Role of duplex doppler in evaluation of portal hypertension as a comparative study between bilharzial and non-bilharzial causes

Duplex Doppler has become powerful diagnostic tool in illustrating the morphology and haemodynamics of portal hypertension. We found that the maximum and mean blood flow velocity of the portal vein were less than control group with no significant difference between bilharzial and non bilharzial groups, while blood flow velocity in splenic vein was slower in 13 cases 3 cases. Blood flow volume did not show significant changes. Congestion index was elevated in portal hypertension with no significant difference between bilharzial and non billiarzial groups

Intrathoracic lesions: ultrasonically guided fine-needle aspiration biopsy

Fluoroscopy and CT are widely used to guide percutaneous needle biopsy for thoracic lesions. However, some lesions are not sufficiently visible on fluoroscopy and others are dangerous to access on CT without real-time monitoring. Real-time sonography was used to guide percutaneous needle biopsy in 67 patients with thoracic lesions after conventional chest X-ray; including pleural, pulmonary and mediastinal lesions. A diagnosis was made in 41 [89%] of 46 malignant lesions and 18 [85.7%] of 21 benign ones. Complications included minor pneumothorax and pain. US-guidance had the advantages of being real-time, mobile equipment and safe; making the thoracic lesions amenable to percutaneous biopsy

role of ultrasonography in the management of acute abdomen

The study comprised of 164 consecutive patients presenting with acute abdominal pain were assessed clinically and ultrasonographic examinations of 76 patients were performed. Of these, 54 [33%] patients would normally have had an immediate ultrasonographic scan requested; routine [within 24 h. of admission] ultrasonographic scan would have been requested in a further 22 [13%] patients. In 88 [54%] patients who were diagnosed as acute appendicitis, and ultrasonographic examination would not have been requested and appendicectomy was done for them. Ultrasonography altered the diagnosis in three patients. In the 1st patient, the diagnosis is altered from probable acute appendicitis to acute cholecystitis. In the 2nd patient, the diagnosis is altered from simple fractured rib [in car accident] to ruptured spleen with the fractured rib. In the 3rd patient, the diagnosis was changed from fracture femur and shock to multiple liver tears and retroperitoneal haematoma with the fracture femur. The study shows that immediate ultrasonographic examination of acute abdomen is helpful especially for patients with a history of trauma, for management and decision for urgent laparotomy and to exclude serious surgical pathology which required immediate intervention