MediAI

  How Delayed CT Imaging Reveals Hidden Urinary Leakage and Prevents Missed Emergency Diagnoses Edited by ScholarGen MediAI Team Executive Clinical Summary A patient presented with persistent left-sided abdominal pain. Initial CT imaging demonstrated delayed nephrogram, proximal ureteral dilatation, and retroperitoneal fluid collection without a visible obstructing stone. The diagnosis remained uncertain until delayed excretory-phase CT revealed contrast extravasation into the retroperitoneal space—confirming spontaneous ureteral rupture with urinoma formation . This case reinforces a fundamental radiologic principle: Urinary leakage cannot be diagnosed without delayed-phase imaging. Clinical Hook The CT scan appears inconclusive. No stone is identified. Yet the kidney enhances asymmetrically. The ureter is subtly dilated. There is unexplained fluid in the retroperitoneum. At that moment, the diagnosis depends not on what is seen— but on what the radiologist chooses t...

https://doi.org/10.1056/NEJMicm1403124 Introduction: Understanding Trichobezoar in Clinical Practice Trichobezoar, commonly referred to as a hair bezoar, is a rare but clinically significant gastrointestinal condition characterized by the accumulation of ingested hair within the stomach and sometimes extending into the small intestine. This condition is strongly associated with psychiatric disorders such as trichotillomania and trichophagia, making it a fascinating intersection between gastroenterology, radiology, and psychiatry.  This column provides a comprehensive, expert-level yet reader-friendly analysis of trichobezoar, integrating real case imaging findings, pathophysiology, and diagnosis. https://doi.org/10.4021/gr2008.11.1287 Case Overview: 18-Year-Old Female with Abdominal Pain and Vomiting An 17-year-old female with a known history of autism and trichotillomania presented with: Persistent vomiting for 48 hours Abdominal pain Normal vital signs and laboratory findings Im...

  Abstract Ogilvie’s syndrome, also known as acute colonic pseudo-obstruction (ACPO), is a rare but potentially life-threatening condition characterized by acute colonic dilatation in the absence of mechanical obstruction. This column presents a comprehensive, expert-level review integrating clinical case insights, imaging interpretation, and current global literature. Emphasis is placed on pathophysiology, epidemiology, diagnostic imaging, and evidence-based management strategies, structured in the format of a biomedical review. Keywords Ogilvie’s syndrome, acute colonic pseudo-obstruction, colonic dilatation, CT imaging, bowel obstruction, neostigmine, colonoscopic decompression I. Introduction Ogilvie’s syndrome is a critical gastrointestinal emergency that mimics mechanical bowel obstruction but lacks any obstructive lesion. First described by Sir William Ogilvie in 1948, this syndrome is increasingly recognized in hospitalized and critically ill patients. Failure to promptly ...

  Abstract Intussusception is a critical gastrointestinal condition characterized by the telescoping of one bowel segment into another, often leading to obstruction, ischemia, and potential perforation. While predominantly observed in pediatric populations, adult intussusception represents a diagnostically challenging and clinically significant entity, frequently associated with a pathological lead point such as malignancy. This article provides a comprehensive, expert-level review of intussusception, integrating clinical insights from a real-world case involving a 54-year-old male patient. Emphasis is placed on pathophysiology, epidemiology, clinical presentation, imaging features, differential diagnosis, diagnostic strategies, treatment modalities, and prognosis. Additionally, radiologic interpretation of CT imaging—including the hallmark “target sign”—is explored in depth.  Keywords Intussusception, Intussusception CT target sign, Adult intussusception diagnosis, Intus...