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Biomedical subjects

J Casillas

Publications and source records attributed to J Casillas.

At least 19 recordsLinked to original sources
PubMed1996

Genitourinary tract gas: imaging evaluation.

Gas-forming infections of the genitourinary tract may manifest as life-threatening conditions, often requiring aggressive medical and surgical management. Accurate interpretation of the radiologic studies is essential for early and accurate diagnosis of gas within the renal parenchyma or collecting system, bladder, uterus, and scrotum. Three distinct entities are associated with renal or perirenal gas: emphysematous pyelonephritis, emphysematous pyelitis, and gas-forming perirenal abscess. Gas in the bladder may occur secondary to emphysematous cystitis or a vesicoenteric fistula and must be differentiated from air introduced by means of instrumentation. Uterine gas usually indicates an underlying infection or a neoplasm. Gas in the scrotum is most commonly due to an infectious process or bowel herniation into the scrotal sac. Before institution of a specific therapeutic regimen, an effort should be made to establish the exact location of gas in the genitourinary tract. Plain radiography, including tomography, and ultrasonography are useful screening modalities. Although in some cases urography, barium enema studies, and other contrast material-enhanced studies enable a diagnosis to be made, in many patients computed tomography is the definitive diagnostic technique.

Adult↗
PubMed1992

Intraductal carcinoma of the pancreas.

Four multicentric intraductal papillary carcinomas arising in the main pancreatic duct are presented. Three of the neoplasms showed stromal invasion and metastasized to regional lymph nodes. Three patients had a long history of epigastric pain, confirming the progressive slow growth and less aggressive nature of this clinicopathologic entity. Histologically, all tumors were papillary, and three also showed a pseudocribriform pattern. Individual cells exhibited a range of atypia from mild to overt malignant change. Focal intestinal differentiation was recognized in two tumors. Despite the well-differentiated appearance of these tumors, two patients died within 1 year of surgery. One patient with an entirely intraductal carcinoma is alive and well 3 years after surgical treatment. The fourth patient who had lymph node metastasis is alive 6 months after a Whipple's procedure.

Adult↗
PubMed1992

Case report: adrenal myelolipoma--rationale for a noninvasive diagnosis.

Myelolipomas are nonfunctioning, benign tumors of the adrenal gland composed of fat and normal bone marrow elements in varying proportions. Although rare, they should be included in the differential diagnosis of the incidentally discovered adrenal mass. The authors describe a patient with a myelolipoma diagnosed by characteristic radiological findings in whom the use of invasive procedures or surgical exploration was unnecessary.

Adrenal Gland Neoplasms↗
PubMed1991

Imaging of intra- and extraabdominal desmoid tumors.

Desmoid tumors are characterized by proliferation of fibroblastic cells that arise from the fascia or aponeurosis of muscle. They are most commonly found in the abdomen of adults, arising from the anterior abdominal wall, mesentery, or retroperitoneum. At sonography, desmoids have variable echogenicity, with smooth, well-defined margins. On contrast-enhanced computed tomographic scans, the tumors are generally high attenuation (relative to muscle) and have either ill- or well-defined margins. At magnetic resonance imaging, desmoids have low signal intensity relative to muscle on T1-weighted images and variable signal intensity on T2-weighted images. There are no specific imaging features to distinguish desmoid tumors from other solid masses. The diagnosis of desmoid tumor should be considered in patients with an abdominal mass, a history of abdominal surgery or injury, or Gardner syndrome.

Abdominal Neoplasms↗
PubMed1990

Sonographic anatomy of the caudate lobe veins.

Because of their small size, the caudate lobe veins (CLV) are not routinely imaged with ultrasonography. We recently examined 4 patients with elevated central venous pressure in whom the CLV were easily identifiable. To our knowledge this is the first report of sonographic visualization of these veins. We suggest that visualization of the CLV may not be as rare as previously presumed, and based on our experience, we will propose a nomenclature system for these veins.

Central Venous Pressure↗
PubMed1990

CT in the diagnosis of renal trauma.

Computed tomography (CT) is frequently employed as the initial diagnostic study in patients with known or suspected renal trauma, especially in large trauma centers where multiple-system injuries are common. In our 3-year experience, which encompasses over 2,500 CT scans for abdominal trauma, the following traumatic renal lesions were identified: renal contusion, small and large subcapsular hematomas, laceration, complete laceration, ureteropelvic junction disruption, fractured kidney, shattered kidney with and without an intact renal capsule, renal vein injury, renal artery thrombosis, avulsion, and trauma to the abnormal kidney. The CT findings and clinical features and management of each lesion are reviewed.

Hematoma↗
PubMed1990

CT appearance of uterine leiomyomas.

Uterine leiomyomas, commonly known as fibroids, are one of the most common pelvic tumors found in women. Ultrasonography is the primary modality for evaluating leiomyomas. However, frequently these tumors are not accompanied by symptoms, and they are found incidentally during computed tomographic (CT) examinations performed for other indications. Because leiomyomas may first be noted on CT scans, radiologists should become familiar with their characteristic appearance. The authors describe the CT findings of uterine leiomyomas and their secondary changes, including cystic degeneration, calcification, infection, necrosis, fatty degeneration, and sarcomatous degeneration.

Calcinosis↗
PubMed1989

The CT appearance of cystic masses of the liver.

The authors here discuss twelve discrete pathologic entities that they found, in a review of over 500 abdominal CT scans, caused the appearance of a cystic lesion in the liver. The CT characteristics of the various lesions are illustrated, differential points in the patients' histories are noted, and gross and microscopic pathology specimens are correlated with the CT appearances to explain the CT findings. Lesions considered include: simple (bile duct) cyst, adult polycystic kidney disease, Caroli disease, pyogenic abscess, echinococcal cyst, amebic abscess, metastasis, biliary cystadenoma and cystadenocarcinoma, hepatocellular carcinoma, cholangiocarcinoma, biloma, and extrapancreatic pseudocyst.

Carcinoma, Hepatocellular↗
PubMed1988

Traumatic adrenal hemorrhage: radiologic findings.

Four patients with traumatic hemorrhage in the right adrenal gland were examined with computed tomography (CT) and ultrasound (US) (initial US studies in three patients; follow-up study at least 1 month after the trauma in all patients). CT showed an enlarged inhomogeneous gland of normal to increased attenuation. This finding was associated with stranding of the periadrenal fat and stranding of the subcutaneous fat of the right flank, which corresponded to the site of trauma. US showed an enlarged, hyperechoic mass with a bright central echo that became cystic on follow-up examinations. Magnetic resonance imaging, performed in one patient, showed an enlarged gland that was isointense with liver on T1-weighted images and had increased signal intensity on T2-weighted images. Stranding of the periadrenal and subcutaneous fat of the right flank was present on T2-weighted images and appeared as streaky areas of increased signal intensity.

Adolescent↗
PubMed1985

Transgastric drainage of pancreatic fluid collections.

Eight pancreatic fluid collections in seven patients were successfully drained percutaneously through a transgastric approach. The drainage catheters were left in place for 3-6 weeks to promote the formation of a fistulous tract between the stomach and the pancreatic collection. Computed tomography (CT) was used for diagnosis and for planning of the access route. Combined sonography and fluoroscopy were used for guidance. Radiologic follow-up examinations (CT and sinograms) have shown no recurrences (3-12 months). No complications were encountered.

Drainage↗
PubMedDate not supplied

Fournier's gangrene: CT findings.

Fournier's gangrene is an uncommon gas-forming infection of the scrotum which if not recognized early and treated appropriately may be fatal. In three patients recently seen at our institution, computed tomography (CT) was instrumental in establishing the correct diagnosis and determining the extent of the infectious process prior to surgery. The imaging findings at CT and its differential diagnosis are illustrated. A brief review of the current theories of pathogenesis of this interesting entity is presented.

Aged↗
PubMedDate not supplied

CT appearance of giant renal angiomyolipoma.

Renal angiomyolipomas are rare benign tumors readily identified by computed tomography due to their high fat content. When they attain giant proportions other fatty neoplasms, specifically liposarcomas, cannot be excluded based on the radiographic findings. A case in which a notch defect in the lateral border of the kidney was the single most important clue as to the intrarenal origin of the mass and led to the correct pre-operative diagnosis is presented.

Adult↗