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1 Nam 28 tuổi với đau HC(P) Đại tràng lên Khối cạnh ĐT kèm thậm nhiểm Thậm nhiễm quanh ĐT 2 Vieõm ruoọt thửứa laùc choồ. Brief review of Epiploic Appendagitis Rare inflammatory and ischemic condition Results from torsion or spontaneous venous thrombosis of one of the appendices epiploicae ischemia or infarction of the appendix epiploica & localized inflammation Sudden, severe, focal abdominal pain, mimic other conditions such as appendicitis. Can be managed conservatively CT: 1- 4-cm, oval, fatty pericolic lesion with surrounding mesenteric inflammation Adjacent cecal wall thickening and compression Rarely, a central high-attenuation "dot" within the inflamed appendage; corresponds to the thrombosed vein (17). 3 4 Diffuse largeB-cell lymphoma Brief review of round solid mesenteric masses Malignant solid tumors have a tendency to be located near root of mesentery benign solid tumors in periphery near bowel! 1. Metastases especially from colon, ovary (most frequent neoplasm of mesentery) 2. Lymphoma 3. Leiomyosarcoma (more frequent than leiomyoma) 4. Neural tumor (neurofibroma, ganglioneuroma) 5. Lipoma (uncommon), lipomatosis, liposarcoma 6. Fibrous histiocytoma 7. Hemangioma 8. Desmoid tumor (most common primary) 5 6       7 Gallbladder carcinoma Brief review of gallbladder carcinoma Most common biliary cancer Associated with: (1) Gallstones in 64 - 98% Gallbladder carcinoma occurs in only 1% of all patients with gallstones! (2) Porcelain gallbladder (in 4 - 60%) (3) Inflammatory bowel disease (predominantly ulcerative colitis) (4) Familial polyposis coli (5) Chronic cholecystitis Growth types: replacement of gallbladder by mass (37 - 70%) focal / diffuse asymmetric irregular thickening of GB wall (15 - 47%) polypoid / fungating intraluminal mass with wide base (14 - 25%) Differential diagnosis see note below 8 9 !"  #$  10 Addison disease caused by adrenal tuberculosis Brief review of addison disease = Primary adrenal insufficiency 90% of adrenal cortex must be destroyed! Cause: 1. Idiopathic adrenal atrophy (60 - 70%): likely autoimmune disorder 2. Granulomatous disease: tuberculosis, sarcoidosis 3. Fungal infection: histoplasmosis, blastomycosis, coccidioidomycosis 4. Adrenal hemorrhage: anticoagulation therapy, bleeding, coagulation disorders, sepsis, shock 5. Bilateral metastatic disease (rare) Diminutive glands (in idiopathic atrophy + chronic inflammation) Enlarged glands (acute inflammation, acute hemorrhage, metastasis . 1 Nam 28 tuổi với đau HC(P) Đại tràng lên Khối cạnh ĐT kèm thậm nhiểm Thậm nhiễm quanh ĐT 2 Vieõm ruoọt thửứa