Tracheopathia osteoplastica is a rare benign disorder of the trachea and major bronchi. It is characterized by multiple cartilaginous or osseous submucosal nodules that project into the tracheobronchial lumen. Awareness of the condition is important to avoid unnecessary surgery. We report here on the CT and bronchoscopic findings of tracheopathia osteoplastica associated with anthracofibrosis in a 67-year old woman, and we will then discuss our findings.
Aged ; Bronchi ; Female ; Humans ; Trachea ; Unnecessary Procedures

Congenital megacalyces is a congenital renal disease characterized by hypoplasia of the medulla and a non-obstructive dilatation of the calyces. More than 100 cases have been reported in the literature after first described by Puigvert in 1963, but it has been reported only three cases (two cases of adults and one case of child) in the literatures in Korea. The etiology of the congenital megacalyces is unknown. Renal pelvis and ureter are mostly normal in size and there is no urinary obstruction or reflux. Renal medulla of congenital megacalyces is thinner than that of normal kidney but renal cortex retains its normal thickness and function. This is features that help to distinguish megacalyces from obstructive atropy. The calyces are polygonal in shape and the majority of kidney with megacalyces have increased number of calyces. Since congenital megacalyces is a non-progressive lesion, it is important to recognize the clinical entity and avoid unnecessary surgery. We report one case of congenital megacalyces without urinary obstruction or reflux with a brief review of related literatures.
Adult ; Dilatation ; Humans ; Kidney ; Kidney Pelvis ; Korea ; Unnecessary Procedures ; Ureter

Perforated appendicitis with an abscess formation is known to be the most common cause of tender mass in right lower abdomen. The differential diagnosis of a tender mass in right lower abdomen, however, is broad and includesvarious intraabdominal and intrapelvic lesions in origin. Preoperative accurate diagnosis is essential in order toavoid unnecessary surgery or complications resulting from delayed surgery. The purpose of this pictorial essay isto illustrate examples of various causes and methods to differentiate them with ultrasonography and CT.
Abdomen* ; Abscess ; Appendicitis ; Diagnosis ; Diagnosis, Differential ; Ultrasonography ; Unnecessary Procedures

Acute appendicitis is the most common reason for non-obstetric abdominal surgery during pregnancy. The diagnosis of appendicitis in pregnancy is difficult due to the blunting of signs and symptoms during pregnancy along with a migration of appendiceal location. When appendicitis in pregnancy is suspected, the physician must balance the risk of delaying surgery and incurring the morbidity of delay against acting hastily and performing unnecessary surgery. Eleven patients who underwent appendectomy during pregnancy from April 1995 through February 1997 were reviewed. Seven patients were proven to be acute appendicitis at laparotomy and by subsequent histopathology. There were no significant differences between patients with positive and negative laparotomies regarding frequency of presenting symptoms and signs or laboratory results. Two cases of preform(25 and 31 weeks) deliveries occurred, one with a perforated appendicitis and the other with negative laparotomy.
Appendectomy ; Appendicitis* ; Diagnosis ; Humans ; Laparotomy ; Pregnancy* ; Unnecessary Procedures

Endoscopic biopsy is the most popular diagnostic procedure for gastric epithelial neoplasm. However, discrepancy between biopsy and endoscopic resection diagnosis occasionally occurs and leads to an unnecessary procedure. A negative pathologic diagnosis following endoscopic resection is particularly problematic. In this context, we reviewed factors that may be associated with a diagnostic discrepancy between endoscopic biopsy and endoscopic resection, with focus on crypt dysplasia.
Biopsy ; Diagnosis ; Neoplasms, Glandular and Epithelial ; Stomach ; Unnecessary Procedures

Intraoperative fracture in total knee arthroplasty (TKA) is a rare complication. However, when it happens, additional surgery to fix the fracture site is needed. Therefore, it is important to diagnose intraoperative fractures in TKA exactly. The authors experienced two cases of cortical perforation of medial femoral condyle misidentified as the fracture in TKA. Cortical perforation could be misdiagnosed as the fracture, which could lead to unnecessary surgery. This is the first report about cortical perforation in TKA. We report two cases of intraoperative cortical perforations and describe the radiological characteristics.
Arthroplasty ; Arthroplasty, Replacement, Knee ; Femur ; Knee ; Unnecessary Procedures

Rudimentary uterus with ipsilateral renal agenesis is a very rare Mullerian duct malformation. The most common clinical presentation is pelvic pain and dysmenorrhea shortly after menarche, in associated with the finding of a vaginal or pelvic mass. An appropriate and prompt diagnosis and treatment will prevent unnecessary procedures and offer relief of symptoms. We report one case of rudimentary uterine horn with ipsilateral renal agenesis with a brief review of concerned literatures.
Animals ; Diagnosis ; Dysmenorrhea ; Female ; Horns ; Menarche ; Pelvic Pain ; Unnecessary Procedures ; Uterus*

There are many causes of chronic abdominal pain and abdominal protrusion. But, they are likely to be confused with diabetic thoracic polyradiculopathy. Differentiation between this self-limiting complication and abdominal herniation is important to avoid unnecessary procedure. We describe the case of 77-years-old man with 10 years history of non-insulin dependent diabetes mellitus, who was suffering from postherpetic neuralgia for 10 months and presented with a abdominal segmental paresis and protrusion. The paraspinal electromyography showed bilateral lower thoracic radiculopathy.
Abdominal Pain ; Diabetes Mellitus ; Electromyography ; Humans ; Neuralgia, Postherpetic ; Paresis ; Polyradiculopathy ; Radiculopathy ; Stress, Psychological ; Unnecessary Procedures

We report a case of an 86-year-old man diagnosed with bilateral elastofibroma dorsi who was managed conservatively after a two year follow-up. An elastofibroma dorsi is a benign, slow-growing tumor that is most often located in the inferior periscapular area in elderly patients. It should be considered to differentiate them from other soft tissue tumors located at the inferior periscapular region. Increased awareness of these characteristics will decrease the incidence of a misdiagnosis of elastofibroma dorsi as a malignancy and avoid unnecessary surgery.
Aged ; Aged, 80 and over ; Diagnostic Errors ; Follow-Up Studies ; Humans ; Incidence ; Shoulder* ; Unnecessary Procedures

Even though the value of computed tomography (CT) used to detect the colon carcinoma with minimal invasion is limited, its usefulnes sin the evaluation of the extent of disease such as hepatic metastasis or distant lymph node invasion has been emphasized. To examine the role of CT in the evaluation of colon carcinoma, CT scans obtained during the past 2 years in 56 patients with surgically proven colon carcinoma were reviewed and the findings correlated with pathologic results. The sensitivity and accuracy of CT for pericolic fat infiltration were 86, 58 and 80% respectively. Those of regional node were 60, 83 and 75% and distant node 67, 100 and 95%. Liver metastases showed sensitivity, specificity and accuracy of 83, 98, 96% and peritoneal metastases 67, 94 and 89% respectively. CT detected local invasion with fair degree of accuracy but the true value of CT lie in the detection of distant invasions such as liver and distant lymph node metastases thereby leading to preclusion of unnecessary procedures and implementation of appropriate precedures.
Colon* ; Humans ; Liver* ; Lymph Nodes* ; Neoplasm Metastasis* ; Sensitivity and Specificity ; Tomography, X-Ray Computed ; Unnecessary Procedures