Biomedical subjects
Publications and source records attributed to M Boyez.
A case of aneurysmal dilatation of the portal vein is reported. A real-time ultrasound study showed a cystic mass behind the pancreatic head, freely communicating with the lumen of the portal, superior mesenteric, and splenic veins, which was diagnostic of portal vein aneurysm. The diagnosis was confirmed by dynamic computed tomography and celiac and superior mesenteric angiograms.
A case of calcified and infected mucocele of the appendix is reported. The appearance of the calcification, the presence of gas with an air fluid level on plain films, and the opacification of the lumen of the mucocele by opaque enema allowed the correct radiologic diagnosis to be made.
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Fecal concretions adherent to the caecal mucosa and an appendicular mucocele may present as a palpable mass in the right iliac fossa. The authors report a case of a young man with mucoviscidosis who presented with these two signs and they propose a non-invasive diagnostic approach consisting of a plain X-ray of the abdomen, an ultrasound examination and a hypertonic, hydrosoluble contrast enema. Fecal concretions do not produce any specific features on the plain X-ray or on ultrasound but they are seen as a constant filling defect on the contrast enema and they may be evacuated with this technique, thus avoiding the need for surgery. The mucocele is rarely calcified on the plain abdominal film and ultrasound reveals a liquid contents. It should be treated by limited excision of the appendix. The discovery of an appendicular mucocele at any age should lead to the investigation for mucoviscidosis.
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A 22 year old woman was diagnosed as having a Fitz-Hugh and Curtis syndrome (FHCS) or venereal perihepatitis during laparoscopy for investigation of pain in right hypochondrium and fever. Abdominal ultrasonography images presented an unusual appearance suggestive of a perihepatic effusion and of thickening of Glisson's capsule, lesions that were confirmed on laparoscopy. This ultrasound image could not be formally distinguished from a normal variant, but ultrasonography is still a valid method of diagnosis of FHCS. An acute cholecystitis in a young woman should suggest the diagnosis; absence of a right renal, hepatic or gallbladder anomaly should lead to investigation by ultrasound of the possible presence of an abdominal effusion of fluid and pelvic inflammation. Perihepatitis is confirmed on laparoscopy, which also allows sampling for bacteriologic and serologic tests to identify the causal germ: gonococcus and particularly Chlamydia trachomatis. Treatment consists of administration of specific antibiotics (ampicillin or doxycycline).