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| Search Results for => Penetrating <= Result Items 1 - 20 |
| Case ID: 14135 Sample Image  Click to View  |  ::  - TF Case ::  - Thumbnails :: No Topic
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| Diagnosis | Penetrating orbit injury | |
| History | 32 year old woman lost control of her car and stuck tree | |
| Findings | Low density linear object (wood - tree branch) penetrates medical aspect of left orbit and into the ethmoid sinuses. No penetration of the intracranial space nor right orbit. | |
| Differential Dx | • Chopstick • Pencil • Coffee stirrer • Twig Companion Case http://rad.usuhs.edu/medpix/cow_image.html?mode=case_viewer&imid=45434&pt_id=12367 | |
| Discussion | ... (continues ...) | |
| User Group | ||
| Contributor | Steven J Goldstein :: University of Kentucky -  | |
| Reviewer | James G. Smirniotopoulos, M.D. :: Uniformed Services University - Case Accepted: 2012-05-23 11:52:08-04 :: Revised: 2012-05-24 15:20:56.440778-04 :: Submitted: 2012-05-22 10:45:56.642777-04 | |
| Case ID: 13365 Sample Image  Click to View | :: - TF Case :: - Thumbnails ::  - Topic
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| Diagnosis | Penetrating gastric ulcer (into pancreas) Helicobacter pylori gastritis | |
| History | This is a 13 y.o. boy with recurrent iron deficiency anemia since age four years, managed with chronic iron supplementation. Recent recurrence of anemia in the last 6 weeks accompanied by epigastric pain, and several episodes of emesis. Two episodes of vomiting contained blood (hematemesis). | |
| Findings | Abdominal ultrasound: Hypoechoic heterogeneous mass in the head of the pancreas extending along the body of the pancreas with reactive lymph nodes anterior to the pancreas head. Abdominal CT with contrast: Enlarged pancreatic head with edema at the junction of the head and body and disruption anteriorly. Marked gastric wall thickening and distention with a collection of fluid along the posterior stomach wall. | |
| Differential Dx | • Ulcer disease (H. pylori vs hyperacidity) • Trauma with pancreatic laceration • Walled-off perforation • Pancreatic pseudocyst • Pancreatitis | |
| Discussion | ... (continues ...) | |
| User Group | ||
| Contributor | Lindsay M Stollings :: Childrens Hospital of Dayton, OH - | |
| Reviewer | Dawn E Light :: Childrens Hospital of Dayton, OH - Case Accepted: 2012-05-23 11:52:08-04 :: Revised: 2012-05-24 15:20:56.440778-04 :: Submitted: 2012-05-22 10:45:56.642777-04 | |
| Case ID: 13153 Sample Image  Click to View | :: - TF Case :: - Thumbnails :: - Topic
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| Diagnosis | Penetrating injury to the neck secondary to dog attack | |
| History | 6 year old boy attacked by grandmother's large dog | |
| Findings | Lacerations back of neck and suboccipital region. Bilateral subcutaneous emphysema in the neck. No vascular injury. | |
| Differential Dx | None | |
| Discussion | ... (continues ...) | |
| User Group | ||
| Contributor | Steven J Goldstein :: University of Kentucky - | |
| Reviewer | James G. Smirniotopoulos, M.D. :: Uniformed Services University - Case Accepted: 2012-05-23 11:52:08-04 :: Revised: 2012-05-24 15:20:56.440778-04 :: Submitted: 2012-05-22 10:45:56.642777-04 | |
| Case ID: 12367 Sample Image  Click to View | :: - TF Case :: - Thumbnails :: - Topic
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| Diagnosis | Penetrating eye injury | |
| History | 17 month old boy who fell while running with keys in his hand | |
| Findings | Key Penetrating into right orbit with extension into right anterior cranial fossa | |
| Differential Dx | none | |
| Discussion | ... (continues ...) | |
| User Group | ||
| Contributor | Steven J Goldstein :: University of Kentucky - | |
| Reviewer | James G. Smirniotopoulos, M.D. :: Uniformed Services University - Case Accepted: 2012-05-23 11:52:08-04 :: Revised: 2012-05-24 15:20:56.440778-04 :: Submitted: 2012-05-22 10:45:56.642777-04 | |
| Case ID: 8489 Sample Image  Click to View | :: - TF Case :: - Thumbnails :: - Topic
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| Diagnosis | Penetrating trauma from GSW | |
| History | Gunshot wound from sniper. | |
| Findings | metalic fragments seen along track of bullet as it progresses from the back striking the left transverse process of T1 and progressing further forward | |
| Differential Dx | ||
| Discussion | ... (continues ...) | |
| User Group | ||
| Contributor | David M Danielson :: Madigan Army Medical Center - | |
| Reviewer | David M Danielson :: Madigan Army Medical Center - Case Accepted: 2012-05-23 11:52:08-04 :: Revised: 2012-05-24 15:20:56.440778-04 :: Submitted: 2012-05-22 10:45:56.642777-04 | |
| Case ID: 6212 Sample Image  Click to View | :: - TF Case :: - Thumbnails :: - Topic
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| Diagnosis | Penetrating orbital trauma | |
| History | 27 y.o. man was in a combat firefight in Afghanistan. | |
| Findings | Radiopaque fragments in right orbit near expected location of the optic nerve | |
| Differential Dx | Optic nerve avulsion Fragment missed optic nerve, or did not sever | |
| Discussion | ... (continues ...) | |
| User Group | ||
| Contributor | Les R Folio :: Uniformed Services University - | |
| Reviewer | James G. Smirniotopoulos, M.D. :: Uniformed Services University - Case Accepted: 2012-05-23 11:52:08-04 :: Revised: 2012-05-24 15:20:56.440778-04 :: Submitted: 2012-05-22 10:45:56.642777-04 | |
| Case ID: 2940 Sample Image  Click to View | :: - TF Case :: - Thumbnails :: - Topic
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| Diagnosis | Penetrating injury (gunshot wound) to the head and temporal bone. | |
| History | 17-year-old college student was admitted to the ER following an attempted suicide. He was completely unresponsive except for withdrawal of the right arm and leg to painful stimuli. (Look at Films 1,2,3,4 first). What are your diagnoses? What additional studies (if any) will you obtain to further evaluate the patient? (Now look at Films 5,6,7,8.) | |
| Findings | Films 1, 2, 3, 4: Multiple metallic fragments from the gunshot wound (GSW) are seen in a path extending from just below the right external auditory canal, through the temporal bone, and into the sphenoid sinus and parasellar region. Vital structures that are vulnerable to injury by the specific course of the bullet fragments include: the ossicular mass, intratemporal facial nerve, internal jugular vein, cavernous sinus, trigeminal nerve, pituitary gland, optic chiasm, and the internal carotid artery (petrous, cavernous, and supraclinoid segments). Film 1, scan 4, and Film 2, scans 1-2 reveal poorly defined areas of hemorrhage and adjacent low density within the temporal lobe. A more sharply marginated area of hemorrhage that is suggestive of a subtemporal epidural hematoma (Film 1, scan 3) is present along the floor of the middle cranial fossa. The bone windows clearly show that bullet fragments have shattered the petrous segment of the carotid canal (Film 3, scan 2), strongly suggesting internal carotid artery (ICA) injury. An urgent arteriogram, therefore, is imperative for assessing the integrity of the ICA. Also note the presence of pneumocephalus (Film 3, scans 2-4). This is highly suggestive of a dural tear involving either the roof of the tympanic cavity or the sphenoid sinus. This patient is at great risk, therefore, for subsequent development of CSF rhinorrhea, CSF otorrhea, meningitis, and brain abscess. Finally, note the severe edema and swelling of the right cerebrum resulting in severe ventricular compression, subfalcine herniation, and effacement of the suprasellar and basal cisterns. Film 5: Scans 1 and 2 are lateral films from a right common carotid arteriogram. Scan 3 is an AP view of a left internal carotid arteriogram. There is traumatic occlusion of the right ICA, beginning a short distance from its origin (scans 1-2). There is a tapered appearance of the remaining portion of the proximal ICA. The tapering is most likely due to a lack of complete retrograde thrombosis, traumatically induced vasospasm, and retrograde dissection of a more distal intramural hematoma. The ICA occlusion extends to the level of the supraclinoid segment. This portion of the right ICA is opacified in retrograde fashion during the left carotid injection by means of a patent anterior communicating artery (scan 3). Also note the extravasation of contrast from injured branches of the occipital artery (scan 2). The internal jugular vein (not shown) was normal. Films 6, 7, 8: A high resolution CT scan of the temporal bone more clearly reveals the bullet fragments in the vertical (Film 6, scans 1-2) and horizontal (Film 6, scans 3-4, and Film 7, scans 1-2) petrous segments of the carotid canal. The fragments are anterior to the jugular foramen and sigmoid sinus (Film 6 and Film 7, scan 1). The ossicles are markedly dislocated (Film 7, scans 2-3; Film 8, scan 1). Bullet fragments have shattered the cochlea (Film 7, scans 2-3) and transected the internal auditory canal (Film 7, scan 3, and Film 8, scan 1). A fracture line extends across the anticipated course of the facial nerve, just prior to its entry into the labyrinthine segment of the facial canal. | |
| Differential Dx | ||
| Discussion | ... (continues ...) | |
| User Group | ||
| Contributor | Neuroradiology Learning File - © ACR :: ACR Learning File® - | |
| Reviewer | :: - Case Accepted: 2012-05-23 11:52:08-04 :: Revised: 2012-05-24 15:20:56.440778-04 :: Submitted: 2012-05-22 10:45:56.642777-04 | |
| 7 Search Results for => Penetrating <= Result Items 1 - 20 |
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