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Wednesday, 16 January 2019

CASE 533: RETROPERITONEAL HEMATOMA, Dr PHAN THANH HAI, MEDIC MEDICAL CENTER, HCMC, VIETNAM.



MAN 60YO WITH ACUTE  EPIGATRIC PAIN.

ULTRASOUND EMERGENCY  OF ABDOMEN DETECTED  =
U S 1 :  RIGHT KIDNEY HYDRONEPHROSIS IN FIRST DEGREE).



U S 2 : ONE  9CM MASS   AT BIFURCATION OF ABDOMINAL AORTA TO PELVIS,  HYPOECHOIC STRUCTURE  WITH DEPLACEMENT OF R/L ILIAC ARTERIES).

U S 3: THIS MASS  AT LEFT ILIAC ARTERY.

U S 4 : THIS MASS AT RIGHT ILIAC ARTERY. IT COULD BE A HEMATOMA IN RETROPERITONEUM.
  


EMERGENCY CT CE OF ABDOMEN=
C T 1 : CROSSED SECTION AT R/L KID  SHOWS HYPOPERFUSION IN RIGHT KIDNEY.


C T 2 : CROSSED SECTION AT PELVIS MASS  RUPTURE OF ILIAC ANEURYSM.


C T 3:  FRONTAL VIEW.


C T 4: SAGITTAL VIEW OF  THIS MASS.


C T 5: 3D  VASCULAR  RECONSTRUCTION WITH 2 MASSES LEAKING OF CONTRAST AT R/L ILIAC ARTERIES.


EMERGENCY ENDOVASCULAR  STENTING  OF R/L COMMUN ILIAC ARTERIES WAS DONE SUCCESSFULLY.

SUMMARY:  HEMATOMA IN RETROPERITONEUM DUE TO RUPTURES OF R/L COMMUN ILIAC ARTERIES ANEURYSMS  DETECTED BY ULTRASOUND AND CT WITH CE.

Tuesday, 8 January 2019

CASE 532: URINOMA and A 2-Year Tap Wound, Dr PHAN THANH HAI, Dr NGUYEN THE ANH, MEDIC MEDICAL CENTER, HCMC, VIETNAM.


MAN 26 YO WITH ABDOMEN PAIN AND DISTENTION.
 US of ABDOMEN DETECTED ASCITES AND LEFT KIDNEY HYDRONEPHROSIS, RIGHT LUNG WITH FLUID COLLECTION ( US 1  R LUNG,  US 2 L KID,  US 3 PELVIS FRONT, US 4 SAGITTAL PELVIS).







X-RAYS OF ABDOMEN DETECTED  METALIC OBJECT AT PELVIC LIKE KNIFE.


MSCT OF THORAX AND ABDOMEN = CT1  CROSSED-SECTION THE  LUNG, CT2  FRONTAL VIEW  LUNG -ABDOMEN,  LEFT KIDNEY HYDRONEPHROSIS, CT  3D VIEW OF  ABDOMEN.





OPERATION   REMOVED A KNIFE HAVING TAP WOUND 2 YEARS BEFORE AT THE LEFT FLANK LOCATED AT CUL- DE- SAC.



 ASCITES ANALYSIS  IS URINE   AND LEFT URETER  HAD BEEN RUPTURED  AND LEAKING URINE TO RETROPERITONEUM AND INTRA ABDOMEN

CONCLUSION:   URINOMA FORMATION BY TAP WOUND AT LEFT FLANK.

Wednesday, 2 January 2019

CASE 531: TOOTHPICK PERFORATING SPLEEN, Dr PHAN THANH HAI, Dr LE VAN TAI, MEDIC MEDICAL CENTER, HCMC, VIETNAM.


Man 46 yo  with epigastric pain,  gastroscopic result is  gastritis but being treated with  no response. 
Ultrasound of abdomen   detected  foreign body ( fb) intra the spleen that looked like the toothpick
US 1  the  fb is long 5 cm  intra central hilus the pleen to peripheral,  (US 1  crossed-section).


US  2 with CDI vascular of spleen.


US 3 :  hilus the spleen.


US 4 video.



Blood test is normal.  Colonoscopy is normal.
MSCT of abdomen  confirmed the  toothpick in penetration of the spleen, from the gastric wall to hilus of pleen.


Operation  removed toothpick in hilus of spleen,
as views by via ultrasound and CT.