Kun-Eng Lim

Ruptured Ovarian Cystic Teratoma with Peritoneal Reaction: A Case Report

Although ovarian teratomas are the most common neoplasms in younger patients, ruptured teratomas are rare. Ruptured teratomas may mimic malignant tumors, and chronic rupture may result in granulomatous peritonitis. We report a case of ruptured teratoma with peritoneal seeding in a 31-year-old woman without a significant history complained of progressive abdominal fullness. Abdominal computed tomography and 1.5-Tesla magnetic resonance imaging revealed a large cystic tumor in the right adnexa with diffuse fat implants in the peritoneum. In addition, dense calcifications and fat inclusions were observed within the tumor. The right ovarian tumor and most of the peritoneal implants were surgically excised. Follow-up computed tomography performed 4 years after resection showed no lesion recurrence, although some residual fat implants were observed in the peritoneum.

Pneumothorax Due to Migration of a Fractured Kirschner Wire-A Case Report

Pneumothorax has many causes. We report an unusual cause of pneumothorax due to fracture and migration of a Kirschner wire from the shoulder in a 58 year-old man. We review his clinical history, physical examination, imaging findings, surgical method, and outcome. We also review the literature on orthopedic pin and wire migration. Chest radiographs and chest computed tomographic scans are useful in detection and diagnosis of this disorder. Regular radiographic follow-up is needed for patients with internal fixation devices; any fractured pins or wires must be removed immediately to prevent dangerous complications.

A Modified Drainage Method for Peripancreatic Abscess

Severe pancreatitis can induce a peripancreatic abscess, and drainage of the abscess is the primary treatment applied to this condition. However, drainage tubes are often obstructed by viscous pus and tissue residue. Failure to treat a pancreatic abscess can lead to complications such as sepsis and organ failure, ultimately resulting in death. To improve drainage quality and solve drainage tube obstructions, we used suction tubes connected to a suction bottle during patient treatments. We found that this assembly not only demonstrated excellent drainage performance for severe peripancreatic abscesses, but was also cost efficient.

Cystic Lung Changes in a Patient With Pulmonary Tuberculosis

Abstract A 32-year-old male had complained of a dry cough on and off for 1 year. Chest radiography revealed reticular infiltration of bilateral lungs. Chest computed tomography showed multiple thin-walled cystic lesions of bilateral lungs with a scattered tree-in-bud appearance. Histological diagnosis obtained via a video-assisted thoracoscopic lung biopsy indicated pulmonary tuberculosis. The cystic lesions regressed after antituberculous chemotherapy. Active pulmonary tuberculosis presenting as multiple cystic lung lesions on computed tomography is very rare. Here, we report the computed tomo-graphic findings for this patient and review the literature.

Infrarenal Aortic Occlusion (Leriche Syndrome) Depicted on Multidetector-row CT Angiography

Digital subtraction angiography is regarded as the gold standard for the evaluation of aortoiliac and peripheral arteriosclerotic disease. However, it is invasive, and difficulties may be encountered during the evaluation of total occlusion of the infrarenal aorta. The rapid development of multidetector-row computed tomography scanners has promoted the use of this modality for assessing the vascular system in a minimally invasive manner. We report a case of Leriche syndrome assessed using multidetector-row computed tomography angiography as the diagnostic tool. The technique allows high-quality angiography-like images and provides adequate information necessary for surgical treatment.

Right Coronary Artery Aneurysm with Fistula to the Left Ventricle Demonstrated by Multidetector Computed Tomography Coronary Angiography

A large coronary artery aneurysm with fistula to the left ventricle is an uncommon form of coronary artery disease. We describe a 66-year-old man who presented with increasing exertional dyspnea for 2 months. Electrocardiography-gated enhanced multidetectorrow computed tomography angiography was performed. Multiplanar reconstructed and three-dimensional volume-rendered images showed a large right coronary aneurysm and its distal portion which drained directly into the left ventricle.

Cystic Heterotopic Brain Tissue Presenting as a Unilateral Neck Mass-A Case Report

Heterotopic brain tissues are rare. Most heterotopic brain tissues are solid or solid with cystic compartments. To the best of our knowledge, there are only 2 case reports of pure cystic heterotopic brain tissues in the literature. We present a 5-month-old infant with pure cystic heterotopic brain tissue in the right neck and review the literature on this subject.