ABSTRACT
Background: Biliary postoperative complications include biliary stenoses, biliary leaks, fistulas and collection or abscess formation. These complications usually occur due to injury after laparoscopic cholecystectomy, gastric or hepatic resection, bilio-enteric anastomosis and after liver transplantation. In most of the cases a new surgical intervention is not possible. Endoscopic intervention is usually the optimal initial management of these complications; however, in patients with altered enteric passage, tight low biliary stricture, high up obstruction or leakage endoscopic approach becomes impossible. Therefore, the percutaneous trans-hepatic approach is of extreme importance in the diagnosis and treatment of the problem especially in complex cases
Objective: This study aimed to highlight the spectrum of percutaneous cholangiographic findings and methods of treatment of postoperative benign biliary stenoses, biliary leaks and to detect its significance in management of these problems
Patients and Methods: This study was conducted in Theodor bilharz research institute [TBRI], Egypt from February 2013 to June 2018. 17 patients with benign postoperative biliary complications [stricture and leak] were treated with a percutaneous transhepatic procedure. Only adult patients [age >18 years] were included in the study
Results: All patients had cholestasis and/or bile leak according to clinical and biologic findings [i.e., jaundice or an episode of cholangitis]. Biliary obstruction and/or leak was confirmed by abdominal ultrasonography [US], multidetector computed tomography, and/or magnetic resonance [MR] cholangiography when US results were not conclusive and confirmation of the site and extension of the stricture and/or leak was needed. The results of the present study demonstrated that treatment of post-operative biliary complications [stricture and/or leak] by percutaneous transhepatic procedures was an effective option with acceptable rate of complication
Conclusion: We concluded that the percutaneous treatment of post- operative biliary complications is an effective alternative to surgery. This method should certainly be preferred when the local conditions were not favorable to a surgical repair, failure of endoscopic approach or when a recurrence was observed after an unsuccessful previous repair. Its advantages compared with surgery were its minimally invasive nature, reduced risk of complications, and the fact that all options remain open in case of failure
ABSTRACT
Background: the introduction of Doppler technology has proved the first opportunity for repetitive, noninvasive hemodynamic monitoring in human pregnancy compared to other methods of maternal and fetal monitoring
Aim of the Work: this study aimed to predict usefulness of uterine artery Doppler in predicting pre-eclampsia and to study uterine artery Doppler waveforms at 14-20 weeks of gestation
Patients and Methods: this prospective study was carried out in the Radiodiagnosis Department Ain Shams University. This study included 33 pregnant women [between 14 to 20 weeks of pregnancy]; they were chosen randomly from patients referred from maternal clinics, all were primigravida, single pregnancy during the period from June 2017 to December 2017
Results: regarding our results when RI index was used, sensitivity, specificity were 90.0%, 87.0% and when PI index was used sensitivity, specificity were 60.0%, 87.0%
Conclusion: we can conclude that uterine artery Doppler between 14- 20 weeks of gestation is a simple rapid non-invasive procedure and it can be used as a reliable indicator for prediction of preeclampsia to use it as a screening test
Recommendations: we recommend other studies with a wide scale of population [large number] in more than one center; this will lead to increased surveillance and delivery in a well-equipped setup in high risk detected patient which is necessary to reduce the maternal and fetal complications
ABSTRACT
Cervical cancer is the second most common gynecologic malignancy. It usually takes years for pre-cancerous changes to turn into cervical cancer. This pre-cancerous change when detected is 100% treatable. Accurate cervical cancer staging is crucial for appropriate treatment selection and treatment planning. The greatest difficulties in the clinical staging are the estimation of tumor size, especially if the tumor is primarily endocervical in location. MRI has excellent soft-tissue contrast resolution, which exceeds that of CT and US. Consequently, MRI is significantly more valuable in the assessment of the size of the tumor, the depth of cervical invasion, and the local-regional extent of the disease
Aim of the Study: to highlight the role of transvaginal contrast enhanced MRI in the early detectionand staging of cervical cancer to guide for accurate management
Conclusion: high-resolution MRI is accepted as optimal for evaluation of the main prognostic factors and selection of therapeutic strategy for cervical cancer
ABSTRACT
Background: diagnosis of liver metastases is of essential importance in the staging of patients with a known primary tumor
Aim of the work: The study aimed to evaluate role of DWI in diagnosis of liver metastasis
Patients and methods: twenty patients were included in this study. The cases were evaluated over 6 months at Ain Shams University Hospital with a 1.5 Tesla Phillips [MR System Achieva] whole body imager
Results: in the sample of the study which was composed of 20 patients there were two patients who presented with negative lesion in DW MRI with sensitivity 100%, specificity 90% and accuracy 95%
Conclusion: DWI alone performs equally well as Gd-MRI in the diagnosis of liver metastases. In cases where gadolinium injection is not allowed, dynamic contrast-enhanced imaging can be replaced by a protocol based on unenhanced T1- and T2-weighted imaging combined with DWI
Recommendations: Further studies on larger scale of patients are needed to confirm the results of the study