Page 136 - RESUME NOTE REMINDER

symptoms are non-specific and are usually weight-loss, diarrhoea, fever, and abdominal pain

[2]. Four main CT patterns have been described in the literature: 1. lymphoma may present as
multiple contrast-enhancing mucosal nodules that affect the small bowel multifocally,
differentiating it from adenocarcinoma and carcinoid. 2. lymphoma may appear as a single

mass lesion which may vary in size that can lead to intussusception but will rarely cause

obstruction as it is characteristically soft. 3. lymphoma may infiltrate and destroy the normal
small bowel folds causing local thickening and dilatation of the affected small bowel loops –
as in our case - but being a soft tumour unlike adenocarcinoma it will not cause obstruction. 4.

lymphoma may manifest as an exophytic mass which may ulcerate mimicking
adenocarcinoma or gastrointestinal stromal tumour. Mesenteric nodal disease, necrosis and

fistulous tracts to adjacent bowel loops may also be demonstrated [3, 4]. HCC in a
noncirrhotic liver may present with 4 main growth patterns: 1. as a solitary large hypodense

mass, 2. as multifocal hypodense lesions, 3. as a dominant hypodense mass with hypodense
satellite nodules and 4. as an encapsulated rounded mass with well defined margins. On

dynamic CT study HCC usually shows heterogeneous enhancement on arterial phase and
decreased attenuation on portal-venous phase with heterogeneous areas of contrast

accumulation. It is worth noting that small HCCs may mimic haemangiomas [5].

15. Siasios J, Foutzitzi S, Deftereos S, Karanikas M, Birbiis T. The traumatic brain injury: diagnosis
and management at emergency department by general surgeon. A retrospective critical

analysis on the use of the CT head scan. Turk Neurosurg. 2011;21(4):613-7. doi:
10.5137/1019-5149.JTN .3749-10.1. PMID: 22194124 [PubMed] [Scopus]

Abstract: AIM: In recent decades, considerable progress has been made in diagnosis and

management of cranial trauma patients. Computed Tomography has resulted in a revolution in
head injury diagnosis, making it possible to detect cases suitable for surgical treatment in a

rapid, non-invasive manner. We present our experience in treating patients with head injuries at
Emergency Department by describing the process and the criteria under which any diagnostic

test is performed focusing in CT head scan.

MATERIAL AND METHODS: Between 2007-2009 we studied 1356 adult patients (725 male
and 631 female) who came at the emergency department claiming head injury. The factors

registered were the mechanism of injury, the neurological evaluation, the Glasgow Coma Scale
(GCS), the specialty of the doctor who made the first evaluation, and finally in which cases and
with which criteria the CT scan was performed.

136