Ultrasound diagnosis of clinically undetected Clostridium difficile toxin colitis.
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Adult↗
Biomedical subjects
S A Sukumar
Publications and source records attributed to S A Sukumar.
Primary and metastatic lobular carcinoma of the breast.
Invasive lobular carcinoma of the breast is the second most common type of primary breast cancer, accounting for 8-14% of cases, but is often difficult to diagnose early. It typically shows a diffuse pattern of infiltration within the breast, resulting in a variety of often subtle radiological appearances. A similar infiltrative pattern is seen in its metastatic form, with involvement of the gastrointestinal tract, peritoneum, retroperitoneum, bone marrow, meninges and uterus occurring more frequently than with the more common infiltrating ductal carcinoma of the breast. This pictorial essay illustrates the spectrum of radiological appearances which may be encountered with both primary and secondary lobular carcinoma.
Aged↗
Could factor V Leiden defect cause Addison's disease?
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Addison Disease↗
Liver and bone window settings for soft-copy interpretation of chest and abdominal CT.
OBJECTIVE: We evaluated whether the use of multiple window and level settings on a soft-copy workstation improves diagnostic accuracy on chest and abdominal CT. We hypothesized that routinely using window and level settings during soft-copy interpretation would beneficially affect the final diagnosis without compromising efficiency. MATERIALS AND METHODS: Two hundred three randomly selected abdominal and chest CT scans were interpreted by three radiologists using a four-monitor soft-copy workstation (images per screen, nine; resolution, 2K). After the initial interpretations, all scans were reevaluated by the same radiologists using additional liver and bone window and level settings. Differences in conspicuity and characterization of abnormalities were graded on a three-point scale. RESULTS: Conspicuity and characterization of abnormalities were improved in 67% of abnormal findings (81/121; p = 0.01). Improvement (a finding that substantially affected the final diagnosis) was present in 18% of abnormal findings (22/121; p = 0.04). On average, the evaluation of images at multiple window and level settings required an additional 40 sec per case. CONCLUSION: The use of multiple window and level settings during soft-copy interpretation resulted in improved lesion detectability and characterization with greater diagnostic efficacy. Using soft-copy workstations, radiologists can evaluate images using multiple settings without compromising efficiency.
Bone Diseases↗
Paradoxical pulmonary embolism secondary to aortocaval fistula: diagnosis by helical CT.
Spontaneous aortocaval fistula is an unusual but well recognized complication of abdominal aortic aneurysm. Reports of aortocaval fistula as the source of pulmonary embolism are rare. We report a case of paradoxical pulmonary embolism secondary to an aortocaval fistula. The abdominal aortic aneurysm and the associated aortocaval fistula were well demonstrated on helical CT, leading to early diagnosis and prompt surgical treatment with good clinical outcome.
Aged↗
Nonbiliary laparoscopic gastrointestinal surgery: role of CT in diagnosis and management of complication.
OBJECTIVE: Laparoscopic techniques are evolving for a wide range of surgical procedures outside the biliary tree. We describe the CT findings of important complications detected after nonbiliary laparoscopic gastrointestinal surgery and the role of CT in their management. MATERIALS AND METHODS: Over a 3-year period, 209 patients had nonbiliary gastrointestinal laparoscopic procedures (partial or total colectomy, splenectomy, Nissen fundoplication, lymph-node dissection, herniorrhaphy, appendectomy, and exploratory laparoscopy). Thirty-seven abdominopelvic CT studies were performed on 18 (9%) of these patients for complications after surgery. In all cases CT findings were reviewed and correlated with follow-up surgical, clinical, or interventional radiologic findings. RESULTS: Fourteen major complications were detected on CT in 12 of 18 (67%) patients who had undergone partial or total colectomy (6/25, 24%), splenectomy (4/41, 10%), appendectomy (1/15, 7%), or lymph-node dissection (1/43, 2%). These complications included seven abscesses (three of the splenic bed, two of the pelvis, one of the liver, and one of the abdominal wall). The remaining complications were four hematomas (two in the abdominal wall caused by trocar site bleeding, one intraperitoneal, and one retroperitoneal), one case of colon perforation, one case of pancreatitis, and one case of splenic infarction. Percutaneous abscess drainage was performed successfully in seven patients, using CT guidance in six. Six patients had negative CT studies. CONCLUSION: Major complications may occur after complex nonbiliary laparoscopic procedures and are probably related to lack of experience with new surgical techniques. In this study, such complications occurred most often after laparoscopic colectomy and splenectomy. CT valuable in their diagnosis and in the management of abscess collections.
Adult↗