Carl R. Larsen

The Choledochocele: Correlation of Radiological, Clinical and Pathological Findings

Two cases of choledochocele are presented and 14 cases in the literature reviewed. Choledochocele is defined as a herniation of the common bile duct into the duodenum. This entity is distinguishable radiographically from duodenal diverticulum and duodenal duplication cyst by filling during cholangiography but not during upper gastrointestinal series. The duodenal diverticulum fills on upper gastrointestinal series but not on cholangiography. The duplication cyst will not fill with either method.

Idiopathic segmental thrombosis of the corpus cavernosum as a cause of partial priapism

Idiopathic segmental thrombosis of the corpus cavernosum as a cause for partial priapism is an uncommon event. Diagnosis and treatment in the past have principally involved invasive methods. We present a case in which both conventional invasive methods and noninvasive imaging were used.

Regression of large pelvic desmoid tumor by tamoxifen and sulindac

A 54-year-old man was evaluated for symptoms of bladder outlet obstruction. Evaluation revealed a 10 by 9.8-cm tumor composed of bland, fibroblastic, poorly cellular material adjacent to the prostate. Administration of a course of antiestrogen (tamoxifen) and a nonsteroidal anti-inflammatory agent (sulindac) resulted in prompt relief of symptoms and a slow decrease in the size of the tumor as measured by computed tomography. After 54 months of therapy, the tumor was undetectable clinically and dramatically reduced in size as seen on computed tomography. Data on the natural history of desmoid tumors and the efficacy of various therapeutic strategies are reviewed.

Computerized tomographic appearance of hernias of the bladder.

Herniation of the bladder is not uncommon and it can occur with any type of hernia in the groin. Most bladder hernias are discovered unexpectedly during herniorrhaphy, and serious complications can result from intraoperative injury to the bladder. The appearance of hernias on excretory urography and cystography has been described extensively but experience with computerized tomography (CT) has been limited. We describe the appearance of 8 bladder hernias on CT: 2 incisional, 2 femoral, 3 small direct inguinal, and 1 massive direct inguinal hernia with bladder necrosis and perforation. Appearance on CT is characteristic, and this modality may be useful for preoperative evaluation.

Computed tomographic evaluation of spigelian hernia

Spigelian hernia is an uncommon hernia of the anterior abdominal wall. Because of its insidious nature and at times nonspecific physical findings associated with it, the diagnosis of this hernia is often not made. Typically, the hernial orifice is small, and strangulation of the contents of the hernial sac can occur. Computed tomography permits the distinction between spigelian hernia and other anterior abdominal wall or intra-abdominal masses. When a spigelian hernia is found, CT is useful in establishing contents of the hernial sac and defects in the fascial plane.

Modification of the Gouda frame to allow stereotactic biopsy of the brain using the GE 8800 computed tomographic scanner.

The Gouda stereotactic frame has been modified to interface with the GE 8800 scanner. The patient, attached to the frame, is scanned and then moved to the operating room for a stereotactic biopsy. This is a safe, accurate method of obtaining biopsy specimens of otherwise inaccessible tumors of the brain.

Computed Tomography of Xanthogranulomatous Cholecystitis

A case is presented of xanthogranulomatous cholecystitis that resembled carcinoma of the gallbladder on computed tomography. The large, infiltrating mass satisfied the criteria for massive carcinoma of the gallbladder.

Gastrosplenic fistula: Complication of adenocarcinoma of stomach

Penetration of the spleen by an adenocarcinoma of the stomach is described in a patient undergoing chemotherapy. The diagnosis was made by computed tomography.

Computed tomography of intrathoracic kidney

We report a case of congenital intrathoracic kidney, a rare developmental anomaly, which may present as an asymptomatic posterior mediastinal mass. The evaluation of such lesions can be performed expeditiously with computed tomography and obviate the need for any further clinical studies or operation.

Is magnetic resonance imaging alone accurate enough in staging renal cell carcinoma

A patient with renal cell carcinoma extending into the inferior vena cava presented to our institution. Magnetic resonance imaging demonstrated the superior extent of the thrombus to be at the level of the hepatic veins. Preoperative venacavography showed extension into the right atrium. The need for both studies in evaluating patients with Stage 3A disease is reviewed.