Murray Rothberg

Metastatic neoplasm to the kidney studied by computed tomography and sonography.

Surgicalue to the widespread use of CT for tumor staging and diagnostic workup, the discovery of metastatic neoplasm to the kidney has become a more frequent occurrence. Nine patients with metastatic carcinoma to the kidney have been studied by CT, including six by sonography. Carcinoma of the lung was the primary tumor in eight. Bilateral renal involvement was seen in all cases. The presentation of the clinical and radiologic findings in these cases with differential diagnosis is included.

Correlation of CT and ultrasound in the evaluation of renal lymphoma

In a series of 225 patients with lymphoma studied by computed tomography, involvement of the kidney(s) was found in 11 (4.9%). These cases were then also studied by ultrasound. Because of the characteristic findings of computed tomography and sonography in renal lymphoma, a reliable diagnosis was possible along with an accurate assessment of the incidence and types of renal involvement. Illustration of this material along with a discussion of the clinical implications of these findings is presented.

Management of symptomatic renal angiomyolipomas by embolization.

Renal angiomyolipomas are benign tumors which occur commonly in association with tuberous sclerosis or as isolated lesions. Symptomatic angiomyolipomas, particularly those in patients with tuberous sclerosis, should be approached conservatively with the goal of preserving as much normal renal tissue as possible. We report 2 patients in whom selective embolization was used to achieve this goal.

CT findings in acute renal infarction.

CT scans of 12 patients with renal infarcts were reviewed. CT findings along with the clinical presentation were diagnostic in 10 cases. Correlation with angiography (5 cases) and sonography (8 cases) was made. The diagnosis of renal infarction can usually be made on the basis of specific CT findings. Angiography is valuable in helping to establish the cause and direct treatment.

Ureteral obstruction by shotgun pellet seven years after injury

Ureteral obstruction by an extrinsic object is rare. We herein report a case of renal colic caused by a shotgun pellet lodged in the ureter seven years after the injury. Computerized tomography scan and antegrade pyelogram demonstration were obtained.

CT evaluation of pancreatic injury following splenectomy

A fluid collection in the left subphrenic space immediately after splenectomy is often associated with pancreatic injury. The configuration, location, and vascular supply of the tail of the pancreas explain this postoperative complication. Depending on the degree of injury, the CT findings may show swelling of the tail of the pancreas, ill-defined fluid collections, or a well-encapsulated pancreatic pseudocyst. The diagnosis is confirmed by percutaneous aspiration with amylase determinations and the demonstration of a pancreatic fistula. Failure to diagnose this complication promptly may lead to a protracted postoperative clinical course and the development of a subphrenic abscess or a pancreatic pseudocyst.

Management of simple renal cysts during percutaneous nephrostolithotomy

Simple renal cysts can coexist with renal stones. Percutaneous removal of these stones requires special considerations. We describe the management of 2 patients with this problem and propose a simple logarithm.

Angiographic demonstration of bleeding site following late rare complication of aorto-coronary by-pass

The intravascular injection of contrast may demonstrate the site of bleeding more successfully than conventional radiographic methods. This technique has been applied to lesions involving various sites. The application of angiography to demonstrate a bleeding site following a late unsuspected complication (removal of epicardial pacemaker) after aorto-coronary saphenous vein by-pass grafting has to our knowledge, not yet been reported in the literature, although uneventful perforation of a coronary artery during coronary catheterization has been observed (Morettin and Wallace, 1970).

The unbreakable stone

A case of a failed percutaneous ultrasonic lithotripsy is reported as an unusual occurrence.

Visualization of collateral venous circulation during intravenous urography secondary to superior vena cava syndrome.

Transient visualization of superficial collateral abdominal veins can occur in intravenous urography in some patients with the superior vena cava syndrome. The findings are characteristic enough to lead the radiologist to the correct diagnosis. A presentation and explanation of this finding is made.