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Radiology gallery 9

Ovarian dermoid cyst This appearance on a plain abdominal film of a 30 year-old woman was an incidental finding.  The calcification seen in the left side of the pelvis is the typical appearance of an ovarian dermoid cyst.  Dermoid cyst is a loose term given to cysts are various sites lined by squamous epithelium.  Ovarian dermoids account for about 20% of ovarian tumours.  The vast majority (99%) are benign and may contain mature tissues such as bone, teeth, cartilage, hair and thyroid tissue.
Malignant percutaneous transhepatic cholangiogram This 70 year-old man presented with a one month history of jaundice, pale stools and dark urine.  He had been generally unwell with right upper quadrant pain and weight loss for approximately three months prior to admission.  A liver ultrasound showed multiple hepatic metastases.  An ERCP showed obstruction within the porta hepatitis suggestive of portal lymphadenopathy.  A stent could not be inserted endoscopically.  This procedure is a percutaneous transhepatic cholangiogram showing grossly dilated intra-hepatic ducts.  A guide wire was inserted percutaneously and stenting achieved by a combined procedure

Caecal volvulus This 79 year-old lady presented with a one week history of colicky abdominal pain, distension and vomiting.  She was dehydrated.  Abdominal examination confirmed distension and showed a midline mass and high pitched bowel sounds.  This supine film was taken showing a coffee bean shaped gas-filled viscus arising from the right iliac fossa.  The radiological appearance is that of caecal volvulus.  After resuscitation the patient proceeded to a laparotomy.  The caecum was decompressed.  The caecum was viable, no resection was required and caecopexy with a tube caecostomy was performed.  She made an uncomplicated recovery from her surgery.

Pelvi-ureteric junction obstruction This 30 year-old lady presented with left loin pain.  She had no other urinary symptoms of note. Abdominal examination was unremarkable. Urinalysis was normal.  As part of her out-patient investigation this intravenous urogram was performed.  It shows dilatation of the left renal pelvi-calyceal system with delay in the excretion of contrast.  The ureter was normal.  The   appearances are those of a pelvi-ureteric junction obstruction.  A renal isotope scan showed good renal function and she proceeded to an Anderson-Hymes pyeloplasty to improve drainage of the kidney.  She made an uncomplicated recovery from her surgery.


Last updated: 03 January 2011

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