bowel lumen. The radiological finding for small bowel obstruction is determined by observation of the degree of small bowel dilatation and/or air-fulid levels. RESULTS: Ninety-two cases out of 140 showed one or more radiographic signs. Two most common signs were soft tissue mass and small bowel obstruction. The success rate of air or barium reduction was significantly lower in patients with most severe degree of dilatation of small bowel and/or more than 7 air-fulid levels on erect view. The suspected location of intussusception on plain radiographs correlated well with the true location of intussusception seen in the first few seconds of barium reduction. CONCLUSION: Plain abdominal radiography is useful in the diagnosis of intussusception and provides helpful informations for the reduction procedure as well as for the exclusion of the contraindications such as bowel perforation.
Barium ; Child ; Diagnosis ; Dilatation ; Enema ; Humans ; Intussusception* ; Peritoneal Cavity ; Radiography, Abdominal ; Retrospective Studies

A laparoscopic cholecystectomy has been accepted as one of the methods of treatment for patients with gallbladder(GB) pathology. Occasionally some cases can be diagnosed as cancer of the gallbladder incidentally after a laparoscopic cholecystectomy. We did 855 laparoscopic cholecystectomies from September 1991 to July 1996 and found 9 GB cancer patients after the operation. Most of the patients with GB cancer have a poor prognosis, but recently there have been some reports with good prognoses in this group of patients. The incidence of incidental GB cancer in laparoscopically resected GB specimens was 1.1% (9/855). The age distribution was between 44 and 72 yrs. Among the 9 cancer patients, 6 patients were found to have a GB mass as a result of the preoperative ultrasound examination. Four patients had mucosa-confined cancer and did not undergo any further treatment. One patient had mucosa confined cancer with a residual tumor in the cystic duct resection margin and underwent segmental resection of the liver (IVa & V) and segmental resection of the common bile duct, including dissection of the pericholedochal lymph node. The other four patients had advanced GB cancer with subserosal invasion. One patient underwent segmental resection of the liver (IVa & V) and segmental resection of the common bile duct, including dissection of the pericholedochal lymph node, and the other patient received a pericholedochal lymph node dissection only. The follow-up period ranged from 39 months to 3 months. Only one patient, who had mucosa-confined cancer with cystic duct invasion, died from lung metastasis with local recurrence of the midclavicular trocar site at 16 months after the laparoscopic cholecystectomy, but the other 8 patients have been doing well until now. We recommend a habit of opening the gallbladder, examining the gross pathologic features, and performing a frozen-section examination in patients where GB cancer is suspected. During that procedure, a careful isolation technique (careful dissection and delivery of the specimen in vinyl bag is vital) for preventing tumor implantation.
Age Distribution ; Cholecystectomy, Laparoscopic* ; Common Bile Duct ; Cystic Duct ; Follow-Up Studies ; Gallbladder Neoplasms* ; Gallbladder* ; Humans ; Incidence ; Liver ; Lung ; Lymph Node Excision ; Lymph Nodes ; Mucous Membrane ; Neoplasm Metastasis ; Neoplasm, Residual ; Pathology ; Prognosis ; Recurrence ; Surgical Instruments ; Ultrasonography

We report a case of histopathologically confirmed hepatic angiosarcoma. A 29-year old patient was admitted with fever and palpable tender mass in the right upper abdomen. On ultrasonography, a large, well circumscribed mixed echoic mass was seen in the right lobe of the liver. On CT scan, irregular enhancement was seen mainly in the peripheral portion of the mass ; the central portion was not enhanced. The mass showed low signal intensity on T1W1, and high signal intensity on T2WI. Peripheral nodular enhancement was noted on Gd-enhanced MR images; In the peripheral portion of the mass,
Abdomen ; Adult ; Angiography ; Fever ; Hemangiosarcoma* ; Hepatic Artery ; Humans ; Liver* ; Radionuclide Imaging ; Sarcoma ; Tomography, X-Ray Computed ; Ultrasonography

PURPOSE: To evaluate useful findings and diagnostic value of TI-201 thyroid scan in differentiating benign from malignant nodules. MATERIAL AND METHOD: We studied 77 cold thyroid nodules proven histologically(27 malignat and 50 benign). Early (5--15rain) and delayed images(3--5hours) were obtained after intravenous injection of thallium 201. In these nodules, we retrospectively analyzed the degree of TI-201 uptake in early and delayed images, histopathologic type, size, and presence or absence of cystic change in the sonograms of 22 malignant nodules. RESULTS: Useful finding for diagnosis of malignant nodules was strong uptake of TI-201 in early and delayed images(specificity:98%, sensitivity:63%, positive predictive value:94.4%). Useful finding for benign nodules was no uptake of TI-201 in delayed image(specificity :88.9%, sensitivity :68%, positive predictive value :91.9%). The accuracy of TI-201 thyroid scan in differentiating benign from malignant nodules was 66.2%. The nodules with strong TI-201 uptake in early image and low TI-201 uptake in delayed image were malignant in 29.4%. Cystic changes were found in 40% of malignant nodules with atypical TI-201 uptake. TI-201 thyroid scan showed high specificity in follicutar neoplasm and adenomatous goiter in which differentiation of benignancy and malignancy is difficult with only cytologic examination. CONCLUSION: We consider that TI-201 thyroid scan is valuable in differentiating benign from malignant nodules and when combined with fine needle aspiration and ultrasound examination, it will enable more accurate differential diagnosis between benign and malignant thyroid nodules.
Biopsy, Fine-Needle ; Diagnosis ; Diagnosis, Differential* ; Goiter ; Injections, Intravenous ; Retrospective Studies ; Sensitivity and Specificity ; Thallium* ; Thyroid Gland* ; Thyroid Nodule ; Ultrasonography

PURPOSE: To measure the normal size of the styloid process using 3D (three-dimensional) reconstruction CT. MATERIALS AND METHODS: We retrospectively analyzed 3D reconstruction images obtained after coronal and axial CT scanning of the temporal bone or neck of 115 patients. The length and shape of both sides of the styloid process, the location of its tip, and calcification of the stylohyoid ligament were retrospectively analysed. RESULTS: The mean length of the styloid process was 26.6 (+/-7.9)mm on the right side, and 26.4(+/-8.3)mm on the left, a statistically insignificant difference (p=0.694). Its mean length was 26.2 (+/-8.5)mm in men and 26.7 (+/-7.2)mm in women, a statically in significant difference (p=0.733). As for variation with age, mean length tended to increase until the third decade, but not beyond. Segmental type (104/230, 45.2%) and fragmental type (73/230, 31.7%) were more commonly seen in shape of styloid process, and tapering tip of styloid process (156/230, 67.9%) is more commonly seen than clubbing tip of it (74/230, 32.1%). The process was angulated in six cases (2.6%); its tip was more frequently located between the internal and external carotid artery (211 cases, 91.7%) than more medially (19 cases, 8.3%). In the former location, the length of the process was 26.2(+/- 7.2)mm, and in the latter, 37.0(+/-6.0)mm. The difference was statistically significant (p=0.000). Calcification had occurred in 33 cases (14.3%). CONCLUSION: The length of a normal styloid process was 18-32 mm. There were no statistically significant differences between its two sides, or between the sexes. Length tended to increase until the third decade, but not beyond. Predominantly the tip was located between the internal and external carotid artery, though the process was longer when its tip was located medially.
Carotid Artery, External ; Female ; Humans ; Ligaments ; Male ; Neck ; Retrospective Studies ; Temporal Bone ; Tomography, X-Ray Computed

PURPOSE: The purpose of this study was to determine the efficacy of sonography in the evaluation of normal pseudocapsular morphology and the detection of complications after total hip arthroplasty. MATERIALS AND METHODS: Between Janvary 1997 and June 2000, 47 patients [35 men and 12 women aged 24 to 84 (mean, 61) years] using real-time linear-array, convex US units with 3.5-MHz and 10-MHz transducers. Normal capsular morphology in 30 with total hip replacements, who had been asymptomatic for at least one year, was studied, and the prosthetic joint infection demonstrated in six of 17 who had experienced was confirmed at surgery or by US-guided aspiration. RESULTS: Sonograms indicated that a normal pseudocapsule lay straight over the neck of the prosthesis or was slightly convex toward the neck, and that the mean bone-to-pseudocapsule distance was 2.9 mm. However, in the 11 symptomatic patients in whom no evidence of infection was revealed by cultures, th mean distance was 4.7 mm; in the remaining six patients, whose joints were infected (a condition strongly suggested by the presence of extracapsular fluid), the mean distance was 5.5 mm, with no significant difference between the two groups. CONCLUSION: Sonography can be used to evaluate normal caspular morphology after total hip replacement and to diagnose infection around hip prostheses. In all patients in whom sonography revealed the presence of extra-articular fiuid, infection had occurred.
Arthroplasty, Replacement, Hip* ; Female ; Hip Prosthesis ; Humans ; Joints ; Male ; Neck ; Prostheses and Implants ; Transducers ; Ultrasonography*

PURPOSE: The purpose of this study was to evaluate the CT features of second branchial cleft cysts. MATERIALS AND METHODS: We retrospectively analyzed the computed tomographic images in nine cases of second branchial cleft cyst which was confirmed pathologically. Emphasis was on localization of the masses to fascial spaces as defined by the deep cervical fasica. RESULTS: In all nine cases, the lerions were located in the submandibular and carotid spaces. Among these cases, six(67%) had simultaneous involvement of the other contiguous spaces, such as anterior and posterior cervical spaces. All cases had round or oval, unilocular, cystic masses with partial or complete rim enhancement. In eight cases(89%), smooth and thin walls were observed. In one case, thick wall and septations were noted. No definite calcifications were noted in all cases. The internal contents of cystic masses showed relatively homogeneous appearance, and CT number ranged from 20 to 35.2 Hounsfield unit(HU)(mean, 28.4HU). CONCLUSION: CT diagnosis of second branchial cleft cyst would be easily obtained from recognition of frequent simultaneous involvement of the other contiguous spaces, along with a typical location and characteristic morphology.
Branchial Region* ; Branchioma* ; Diagnosis ; Retrospective Studies

The traffic accident was one of most common cause for the facial bone fracture. When it involved the midfacial structures, the nasal bone fracture was usually shown. If the reduction was not done in time, it would result in facial deformity. Simple case could be corrected by simple rhinoplasty. However, severe cases would require more invasive technique. We used triangular osteotomy included the nasal bones, the vomer, and the medial wall of maxilla for the correction of post-traumatic nasal deformity and reported the result with the review of literatures.
Accidents, Traffic ; Congenital Abnormalities* ; Facial Bones ; Maxilla ; Nasal Bone ; Osteotomy* ; Rhinoplasty ; Vomer