BACKGROUND/AIMS: It remains uncertain which patients with stricturing-type Crohn's disease (CD) require early small bowel surgery after the initial diagnosis. We aimed to clarify clinical characteristics associated with the intervention in such condition of CD. METHODS: We retrospectively evaluated the clinical course of 53 patients with CD and small bowel strictures who were initially treated with medications after the initial diagnosis. We investigated possible associations between small bowel surgery and the following: clinical factors and radiologic findings at initial diagnosis and the types of medications administered during follow-up. RESULTS: Twenty-eight patients (53%) required small bowel resection during a median follow-up period of 5.0 years (range, 0.5–14.3 years). The cumulative incidence rates of small bowel surgery at 2, 5, and 10 years were 26.4%, 41.0%, and 63.2%, respectively. Univariate analysis indicated that obstructive symptoms (P=0.036), long-segment stricture (P<0.0001), and prestenotic dilation (P<0.0001) on radiography were associated with small bowel surgery, and immunomodulatory (P=0.037) and biological therapy (P=0.008) were significant factors during follow-up. Multivariate analysis revealed that long-segment stricture (hazard ratio [HR], 4.25; 95% confidence interval [CI], 1.78–10.53; P=0.001) and prestenotic dilation (HR, 3.41; 95% CI, 1.24–9.62; P=0.018) on radiography showed a positive correlation with small bowel surgery, and biological therapy (HR, 0.40; 95% CI, 0.15–0.99; P=0.048) showed a negative correlation. CONCLUSIONS: CD patients with long-segment stricture and prestenotic dilation on radiography seem to be at a higher risk of needing small bowel surgery. For such patients, early surgical intervention might be appropriate, even at initial diagnosis.
Biological Therapy ; Constriction, Pathologic ; Crohn Disease ; Diagnosis ; Follow-Up Studies ; Humans ; Incidence ; Intestine, Small ; Multivariate Analysis ; Radiography ; Retrospective Studies

Pulmonary vein (PV) stenosis is a complication of ablation therapy for arrhythmias. We report two cases with chronic lung parenchymal abnormalities showing no improvement and waxing and waning features, which were initially diagnosed as nonspecific pneumonias, and finally confirmed as PV stenosis. When a patient presents for nonspecific respiratory symptoms without evidence of infection after ablation therapy and image findings show chronic and repetitive parenchymal abnormalities confined in localized portion, the possibility of PV stenosis should be considered.
Atrial Fibrillation/surgery ; Catheter Ablation/*adverse effects/methods ; Constriction, Pathologic/diagnosis/*radiography ; *Diagnostic Errors ; Female ; Humans ; Lung/surgery ; Male ; Middle Aged ; Pneumonia/diagnosis ; Pulmonary Infarction/pathology/*radiography ; Pulmonary Veins/physiopathology/radiography ; Tomography, X-Ray Computed/adverse effects ; Vascular Diseases/physiopathology

No abstract available.
Aged ; Constriction, Pathologic ; Diagnosis, Differential ; Female ; Humans ; Jejunum/pathology ; Mesenteric Artery, Superior/*pathology/radiography/surgery ; Stents ; Superior Mesenteric Artery Syndrome/diagnosis/radiography ; Thrombosis/radiography/surgery ; Tomography, X-Ray Computed

Self-expandable stents are widely available for the treatment of perforation of the gastrointestinal tract. Because of the risk of migration, there has been no report of the use of self-expandable stents for the treatment of perforation of the colon or rectum. This is a report of successful treatment of iatrogenic colonic perforation during balloon dilatation of anastomotic stricture with a fully covered stent. Fully covered, self-expandable metallic stents can be considered useful tools for management of this condition.
Aged, 80 and over ; Colon/*injuries/pathology/radiography ; Colonic Diseases/diagnosis/*therapy ; Constriction, Pathologic ; Dilatation/*adverse effects ; Humans ; *Iatrogenic Disease ; Intestinal Obstruction/diagnosis/*therapy ; Intestinal Perforation/diagnosis/etiology/*therapy ; Male ; *Metals ; Prosthesis Design ; Sigmoidoscopy ; *Stents ; Treatment Outcome ; Wound Healing

No abstract available.
Acute Disease ; Adult ; Cholangiopancreatography, Endoscopic Retrograde ; Colon, Transverse/*radiography ; Colonic Diseases/*diagnosis/etiology ; Colonoscopy ; Constriction, Pathologic ; Humans ; Male ; Pancreatitis/complications/*diagnosis ; Tomography, X-Ray Computed

No abstract available.
Bile Ducts/physiopathology ; Biliary Tract Diseases/*diagnosis/radiography/therapy ; Cholangiopancreatography, Endoscopic Retrograde ; Constriction, Pathologic/therapy ; Hepatitis B, Chronic/diagnosis ; Humans ; Liver Neoplasms/diagnosis/therapy ; Liver Transplantation ; Male ; Middle Aged ; *Stents

The dual energy CT (DECT) technology has been recently employed in the form of two X-ray sources of different energies to enhance the contrast between adjacent structures. Its use in the cardiac arena has been widely highlighted due to the higher temporal resolution. However, it may also be used in the craniocervical and peripheral vasculature for better differentiation between contrast-enhanced vascular lumina and calcified plaques, in the characterisation of ureteric stones, and in the evaluation of hepatic lesions. The objective of this paper is to revisit DECT physics, review the literature and discuss its use in CT neuroangiography with case illustrations from our institution, and impact on dose savings.
Cerebral Angiography ; Constriction, Pathologic ; diagnosis ; Humans ; Image Interpretation, Computer-Assisted ; Intracranial Aneurysm ; diagnosis ; Radiation Dosage ; Radiography, Dual-Energy Scanned Projection ; methods ; Review Literature as Topic ; Tomography, X-Ray Computed ; methods

PURPOSE: To describe the CT and clinical features of tuberculosis involving the right middle lobe of the lung. MATERIALS AND METHODS: Among patients diagnosed with pulmonary tuberculosis at our hospital during the past three years, 16 cases (mean age of patients: 72 years) were reviewed for radiological and clinical presentation of patients that underwent CT and chest radiography and showed mainly right middle lobe involvement. RESULTS: Middle lobe collapse or consolidation (n=16) and bronchial stenosis or obstruction without the presence of soft tissue masses (n=15) were the main findings. Enlarged mediastinal or hilar lymph nodes (n=15), cavities within consolidated tissue (n=2), ill-defined centrilobular nodules (n=12), a tree-in-bud appearance (n=10), focal consolidations (n=7) and small nodules (n=4) were found. All patients were older than 64 years and most complained of non-specific symptoms. A sputum smear for AFB was positive in four cases. CONCLUSION: A diagnosis of tuberculosis in the right middle lobe is suggested in older patients with following CT findings: 1) middle lobe collapse or consolidation; 2) middle lobe bronchus stenosis or obstruction without the presence of soft tissue masses; 3) mediastinal or hilar lymphadenopathy; 4) cavities within consolidation, and centrilobular nodules with branching linear structure in the adjacent lungs. Further evaluation such as bronchoscopy is recommended for confirmation even when the sputum smear for AFB is negative.
Bronchi ; Bronchoscopy ; Constriction, Pathologic ; Diagnosis ; Humans ; Lung* ; Lymph Nodes ; Lymphatic Diseases ; Radiography ; Sputum ; Thorax ; Tuberculosis ; Tuberculosis, Pulmonary*

No abstract availble
Adenocarcinoma/*diagnosis/radiography ; Aged ; Anus Diseases/complications ; Colon, Ascending ; Colonic Neoplasms/*diagnosis/radiography ; *Colonography, Computed Tomographic ; *Colonoscopy ; Constriction, Pathologic ; Humans ; Male ; Tomography, X-Ray Computed

Cystic adventitial disease of the popliteal artery (CADPA) is a rare but a well-known cause of intermittent claudication, especially in young patients. The etiology of the disease is still controversial. Diagnosis starts with thorough history taking, physical examination, and radiography. A 44-year-old man presented with intermittent left calf claudication that had begun 9 months earlier (; the symptom-free interval was about 500 m). 3D-CT and CT-angiography revealed an oval cystic mass that compressed the popliteal artery, causing severe stenosis. Surgery was performed; the affected segment of the artery was successfully excised and replaced with an autogenous saphenous vein graft. Follow-up is on going. No cyst recurrence has so far been detected either clinically or by duplex-sonography during the 6-month postoperative period. The graft was patent and the patient was completely symptom free. Severe claudication in young patients, possibly without significant vascular risk factors, should prompt the clinical suspicion of CADPA.
Adult ; Arteries ; Constriction, Pathologic ; Diagnosis ; Follow-Up Studies ; Humans ; Intermittent Claudication ; Physical Examination ; Popliteal Artery* ; Postoperative Period ; Radiography ; Recurrence ; Risk Factors ; Saphenous Vein ; Transplants