Heterotopic pregnancy refers to the simultaneous development of an intrauterine pregnancy and an extrauterine pregnancy. We experienced a case of a ruptured heterotopic pregnancy for a patient with a history of a right segmental salpingectomy from an ectopic pregnancy. The 30-year-old patient with amenorrhea for six weeks complained of lower abdominal pain with hypovolemic shock. Transabdominal ultrasonography showed diffuse hemoperitoneum with a structure similar to an ectatic tube or a deformed cyst with no echogenic double ring or peripheral hypervascularity in the right adnexa and an intrauterine gestational sac. We considered a ruptured corpus luteum cyst as an ultrasonographic finding and found a ruptured tubal mass in the right salpinx and hemoperitoneum through an emergency laparotomy. We performed a right salpingectomy, and the histopathologic report confirmed ectopic pregnancy.
Abdominal Pain ; Adult ; Amenorrhea ; Emergencies ; Fallopian Tubes ; Female ; Gestational Sac ; Hemoperitoneum ; Humans ; Laparotomy ; Ovarian Cysts ; Pregnancy ; Pregnancy, Ectopic ; Pregnancy, Heterotopic ; Pregnancy, Tubal ; Salpingectomy ; Shock

PURPOSE: The purpose of this study was to know whether ultrasonography is proper diagnostic tool for decision of treatment method or not, as compared the efficacy of US in allowing identifying fracture patterns of nasal bone with that of CT. MATERIALS AND METHODS: Fifty patients with nasal trauma were investigated prospectively by CT and US. According to CT and ultrasonographic findings, each case of nasal bone injury were rated as grade 1 (nasal injury but not fracture), grade 2 (simple fracture without displacement), grade 3 (unilateral simple fracture with displacement), grade 4 (bilateral simple fractures with displacement), and grade 5 (bilateral comminuted fractures with depression). Assessment for ultrasonographic method were defined as overestimations or underestimation according to whether the nasal fracture had been assigned a higher or lower grade at the review of the findings of CT. The correlation between the results of CT and ultrasonography were measured. RESULTS: In ultrasonographic estimation of grade of 50 cases of nasal bone injuries, there were correctly graded in 42 cases, overestimated in 5 cases, underestimated in 3 cases. In allowing accurate grading of nasal bone injury, images of nasal ultrasonography correlated closely with those of CT (r = 0.796). CONCLUSION: Nasal ultrasonography is a reliable method that allows appropriate grading of nasal bone injury and would be a useful first line imaging method in providing the detail necessary for proper management of patients with mild simple nasal bone injury.
Fractures, Comminuted ; Humans ; Nasal Bone ; Prospective Studies

We report here on a case of a recurrent left anterior neck infection and focal left suppurative thyroiditis that were associated with a congenital pyriform sinus fistula (PSF) in an 18-year-old male. Acute suppurative thyroidits is a very rare clinical condition and it is usually caused by infection that's derived from infected perithyroidal tissue or a congenital internal fistula. The PSF can lead to recurrent episodes of neck inflammation and abscess, and it is the most common cause of acute suppurative thyroiditis in young man. In this current case, the CT scan showed an air-containing tract of a PSF from the left pyriform sinus to the left thyroid gland and the perithyroidal soft tissue. The CT scan also showed a neck inflammatory infiltration or abscess along the course of the sinus tract. The focal low density of the thyroid parenchyma was seen and this was suggestive of suppurative thyroiditis. Barium esophagography demonstrated the fistulous tract in the PSF. We performed laryngoscopy, and the internal opening of the pyriform sinus fistula was successfully cauterized with AgNO3 and the post procedure course was fair. When an air-containing tract and a recurrent inflammatory infiltration or abscess are present at the left anterior neck with including the thyroid and perithyroidal soft tissue, a PSF should be strongly suspected.
Abscess ; Adolescent ; Barium ; Fistula* ; Humans ; Inflammation ; Laryngoscopy ; Male ; Neck ; Pyriform Sinus* ; Soft Tissue Infections* ; Thyroid Gland* ; Thyroiditis ; Thyroiditis, Suppurative ; Tomography, X-Ray Computed

We report here on a case of diffuse sclerosing papillary carcinoma (DSPC), which is a subtype of papillary carcinoma of thyroid, in a 27-year-old female. The ultrasound images showed diffuse enlargement of the thyroid lobes and this was associated with underlying diffuse scattered microcalcifications and a heterogeneous hypoechoic background parenchyma that was without any masses. The CT image showeddiffuse scattered dot-like hyperdensities with bilateral multiple metastastic lymph nodes. Because making the cytological diagnosis of DSPC is still challenging, the radiological findings that show this disease's characteristic features may be important clues for making the correct diagnosis.
Adult ; Carcinoma, Papillary* ; Diagnosis ; Female ; Humans ; Lymph Nodes ; Thyroid Gland* ; Ultrasonography*

There has been only 23 cases of neonatal adrenal hemorrhage presenting as an acute scrotum and unnecessary surgical exploration was performed in nine of these case(39%) due to suspected testicular torsion. We report here on a case of a 2-day-old boy with neonatal adrenal hemorrhage, and he presented with an acute scrotum; this child's condition was managed conservatively.
Adrenal Glands ; Hemorrhage* ; Humans ; Infant, Newborn ; Male ; Scrotum* ; Spermatic Cord Torsion

Primary branchiogenic carcinoma is a rare malignant tumor resulting from the malignant transformation of a branchial cleft cyst. In the case we describe, CT scanning and ultrasonography demonstrated the characteristic findings of a second branchial cleft cyst located in the anterior triangle of the neck, along the anterior margin of the sternocleidomastoid muscle. This lesion presented as a well-defined cystic mass with a thick irregular inner wall and central septa, and associated multiple neighboring necrotic lymph nodes. Microscopic examination revealed a transition zone from squamous epithelium to squamous cell carcinoma.
Branchial Region ; Branchioma ; Carcinoma, Squamous Cell* ; Epithelium ; Lymph Nodes ; Neck ; Tomography, X-Ray Computed ; Ultrasonography

PURPOSE: To determine the usefulness of unenhanced helical CT in patients with suspected renal colic. MATERIALS AND METHODS: One hundred and fourteen patients with suspected ureteral colic, referred by physicians, underwent unenhanced helical CT. Two radiologists prospectively interpreted the results, determining the presence or absence of ureter stone and other diseases that arise outside the urinary tract. In cases of ureteral stone, we retrospectively sought secondary signs of hydronephrosis, perinephric fat stranding, thickening of renal fascia, renal enlargement, and the tissue rim sign. RESULTS: Among the 114 patients, 57 were confirmed as having ureter stones. Unenhanced helical CT depicted 57 of 58 stones in 57 patients, producing one false-negative and one false-positive result. Overall, the results showed 98% sensitivity, 95% specificity, 98% positive predictive value, 95% negative predictive value, and 97% accuracy. The frequencies of secondary signs were as follows: hydronephrosis, 95% (54/57); perinephric fat stranding, 81% (46/57); thickening of renal fascia, 77% (44/57); renal enlargement, 65% (37/57); and the tissue rim sign 72% (21/29). In 20 patients, the diagnoses were not related to stone disease and included one falsenegative diagnosis of pyonephrosis. CONCLUSION: Unenhanced helical CT provides information which is valuable in the accurate diagnosis of ureteral stone as well as other diseases that arise outside the urinary tract in patients with suspected renal colic.
Diagnosis ; Fascia ; Humans ; Hydronephrosis ; Prospective Studies ; Pyonephrosis ; Renal Colic* ; Retrospective Studies ; Sensitivity and Specificity ; Tomography, Spiral Computed* ; Ureter* ; Urinary Tract

Phlegmonous enteritis is a rare infective inflammatory disease of the intestine, predominantly involving the submucosal layer. It is difficult to diagnose and often fatal. Its association with alcoholism and various liver diseases, although rarely reported, is well documented. We report a case of phlegmonous enteritis in a male patient with congestive heart failure and colon cancer, and describe the ultrasonographic and CT findings.
Aged ; Case Report ; Colonic Neoplasms/*complications ; Enteritis/complications/*radiography/*ultrasonography ; Heart Failure, Congestive/*complications ; Human ; Male ; Tomography, X-Ray Computed

Most acinic cell carcinomas arise within the parotid gland: extraparotid origin is rare. We encountered three cases of extraparotid acinic cell carcinoma arising in the buccal or palatal region, or the submandibular gland. All three tumors presented as a painless, slow-growing mass. CT imaging indicated that they were well defined, homogeneously enhanced, round masses. In one case, sonography demonstrated relatively homogeneous low echogenicity.
Acinar Cells* ; Carcinoma, Acinar Cell* ; Parotid Gland ; Salivary Glands ; Submandibular Gland

Endometriosis is a relatively common gynecologic disease affecting women during their reproductive years. For its diagnosis, magnetic resonance imaging has been shown to have greater specificity than other modalities. Although lesions may show variable signal intensity due to numerous stages of bleeding, the characteristic finding of endometrioma which distinguishes it from other ovarian cystic masses is relatively high signal intensity on T1-weighted images and heterogeneous signal intensity with prominent shading on T2-weighted images. We report an atypical case involving a huge endometrioma. Because of varying signal intensity on T1- and T2-weighted images and scanty shading on T2-weighted images, the findings were misinterpreted and mucinous cystadenoma was diagnosed.
Cystadenoma, Mucinous* ; Diagnosis ; Endometriosis* ; Female ; Genital Diseases, Female ; Hemorrhage ; Humans ; Magnetic Resonance Imaging ; Mucins* ; Ovarian Cysts ; Sensitivity and Specificity