Percutaneous drainage of hepatic abscesses

To report our experience with percutaneous drainage of hepatic abscesses. Retrospective study of patients with hepatic abscesses seen at 2 institutions: Toronto General Hospital in Toronto, Canada and King Abdulaziz University Hospital in Jeddah, Saudi Arabia over a 7 year period. Complete resolution in 20 out of 22 [91%] patients. Pleural effusions developed in 4 [18%] patients. Death occurred in 2 [9%] patients with multiple abscesses on top of liver malignancy. Procedural related surgical intervention was not required. Radiologically guided percutaneous drainage of hepatic abscesses remains the gold standard approach to liver abscesses. This is in agreement with studies of other authors

Imaging of undescended testes: a prospective study

Evaluation of various imaging modalities in localizing undescended testes. Prospective study. Fifty patients [74 testes]. Ultrasound [US], computerized tomography [CT], and one testicular venography were performed; 32 testes of 67 had a US examination and were operated upon; 27 testes of 66 had CT examination and were operated upon. The US surgically proven sensitivity was 53.85% with a specificity of 33.33%. The US positive predictive value was 77.78% and the negative predictive value was 14.3%. The CT sensitivity was 95.9% with a specificity of 60%. The positive predictive value of CT was 91.3% and the negative predictive value was 75%. The accuracy of US and CT were 50% and 88.9% respectively. Ultrasound is a good positive test. Patients will have to be considered for CT examination if US is negative. Testicular venography can be used to save the patient from surgical exploration

Percutaneous cholecystostomy and gall stones dissolution by methyl tertiary-butyl ether

Methyl tertiary-butyl ether [MTBE] is a new potent cholesterol solvent. It has proved to be useful in dissolving human non-calcified gall stones. We report our initial experience of ten consecutive patients with symptomatic cholelithiasis treated by percutaneous Cholecystostomy and gall stone dissolution with MTBE. All patients had successful catheter insertion; nine of them had complete stone dissolution. One patient had partial dissolution of her stones. This patient had positive cytology for malignancy in bile aspirated after Cholecystostomy. She had a cholecystectomy and was found to have carcinoma in situ. Follow-up ultrasound examination showed the presence of small stones in five of our patients. These patients are receiving an oral chenodeoxycholic acid preparation to treat their recurrence. In the proper clinical set-up, percutaneous MTBE gall stones dissolution may become an alternative to traditional surgical cholecystectomy for the management of cholelithiasis. Further steps to accelerate and increase the efficiency of dissolution are feasible and under investigation

Non-endoscopic percutaneous gastrojejunostomy for enteral feeding: the first Saudi Arabian experience

Non-endoscopic percutaneous gastrojejunostomy is an established procedure for enteral feeding. It requires no general anaesthesia or gastroscopy. We recently performed it successfully on two adult patients with no complications. To our knowledge this is the first Saudi-reported experience using this procedure. We recommend it as a simple and less traumatic method for enteral feeding when compared with the endoscopic or surgical versions

Mucocele of the appendix: additional radiological findings

We report a patient with pathologically proven mucocele of the appendix Multi-imaging modalities were employed. The Hounsfield Units of the mucocele content before and after contrast together with ultrasonographically detected septation are reported. The ultrasound and computed tomography findings of mucocele of the appendix are discussed