Comments on: Radiology Quiz http://www.gcgeorge.net/2007/12/14/radiology-quiz-3/ As life cruises along; vita non est vivere sed valere Fri, 20 Jan 2012 16:15:14 +0000 hourly 1 http://wordpress.org/?v=3.0.1 By: Vijay http://www.gcgeorge.net/2007/12/14/radiology-quiz-3/comment-page-1/#comment-15895 Vijay Tue, 18 Dec 2007 06:43:10 +0000 http://www.gcgeorge.net/2007/12/14/radiology-quiz-3/#comment-15895 :o) :o )

]]> By: George http://www.gcgeorge.net/2007/12/14/radiology-quiz-3/comment-page-1/#comment-15882 George Mon, 17 Dec 2007 17:32:59 +0000 http://www.gcgeorge.net/2007/12/14/radiology-quiz-3/#comment-15882 MRI of her cervical spine was normal MRI of her cervical spine was normal

]]> By: George http://www.gcgeorge.net/2007/12/14/radiology-quiz-3/comment-page-1/#comment-15881 George Mon, 17 Dec 2007 17:31:00 +0000 http://www.gcgeorge.net/2007/12/14/radiology-quiz-3/#comment-15881 well thanks all. Looks like Vijay got it right. It is a diaphragmatic palsy. Her history only begins after the fall thus suggesting a traumatic cause. The obstruction was due to the anatomical displacement of the upper gastrointestinal tract together with adhesion formation . Therefore, surgery was indicated where the plication of the paralysed diaphragm was done and the stomach was returned to position. She recuperated well and was discharged well after a week. well thanks all. Looks like Vijay got it right. It is a diaphragmatic palsy. Her history only begins after the fall thus suggesting a traumatic cause. The obstruction was due to the anatomical displacement of the upper gastrointestinal tract together with adhesion formation . Therefore, surgery was indicated where the plication of the paralysed diaphragm was done and the stomach was returned to position. She recuperated well and was discharged well after a week.

]]> By: Bai http://www.gcgeorge.net/2007/12/14/radiology-quiz-3/comment-page-1/#comment-15868 Bai Mon, 17 Dec 2007 02:50:04 +0000 http://www.gcgeorge.net/2007/12/14/radiology-quiz-3/#comment-15868 C4 injury C4 injury

]]> By: Bongi http://www.gcgeorge.net/2007/12/14/radiology-quiz-3/comment-page-1/#comment-15857 Bongi Sun, 16 Dec 2007 10:23:14 +0000 http://www.gcgeorge.net/2007/12/14/radiology-quiz-3/#comment-15857 i'm going to go with rupture. even chronic. i’m going to go with rupture. even chronic.

]]> By: Vijay http://www.gcgeorge.net/2007/12/14/radiology-quiz-3/comment-page-1/#comment-15834 Vijay Sat, 15 Dec 2007 09:53:08 +0000 http://www.gcgeorge.net/2007/12/14/radiology-quiz-3/#comment-15834 My first impression when I saw the Chest xray & the digital scanogram was that it is a diaphragmatic palsy. The xrays, scanogram and the axial CT images are not typical for a traumatic diaphragmatic rupture. The shape of the air-filled stomach appears normal. There is no constriction, which should've been there if it had herniated into the thorax through a rent in the diaphragm. Of course, the stomach would appear normal if the rent was large enough to let it pass into the chest without constriction. But then the pleural effusion and intrathoracic changes ought to have been more severe. Why is there so much of gas dilatation of the small bowel? I wonder if it is just a traumatic phrenic nerve palsy? Given the h/o vomiting, I would also think of some kind of vagal injury. I know I'm out on a limb here. I'll wait for your denouement George. My first impression when I saw the Chest xray & the digital scanogram was that it is a diaphragmatic palsy.
The xrays, scanogram and the axial CT images are not typical for a traumatic diaphragmatic rupture.
The shape of the air-filled stomach appears normal. There is no constriction, which should’ve been there if it had herniated into the thorax through a rent in the diaphragm. Of course, the stomach would appear normal if the rent was large enough to let it pass into the chest without constriction. But then the pleural effusion and intrathoracic changes ought to have been more severe. Why is there so much of gas dilatation of the small bowel?
I wonder if it is just a traumatic phrenic nerve palsy? Given the h/o vomiting, I would also think of some kind of vagal injury.
I know I’m out on a limb here. I’ll wait for your denouement George.

]]> By: Tiny Shrink http://www.gcgeorge.net/2007/12/14/radiology-quiz-3/comment-page-1/#comment-15814 Tiny Shrink Fri, 14 Dec 2007 17:30:33 +0000 http://www.gcgeorge.net/2007/12/14/radiology-quiz-3/#comment-15814 Diaphragmatic rupture or incarcerated paraesophageal hiatal hernia Diaphragmatic rupture or incarcerated paraesophageal hiatal hernia

]]> By: Paddy http://www.gcgeorge.net/2007/12/14/radiology-quiz-3/comment-page-1/#comment-15811 Paddy Fri, 14 Dec 2007 12:55:35 +0000 http://www.gcgeorge.net/2007/12/14/radiology-quiz-3/#comment-15811 (A) Boerhaves Syndrome or (B) Diaphragmatic Rupture (A) Boerhaves Syndrome

or

(B) Diaphragmatic Rupture

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