Laparoscopy, hysteroscopy and fluorscopically monitored hysterosalpingography in evaluation of female infertility

The diagnostic accuracy of 1aparoscopy hysteroscopy and fluoroscopically monitored hysterosalpingography [HSG] were evaluated in 80 infertile women who underwent these procedures as part of their infertility work-up. HSG versus laparoscopy in evaluation of the tuboperitoneal factor showed 64.44% sensitivity and 85,71% specificity with diagnostic efficacy of 73.75%. HSG versus hysteroscopy in evaluation of the uterine factor showed 69.56% sensitivity and 87.71% specificity with diagnostic efficacy of 82.5% These data indicates that for optimal evaluation, a combiend approach using the three procedures is recommended. The clinical history. suggestive symptoms together with physical examination should provide a base for more selective use of these diagnostic techniques

Correlation of CT and operative staging in cancer head of the pancreas

In a current series of 150 patients with obstructive jaundice studied by abdominal CT, there were only 30 cases with operatively proved pancreatic carcinoma. A correct CT diagnosis was made in 24 cases [80%] while 6 patients [20%] were incorrectly diagnosed. The primary CT finding of pancreatic carcinoma was a tumour mass with associated bile and or pancreatic duct dilatation. The mass was located in the head in 28 cases [93%] and involved most of the gland in 2 cases [7%]. On CT, the mass was demonstrated as a central hypodense zone in 18 cases representing the hypovascular scirrhous tumour surrounded by normal parenchyma or inflammatory tissue caused by obstructive pancreatitis. In 6 cases, the mass was heterogenous in density. The common bile duct was dilated in all of our cases. A dilated pancreatic duct was seen in 12 cases, Tumour obstruction of the main pancreatic duct causing rupture of lateral side branch ducts resulted in the formation of post obstructive pseudo-cysts in 2 cases. Knowledge of this finding is important to avoid the mis-diagnosis of a tumour as pancreatitis with pseudocysts. The secondary findings of local tumour extension or metastatic diasease help to differentiate malignant masses from benign ones and aid in tumour staging and resectability. One or more of the ancillary findings were seen in 22 out of 24 correctly diagnosed cases. CT diagnosed resectable tumours in 2 cases. During operation however one case only was resectable