0000000000017880
AUTHOR
Francesco La Seta
Delayed-Onset Superior Mesenteric Artery Syndrome Presenting as Oesophageal Peptic Stricture
Superior mesenteric artery (SMA) syndrome is an infrequent cause of vomiting and weight loss due to compression of the third part of the duodenum by the SMA. We describe the case of a 17-year-old woman, admitted to our department for progressive dysphagia and severe weight loss due to an oesophageal peptic stricture, caused by chronic acid reflux secondary to duodenal compression by the SMA. Symptoms improved after (par)enteral nutrition and repeated oesophageal dilatation, thus supporting the role of intensive medical and endoscopic intervention as an alternative to surgery, at least in some cases.
Ultrasound in children and adolescents with inflammatory bowel disease
The term Inflammatory Bowel Disease (IBD) is used to describe several idiopathic gastrointestinal disorders; among these diseases, the most commonly encountered in clinical practice are Crohn’s Disease (CD) and Ulcerative Colitis (UC). CD and UC are different both in distribution of gastrointestinal tract involvement and depth of inflammation. 25% of patients reveals IBD during childhood or adolescence. [1] No consensus exists regarding the optimal techniques and imaging modalities when evaluating IBD, especially in the paediatric age. [2] The correct imaging choice often depends on clinical presentation of patients. The most common situations are: the initial diagnosis of suspected IBD; pa…
Ultrasonographic and radionuclide detection of hepatocellular carcinoma in cirrhotics with low alpha-fetoprotein levels
A total of 67 cirrhotic patients with clinically suspected neoplastic degeneration and low alpha-fetoprotein levels were assessed prospectively with ultrasound and gold (198Au) scintigraphy. Ultrasound showed space-occupying lesions in 22 of the 24 patients who had a final diagnosis of hepatocellular carcinoma (HCC) (sensitivity, 95.8%) and excluded the presence of HCC in 37 of the 43 patients with cirrhosis only (specificity, 86.0%; efficiency, 90.8%). Scintigraphy demonstrated a cold defect in 22 of the 24 patients who had a final diagnosis of HCC (sensitivity, 95.8%) and excluded the presence of HCC in 22 of the 43 patients with cirrhosis only (specificity, 51.1%; efficiency, 69.8%). It …