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Tuesday, 1 October 2019

CASE 567: TESTICULAR TORSION, Dr PHAN THANH HẢI, Dr LÊ VĂN TÀI,MEDIC MEDICAL CENTER, HCMC, VIETNAM


BOY 17 YO  PAIN AT LEFT TESTIS.  EMERGENCY DIAGNOSIS IS ORCHITIS . MEDICAL TREATMENT FOR 20 DAYS  BUT STILL PAIN  AT LEFT TESTIS.


ULTRASOUND  CHECKS SCROTUM  
US1 =  AT LEFT TESTIS   SIZE 4CM  HYPOECHOIC TESTIS,  HYPERECHOIC EPIDIDYME   WITH SMALL FLUID AROUND TESTIS.


US2 =  COLOR DOPPLER NO VASCULAR SIGN IN LEFT TESTIS   BUT HIGH  VASCULARIZATION  IN TESTICULAR CORD.


US3 = CROSSED SECTION VASCULARIZATION ONLY ONE PART OF EPIDIDYME


US4 = ELASTO US OF LEFT TESTIS  BY STRAIN TECHNIC  IS  VERY HARDENING  INHOMOGENOUS IN
COMPARISON TO RIGHT TESTIS  


US5  = CDI  POOR VASCULAR SIGN IN LEFT TESTIS  


US6 =  ELASTO OF RIGHT IS  SOFT TESTIS HOMOGENEOUS  STRAIN  SCORE



CTCE  OF TESTIS  HYPOPERFUSION AT LEFT TESTIS  


ULTRASOUND  REPORT IS  TORSION OF LEFT TESTIS AVASCULAR NECROSIS  

EMERGENCY OPERATION DETECTED AND REMOVED LEFT TESTIS NECROSIS IN BLACK.

MICROSCOPIC REPORT  IS TESTIS  NECROSIS.


Wednesday, 25 September 2019

CASE 566: PERIVASCULAR TUMOR, Dr PHAN THANH HAI, Dr HO CHI TRUNG, MEDIC MEDICAL CENTER, HCMC, VIETNAM.


WOMAN 36YO  DETECTED  ONE MASS AT THE LEFT THIGH,  PAINFUL  PALPATION.

ULTRASOUND OF  THIS MASS.

US1:  THE PERIVASCULAR TUMOR  OF LEFT FEMORAL ARTERY  HAD HYPOECHOIC PATTERN ,  SIZE 4 CM  AND THE FEMORAL ARTERY IS STILL IN THIS MASS.
US2 : THE LEFT FEMORAL VEIN  DILATED  BUT  FEMORAL ARTERY IS NOT STENOSIS
US3 : COMPRESSION OVER THIS TUMOR  THE FEMORAL VEIN IS COMPRESSIBLE  
US 4:  CROSSED SECTION THIS MASS  THE ARTERY LUMEN STILL HAD NORMAL FLOW.  
SONOLOGIST SUSPECTED  THAT TUMOR OF PERIVASCULAR FEMORAL ARTERY.




MRI  OF THIS MASS  SHOWED  THIS TUMOR FROM THE WALL OF ARTERY  ( MRI1) 
MRI2  VEIN DILATATION.



CT ANGIO: NORMAL  FLOW OF LEFT FEMORAL ARTERY.


Operation  removes the tumor covered around  left  femoral artery.




MICROSCOPIC REPORT OF THIS TUMOR IS  LEIOMYOMA  OF VASCULAR WALL  ( ANGIOLEIOMYOMA).


REFERENCE CASE  



Sunday, 15 September 2019

CASE 565: SUPRARENAL AORTIC ANEURYSM, Dr PHAN THANH HAI, Dr LE TU PHUC, MEDIC MEDICAL CENTER, HCMC, VIETNAM.


Man 72 yo with pain at RUAQ.


CHEST X-RAYS AND  SPINE  X-RAYS CANNOT DETECTED  ABNORMAL.

US SCANNING OF EPIGASTRIC AREA  DETECTED ONE MASS NEAR AORTA IN RETROPERITONEUM  # 4 CM   WITH DOPPLER  FLOW IN THIS MASS
US 1: PW DOPPLER SHOWS ARTERY FLOW PATTERN
US 2: THIS FLOW IS CONNECTED TO AORTA.






MSCT CE AORTA   
CT1 = CROSSED SECTION AND FRONTAL VIEW  THIS  MASS IS ANEURYSM WITH  BLOOD CLOT INSIDE  
CT2 = 3D VIEW  THIS SITUATION IS  CLOSE  BY SMA AND RENAL ARTERY 



EMERGENCY ADMITTED TO HOSPITAL FOR  TREATMENT PLANNING.
Operation for devascularization  SMA and renal artery  (DSA 1)AND  PUT STENT IN AORTIC ANEURYSM (DSA 2).


AFTER OPERATION  IN ICU  ULTRASOUND POCKET AT BEDSITE WITH BUTTERFLY IQ  MAKES SURE AORTIC FLOW.




Thursday, 5 September 2019

CASE 564: VAGINAL CUP, Dr PHAN THANH HAI, MEDIC MEDICAL CENTER, HCMC, VIETNAM.

Woman 35 yo  goes to general ultrasound check up .
Ultrasound scans at pelvis detected  uterus  had IUD T shape.
 U S 1  cervix deformation looks like tumor on longitudinal scan with   some echogenic things around the vagina.

U S 2  longitudinal scan  cervix  and vagina


U S 3:  crossed section scan  cannot see well  cervix by echogeneicity prothesis


 U S 4: scan at uterus  detected T shape IUD.



MSCT scan  detected a vaginal cup covered over cervix.




Conclusion:  we should know  some abnormal pictures due to vaginal cup.

Thursday, 29 August 2019

CASE 563: ILEOCECAL TUBERCULOSIS, Dr PHAN THANH HAI, MEDIC MEDICAL CENTER, HCMC, VIETNAM


MAN 41 YO  with CLINICAL COMPLAINT about HYPERPERISTALTIS AT RLAQ due  to SUB-OCCLUSION OF BOWEL. 
ULTRASOUND  AT  RLAQ   
US1  SHOWS THICKENING of THE WALL OF ILEUM   
US2 COECUM WALL
US3  MANY LYMPH NODES AROUND ILEO-COECAL AREA





MSCT WITH CE    
CT1  CROSS SECTION THE COECUM , THICKENING OF THE WALL AND SOME LYMPH NODES  ENHANCED CE 
CT2  = FRONTAL VIEW OF  ILEO-COECUM


COLONO ENDOSCOPY   REPORTS  STENOSIS AT ILIO-COECAL JUNCTION ( PHOTO ENDOSC).


OPERATION OF  LAPAROSCOPY AT  FIRST   DETECTED COECUM  CHANGES SURFACE  NODULAR  ( IMAGE LAPARO)
SURGERY RESECTION of the USPSTF's COECUM AND 50CM OF ILIUM  ( FOTO MACRO)




MICROSCOPIC REPORT IS  TUBERCULOSIS OF  ILIO-COECUM AND  LYMPH NODES.


Monday, 26 August 2019

CASE 562: CARDIAC CT DETECTED BREAST TUMOR, DR PHAN THANH HAI, MEDIC MEDICAL CENTER, HCMC, VIETNAM.


WOMAN 54 YO in  BEING PERFORMED CT CORONARY ANGIO  SAME TIME  RADIOLOGIST DETECTED ONE MASS AT LEFT BREAST   ( CT)


MAMMOGRAPHY  ALSO  DETECTED ONE MASS 4 CM ROUND BORDER   NO CALCIFICATION INTRA MASS ( MAMMO 1, MAMMO 2 ).



ULTRASOUND: US 1  MASS AT L BREAST IS HYPOECHOIC, THE BORDER IS ROUND 
US 2  CDI  NO MORE BLOOD SUPPLY  
US 3  ELASTOGRAPHY STRAIN TECHNIC,  THIS MASS IS  SOFT  
US 4  ELASTOSCAN   THIS MASS  NOT INVADED AROUND NO LYMPH NODE  AXILLARY





CORE BIOPSY  REPORT IS  FIBROCYSTIC CHANGE . 


SUMMARY: SAME TIME CT CARDIAC  DETECTED INCIDENTILOMA BREAST TUMOR.