Antonio Certo

Multiple hypervascular pancreatic metastases from renal cell carcinoma:Dynamic MR and spiral CT in three cases

Pancreatic metastases are rare. Melanoma, lung cancer and breast carcinoma are the most common origin of pancreatic metastases, whereas renal cell carcinoma is counted in only 1-2%. Renal cell carcinoma usually leads to a solitary pancreatic metastasis, whereas multiple pancreatic metastases are uncommon. We present three cases of multiple hypervascular pancreatic metastases from renal cell carcinoma, studied with spiral CT and dynamic MR.

Embryologic and acquired anomalies of the inferior vena cava with recurrent deep vein thrombosis.

AbstractAnomalies of the inferior vena cava theoretically favor venous stasis and development of deep vein thrombosis. We report two cases of repeated deep vein thrombosis in patients with embryologic and acquired anomalies of the inferior vena cava, in which hypercoagulability syndrome was ruled out.

Mediastinal pseudotumor due to passage of ascites through the esophageal hiatus.

Ascites can extend from the peritoneal cavity into the posterior mediastinum through the esophageal hiatus. This mediastinal fluid can simulate the appearance of a mediastinal tumor. Demonstration of hiatal hernia and continuity between the thoracic and abdominal fluid assist in establishing the correct diagnosis.

Nonoperative management of iatrogenic lesions of celiac branches by using transcatheter arterial embolization.

We present our experience in the nonoperative management of iatrogenic lesions of celiac branches by using transcatheter arterial embolization. We treated 6 pseudoaneurysms (5 intrahepatic and 1 of the gastroduodenal artery), 6 vessel lacerations (1 common hepatic artery, 1 right hepatic artery, 1 gastroduodenal artery, 2 pancreatoduodenal, 1 polar intrasplenic artery), 1 arterioportal fistula, and 1 arteriobiliary fistula; all the bleeding lesions were secondary to surgical, endoscopic, or interventional radiologic procedures.

Hepatobiliary imaging in a patient with liver abscess : Interesting diagnostic findings

Hepatobiliary scintigraphy (HBS) was performed in a patient in whom pyogenic liver abscess developed approximately 1 month after he underwent an interventional radiology procedure to relieve obstructive jaundice caused by an ampullary tumor. HBS, apart from detecting the abscess cavity as a cold space-occupying lesion, well demonstrated biliary flow impairment and dilatation of bile ducts, the communication between the abscess cavity and the biliary tree, and the presence of a bile leak. All these findings were disclosed by a single imaging procedure and appeared to be useful for patient management.

Novel use of a T-tube access to perform an internal/external biliary drainage

We report a case of post-surgical temporary functional stenosis of the sphincter of Oddi and biliary leak in a patient with a previous Billroth II reconstruction who had undergone cholecystectomy, surgical choledocotomy and sphincterotomy for biliary calculi. The patient was treated by creation of an internal/external biliary drainage using the T-tube access with an unreported technique.