Double Wall Sign Research Articles

Double-wall sign because of intestinal perforation.

This study sought to describe the case of an 86-year-old man who presented to our hospital complaining of abdominal pain, abdominal distention, and loss of appetite for 4days prior. This case suggests that an amount of accumulated air clearly highlights the intestinal wall, like a "double-wall sign," even when the patient is standing.

Blowing off steam-Identifying bowel perforation after routine colonoscopy.

Colonoscopy is an effective procedure for colorectal cancer (CRC) screening. Perforation is a rare yet the most severe complication, identified by landmarks—double dolphin, triangle, or double‐wall sign signifying air and intracolonic contents leaking into the peritoneal space. Prompt recognition and surgical intervention are imperative to avoid high mortality.

ВИЗНАЧЕННЯ ВЕЛИЧИНИ Й ТОЧНОСТІ СТАЛОЇ ВІДДАЛЕМІРА ЕЛЕКТРОННОГО ТАХЕОМЕТРА ЗА РЕЗУЛЬТАТАМИ ПРИВ’ЯЗКИ ДО ПОДВІЙНОГО СТІННОГО ГЕОДЕЗИЧНОГО ЗНАКУ

Urgency of the research. Now manufacturers of geodetic instruments supply a variety of geodetic equipment to the market. An important place in this assortment belongs to electronic range finders. They combine in their design a goniometer, an electronic rangefinder and a processor that allows to solve various geodetic tasks based on the measurements. Target setting. To ensure reliable data on the measured distance, it is necessary to periodically determine the constant correction of the range finder of the electronic total station. This is especially true in the case of measuring distance using a reflector from an electronic total station of a different brand. Actual scientific researches and issues analysis. The method for determining the constant correction of the range finder of an electronic total station based on the results of binding to a double geodetic wall sign is described in [1]. The technology of measurements and the formula for determining the constant are shown. An unexplored parts of a common problem. In continuation of the topics given in [1], it is advisable to carry out a practical implementation of the method for determining the constant correction and establish its accuracy. The research objective. The main goal of this article is to determine the constant correction of the range finder of an electronic total station based on the data obtained from the results of binding to a double geodetic wall sign, and also to calculate its accuracy. The statement of basic materials. The approbation of the technology for determining the constant correction of the range finder of an electronic total station for the results of measurements made during binding to the double wall sign of the city polygonometry of Chernihiv is presented. The Trimble 3305 DR total station and reflector for binding to wall signs, developed at the Department of Geodesy, Cartography and Land Management of the Chernihiv Polytechnic National University, were used. As a result, a constant correction value of +22.6 mm was obtained. Formulas for calculating the mean square error of the constant correction for various options for binding to a double wall sign are derived and calculations are performed using these formulas. Conclusions. The developed technology was tested for determining the constant correction of the range finder of an electronic total station according to the measurement results obtained during binding to a double wall sign. Formulas are obtained and calculations are performed to determine the mean square error of the constant correction of the range finder of an electronic total station

The Double Wall Sign

The Double Wall Sign

Endoscopic Decompression and Marsupialization of A Duodenal Duplication Cyst

Abstract Introduction Duodenal duplication cysts are rare congenital foregut anomalies, accounting for 2%–12% of all gastrointestinal tract duplications. Surgical excision entails risk of injury to the pancreaticobiliary structures due to proximity or communication with the cyst. We present a case of duodenal duplication cyst in a 3 year-old boy who successfully underwent endoscopic decompression. Case report AT is a young boy who first presented at 15 months of age with abdominal pain. There was one subsequent episode of pancreatitis. Ultrasonography showed the typical double wall sign of a duplication cyst and magnetic resonance cholangio-pancreatography showed a large 5 cm cyst postero-medial to the second part of the duodenum, communicating with the pancreaticobiliary system and causing dilatation of the proximal duodenum. He subsequently underwent successful endoscopic ultrasound guided decompression at 3 years of age under general anesthesia, and had an uneventful postoperative recovery. Conclusion Endoscopic ultrasound guided assessment and treatment of gastrointestinal duplication cysts is increasingly reported in adults. To the best of our knowledge, only one case of endoscopic treatment of duodenal duplication cyst, in an older child, has been reported thus far in the paediatric literature. In this paper, we review the current literature and discuss the therapeutic options of this rare condition.

Ultrasound Semiotics the Intraabdominal Cysts in Newborns

Aim: to determine the diagnostic value of individual echographic symptoms in abdominal cysts in newborns.Мaterials and Methods. The results of ultrasound examination of 65 newborns (the average age 15.93 ± 1.15 days) with intraabdominal cysts (IACs) diagnosed with echography from 2004 to 2016 are analyzed. Girls were 80% (52/65), boys – 20% (13/65). Results. 23 (35%) neonates had complicated ovarian cysts (OC) (antenatal torsion, necrosis of the cystic formation and ipsilateral ovary), in 16 (25%) cases uncomplicated OC were detected. In 14 (22%) cases enterocysts (8 girls, 6 boys) were detected, and mesenteric lymphangiomas (LAB) were diagnosed in 12 (18%) newborns (5 girls, 7 boys). The main echographic signs of various IACs were picked out.Conclusion. Ultrasonography is an informative method of diagnostics the IACs in newborns. The presence of parietal intraluminal cysts was typical for OC. In the case of uncomplicated OC anechogenous contents were noted. In the case of complicated OC heterogeneous content of various echostructure (debris, clots, septa and a networked structure of the content) took place. For the enterocysts a thick wall was typical and it’s variants of echographic representation were the gut-signature (double wall sign), layered structure of the wall and Y-configuration of the cyst wall. LAB were characterized by irregular shape, thin wall and anechogenous content, less often the disperse component and thin septa in the lumen were determined. The networked structure of the contents was detected at various nosological forms (complicated OC, LAB and delimited peritonitis typical for severe enterocolitis) and required careful diagnostics of the totality of all detected echographic symptoms.

Localized Hyperlucency in an Acutely Dyspneic Patient: Always a Pneumothorax?

BackgroundEvery emergency physician encounters acutely dyspneic patients with localized hyperlucency on chest x-ray study. Although most commonly due to pneumothorax, alternative diagnosis in selected cases with atypical features includes bullae and cystic lesions, especially in childhood. Presence of atypical radiology shouId alert an emergency physician to rule out any alternative diagnosis. Computed tomography is usually diagnostic in such cases and a double-wall sign on computed tomography aids to distinguish between pneumothorax and bullous disease. Case ReportA 60-year-old male presented with sudden increase in dyspnea and a localized hyperlucency on chest x-ray study. A review of his medical records and evaluation of atypical radiology by computed tomography revealed increase in size of bulla to be the cause for distress rather than a pneumothorax. Why Should an Emergency Physician Be Aware of This?Every emergency physician encountering acutely dyspneic patients should be aware of these potential mimickers of pneumothorax and ways to distinguish them to avoid inadvertent tube thoracostomy and possible complications.

Diagnosis of neonatal ovarian torsion: Emphasis on prenatal and postnatal sonographic findings.

Our aim was to retrospectively review the imaging findings of patients with neonatal ovarian torsion, emphasizing prenatal and postnatal sonographic findings. Eleven patients who had had neonatal ovarian torsion diagnosed surgically (n = 9) or clinicoradiologically (n = 2) were enrolled. Prenatal and postnatal sonographic features, including sequential postnatal change, were reviewed. Clinical and pathologic features were also investigated. All patients except one had a fetal ovarian cyst (mean, 5.3 cm) detected on third-trimester sonography, either simple (n = 6) or complex (n = 4). In all 11 patients, initial postnatal sonography had revealed a complex cyst (mean, 4.7 cm) with intracystic clot or debris, the double-wall sign, a fluid-fluid level, and multiple septation. None of the patients had had symptoms or signs related to the ovarian torsion. Follow-up sonography in seven patients had revealed increased echogenicity of the cyst wall with frequent calcification and a decrease in size of the cyst. In two patients, the interval of the change in cyst position was noted, and autoamputation of the torsed ovary had been surgically confirmed. Serous cystadenoma had been identified in one patient. Neonatal ovarian torsion most commonly manifests as an asymptomatic complex cyst on sonography due to torsion of a fetal ovarian cyst. Serial monitoring of a fetal ovarian cyst for its resolution or changes in its appearance is mandatory for making an early diagnosis of torsion. © 2016 Wiley Periodicals, Inc. J Clin Ultrasound 44:290-297, 2016.

A case of perforated multiple gastric duplication cysts with five-layered appearance on ultrasonography

A case of perforated multiple gastric duplication cysts is presented. One of the gastric duplication cysts without perforation was seen on ultrasonography (US) with the following specific findings of gastric duplication cysts: a five-layered appearance, fold-like structures in the wall, and blood supply from the gastroepiploic artery. Other cysts with perforation presented with irregular and thin walls with a lack of the "double-wall sign" on US. These characteristic findings may be specific to perforated multiple gastric duplication cysts.

A Case of Intestinal Duplication Cyst Identified as Pathological Lead Point in a Child with Recurrent Intussusception

Intestinal duplication cysts are characterized by the attachment to some part of the gastrointestinal tract with which a blood supply is shared, and have an epithelial lining resembling some part of the alimentary tract. A 15-month-old female was admitted to our hospital with cyclic irritability, vomiting, and blood-tinged stool. The results of an ultrasound showed an ileocolic intussusception and a 1.3 cm cystic mass had double-wall sign and a Y-configuration with an adjacent ileal loop. She had a past history of two ileocolic intussusceptions. The cystic mass was considered to be a pathologic lead point, so resection and end-to-end anastomosis was performed. The gross and histologic evaluation of the specimen demonstrated a 2.4×2.4 cm cystic mass containing yellow mucoid fluid and the cyst wall was lined with intestinal and gastric mucosa and enclosed by a layer of muscle, which was shared with the adjacent ileum. (Korean J Pediatr Gastroenterol Nutr 2010; 13: 75∼80)

The Mount Fuji sign of the pneumoperitoneum

A 58-year-old man presented with acute onset of epigastric pain that lasted for 2 h. Physical examination showed generalised abdominal tenderness and a positive peritoneal sign. Plain abdominal radiography disclosed...

Sonographic Pitfalls in the Diagnosis of Enteric Duplication Cysts

The sonographic double wall sign has been well described in the literature and is often the cornerstone in suggesting the diagnosis of an enteric duplication cyst. We report two cases with this sign that were erroneously diagnosed as enteric cysts and a third case without this sonographic feature that proved to be a duplication cyst. Histologic analysis of the specimens helps explain the cause of the sonographic pitfalls. The potential sonographic visualization of the split hypoechoic muscularis propria layer or identification of all five layers will increase the specificity in making the sonographic diagnosis of duplication cyst.

Ultrasound findings in orbital hydatid cysts

Purpose To describe the ultrasound features seen in orbital hydatid disease, which may confirm the diagnosis preoperatively. Design Interventional case series. Methods Nine patients of orbital hydatid cyst were evaluated preoperatively with ultrasound and computed tomography scans. The diagnostic features seen on ultrasound as well as the CT features are described. All patients underwent surgery to remove the cyst, and the diagnosis was confirmed surgically in all nine cases. Results We found that ultrasound was most helpful in diagnosing a hydatid cyst, even more so than a computed tomography scan, and we saw a diagnostic “double wall” sign in all cases, on ultrasound, a sign not previously described in orbital hydatids. Conclusions It is difficult to diagnose an orbital hydatid cyst preoperatively. However, we found that the double wall sign could be elicited ultrasonically in all cases of hydatid cyst, if looked for carefully, and the diagnosis could be confirmed.

Usefulness of the double-wall sign in detecting pneumothorax in patients with giant bullous emphysema.

We describe a new sign improving detection of pneumothorax in patients with giant bullous emphysema: air surrounding both sides of the bulla wall (the intrathoracic equivalent of the double-wall sign of pneumoperitoneum). We report the radiographic and CT appearances of the double-wall sign in seven patients with giant bullous emphysema, four of whom had pneumothorax. Recognizing the double-wall sign of pneumothorax should aid in the triage of patients with giant bullous emphysema.