ACR Appropriateness Criteria® Staging and Follow-Up of Pancreatic Neuroendocrine Tumors.

A 7-year-old neutered male domestic shorthair cat was presented for evaluation of a large intra-abdominal mass. Contrast-enhanced CT revealed a pedunculated hepatic mass measuring 15 × 9.5 × 6.5 cm arising from the papillary process of the caudate lobe, without evidence of metastasis. A three-port laparoscopic liver lobectomy was performed. The mass, attached by a torsed pedicle, was excised using a bipolar advanced energy vessel sealing device (ENSEAL®, Ethicon, USA). Histopathology confirmed a primary hepatic fibrosarcoma with complete resection. The cat recovered uneventfully, was discharged the following day, and received five cycles of adjuvant doxorubicin (Adriamycin®, Pfizer, USA), maintaining an excellent quality of life and stable disease for at least three years.

Radiogenomics promises noninvasive tumor profiling; however, the extent to which imaging morphology reflects tumor lineage versus host-organ milieu remains unclear. This study aimed to quantify the relative influence of tumor type and anatomical environment on contrast-enhanced computed tomography (CT) radiomic phenotypes. A discovery cohort of 1,598 patients (10,485 lesions) and an external validation cohort of 2,440 patients (6,597 lesions) underwent portal-venous-phase CT. After manual segmentation, lesion-level radiomic features were standardized and embedded using t-distributed stochastic neighbor embedding. Bayesian-optimized agglomerative clustering defined morphology-based groups. Concordance with the primary tumor site (lineage) and anatomical environment was quantified using bootstrapped adjusted Rand indices (ARI); the silhouette score assessed clustering quality. Feature-class (shape, intensity, texture) and mask-erosion experiments probed mechanistic drivers. Six morphological clusters were identified in the discovery set (silhouette = 0.44). Morphology aligned more strongly with environment (mean ARI = 0.37) but poorly with lineage (mean ARI = 0.04; p < 0.010); this pattern held externally. In solid organ metastases, environment dominance was even stronger (mean ARI = 0.60 versus 0.05; p < 0.010). Intensity and texture drove the morphological association with anatomical environment (ARI = 0.64-0.56) more than shape (ARI = 0.06). When the periphery of the tumor was eroded, the same patterns were observed, implicating the tumor core. Across organs and tumor types, tumor morphological phenotype on CT imaging is largely driven by a host tissue-related environmental "imprint" rather than the primary tumor site. Context-aware modeling is essential for reliable radiomic biomarkers and could motivate a two-step AI pipeline that first identifies the organ habitat and refines lineage-specific predictions. In a large, multicenter cohort, tumors exhibited distinct morphological clustering. These clusters did not align with primary tumor sites (ARI = 0.04). Stronger associations emerged between morphological clusters and the local anatomical environment (ARI = 0.37). Stratification by lesion type revealed even stronger associations between local anatomical context and solid organ metastases (ARI = 0.60).

TrueFidelity (TF), a deep learning image reconstruction algorithm that was originally available only in standard kernel, has recently become available in lung kernel. This is the first study to assess TF in lung kernel (TF Lung) on image quality and nodule sharpness at ultra-low-dose CT (ULD CT). This study included patients who underwent both non-contrast ULD CT and contrast-enhanced CT (CE CT) of the chest. ULD CT scans were reconstructed using 6 algorithms, including Adaptive statistical iterative reconstruction-V in standard kernel (AR50 STD), AR50 in lung kernel (AR50 Lung), TF in standard kernel, and TF Lung at low, medium, and high strengths. CE CT scans were reconstructed using AR50 STD and AR50 Lung. In total, 8 sets of reconstruction images were obtained and reviewed for each patient. Objective image quality, such as image noise, signal-to-noise ratio, and contrast-to-noise ratio, was compared. Nodule sharpness was evaluated by calculating the full-width half-maximum value. Malignancy-related imaging features in nodules that had been pathologically confirmed as malignant were evaluated. CE CT reconstructed in the lung kernel (CE AR50 Lung) served as the reference standard. A total of 68 patients underwent analysis. ULD CT reconstructed with TF Lung at all strengths significantly decreased image noise compared to AR50 Lung (all p < 0.001). TF Lung in low and medium strengths showed similar nodule sharpness compared to the reference standard. TF Lung has the potential to enhance both image quality and nodule evaluation in ULD CT scans. Question How does TrueFidelity in the lung kernel (TF Lung) perform in terms of image quality and lung nodule assessment in ultra-low-dose (ULD) CT scans? Findings TF Lung significantly decreased image noise, and TF Lung in low and medium strengths showed similar nodule sharpness compared to the reference standard. Clinical relevance TF Lung has the potential to reduce image noise without compromising the sharpness of nodules in ULD CT scans. TF Lung may support radiologists' diagnostic decision-making for malignancy.

This study investigated whether liver regeneration after living donor liver transplantation (LDLT) is associated with baseline skeletal muscle status, based on preoperative computed tomography (CT). In this retrospective cohort study, skeletal muscle mass and skeletal muscle attenuation (SMA) from preoperative CT scans of living liver donors who underwent right hemihepatectomy were analyzed. The liver regeneration rate was calculated as the percentage of remnant liver volume on postoperative CT performed 45-90 days after surgery, divided by the estimated preoperative left hemiliver volume. Logistic regression analysis identified risk factors for suboptimal regeneration, defined as the lower 10th percentile of liver regeneration rate. Correlation between skeletal muscle metrics and liver regeneration rate was assessed using Spearman's correlation analysis. A total of 171 living liver donors (101 men, 70 women; median age, 34 years) were included. Lower SMA, measured on contrast-enhanced CT images acquired in the portal venous phase, was significantly and independently associated with an increased risk of suboptimal regeneration (adjusted odds ratio: 1.14 per 1 Hounsfield unit decrease; 95% confidence interval: 1.04-1.25). SMA showed a significant positive correlation with liver regeneration rate (ρ = 0.191, p = 0.013). Lower SMA, as assessed on preoperative CT, is associated with suboptimal liver regeneration following right hemihepatectomy for living donor liver transplantation. Question Adequate liver regeneration is crucial after living donor liver transplantation, but reliable donor-related prognostic factors to predict it remain limited. Findings Lower skeletal muscle attenuation on portal venous phase CT acquired 45-90 days after right hemihepatectomy was independently associated with suboptimal liver regeneration among living liver donors. Clinical relevance Preoperative skeletal muscle attenuation may help identify living liver donors at risk for suboptimal liver regeneration, offering a potential tool for donor selection and personalized assessment to ensure adequate postoperative liver volume and long-term hepatic reserve in clinical practice.

This study aims to assess a spectral computed tomography (CT) color overlay technique for augmenting the visualization of endophytic renal tumors during percutaneous thermal ablation procedures. This retrospective study consisted of renal cryoablation procedures from June to December 2023. Of the 68 renal ablations with spectral results archived, 27 cases were assigned majority endophytic. Two radiologists reviewed and rated two series for each case: a conventional non-contrast CT series and an electron density color overlay series. Tumor conspicuity was evaluated on a continuous sliding scale. Subsequently, radiologists determined whether percutaneous ablation could proceed based on visualization using the conventional non-contrast CT series alone, using the color overlay series, or if additional contrast-enhanced CT was necessary for optimal guidance. Statistical assessment was performed using a two-sided Wilcoxon signed-rank test with a significance level of p=0.01. There was a significant (p<0.001) improvement in endophytic tumor conspicuity with the electron density fusion series (Median: 36.3) compared to the conventional CT series (Median: 19.2). When evaluating adequacy of tumor visualization for procedural planning, readers were more likely to agree when reviewing the electron density color overlay series (44% of reads; 22/50) rather than the conventional CT series (22% of reads; 11/50). Spectral CT color overlay improved visibility of endophytic renal tumors compared to conventional CT alone. This highlights the benefit of a low-noise, narrow-window color overlay for augmenting lesion localization. LEVEL OF EVIDENCE 3: Level 3, retrospective study.

Dynamic changes in spleen volume (SpV) may reflect immune and hemodynamic alterations in hepatocellular carcinoma (HCC). This study aimed to evaluate the prognostic significance of SpV dynamics in patients with unresectable HCC (uHCC) treated with tislelizumab plus lenvatinib. We retrospectively analyzed 103 patients with uHCC treated with tislelizumab plus lenvatinib between June 2021 and June 2025. SpV was measured on contrast-enhanced CT at baseline and approximately 3months post-treatment using AI-assisted segmentation with manual correction. The absolute SpV change (ΔSpV) and monthly SpV change rate were calculated. The optimal cut-off values were identified via maximally selected rank statistics. Survival outcomes were assessed using Kaplan-Meier analysis and Cox regression models. Post-treatment SpV increase was observed in 65% of patients and was associated with shorter progression-free survival (PFS). Both ΔSpV and SpV change rate were independent predictors of PFS (HR for ΔSpV: 1.005, P = 0.01; HR for change rate: 1.02, P < 0.00). Cut-off values of 23.81cm3 (ΔSpV) and 8.24cm3/month (change rate) significantly stratified patients into distinct PFS risk groups (11.6 vs. 25.5months, both P < 0.05). Three-month landmark analysis revealed that a SpV change rate ≥ 8.24cm3/month predicted significantly shorter PFS within the first 3months (P = 0.039), while a ΔSpV ≥ 23.81cm3 was associated with significantly poorer PFS after 3months of treatment (P = 0.040). Baseline portal hypertension and larger tumor size correlated with greater SpV increases. SpV dynamics provide a noninvasive imaging biomarker for identifying uHCC patients at elevated risk of progression during tislelizumab plus lenvatinib therapy. Incorporating these volumetric metrics into routine imaging may enhance prognostic assessment and guide risk-adapted patient management.

Background/Objectives: Although multiple guidelines exist for the management of intraductal papillary mucinous neoplasms (IPMN), the duration and modality of postoperative surveillance remain inconsistent. We aimed to retrospectively review medical images of patients with IPMN after surgery and to investigate the optimal surveillance duration and modality. Methods: In this study, we included 191 patients with IPMN who underwent surgery at a single institution between January 2006 and May 2024. Patients were followed from the postoperative period until July 2025. Image interpretation reports written by diagnostic radiologists were examined to determine the time to recurrence detection and the imaging modality used. Results: Sixteen patients (8.3%) were eligible during the observation period. Seven patients experienced intrapancreatic recurrence, and ten patients experienced extrapancreatic recurrence (one patient was included in both categories). The mean time to identification of intrapancreatic lesions was 63.9 months; five of seven cases were detected using contrast-enhanced computed tomography (CT). The mean time to identification of extrapancreatic lesions was 12.0 months, which was significantly shorter than that for intrapancreatic lesions (p = 0.005). Eight of ten extrapancreatic recurrences were detected using contrast-enhanced CT. Conclusions: Extrapancreatic lesions appeared earlier after IPMN surgery than intrapancreatic lesions. Contrast-enhanced CT was the most commonly used modality for detecting recurrent lesions, suggesting its usefulness in postoperative surveillance.

Patient: Female, 67-year-oldFinal Diagnosis: Splenic hemangiomaSymptoms: Asymptomatic with progressive splenic lesion enlargementClinical Procedure: —Specialty: Gastroenterology and Hepatology • SurgeryObjective: Rare diseaseBackgroundHemangioma is the most common benign primary tumor of the spleen and is often detected incidentally. Laparoscopic-assisted microwave ablation (LMWA) has recently been introduced as a novel approach for managing splenic hemangioma. This report describes the case of a 67-year-old woman with an asymptomatic, progressively enlarging splenic hemangioma successfully treated with LMWA.Case ReportA 67-year-old woman was admitted for evaluation of a gradually enlarging splenic mass found during routine examination. She was asymptomatic, with normal tumor markers and a mildly elevated D-dimer level. Contrast-enhanced CT revealed a 6.0 cm hypervascular lesion in the upper pole of the spleen. After multidisciplinary discussion, LMWA was performed under direct laparoscopic visualization. The lesion was completely ablated, with a total operative time of 80 minutes, including 25 minutes of ablation. Estimated blood loss was minimal (20 mL). Postoperative pathology examination confirmed a splenic cavernous hemangioma. The postoperative course was uneventful, and she was discharged on day 5. Follow-up imaging showed reduction of the ablation zone to 5.4 cm, and laboratory results returned to normal.ConclusionsThis is the first report on the feasibility and safety of LMWA for treating splenic hemangioma. This approach effectively reduces intraoperative bleeding and postoperative hemolysis while preserving splenic function, offering a novel treatment option for splenic hemangioma.

Penetratstab wound. He was hemodynamically stable on admission. Contrast-enhanced CT demonstrated the knife penetrating the antro-pyloric region of the stomach, associated with a small hem pneumoperitoneum and a peri-splenic sentinel hematoma. Emergency laparotomy confirmed a punctiform perforation of the lesser curvature, whicing abdominal trauma is a common surgical emergency. Severity depends on the injured organs and the delay to definitive management. We report the case of a 45-year-old chronic smoker presenting with an epigastric h was treated with primary suture reinforced by an omental patch. Postoperative recovery was uneventful. This case highlights the importance of early CT evaluation and prompt operative management to minimize morbidity and mortality in penetrating abdominal trauma.

Introduction and importance: Dog bite injuries are a major global public health concern, predominantly affecting the extremities. Abdominal wall involvement is rare and underreported. This case demonstrates a significant soft tissue hematoma following a dog bite, underscoring the importance of early imaging and surgical intervention even in the absence of coagulopathy. Case presentation: A 47-year-old obese female presented with progressive left-sided abdominal pain and bruising, 6 days post-dog bite to the left iliac fossa. Examination revealed localized ecchymosis and active bleeding, without systemic signs of infection. Contrast-enhanced CT revealed a 4.7 × 10.8 × 8.9 cm hematoma in the subcutaneous plane of the oblique abdominal muscles. The hematoma was aspirated, and necrotic tissue was debrided. The patient received tetanus prophylaxis and broad-spectrum antibiotics, with favorable postoperative recovery. Clinical discussion: Abdominal wall hematomas from dog bites are rare and may be misdiagnosed due to atypical presentation. In this case, timely CT imaging enabled prompt diagnosis and prevented complications such as compartment syndrome or abscess formation. The absence of anticoagulant use or bleeding disorders confirmed trauma as the etiology. Given the polymicrobial nature of dog saliva, empirical antibiotics were essential to prevent secondary infection. Conclusion: This case highlights the potential for severe abdominal wall injuries from dog bites. It emphasizes the significance of timely surgical intervention and the diagnostic use of CT imaging. Clinicians should include abdominal wall hematoma in the differential diagnosis for patients with localized abdominal pain and bruising after a dog bite, even without typical risk factors.

Brain imaging with MRI or CT is standard in screening for intracranial disease among ambulatory patients with cancer. Though MRI offers greater sensitivity, CT is frequently employed because of its accessibility, affordability, and faster acquisition time. However, the necessity of routinely performing a noncontrast CT with the contrast-enhanced study is unknown. This study evaluates the clinical and economic utility of the noncontrast portion of the brain CT examination. A board-certified neuroradiologist reviewed 737 brain CT reports from outpatients at The University of Texas MD Anderson Cancer Center who underwent contrast and noncontrast CT for cancer staging (October 2014 to March 2016) to assess if clinically meaningful findings were identified only on noncontrast CT. A Generative Pretrained Transformers-3 (GPT-3) model was then fine-tuned to extract reports with a high likelihood of unique and meaningful noncontrast findings from 1980 additional brain CT reports (January 2017 to April 2022). These reports were manually reviewed by 2 neuroradiologists, with adjudication by a third reviewer if needed. The incremental cost-effectiveness ratio of noncontrast CT inclusion was then calculated based on Medicare reimbursement and the 95% CI of the proportion of all reports in which noncontrast CT was necessary for identifying meaningful findings. Seven of 737 reports in the initial data set revealed meaningful findings unique to the noncontrast CT, all of which were hemorrhage. The GPT-3 model identified 145 additional reports with a high unique noncontrast CT finding likelihood for manual review from the second data set of 1980 reports. Nineteen of these reports were found to have unique and meaningful noncontrast CT findings. In total, 0.96% (95% CI: 0.63-1.40) of reports had meaningful findings identified only on noncontrast CT. The incremental cost-effectiveness ratio for the identification of a single meaningful finding on noncontrast CT missed on the contrast-enhanced study was $1855 to $4122. In brain CT for ambulatory screening for intracranial disease in patients with cancer, noncontrast CT offers limited additional diagnostic value compared with contrast-enhanced CT alone. Considering the associated financial cost, workload, and patient radiation exposure associated with performing a noncontrast CT, contrast-enhanced brain CT alone is sufficient for cancer staging in patients with asymptomatic cancer.

Acute kidney injury (AKI) is a common complication among hospitalized patients and is associated with substantial morbidity and mortality. Intravenous contrast media is frequently used in diagnostic imaging, but data on its safety in patients with established AKI remain limited. This study prospectively assessed renal and clinical outcomes following intravenous contrast administration in hospitalized patients with AKI Methods: In this prospective observational study, we included hospitalized adults diagnosed with AKI who underwent CT imaging with or without intravenous contrast between January 2023 and March 2024. The primary outcome was renal recovery within 7 days, defined as return of serum creatinine to baseline. Secondary outcomes included renal improvement within 72 hours, dialysis requirement after CT, length of stay, and in-hospital mortality.. Analyses were performed using inverse probability weighting(IPW), with propensity score matching (PSM) as a secondary robustness analysis. A total of 481 patients were analyzed; 282 received contrast and 188 did not. After IPW adjustment, renal recovery within 7 days occurred in 61.7% of the contrast group vs. 47.3% of the non-contrast group (OR 1.7, 95% CI 1.0-2.97, p = 0.05). Secondary outcomes were similar between groups. Results were consistent in a secondary PSM analysis. In the overall cohort, higher AKI stage and acute tubular injury were independently associated with lower recovery odds. In hospitalized patients with AKI, intravenous contrast administration was not associated with worse renal or clinical outcomes, suggesting that contrast-enhanced CT may be acceptable in selected clinical settings.

Duodenal diverticula are relatively common and usually asymptomatic. However, malignant transformation within these structures is exceedingly rare. The clinical presentation is often non-specific. This uncommon manifestation poses significant challenges in both diagnosis and treatment. Two cases involving patients diagnosed with duodenal diverticular carcinomas have been presented. The first case exhibited imaging characteristics consistent with an enhancing mass within a duodenal diverticular pocket, with hepatic metastasis. This case was accurately diagnosed through contrast-enhanced computed tomography (CECT). The second case involved a patient with a history of recurrent pancreatitis, who was misdiagnosed with mass-like pancreatitis based on findings from both CECT and magnetic resonance imaging (MRI). Unfortunately, both patients succumbed to their illness within two months following confirmation of the pathology. Duodenal diverticular carcinoma presents a significant diagnostic challenge due to the limited availability of medical literature. Nevertheless, early diagnosis is crucial for improving therapeutic outcomes.

Abemaciclib, a cyclin-dependent kinase 4/6 inhibitor, is a standard treatment for hormone receptor-positive and HER2-negative breast cancer. However, liver dysfunction induced by abemaciclib is a significant clinical issue. We report three cases of drug induced liver injury caused by abemaciclib with characteristic liver atrophy. Case 1: A woman in her seventies developed acute liver failure 2months after initiation of letrozole and abemaciclib for breast cancer and bone metastases. A contrast-enhanced CT (CECT) scan revealed liver atrophy accompanied by Chilaiditi syndrome. Despite steroid pulse therapy, she progressed to coma. Her liver failure improved, but she died due to worsening of the underlying disease. Case 2: A woman in her seventies developed liver dysfunction 2months after initiation of anastrozole and abemaciclib to prevent recurrence. A CECT scan revealed liver atrophy and Chilaiditi syndrome. After admission, she progressed to acute liver failure and coma, and steroid pulse therapy was initiated. Hepatic encephalopathy improved with conservative treatment, and liver failure resolved with continued steroid administration. Case 3: A woman in her fifties. After breast cancer surgery, tamoxifen and abemaciclib were started as adjuvant therapy. Blood tests revealed liver dysfunction 2months later. A CECT scan revealed liver atrophy and Chilaiditi syndrome, which improved with liver support therapy alone without progressing to liver failure. This report is the first highlighting the imaging characteristics of rapid-onset hepatic atrophy associated with abemaciclib-induced liver injury. These findings may provide useful insights for distinguishing abemaciclib-induced liver injury from other etiologies.

Background/Objectives: Deep neck space abscesses (DNSAs), representing severe suppurative infections, continue to pose a significant global health challenge due to their morbidity, mortality, and evolving epidemiology. This review synthesizes existing knowledge regarding DNSA definitions, anatomic basis, epidemiological trends, microbiology, clinical presentation, diagnostic strategies, treatment paradigms, outcomes, health system challenges, and disparities to guide global efforts in DNSA prevention, management, and research. Methods: A structured narrative review was performed following SANRA guidelines. PubMed/MEDLINE and the Cochrane Library were searched from January 2000 to May 2025, retrieving 1102 records. After screening, 49 studies met the inclusion criteria. Data were extracted using standardized templates and synthesized thematically. Results: During the period 2004–2015, annual case increases were reported in a Finnish population-based retrospective cohort (n = 277), going from 14 to 24 subjects, and for a UK tertiary center retrospective series, going from 1 to 15 cases annually (2006–2015) (Pearson’s correlation, r = 0.9; p = 0.00019). The microbiological environment is mostly polymicrobial, composed of group streptococci and staphylococcus strains and anaerobes. Factors associated with poor outcomes include diabetes mellitus (adjusted hazard ratio of 10.7 [95% CI 6.0–19.1] in a retrospective, population-based cohort of 12,738 diabetic patients compared to 50,952 individuals without diabetes), immunosuppressed state, elderly age, and multispace involvement. Diagnosis relies on contrast-enhanced CT imaging (sensitivity &gt; 90%), and treatment consists of early multidisciplinary intervention combining empiric broad-spectrum antibiotics with surgical drainage in 60–97% of cases. Mortality ranges from 1.6% to 7.6%, with higher rates in cases complicated by mediastinitis (up to 40%). Conclusions: DNSAs demonstrate a clear upward incidence trend across high-income and resource-limited settings. Establishing standardized DNSA registries, validating risk-stratification tools, reinforcing antimicrobial stewardship to address rising resistance, and implementing early detection protocols in primary care remain critical priorities. While emerging technologies, including rapid molecular diagnostics and AI-based decision support, represent promising research directions, current DNSA management relies fundamentally on conventional clinical assessment, prompt imaging, and coordinated multidisciplinary care.

Pulmonary Arteriovenous Malformation Embolization: The Role of Contrast-Enhanced CT and Standardized Outcome Measures.

Bioengineered polymeric mesh with imaging contrast for enhanced urogynaecological applications.

Introduction: Juvenile Nasopharyngeal Angiofibroma (JNA) is a benign yet highly vascular tumour that primarily affects adolescent males. Surgical resection is the standard treatment; however, it is often associated with significant intraoperative blood loss and increased morbidity. Preoperative Transarterial Embolisation (TAE) has emerged as an adjunctive procedure to minimise vascularity, thereby reducing surgical complications. Aim: To evaluate the impact of preoperative embolisation of JNA on the surgical outcome including intraoperative blood loss, intraoperative time and Intensive Care Unit (ICU) admissions in North Eastern India. Materials and Methods: The hospital-based prospective interventional study was conducted in the Department of Radiology at Gauhati Medical College and Hospital (GMCH), Guwahati, Assam, India, from November 2023 to October 2024 on 50 patients diagnosed with JNA and referred for preoperative embolisation from the Departments of Ear, Nose and Throat (ENT) and Paediatrics. Patients underwent Contrast Enhanced Computed Tomography (CECT) evaluation by the Philips Brilliance iCT 256 slice CT machine for staging (Radowski). Embolisation was done under the Siemens Artis Zee Biplane Digital Subtraction Angiography (DSA) machine by using Polyvinyl Alcohol (PVA) particles. Preoperative embolisation used PVA particles in all cases and parameters such as stage of tumour, grade of devascularisation, mean intraoperative blood loss, intraoperative time, postoperative complications and Intensive Care Unit (ICU) admission were obtained. These data were entered into Statistical Pacakge for Social Sciences (SPSS) software version 26.0 and Chi-square and Analysis of Variance (ANOVA) tests were applied. Results: The study included 50 patients (all males) aged 8 to 17 years with mean age of 14.18 years. In the present study, 6 patients (12.0%) were classified as stage IA JNA, while 18 patients (36.0%) had stage IB. All cases were embolised using PVA particles. The mean intraoperative blood loss was 246.16±110.18 mL. The mean operative time was 122.10±41.52 minutes. Mostly grade II devascularisation was achieved in the majority (58%) of patients. There was a significant association between grade of devascularisation and intraoperative blood loss, time and ICU admissions (p-value&lt;0.05). No significant Post-embolisation complications were encountered. Conclusion: Preoperative embolisation of nasopharyngeal angiofibroma is a safe and effective technique to reduce intraoperative blood loss and reduce postoperative complications. Minor complications may be encountered, but major complications are rare if done using the correct technique.

Duodenojejunal (DJ) flexure perforation due to blunt abdominal trauma is a relatively uncommon condition, but it carries significant morbidity and mortality. Such cases are challenging to diagnose due to their subtle presentation and retroperitoneal location. This case series presents three surgically confirmed cases of DJ flexure perforation, each demonstrating distinct radiological findings on Contrast-Enhanced Computed Tomography (CECT). Key imaging features included free intraperitoneal air, bowel wall thickening, mesenteric fat stranding, and intramural haematoma. The cases underscore the importance of maintaining a high index of suspicion in trauma patients with vague abdominal symptoms. Early identification of these radiological signs led to timely surgical interventions, resulting in favourable outcomes. Through detailed imaging and clinical correlation, this series provides valuable insights for radiologists and emergency clinicians, emphasising the critical role of CECT in diagnosing traumatic bowel perforations at anatomically complex regions like the DJ flexure. Improved awareness and interdisciplinary coordination can significantly enhance early detection and reduce complications from delayed treatment.