Section Mirizzi syndrome 25 Dec 202118 Dec 2021 Common bile duct narrowing and fibrosis due to chronic gallstone diseaseStone usually impacted in gall bladder neck, cystic duct or cystic duct remnantFistula can develop between gall bladder or cystic…
Section Primary sclerosing cholangitis 24 Dec 202118 Dec 2021 70% patients have history of inflammatory bowel disease - ulcerative colitisMultiple segments of stricture involving intra- and/or extra-hepatic ductsBile duct wall thickening at sites of structuring Small diverticula-like outpouchingsCholangiocarcinoma in 10%…
Section Angiosarcoma (spleen) 20 Dec 202115 Dec 2021 Rare, poor prognosisMultiple nodules of varying sizeSolitary solid mass with cystic components, variable enhancement Well-defined hemorrhagic nodulesDiffuse spleen involvement Imaging CT: hypodense on plain with areas of increased attenuation due to…
Section Portal hypertension 20 Dec 202115 Dec 2021 Normal pressure difference between wedged hepatic vein and IVC = 4-8 mm HgHigher pressures suggest portal hypertensionAscitesDistended mesenteric veinsDistended walls of gall bladderStomach and small bowel are edematousSplenomegaly not always…
Section Epithelioid hemangioendothelioma 19 Dec 202115 Dec 2021 Tumor of vascular originAdult womenConsists of epithelioid endothelial cellsOccasionally contains punctate calcificationMultiple peripheral nodules that coalesce, cause capsular retraction, with compensatory hypertrophy of uninvolved liver segments Can cause hepatic vein occlusion…
Section Fibrolamellar carcinoma (liver) 19 Dec 202115 Dec 2021 5-35 years age Arise spontaneouslySolitary, lobulated, well-defined tumor with central scarPunctuate calcification within scar in >50% casesContains fibrotic lamellae and numerous eosinophilic hepatocytesResection when possible5-year survival 60% Imaging CT: well-defined lobulated,…
Section Focal fat (liver) 18 Dec 202115 Dec 2021 Regional or focalCauses confusion if there is any underlying massCommon sites: either side of falciform ligament, around gall bladder fossa, posterior aspect of segment IVVariations in local blood supply and…
Section Hemangioma (liver) 18 Dec 202114 Dec 2021 Commonest benign hepatic tumor 4-20% post-mortem prevalenceVascular channels of varying size, lined with endothelium, has intervening fibrous tissueAsymptomatic incidental findings Lesions 2-4 cm in size show typical imaging findings Imaging US: well…
Section Portal venous gas 17 Dec 202114 Dec 2021 Always abnormalPresent when intestinal permeability increases or when there is increase in intestinal luminal pressureNeonatal necrotising enterocolitis, adults with gastric emphysema, intestinal obstruction, infection, Crohn diseaseBlunt abdominal trauma, invasive malignancies…