Conjoined twins are rare and present a challenge for surgeons and radiologists and classified according to the main site of connection: thorax (thoracopagus), abdomen (omphalopagus), etc. Here, we report a Seventeen-month-old, female omphalopagus conjoined twins, born from a mother with a family history of twins, who performed CT-scan and ultrasound echocardiography for elective surgery preparation and X-ray evaluation after the separation surgery. From the CT-Scan examination, revealed each baby had its own, separate heart (one with dextrocardia), each baby had its own liver but they were partially fused and several small branches crossed each other (superior mesenteric artery, intercostal artery, and hepatic vasculature). Findings at surgery are consistent with radiological findings, but we missed to evaluate the pericardium despite being informed by the CT-scan that each baby had its own heart. Radiological investigation plays an important role in the evaluation, all possibilities must be taken into account: operation feasibility, shared organs, soft tissue, and bone structure.

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Background: Most causative of liver abscess, in about 90% of all cases, are pyogenic abscess. One of the rare and dangerous complications of pyogenic liver abscess (PLA) that requires urgent management, even with nonspecific signs and symptoms, is abscess rupture. Case Presentation: A 27 years old male patient came to the hospital with persistent right upper abdominal pain. The pain started one week ago after the patient fell from the stairs, where the right side of the abdomen hit the stairs. Abdominal ultrasound revealed heteroechoic lesion with ill borders, irregular margin, and internal moving echo (+) in the right lobe of the liver, which on color doppler examination showed minimal perilesional vascularization. The patient underwent abdominal computed tomography (CT) scan with contrast four days later with showed rim enhancing semisolid lesion (23-33 HU) with air density (-925 HU) within it in, in the segments V to VIII of the right lobe of the liver partially ruptured in the periphery of segments VI-VII of the liver lobe with pneumoperitoneum and ascites. A week later, a laparotomy was performed, and the culture of the pus specimen revealed growth of Escherichia coli. Conclusion:Based on clinical symptoms and imaging, PLA is not without any challenges in diagnosis. The key to avoiding misdiagnosis of ruptured PLA is a meticulous examination of the clinical and imaging also vigilant monitoring.

Bowel obstruction caused by intussusception is a rare case. A non-typical sign makes the patient undergo several radiological examinations to establish diagnosis. From various intussusception causes, lipoma is a very rare cause. We reported a rare case of small bowel intussusception caused by lipoma who underwent ultrasonography (USG) and computed tomography (CT) scan examinations in Dr.

Colorectal cancer (CRC) is a type of malignancy in the digestive system. Colorectal cancer can be found anywhere along the large intestine from the cecum to the rectum. However, transverse colorectal cancer is a rare case and is only found in 6.8% of total colorectal cancers. A 64-year-old male patient with complaints of weakness, changes in the pattern of defecation, namely dark brown bowel movements for approximately +/- 8 months, anemia, and an increase in serum CEA. The results of the initial examination with plain abdominal radiographs did not reveal any abnormalities, only normal gas shadows mixed with fecal material were found that were prominent in the right to left hypochondrium region. After further examination, the patient was found to have stage 4 transverse colorectal cancer. The diagnosis of transverse colorectal carcinoma (CRC) was established based on fluoroscopy findings which showed filling abnormalities and colonic lumen irregularities in the medial 1/3 of the transverse colon forming an apple core image with the narrowest diameter + /- 3 mm along +/- 6 cm, shouldering sign (+), and on CT abdomen with contrast, an intraluminal malignant mass was found (Staging AJCC 8th ed 2018 T4aN2aM0). The diagnosis of CRC was confirmed by the results of resection and histopathological examination which found well-differentiated adenocarcinoma of the colon.