OBJECTIVETo explore the procedures of dynamic infusion cavernosometry and cavernosography (DICC) and their application in the diagnosis and classification of venous erectile dysfunction (VED).

METHODSThis study included 103 ED patients, aged 20 to 43 years, highly suspected of VED, with disease courses of 4 months to 6 years. DICC was performed and analyses were made on the results, especially the parameters of flow-to-maintain (FTM) and pressure decay (PD) in the corpus cavernosum.

RESULTSBased on the parameters of FTM and PD, 21 of the patients were normal, 5 were suspected of VED, 39 had mild VED, 25 had moderate VED, and 13 had severe VED. Penile subcutaneous hematoma was found in 4 of the patients, all recovered after 3 to 5 days, with no other complications.

CONCLUSIONDICC is a reliable, safe and minimally invasive method for the diagnosis and classification of VED.

Diagnostic Techniques, Urological ; adverse effects ; Hematoma ; etiology ; Humans ; Impotence, Vasculogenic ; classification ; diagnosis ; Male ; Penile Diseases ; etiology ; Penis ; blood supply ; diagnostic imaging ; Radiography ; Veins

MR imaging appearances of different types of reconstructive muscle flaps following reconstructive surgery of the lower extremity with associated post-surgical changes due to altered anatomy, radiation, and potential complications, can be challenging. A multidisciplinary therapeutic approach to tumors allows for limb salvage therapy in a majority of the patients. Decision-making for specific types of soft tissue reconstruction is based on the body region affected, as well as the size and complexity of the defect. Hematomas and infections are early complications that can jeopardize flap viability. The local recurrence of a tumor within six months after a complete resection with confirmed tumor-free margins and adjuvant radiation therapy is rare. Identification of a new lesion similar to the initial tumor favors a finding of tumor recurrence.
Adult ; Female ; Hematoma/etiology ; Humans ; Limb Salvage ; Lower Extremity/anatomy & histology/radiography/*surgery ; *Magnetic Resonance Imaging ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; Reconstructive Surgical Procedures ; Sarcoma/radiotherapy/*surgery ; Soft Tissue Infections/radiography/*surgery ; Soft Tissue Injuries/radiography/*surgery ; Soft Tissue Neoplasms/radiotherapy/*surgery ; Surgical Flaps/adverse effects

We report 2 cases of complicated spontaneous dissection of the celiac artery, which were successfully treated by a stent graft. The first patient was a 47-year-old man who presented with acute abdominal pain. CT scan showed ruptured saccular aneurysm with surrounding retroperitoneal hematoma. The second patient was a 57-year-old man with progressive dissecting aneurysm. Endovascular stent graft was placed in the celiac trunk to control bleeding, and to prevent rupture in each patient. Follow-up CT scans showed complete obliteration of a dissecting aneurysm.
Abdominal Pain/etiology/radiography ; Aneurysm, Dissecting/*therapy ; Aneurysm, Ruptured/prevention & control ; Celiac Artery/*injuries ; Hematoma/etiology/radiography ; Hemorrhage/etiology/radiography ; Humans ; Male ; Middle Aged ; Retroperitoneal Space ; Rupture, Spontaneous/therapy ; *Stents ; Tomography, X-Ray Computed/adverse effects

Spontaneous retroperitoneal hemorrhage is one of the most serious and often lethal complications of anticoagulation therapy. The clinical symptoms vary from femoral neuropathy to abdominal compartment syndrome or fatal hypovolemic shock. Of these symptoms, abdominal compartment syndrome is the most serious of all, because it leads to anuria, worsening of renal failure, a decrease in cardiac output, respiratory failure, and intestinal ischemia. We report a case of a spontaneous retroperitoneal hemorrhage in a 48-year-old female who had been receiving warfarin and aspirin for her artificial aortic valve. She presented with a sudden onset of lower abdominal pain, dizziness and a palpable abdominal mass after prolonged straining to defecate. Computed tomography demonstrated a huge retroperitoneal hematoma and active bleeding from the right internal iliac artery. After achieving successful bleeding control with transcatheter arterial embolization, surgical decompression of the hematoma was performed for management of the femoral neuropathy and the abdominal compartment syndrome. She recovered without any complications. We suggest that initial hemostasis by transcatheter arterial embolization followed by surgical decompression of hematoma is a safe, effective treatment method for a spontaneous retroperitoneal hemorrhage complicated with intractable pain, femoral neuropathy, or abdominal compartment syndrome.
Abdomen ; Anticoagulants/*adverse effects ; Compartment Syndromes/*etiology ; Female ; Gastrointestinal Hemorrhage/chemically induced/*congenital ; Hematoma/etiology/surgery ; Humans ; Iliac Artery/pathology/radiography ; Middle Aged ; Tomography, X-Ray Computed

After successful renal artery angioplasty and stent placement, a patient in a fully anticoagulated state developed hypotension and flank pain. Computed tomography (CT) of the abdomen revealed a large renal subcapsular haematoma which was successfully managed conservatively without embolotherapy and surgical intervention. To prevent hemorrhage after renal artery stenting, it is necessary to underscore the importance of reducing the contrast volume and pressure of angiography, controlling systemic blood pressure, and monitoring guide wire position at all times.
Aged ; Hematoma ; diagnostic imaging ; etiology ; surgery ; Humans ; Kidney Diseases ; diagnostic imaging ; etiology ; surgery ; Male ; Radiography ; Renal Artery Obstruction ; complications ; diagnostic imaging ; surgery

Therapeutic paracentesis is considered to be a relatively safe procedure and is performed commonly for the control of massive ascites in patients with liver cirrhosis. The commonest puncture site, approximately 4 or 5 cm medial of left anterior superior iliac spine, can be located across the route of the inferior epigastric artery, which is one of the sites of potential massive bleeding. In a 46-year-old woman with liver cirrhosis and refractory ascites, a huge abdominal wall hematoma developed after therapeutic paracentesis. The patient was not stabilized by conservative treatment, and inferior epigastric artery injury was confirmed on angiography. Angiographic coil embolization of the inferior epigastric artery was conducted, after which the bleeding ceased and the hematoma stopped growing. This case indicates that physicians performing paracentesis should be aware of the possibility of inferior epigastric artery injury and consider early angiographic coil embolization when a life-threatening abdominal wall hematoma develops.
Abdominal Wall ; Angiography ; Ascites/surgery ; Embolization, Therapeutic ; Epigastric Arteries/*injuries ; Female ; Hematoma/*etiology/radiography/therapy ; Humans ; Liver Cirrhosis/*diagnosis ; Middle Aged ; Paracentesis/*adverse effects ; Tomography, X-Ray Computed ; Wounds, Nonpenetrating/complications

A 4-year-old boy visited the hospital with exotropia after brain hemorrhage caused by trauma. He had undergone decompressive craniectomy and cranioplasty 18 months prior to presentation at our hospital. An alternate prism cover test showed more than 50 prism diopters (PD) of left exotropia when he was fixing with the right eye and 30 PD of right exotropia when he was fixing with the left eye at near and far distance. On the Hirschberg test, 60 PD of left exotropia was noted in the primary position. Brain computerized tomography imaging performed 18 months prior showed hypodense changes in the right middle cerebral artery and anterior cerebral artery territories. Subfalcian herniation was also noted secondary to swelling of the right hemisphere. The patient underwent a left lateral rectus muscle recession of 7.0 mm and a left medial rectus muscle resection of 3.5 mm. Three weeks after the surgery, the Hirschberg test showed orthotropia. On alternate prism cover testing, 8 PD of left exotropia and 8 PD of right esotropia were noted at distance. We report a patient who developed dissociated horizontal deviation after right subfalcian subdural hemorrhage caused by trauma.
Brain Injuries/*complications ; Child, Preschool ; Decompressive Craniectomy/*adverse effects ; Esotropia/*etiology/surgery ; Exotropia/*etiology/surgery ; Hematoma, Subdural/etiology/radiography/*surgery ; Humans ; Male ; Oculomotor Muscles/*surgery ; Tomography, X-Ray Computed ; Treatment Outcome

We report the first case in Korea of a chronic expanding hematoma, which presented as a huge mass in the pleural cavity. A 67-year-old woman exhibiting a slowly-expanding intrathoracic mass, as revealed by a chest radiograph, was admitted to our hospital. The patient had undergone a pneumonectomy 37 years earlier during treatment for pulmonary tuberculosis. Computed tomography revealed a huge mass in her right hemithorax. The differential diagnosis of this mass included chronic empyema combined with a malignancy, such as lymphoma or a soft tissue sarcoma. The tumor, which was classified as an encapsulated chronic hematoma, was removed surgically. Samples sent for histopathological and microbiological analysis revealed no evidence of neoplasia or infection. The patient was finally diagnosed with a chronic expanding hematoma of the thorax. This case is particularly rare due to the patient's development of a very large mass after undergoing treatment for tuberculosis more than 30 years earlier.
Tomography, X-Ray Computed ; Radiography, Thoracic ; Positron-Emission Tomography ; Pleural Cavity/*pathology/radiography/radionuclide imaging ; Male ; Humans ; Hematoma/*pathology/radiography/radionuclide imaging ; Dyspnea/etiology ; Chronic Disease ; Aged

Scurvy is very rare disease in industrialized societies. Nevertheless, it still exists in higher risk groups including economically disadvantaged populations with poor nutrition, such as the elderly and chronic alcoholics. The incidence of scurvy in the pediatric population is very low. This study reports a case of scurvy in a 5-year-old girl with cerebral palsy and developmental delay based on MRI findings.
Ascorbic Acid/blood/therapeutic use ; Bone Diseases, Metabolic/etiology ; Cerebral Palsy/complications ; Child, Preschool ; Cholecalciferol/blood ; Developmental Disabilities/complications ; Drainage ; Female ; Femur/pathology/radionuclide imaging/surgery ; Fever/etiology ; Follow-Up Studies ; Hematoma/diagnosis/etiology/surgery ; Humans ; Knee/radiography ; Magnetic Resonance Imaging/*methods ; Muscle Weakness/etiology ; Rare Diseases ; Scurvy/complications/*diagnosis/drug therapy ; Thigh/pathology ; Vitamins/therapeutic use

Pure epidural cavernous hemangioma of the spine without vertebral involvement is rare. Due to the slow growth of this lesion, the most common symptoms are chronic pain, myelopathy, and radiculopathy. In our case, the patient complained of an acute onset sensory deficit of the C4 dermatome. An MRI revealed an epidural mass with an acute hematoma. Here, we report a case of a pure epidural cavernous hemangioma that presented with acute neurologic symptoms caused by intralesional hemorrhage and an acute epidural hematoma, which were demonstrated on the patient's MRI.
Tomography, X-Ray Computed ; Middle Aged ; Male ; Hyperesthesia/*diagnosis/etiology ; Humans ; Hematoma, Epidural, Spinal/complications/*diagnosis/radiography ; Hemangioma, Cavernous, Central Nervous System/complications/*diagnosis/radiography ; Epidural Space/radiography ; Epidural Neoplasms/complications/*diagnosis/radiography ; Cervical Vertebrae