The Nutcracker Syndrome is a rare and often unrecognized cause of chronic pelvic pain and left back pain. These symptoms are due to the left renal vein compression between the aorta and the superior mesenteric artery (anterior nutcracker) or between the aorta and the spine (posterior nutcracker). The variety of clinical manifestations make the diagnosis difficult and commonly delayed. Therefore, imaging plays a key role in correcting the diagnosis by confirming the left renal vein stenosis and ruling out any differential diagnosis. Treatment options are discussed by a multidisciplinary team involving urologists, nephrologists and vascular surgeons for each patient. We report the case of 2 patients presenting chronic pelvic and lower back pain in whom clinical investigation and CT imaging findings were consistent with a nutcracker syndrome.
The hydatid cyst is a worldwide anthropozoonosis, which constitutes a health issue in Northern Africa. It may involve any organ, but it mostly affects the liver. This often asymptomatic disease can lead to multiple complications. Among them, spontaneous fistulization of a hepatic hydatid cyst in the stomach is exceptional even in endemic countries. We report the case of a 38-year-old female with febrile biliary colics due to a hydatid cyst of the liver fistulized in the stomach. The diagnosis was established based upon different clinical, biological and mainly radiological features. She received surgical treatment with satisfactory postoperative outcome.
The peritoneal pseudotumor localization of tuberculosis is a rare clinical form, representing 1 to 3% of extrapulmonary site of tuberculosis. It represents the sixth most common extra pulmonary site of tuberculosis. It is a great mimicker with major overlapping clinical and imaging features. Differentiating peritoneal tuberculosis and peritoneal carcinomatosis in imaging remains challenging. We present a case of a 37-year old woman complaining of chronic abdominal pain and distension who has been diagnosed to have peritoneal carcinomatosis based on CT findings, histopathological study then revealed necrotizing, granulomatous inflammation consistent with tuberculosis. This case showed the interest to be aware of the common and uncommon imaging features of tuberculosis by radiologists to better assess for alternative differential diagnosis.
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