We report a case of an accidental extravasation of contrast material. A large-volume extravasation occurred in an adult during spiral contrast-enhanced CT. The amount of contrast material extravasated was 47 ml. The patient had a swelling of the dorsum right hand. The extravasation injury site was determined by CT scanning. The extavasation case was examined using five separate display techniques: axial, multi planar reformation (MPR), maximum intensity projection (MIP), volume rendering, and shaded-surfaced display (SSD). This paper introduces extravasation with the CT and the three-dimensional appearance.
Adult ; Contrast Media* ; Extravasation of Diagnostic and Therapeutic Materials* ; Hand ; Humans ; Injections, Subcutaneous* ; Tomography, X-Ray Computed

In recent years, there has been a noticeable increase in contrast media extravasation injury. However, definite guidelines for the treatment of the injury have not yet been established, although it causes severe complications such as compartment syndrome, skin necrosis etc. We try to introduce conservative management with a thorough review of the relevant literatures about successful treatment and functional restoration from contrast media extravasation injury without any complications.
Compartment Syndromes ; Contrast Media ; Extravasation of Diagnostic and Therapeutic Materials ; Forearm ; Necrosis ; Skin

10 patients with blunt renal trauma have been studied and compared by the excretory urography and renal angiography in the Department of Urology, National Medical Center, Seoul, during the period of January 1976 through June 1977. The following results were obtained: 1) Renal angiography is a more specific diagnostic procedure than the excretory urography in detailing the extent of injury. And it provides more opportunity of a high salvage rate of injured kidney. 2) In a normal excretory urography, renal angiography need not do in deciding surgical management of renal injury. 3) The result of positive renal angiograms was especially great in patients showing any of the following urographic abnormalities; non-or poor visualization and extravasation of contrast media. 4) Surgical intervention was done in only one patient of renal thrombosis.
Angiography* ; Extravasation of Diagnostic and Therapeutic Materials ; Humans ; Kidney ; Seoul ; Thrombosis ; Urography* ; Urology

An experimental study on the vascular alternations of the kidney following biopsy procedure was carried out in 47 kidneys from 28 rabbits to clarify their nature and frequency by renal arteriography and microangiography together with histopathologic investigation. Renal arteriography and microangiography were perforemd immediately 2 days, 1 week, and 2 weeks after percutaneous biopsy and the findings were correlated with histological nature. The results are summerized as follows; 1. Important biopsy injuries verified by renal arteriography and microangiography were arterial spasm, perfusion defect, arteriovenous fistula, injury to vasa recta and renaltubules, intrarenal and extrarenal extravasation of contrast media, and arterial obstruction, in order of frequency. 2. Artierial spasm observed in majority of the cases were relieved during the period of 2 weeks. 3. Detectability of perfusion defect was 57% and 72% by angiography and microangiography, respectively, and this perfusion defect seemed to be mostly caused by renal infarction due to vascular injury, such as arteriovenousfistula, arterial obstruction and other vascular injuries. 4. Arteriovenous fistula was detected in 28% byangiography and 50% by microangiography. Many of the arteriovenous fistula appeared to be closed spontaneously within a week. Above findings suggest that renal biopsy procedure results in various degree of vascular injuries with their sequential modification, and that microangiography is assumed the most effective approach in analysisof biopsy injuries such as small arteriovenous fistula, perfusion defect, injury to vasa recta and renal tubules, overcoming the limitation of traditional angiography.
Angiography ; Arteriovenous Fistula ; Biopsy ; Extravasation of Diagnostic and Therapeutic Materials ; Infarction ; Kidney ; Perfusion ; Rabbits ; Spasm ; Vascular System Injuries

Myelography is widely used fo radiological diagnosis of herniated lumbar disc. But the diagnositc accuracy isonly about 84% with range of 67 to 100% with many cases of false negative and equivocal cases. In cases of extremelateral disc herniation and short cul de sac or wide epidural space, even quite a large disc herniation cannot bedetected to myelography. But with epidural venography these defects of myelography can easily be over come. 52cases of epidural venography were performed in department of Radiology of Capital Armed Forces General Hospitalduring the 20 months from May 1979 to Dec. 1980. And the findings were compared with those of myelography andoperative results. The results are as follows; 1. Of 52 cases, satisfactory opacification was obtained in 48 cases(92.3%). 2. Single vein injection was adequate for satisfactory opacification in 40 cases (76.9%). 3. There were 2cases of retroperitoneal extravasation of contrast media, but the patient recovered without difficulty. 4. Of 24cases operated, the venographic finding was confirmed in 21 casesa (87.5%) and of the 48 cases adequatelyopacified, there were only 3 cases of confirmed diagnostic error and so the error rate is only 6.25%. 5. Abnormalfindings of myelography were exactly reproduced on epidural venography and many cases with equivocal or normalmyelographic findings were accurately diagnosed with epidural venography. 6. In cases of total block, epiduralvenography was very useful for evalutaion of the caudal portion. So lumbar epidural venography is very useful notonly as an adjunctive method to myelography, but also as the first diagnostic procedure for herniated disc, forthe procedure is simple and the diagnostic accuracy is very high.
Arm ; Diagnosis ; Diagnostic Errors ; Epidural Space ; Extravasation of Diagnostic and Therapeutic Materials ; Humans ; Intervertebral Disc Displacement ; Methods ; Myelography ; Phlebography ; Veins

PURPOSE: This study was conducted to evaluate the effectiveness of the treatment strategy of transcatheter arterial embolization after pelvic CT angiography (CTA) in cases of traumatic pelvic hemorrhage. METHODS: This is a retrospective analysis of pelvic hemorrhage patients who underwent transcatheter arterial embolization after pelvic CTA at our regional emergency center during a 31-month period. We reviewed the medical records and imagings of all these patients. RESULTS: Transcatheter arterial embolization was performed in 17 patients (M:F=7:10, mean age=53.9) who underwent pelvic CTA for the evaluation of traumatic pelvic hemorrhage. Arterial bleeding was demonstrated on pelvic CTA in all patients, and the combined injury was also noted in 13 patients. The admission-to-CTA time was 84.53+/-66.92 minutes, and the CTA-to-embolization time was 147.65+/-99.97 minutes. Extravasation of contrast media or pseudoaneurysm was demonstrated on conventional angiography in all patients. Unilateral iliac artery embolization was performed in 8 patients, and bilateral iliac artery embolization was performed in 9 patients. Additional embolizations other than in the iliac arteries were performed in 7 patients. Initial hemostasis was achieved in 16 patients. One patient died of ongoing pelvic bleeding. Rebleeding occurred in only one patient and hemostasis was achieved with the second embolization. Another patient died of intracranial and facial bleeding in spite of pelvic hemostasis. The overall mortality was 11.8%, and there was no significant adverse effects in the other patients. CONCLUSION: Transcatheter arterial embolization after pelvic CTA is an effective treatment strategy in the management of traumatic pelvic hemorrhage patients.
Aneurysm, False ; Angiography ; Embolization, Therapeutic ; Emergencies ; Extravasation of Diagnostic and Therapeutic Materials ; Hemorrhage ; Hemostasis ; Humans ; Iliac Artery ; Medical Records ; Pelvis ; Retrospective Studies

PURPOSE: We present our experience with computerized tomography (CT) for diag nosing bladder rupture in patients with blunt abdominal and/or pelvic trauma, and compare the results of CT with those of retrograde cystography. MATERIALS AND METHODS: We reviewed 52 consecutive cases diagnosed as bladder rupture at our hospital from September 1993 to June 2000. Of them 25 cases under went retrograde cystography and CT scan simultaneously. After CT scan, post-CT KUB were taken in all cases. Blind readings of CT scans were performed by one radiologist, and the presence or diagnostic accuracy of bladder rupture was evaluated. RESULTS: Of the 25 cases, 21 cases (84%) were accurately diagnosed with CT scan alone. With retrograde cystography, diagnosis was made in 23 cases (92%), and 2 cases had no definite finding of bladder rupture. On post-CT KUB, bowel loop highlighting or perivesical extravasation of contrast media was noted in 20 cases (80%) of 25 cases. This finding also contributed to the diagnosis of bladder rupture and evaluation of upper collecting system. With CT scan, other intra-abdominal injuries were found in 9 cases (36%) and 5 cases of them underwent additional operations. CONCLUSIONS: In patients with bladder rupture, evaluation of intra-abdominal injury or upper urinary tract are impossible with retrograde cystography alone. If CT scan is properly performed with pre and post-CT KUB in the initial evaluation, more accurate diagnosis and immediate surgical repair are possible in combination with retrograde cystography.
Diagnosis ; Extravasation of Diagnostic and Therapeutic Materials ; Humans ; Nose ; Reading ; Rupture* ; Tomography, X-Ray Computed ; Urinary Bladder* ; Urinary Tract

Spontaneous rupture of kidney is a rare condition which usually presents as an acute abdomen requiring prompt diagnostic evaluation and proper therapy. We experienced a 27-year-old pregnant woman hospitalized with complaint of right flank pain. Ultrasonography and DIP (shield lower abdomen) revealed multiple sandy renal stones and right caliectasis with extravasation of contrast media through renal fornices into perirenal space. We present a case of spontaneous rupture of kidney associated with multiple renal stones during pregnancy, successfully managed with temporary insertion of ureteral catheter.
Abdomen, Acute ; Adult ; Extravasation of Diagnostic and Therapeutic Materials ; Female ; Flank Pain ; Humans ; Kidney* ; Pregnancy* ; Pregnant Women ; Rupture, Spontaneous* ; Ultrasonography ; Urinary Catheters

The incidence of contrast media extravasation has been increasing gradually. Most contrast media extravasations only can cause pain, swelling and erythema. However, in more severe cases, skin necrosis, ulceration, or compartment syndrome may occur, often necessitating a surgery. Early diagnosis and treatment should be established on the spot in order to avoid such a severe damage. We present a case of 42-year-old woman with a compartment syndrome in the right upper extremity caused by extravasation of computed tomography contrast media.
Adult ; Compartment Syndromes* ; Contrast Media ; Early Diagnosis ; Erythema ; Extravasation of Diagnostic and Therapeutic Materials* ; Female ; Humans ; Incidence ; Necrosis ; Skin ; Ulcer ; Upper Extremity*

Extravasation injury refers to leakage of corrosive liquids from veins, resulting in tissue damage. The authors report on a case of extravasation injury to the left hand after administration of fluid to the antecubital area in a patient with brain damage. In order to minimize the effects of extravasation injury, rapid diagnosis and management are needed. In patients with stiffness, pressure sores can develop requiring more careful management by the medical staff.
Brain* ; Diagnosis ; Extravasation of Diagnostic and Therapeutic Materials ; Extremities* ; Hand ; Humans ; Medical Staff ; Persistent Vegetative State ; Pressure Ulcer* ; Vancomycin ; Veins