The complete or the partial absence of pericardium is a rare congenital
malformation for which the patients are commonly asymptomatic and the diagnosis
is incidental. The absence of the left side of the pericardium is the most
common anomaly that is reported in the literature while the complete absence of
pericardium or the absence of the right side of the pericardium are uncommon and
their criteria are still unrecognized given their rare occurrence in clinical
practice. This paper aims to report a case of 19-year-old male with the
congenital partial absence of both sides of the pericardium and to highlight the
symptoms and the different cardiac imaging modalities used to confirm the
diagnosis of this defect.
We report a case of a 29-year-old man who had been a victim of a public road accident. Four weeks later, the patient developed an isolated right thigh mass located ventrally in the distal one-third of the thigh. The mass was painful and associated with fever and inflammatory syndrome. Plain radiographs showed a bilateral calcified thickening of soft tissues with well-defined bony margins. Ultrasound objectified diffuse calcifications of soft tissues.CT scan-confirmed the diagnosis of myositis ossificans circumscripta, showing a bilateral thickening of the vastus intermedius chief of the quadriceps dotted with calcifications, extending along the femur axis. These calcifications have well-defined bony margins separated from the periosteum by a lucent zone.
Spontaneous right hepatic artery branch gallbladder fistula is a rare condition. Our case reported a spontaneous fistula between the right branch of the hepatic artery and the gall bladder. It constitutes a rare cause of haemobilia. In fact, the most common aetiology of haemobilia is traumatic or iatrogenic secondary to hepatobiliary surgery or interventions. Diagnosis of vascular-biliary fistula is not easy. The gallbladder endoluminal clot can mimic a mass, as in our patient. Selective arterial angiography is helpful in identifying the source of gastrointestinal haemorrhage. It can demonstrate the presence of arteriobiliary fistula. The differential diagnosis is arterial pseudoaneurysm in the vicinity of the vessel. Mini-invasive treatment of this fistula constitutes the best treatment. We here report a case of haemobilia with upper cataclysmic gastrointestinal bleeding revealing a spontaneous fistula between the right branch of the hepatic artery and the gall bladder.
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