S. Zafar H. Jafri

Juxtaglomerular Cell Tumor: Mr Findings

Juxtaglomerular (JG) cell tumor is a rare benign neoplasm of the kidney that typically presents with hypertension, secondary hyperaldosteronism, hypocalcemia, and hyperreninism. We describe a case of JG cell tumor diagnosed with MRI.

Clinical outcome of active extravasation in splenic trauma

The purpose of this study was to determine the necessity for splenectomy in patients with active extravasation on contrast enhanced CT secondary to splenic trauma. We reviewed cases of splenic injury and classified these according to the American Association for the Surgery of Trauma (AAST) grading scale. The presence of active extravasation and associated injuries was assessed. Chart review was then performed to determine age, sex, mechanism of injury, indications for splenectomy, and clinical outcome. Of 82 cases evaluated, 12 grade I, 15 grade II, 30 grade III, 17 grade IV, and 8 grade V injuries were present. Eighteen patients were actively extravasating. Of extravasating patients, 13 eventually underwent open splenectomy or embolization and five (27.8%) were managed expectantly with success. Of grade IV injuries, 9/17 showed active extravasation, of which six underwent splenectomy. Of grade V injuries, 3/8 showed active extravasation, and all three underwent intervention. Splenectomy may not be necessary in appropriately chosen patients with active extravasation from the spleen in blunt abdominal trauma.

Urographic and computed tomographic demonstration of ureteroarterial fistula

Ureteroarterial fistulas are uncommon. We report a patient who developed a spontaneous fistula between the right iliac artery aneurysm and the right ureter. The diagnosis was made by a retrograde pyelogram and body computed tomography. The fistula was ultimately treated by simple transvesical ligation of the distal ureter. A brief description of the case is provided and the cause and management of ureteroarterial fistula are discussed.

Clinical and imaging features of rhabdoid tumor of the kidney

Rhabdoid tumor of the kidney (RTK) is a rare, highly malignant neoplasm of childhood. The clinical profile of this neoplasm differs from that of Wilms’ tumor. We present two cases of RTK. In both our cases, large bulky masses with poorly defined margins and calcifications were demonstrated. The clinical and imaging findings are compared with other childhood renal neoplasms.

Trauma of the Lower Genitourinary Tract

Trauma to the lower genitourinary tract often presents with clear signs and symptoms. Failure to properly diagnose injuries to this region can lead to significant long-term morbidity. Approximately 7.5–16.0% of patients with a pelvic fracture sustain an injury to the lower genitourinary tract.1–5 Attempts should be made to optimize the initial management of a patient with a lower genitourinary injury in order to minimize future sequelae.

Necrotizing fasciitis and myositis: a case report

Necrotizing fasciitis is a relatively rare, potentially life-threatening infection involving the subcutaneous tissues. We report a case of group A streptococcal necrotizing fasciitis/myositis in which CT played an important role in differential diagnosis.

Color Doppler ultrasound of the genitourinary tract

This paper discusses the role of color Doppler ultrasonography (CDU) as it applies to the genitourinary tract. CDU is beneficial in evaluating both the native and allograft kidney in the diagnosis of renal arterial and venous stenosis, arteriovenous fistulas, pseudoaneurysms, arterial and venous thrombosis, and in the characterization and staging of renal masses. CDU has redefined the role of ultrasonography in the evaluation of the scrotum as it relates to testicular torsion, inflammatory disorders and varicoceles. Early results of CDU in prostate carcinoma and benign prostate hypertrophy have shown limited success. Identifying and assessing the neurovascular bundle may have an impact on the staging of prostate carcinoma. It is hoped that the future addition of ultrasound contrast agents will further establish the role of color Doppler in the diagnosis of a variety of genitourinary diseases and disorders.