Noninvasive Imaging of a Retrocardiac Spleen

Three infants with late presentation of Bochdalek hernia are presented. The presenting symptoms were cough, intermittent vomiting, dyspnea, and cyanosis. Initial diagnoses of isolated paravertebral mass and foreign material aspiration were made in two infants, based on plain chest x-ray findings and history of the patients. Further radiological investigations, such as contrast upper gastrointestinal series or enema, computerized tomography, and magnetic resonance imaging of the chest, suggested the diagnosis of Bochdalek hernia. The hernia was found on the left side in two patients and on the right side in one. At operation, the stomach, small intestine, and spleen were found as herniated organs in one patient, ascending colon in one, and all of the small intestine together with ascending colon in the other. A congenital diaphragmatic defect should be suspected in every child presenting with unusual respiratory or gastrointestinal symptoms and with abnormal chest x-ray findings. The radiological findings vary greatly from one case to another, and even in the same case at different times because of differences in herniated organs and intermittent spontaneous reduction. The possibility of congenital diaphragmatic hernia should be kept in mind to avoid a wrong diagnosis, undue delay in diagnosis, and inappropriate treatment.

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Late presentation of Bochdalek hernia: Clinical and radiological aspects

Öztürk

Karnak

Sakarya

et al. 2001

Pediatric Pulmonology

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Echocardiographic Manifestations of Mediastinal Masses Compressing or Encroaching on the Heart

1994

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Because of its central position within the thorax, the heart can be encroached upon by masses originating in either anterior, posterior, or superior mediastinum. A distinction may be made between (A) Encroachment: distortion or partial displacement of one or more cardiac chambers by a contiguous mediastinal mass, without adverse hemodynamic effects, and (B) Compression: resulting in clinical manifestations similar to tamponade. Transthoracic and, recently, transesophageal echocardiography have been found useful in detecting mediastinal masses, the information obtained being complementary or preliminary to more complete imaging by CT or MRI. Anterior masses tend to compress the right heart chambers; posterior masses impinge on or compress the left atrium or ventricle, particularly the former. The wide variety of echographic appearances are briefly reviewed. Recently TEE has made it possible to diagnose masses obstructing the superior vena cava or pulmonary veins. A common, though little known, type of posterior mediastinal encroachment that echocardiographers need to be aware of is that of abnormal esophageal/gastric masses including hiatus hernia and esophageal carcinoma, which have typical two-dimensional echo features and may sometimes simulate left atrial masses.

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Cardiac and Paracardiac Masses

1998

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The objective of this study was to compare the roles of echocardiography and magnetic resonance imaging (MRI) in the evaluation of patients suspected of having cardiac and paracardiac masses. Echocardiography is a widely available and useful technique for characterizing cardiac and paracardiac abnormalities but suffers from a limited field of view and restricted acoustic access to mediastinal structures. MRI is an alternative noninvasive imaging technique for investigation of these abnormalities. Fourteen consecutive patients suspected of having cardiac or paracardiac masses on echocardiography were referred for cardiac MRI. MRI gave more complete visualization in four patients with infiltrating lung tumors and in one patient with intracardiac metastases who had a technically inadequate echo. Echo showed a rapidly moving Chiari network not seen on MRI. Both echo and MRI were helpful in patients with hiatal hernias (2); lipomatous hypertrophy of the interatrial septum (2); left atrial myxoma (1); and calcified mitral annulus (3). We conclude that echocardiography and MRI should be used together to investigate patients with cardiac and paracardiac masses.

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Noninvasive Imaging of a Retrocardiac Spleen

Cited by 4 publications

References 8 publications

Late presentation of Bochdalek hernia: Clinical and radiological aspects

Late presentation of Bochdalek hernia: Clinical and radiological aspects

Echocardiographic Manifestations of Mediastinal Masses Compressing or Encroaching on the Heart

Cardiac and Paracardiac Masses

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