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Gastric Pneumatosis in a 4-Month-Old Infant: Imaging Clues That Revealed a Hidden Duodenal Web

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  Clinical Hook A healthy-looking four-month-old infant presents with persistent non-bilious vomiting and poor feeding. The abdominal examination is surprisingly benign. No signs of peritonitis. No fever. No severe distress. Then the abdominal radiograph reveals something unexpected— air inside the gastric wall. For pediatric radiologists, this single imaging finding immediately changes the differential diagnosis. Is this ischemia? Necrotizing enterocolitis? Emphysematous gastritis? Or simply pressure-related gastric emphysema caused by an unsuspected mechanical obstruction? This case demonstrates how one rare radiographic sign ultimately uncovered a congenital duodenal web , emphasizing why gastric pneumatosis should never be dismissed as an incidental finding. The diagnosis and clinical sequence are based on the provided case materials. Learning Objectives After reading this article, you will be able to: Recognize gastric pneumatosis on abdominal radiographs. Differentiate ga...
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When Hemoptysis Is Not Tuberculosis: A Radiology Case of Pulmonary Paragonimiasis Mimicking Cavitary Lung Disease

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  How Chest CT, Bronchoalveolar Lavage, and AI-Assisted Imaging Revealed an Overlooked Parasitic Infection Hemoptysis Is Not Always Tuberculosis In many countries, chronic hemoptysis immediately raises suspicion for pulmonary tuberculosis. A patient presenting with months of blood-tinged sputum, cavitary pulmonary lesions, and a positive tuberculin skin test often begins empirical anti-tuberculosis therapy before a definitive diagnosis is established. However, radiologists know that cavitary lung lesions represent one of the broadest and most challenging differential diagnoses in thoracic imaging. Infection, malignancy, autoimmune disease, septic emboli, fungal disease, congenital disorders, and parasitic infections may all produce remarkably similar CT findings. Among these conditions, pulmonary paragonimiasis remains one of the most frequently overlooked diseases, particularly in non-endemic countries. Increasing international migration, global travel, and changing dietary habit...
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