International Journal of Gastrointestinal Intervention

pISSN 2636-0004 eISSN 2636-0012

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< Previous Next >Gastrointestinal Intervention 2014; 3(2): 65~119

Case Report 2014-12-30

Looking beyond lymph nodes: Beware of the lurking pseudoaneurysm!

Ayesha Nasrullah, Jon K. Bell, Sailaja Reddy, Ray Ashleigh, and Velauthan Rudralingam

https://doi.org/10.1016/j.gii.2014.10.001

Abstract : An arteriovenous fistula of the superior mesenteric vessels leading to pseudoaneurysm formation is rare and most commonly occurs after blunt trauma or surgery. We describe a case of a superior mesenteric artery?superior mesenteric vein (SMA/SMV) pseudoaneurysm that was initially misinterpreted as an enlarging hypervascular nodal metastasis on surveillance computed tomography (CT) in a patient who had undergone ileal carcinoid resection. When the case was discussed at the specialist multidisciplinary meeting to consider surgical resection, it was noted that the apparent “hypervascular node” on CT had a signal void character on magnetic resonance imaging, which is atypical for a lymph node. Coronal CT reformat demonstrated a vascular origin from the superior mesenteric trunk. This resulted in the correct diagnosis of a pseudoaneurysm secondary to an SMA/SMV fistula. This avoided an unnecessary repeat surgery, and the patient underwent endovascular repair. In our patient, the distal was closed by 3-mm coils and the proximal was closed by an Amplatzer plug with successful results. Hence, it is crucial for radiologists to have a systematic approach and understanding of vascular-related abnormalities to avoid misdiagnosis that can potentially lead to unwanted morbidity.

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Case Report 2014-12-30

Medulloblastoma metastatic to the pancreas: a case report

Hemanth Gavini, Venkat D. Arukala, John Stewart, and Jeffrey H. Lee

https://doi.org/10.1016/j.gii.2014.09.007

Abstract : We present a case of medulloblastoma metastatic to the pancreas in a 41-year-old woman with recurrent cerebellar medulloblastoma. On presentation, computed tomography of the abdomen and pelvis showed a 2.2 cm × 2.6 cm hypodense pancreatic head mass associated with obstruction of the pancreatic duct. Endosonography with fine needle aspiration (EUS-FNA) was performed. Cytology showed a malignant small cell neoplasm that was consistent with medulloblastoma and was morphologically identical to the primary cerebellar medulloblastoma. Metastatic medulloblastoma to the pancreas is an extremely rare form of a secondary pancreatic tumor and very few case reports exist in the literature. The diagnosis rests on comparing cytological features when primary and secondary tumors are both available.

Cited By: 1

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