Shelley Nan Weiner

Hematuria secondary to left peripelvic and gonadal vein varices

The nutcracker syndrome refers to compression of the left renal vein between the aorta and superior mesenteric artery which results in renal vein and left gonadal vein varices. This is an unusual but well accepted cause of hematuria. We report a case of the nutcracker syndrome and present the radiologic workup including computerized tomography (CT) and renal venography with venous pressure measurements.

Combined Adrenal Adenoma and Myelolipoma

Abstract A case of both adrenal myelolipoma and adenoma is presented. The diagnosis of myelolipoma was suggested preoperatively by computed tomography in which one of the masses had negative attenuation coefficients.

The Value of Ultrasound in the Diagnosis of Popliteal Artery Aneurysms

Although popliteal artery aneurysms are among the most common type of peripheral artery aneurysm, 1,2,3,4 they may be difficult to diagnose until com plications such as peripheral embolization, acute thrombosis 6 and rupture occur. Pressure on adjacent structures may cause neurological symptoms and venous thrombosis. The diagnosis of peripheral artery aneurysms is usually made by physical examination and arteriography. Recently, ultrasound of the popliteal space has been found to be very useful in the diagnosis of popliteal artery aneurysms.5,6,7 It is therefore important to recognize the value of ultrasound for imaging popliteal artery aneurysms and to use this readily available non-invasive mod ality in patients in which physical examination and/or angiography of the popliteal fossa is equivocal. We present one case of a popliteal artery aneurysm which was missed by angiography and physical examination in which ultrasound was very important in diagnosing this aneurysm pre-operatively, and two cases in which the ultrasound examination confirmed the presence of the popliteal artery aneurysm but better delineated its size than did angiography.

The ultrasound appearance of tumor extension into the left renal vein and inferior vena cava

Abstract We report on direct ultrasound visualization of tumor extension into the left renal vein in 2 patients with left renal tumors.

The “String sign” on computerized tomography

With the increasing use of computerized tomography (CT), it has become more important to recognize patterns of diseased bowel on CT. We report the CT appearance of the “string sign,” which represents narrowing of the bowel lumen by thickening of the bowel wall or mesentery.

Complications of Vascular Access Devices for Hemodialysis

Hemodialysis is essential in the management of end stage renal disease patients. Forty-eight contrast examinations of hemodialysis vascular access devices were reviewed. Venous fistulography is the method of choice for the evaluation of these devices. Only 12 patients in this series required arteriography and 6 of them had a lower extremity access device. The most common complications included venous stenoses, venous or graft aneurysms, pseudoaneurysms and venous or graft thrombosis. Pseudointimal proliferation resulting in graft stenosis was also observed.Hemodialysis is essential in the management of end stage renal disease patients. Forty-eight contrast examinations of hemodialysis vascular access devices were reviewed. Venous fistulography is the method of choice for the evaluation of these devices. Only 12 patients in this series required arteriography and 6 of them had a lower extremity access device. The most common complications included venous stenoses, venous or graft aneurysms, pseudoaneurysms and venous or graft thrombosis. Pseudointimal proliferation resulting in graft stenosis was also observed.

Intraluminal Renal Vein Thrombus Secondary to Metastatic Disease to the Kidney: A Case Report

AbstractTumor thrombus in the renal vein can be seen with hypernephroma and Wilms tumor. When metastatic tumor in the kidney affects the renal vein it usually causes encasement or amputation of the renal vein. A case is reported of metastatic oat cell carcinoma to the kidney with tumor thrombus in the renal vein. Tumor thrombus in the renal vein cannot be used to distinguish primary from secondary tumor of the kidney.

Steroid-induced mesenteric lipomatosis

A patient undergoing chronic corticosteroid therapy presented with mesenteric lipomatosis that simulated malignant masses. Computerized tomography was instrumental in identifying these apparent tumors as benign fatty deposits. The spectrum of lipomatous abdominal lesions amenable to diagnosis by computerized tomography is reviewed.

Demonstration of an internal pancreatic fistula by computed tomography.

The computed tomographic demonstration of a mediastinal pseudocyst communicating with the pancreatic duct in a patient with severe acute pancreatitis is reported. An awareness of this communication was essential in planning the appropriate surgical management.

Intrarenal hemangiomas in the Klippel-Trenaunay syndrome

The Klippel-Trenaunay syndrome is composed of the triad of unilateral limb hypertrophy, abnormalities of the deep venous system, and port-wine hemangiomas. An interesting case is presented in which there were multiple abnormalities of the renal veins and intrarenal hemangiomas resulting in renal failure in addition to the usual peripheral abnormalities.