Gu. Write adrenal protocol? In ct Case 2 Renal injury can be classified according to the American Association of Surgeons in Trauma (AAST). Type.

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Presentation transcript:

gu

Write adrenal protocol? In ct

Case 2

Renal injury can be classified according to the American Association of Surgeons in Trauma (AAST). Type 1 injury includes renal contusions or non-expanding subcapsular hematoma. Type 2 injury includes parenchymal lacerations of less than 1 cm. Type 3 injury includes parenchymal lacerations of greater than 1 cm but not involving the renal collecting system, or segmental renal artery thrombosis without renal lacerations. Type 4 injury includes parenchymal lacerations that extend to the collecting system, or vascular injury with contained hemorrhage. Type 5 injury includes shattered kidney, lacerations to the renal hilum, or devascularization of the kidney.

Case 3 What is the abnormality ?

Retrocaval ureter

Case 3

Renal vein thrombosis

Case 4

ANATOMICAL FEATURES: 1. Right lobe of liver 2. Aorta 3. Right ventricle of heart 4. Left ventricle of heart 5. Inferior vena cava (IVC) 6. Esophagus 7. Azygous vein 8. Hemiazygous vein 9. Left lobe of liver 10. Fundus of stomach 11. Spleen 12. Right crus of diaphragm 13. Left crus of diapgragm 14. Left portal vein 15. Body of stomach 16. Right portal vein 17. Right adrenal gland 18. Celiac artery (trunk) 19. Splenic artery 20. Hepatic artery 21. Main portal vein 22. Left adrenal gland 23. Body of pancreas 24. Splenic vein 25. Gallbladder 26. Antrum of stomach 27. 1st part of duodenum 28. Superior mesenteric artery (SMA) 29. Right kidney 30. Left kidney 31. Head of pancreas 32. 2nd part of duodenum 33. Left renal vein 34. Right renal artery 35. Right renal vein 36. Superior mesenteric vein (SMV) 37. Hepatic flexure of colon 38. 3rd part of duodenum 39. Jejunum 40. Transverse colon 41. Inferior mesenteric artery (IMA) 42. Right common iliac artery 43. Left common iliac artery View Thumbnails in This Series

Case 3 What is the abnormality ?

Right portal vein 1 Left portal vein 2 Main portal vein 3 Splenic vein 4 Superior mesenteric vein 5 Inferior mesenteric vein 6

Subsequent abdominal CT again reveals an abdominal aortic aneurysm with focal posterior outpouching anterior to the left renal vein. Again, contrast enhancement of the aorta, left renal vein and inferior vena cava are noted. There is now only minimal contrast enhancement of the left kidney with normal contrast enhancement of the right kidney.

Case 3 What is the abnormality ?

Aorta 1 Celiac artery 2 Superior mesenteric artery 3 Left gastric artery 4 Left renal vein 5 Left lobe of liver 6 Inferior vena cava 7 Left hepatic vein 8 Ligamentum venosum 9 Caudate lobe of liver 10 Hepatic artery 11 Splenic artery 12 Portal vein 13

Findings: Abdomen plain film shows pneumatosis of the ascending and descending colon, with no evidence for gross pneumoperitoneum. Abdomen CT with intravenous contrast showed extensive colonic pneumatosis, with no gross pneumoperitoneum. No portal venous gas. No obvious cause for the colonic pneumatosis