David P. Colley

Renal Vein Thrombosis: An Underdiagnosed Complication of Multiple Renal Abnormalities

Thirty-one cases of renal vein thrombosis (RVT) were reviewed retrospectively for clinical laboratory, and radiographic findings. An underlying renal disorder was present in 28 cases, absent in only 3. This supports other evidence that RVT is usually a complication of renal disease rather than a primary event, and that nephrotic syndrome may be due to renal disease rather than RVT. The findings also confirmed the large spectrum of urographic appearances in RVT, and were used as a basis for developing specific and liberal indications for renal venography.

Transcatheter embolization of hepatic arteriovenous fistulas for control of hemobilia.

Two cases of traumatic hemobilia are presented in which hemorrhage was controlled by transcatheter vascular occlusion with stainless steel coils. Embolie therapy was safely performed without liver necrosis, despite the presence of portal hypertension in 1 patient. The technique is a useful alternative to surgery, which did not control hemorrhage in 1 case.

Computed tomography of retroperitoneal fluid collections

F LUID collections in the retroperitoneum generally consist of pus, hemorrhage, or urine. Infections in this area are typically subacute with nonspecific symptoms of chills, fever, night sweats, and pain. The retroperitoneum has been difficult to evaluate clinically; the diagnosis of retroperitoneal abscess or inflammation has been overlooked in 25-50s of patients.‘,’ Unfortunately, the morbidity and mortality increase with delayed diagnosis; failure to drain an abscess results in a mortality that approaches I OO%.’ For similar reasons, retroperitoneal hemorrhage and urinoma have been difficult to diagnose. With the advent of CT, however, the retroperitoneum can now be well demonstrated in most people. The normal bilateral symmetry, the usual abundance of fat, and the lack of motion in this region are ideal for CT examination.

CT of congenital anomalies of the inferior vena cava

The authors report six congenital abnormalities of the inferior vena cava detected on computed tomography (CT). The CT findings of one of these, the left inferior vena cava, have not been previously reported. The embryology of the inferior vena cava and the possible congenital abnormalities that can occur are discussed. Congenital abnormalities of the inferior vena cava are rare but potentially important to the radiologist, the surgeon, and the patient. They are easily identified on CT and should be considered when interpreting any CT of the abdomen or chest.

Cervicothoracic complications of intravenous drug abuse

Abstract During a recent four month period, clinical and radiologic evaluation of four patients with inflammatory disease in the neck or upper mediastinum was performed. All patients admitted to attempting intravenous narcotic injections in the neck. Three patients were examined by computed tomography in addition to plain films and one patient was also examined angiographically. Complications in this group of patients included cellulitis, abscess, venous thrombosis and pneumothorax. Computed tomography appears to be the imaging modality ideally suited to the evaluation of these abnormalities.

Perforated colon carcinoma presenting as a suprarenal mass

Abstract A patient with fever and anemia was found to have a left suprarenal mass on excretory urography. Computed tomography (CT) accurately delineated abscess formation in the perinephric space external to the renal capsule. A perforated carcinoma of the transverse colon was the underlying cause of the abscess. Pertinent radiological and CT findings are presented. The value of CT in the analysis of disease processes adjacent to the kidney is emphasized.

The influence of computed tomography on clinical decision making in the evaluation of a nonvisualizing kidney

Nonvisualization of a kidney in an elderly man was investigated by computed tomography (CT). Simple low lying ureteral obstruction was excluded, multiple pathologic abnormalities were identified and causes for the nonvisualization are postulated. This case report demonstrates the important effect CT scanning produced on the clinical management of the patient in question.