Kuo-Hsien Chiang

Marjolin's ulcer : MR appearance

1All authors: Department of Medical Imaging, Buddhist Tzu Chi Medical Center, Hualien, No. 707, Section 3, Chung Yang Rd., Hualien, Taiwan 886. Address correspondence to P.-Y. Chang. alignant degeneration of untreated chronic wounds is a well-known complication. These rare, aggressive tumors that originate in chronically nonhealing wounds are called Marjolin’s ulcer [1]. A multidisciplinary approach is necessary in these patients. Here we report a case of Marjolin’s ulcer and the MRI findings.

Percutaneous Retrieval of Dislodged Port-A Catheters by Loop Retriever

Objective: Port-A catheter fracture with embolization is a serious complication. The percutaneous retrieval of intravascular foreign bodies avoids the need for surgery in this high risk population. We report on 14 patients who underwent percutaneous retrieval of dislodged Port-A catheters by loop retriever. Materials and Methods: Fourteen patients who had undergone percutaneous foreign body retrieval between 2002 and 2007 were evaluated retrospectively. In all procedures, retrieval of foreign bodies was performed using a 6.3-F angled wire loop retriever. Results: The percutaneous retrieval procedure was successful in all 14 patients. Repositioning of the foreign body was done in seven cases using an RC1 catheter for the intracardiac Port-A catheter fragments. Additional surgery was not required. No further complications, such as damage to the vascular wall, were noted. Conclusion: With the increasing use of indwelling catheters and interventional devices, we are frequently confronted with the problem of dislodged catheters. The percutaneous approach should be considered as the first choice when trying to resolve the problem of an embolized catheter in the cardiovascular system.

Imaging of a Gastrointestinal Foreign Body in a Feline — A Case Report

Radiology is not only used for diagnosis in humans, but also in other fields. We report a case of a gastrointestinal foreign body in a feline with radiographs, upper gastrointestinal study and computed tomography (CT). Radiology provides the same type of services for animals as it does for humans. Abnormal opaque shadows on plain radiographs indicate the location of foreign bodies. An upper GI series can assess GI disease such as masses, stmctural abnormalities, and motility disorders. Sometimes foreign bodies can be detected by ultrasound. CT evaluation may replace the barium GI examination because it is better able to detect thin, small, minimally calcified foreign bodies which are often obscured by overlying tissues in radiological studies. Preoperative image study plays an important role in disease diagnosis and treatment of these patients.

Chronically Rejected Renal Allograft Replaced by a Huge Organized Hematoma Mimicking Malignancy

A 44-year-old man received a cadaveric renal allograft, however, the allograft failed after 1 year owing to septic complications. Five years after the complications, the patient noted an enlarged mass in the lower left abdominal area accompanied by discomfort. Abdominal computed tomography (CT) revealed the failed kidney transplant had been replaced by a mass with multiple calcifications. The tumor showed heterogenous-enhancement, as well as some vascular structures that were noted within the tumor. Aortogram demonstrated a huge hypovascular lesion in the lower left abdominal area with displacement of adjacent arteries. He received transplant nephrectomy and histological examination of the tumor showed a hematoma with organization and calcification accompanied by thromboemolism in the blood vessels. A hematoma is a common acute or chronic complication of kidney transplantation. It can be secondary to graft rupture or injury to the vascular pedicle. It is not well known that a hematoma can develop and slow expansion and total replacement can occur after graft failure. CT is limited in helping to determine the definitive pre-operative diagnosis.

Treatment of Pseudoaneurysm of the Ileocolic Artery with Microcoil Embolization in a Post-ileostomy Patient

Pseudoaneurysms arising from branches of the superior mesenteric artery (SMA) are very rare. It is important to recognize and treat a pseudoaneurysm because of the risk of bleeding and even death. Angiography is the standard means for detecting intestinal and mesenteric hemorrhage. Endovascular treatment is a prompt and effective method for control of gastrointestinal hemorrhage. Status post-ileostomy with pseudoaneurysm formation and active bleeding has not been reported in the literature. We present the first case of ileocolic artery pseudoaneurysm post-ileostomy successfully treated by transcatheter arterial microcoil embolization.