Case 9

49 year old woman status post cytoreductive surgery 2 weeks prior. IV contrast enhanced CT shows:

1. retained barium in the colon
2. colonic stent
3. retained malleable retractor
4. ingested large metal object

Case 9

49 year old woman status post cytoreductive surgery 2 weeks prior. IV contrast enhanced CT shows:

1. retained barium in the colon
2. colonic stent
3. retained malleable retractor
4. ingested large metal object

Retained Metal Malleable Retractor

• A case report in the literature describes asymptomatic intra-abdominal ribbon malleable (similar to this one), removed laparoscopically after 14 years
• In this case, the most likely interpretation of the radiograph would be that the metal object was on the bed or at the very least outside of the patient

Case 10

Chest radiograph on a 48 year old man shows:

1. aortic turbine pump
2. pH probe in the esophagus
3. retained epicardial lead
4. canter tube tip in the esophagus

Case 10

Chest radiograph on a 48 year old man shows:

1. aortic turbine pump
2. pH probe in the esophagus
3. retained epicardial lead
4. canter tube tip in the esophagus

Wireless capsule pH monitoring device

• Attached to the esophageal mucosa about 6 cm above the squamo-columnar junction, the location of which is determined by prior endoscopy.
• Placed with a special delivery device, through nose or mouth, into the esophagus and anchored to the wall with a special system.
• Should the capsule detach it might be seen elsewhere in the gastrointestinal tract.

Case 11

55-year-old man with a pancreatic mass and history of recent inguinal hernia repair. Axial (A) and coronal MPR (B) CT images of the pelvis reveal:

1. retained needle fragment
2. retained sponge
3. retained Kelly clamp
4. mesh status post inguinal hernia repair

Case 11

55-year-old man with a pancreatic mass and history of recent inguinal hernia repair. Axial (A) and coronal MPR (B) CT images of the pelvis reveal:

1. retained needle fragment
2. retained sponge
3. retained Kelly clamp
4. mesh status post inguinal hernia repair

Retained Surgical Sponge

Retained Surgical Sponge

This is another example of how the sponge marker is better displayed with 3D volume rendering

Case 12

67 year old man w/ampullary adenocarcinoma, status post whipple complicated by gastroduodenal artery hemorrhage necessitating hepatic artery stent. CT performed for follow up showed interval increase in biliary obstruction, narrowing of the portal vein confluence, concerning for recurrent tumor Axial CT and sagittal MPR demonstrate:

1. ingested razor
2. retained needle
3. migrated hepatic artery stent
4. pancreaticoduodenal stent

Case 12

67 year old man w/ampullary adenocarcinoma, status post whipple complicated by gastroduodenal artery hemorrhage necessitating hepatic artery stent. CT performed for follow up showed interval increase in biliary obstruction, narrowing of the portal vein confluence, concerning for recurrent tumor Axial CT and sagittal MPR demonstrate:

1. ingested razor
2. retained needle
3. migrated hepatic artery stent
4. pancreaticoduodenal stent

Migrated Hepatic Artery Stent

Migrated Hepatic Artery Stent

• For comparison, the previous CT is shown, confirming that the enlarging tumor recurrence had dislodged his stent from the hepatic artery.
• He underwent portal vein stenting to prevent occlusion of his only remaining hepatic arterial blood supply.

Case 13

Abdominal images on a 60 year old woman show small bowel obstruction and:

1. retained capsule endoscopy
2. ingested snap
3. intraperitoneal chemotherapy pump
4. bullet

Case 13

Abdominal images on a 60 year old woman show small bowel obstruction and:

1. retained capsule endoscopy
2. ingested snap
3. intraperitoneal chemotherapy pump
4. bullet

Retained Capsule Endoscopy

• This patient initially presented with nausea and vomiting.  Following negative upper and lower endoscopy, a capsule endoscopy was performed.  
• The capsule failed to pass, and she was monitored for some time for passage.
• After 15 months, she developed small bowel obstruction, shown in radiographs and CT images.

Retained Capsule Endoscopy

Case 14

89 year old woman being imaged for melanoma staging. Axial IV contrast enhanced CT shows which of the following:

1. left ventricular rupture
2. aortoenteric fistula
3. apicoaortic graft
4. small bowel loop in post traumatic diaphragmatic hernia

Case 14

89 year old woman being imaged for melanoma staging. Axial IV contrast enhanced CT shows which of the following:

1. left ventricular rupture
2. aortoenteric fistula
3. apicoaortic graft
4. small bowel loop in post traumatic diaphragmatic hernia

Apicoaortic Graft

Apicoaortic Graft

Case 15

Axial image (A), coronal MPR (B), right sagittal oblique MPR (C) and left sagittal oblique MPR (D) from IV contrast enhanced CT of the pelvis demonstrate:

1. migrated IUD
2. tubal ligation clips
3. calcified tubes due to tuberculosis
4. hysteroscopic sterilization

Case 15

Axial image (A), coronal MPR (B), right sagittal oblique MPR (C) and left sagittal oblique MPR (D) from IV contrast enhanced CT of the pelvis demonstrate:

1. migrated IUD
2. tubal ligation clips
3. calcified tubes due to tuberculosis
4. hysteroscopic sterilization

ESSURE Noninvasive Sterilization

ESSURE Noninvasive Sterilization

Intraoperative Radiography

Intraoperative Radiography

Intraoperative Radiography

Intraoperative Radiography

Intraoperative Radiography

Intraoperative Radiography

Conclusion

References