Direct percutaneous embolization of renal pseudoaneurysm

To describe and evaluate a novel method of direct ultrasound [US] guided percutaneous embolization of renal pseudoaneurysm. Elevn patients with severe hematuria were included in this study during the period from February 2005 to February 2006. They included five patients with penetrating renal trauma, two patients post-renal biopsy and four patients after percutaneous nephrolithotripsy. Diagnostic duplex US of the pseudoaneurysm was performed. The size of the pseudoaneurysm and its neck were determined. A solution of Gelfoam particles was prepared in sterile saline solution and under US guidance, the tip of the needle was inserted into the aneurysm and slowly Gelfoam particles solution was injected. During the injection of Gelfoam, the pseudoaneurysm initially filled with an echo genic thrombus, decreasing thereby the color flow detected by US. The needle was removed when no flow in the pseudoaneurysm was detectable. The patient was kept for 30 minutes in the department and then discharged home. Follow up by color Doppler US every 2 to 4 weeks. In 10 patients bleeding was effectively controlled with direct embolization in a single session and did not need any further intervention, while one patient needed endovascular embolization due to recurrent severe hematuria after 24 hours. The amount of the injected Gelfoamn particles [1-2 mm diameter] was from 1 to 3 ml, according to the size of the pseudoaneurysm. No complication was observed secondary to embolization procedure. Re-bleeding did not occur in any patient during their follow-up period that ranged from 3-12 months. Direct ultrasound guided percutaneous embolization of renal pseudoanureysm is a new method for treating renal pseudoaneurysm. It avoids the side effects of contrast media, hazards of irradiation and complications of angiographic catheterization. Moreover, it saves the patient the risk of surgical interference to control bleeding by partial or total nephrectomy specially in patients with solitary kidney. it has been proved to be a rapid, effective, feasible, tissue preserving, and likely to reduce morbidity and mortality. Therefore, it is recommended to be a first line of treatment of actively bleeding renal pseudoaneurysms

role of color doppler sonography in the diagnosis of testicular lesions

Testicular lesions are common clinical problems affecting males of all age groups. Forty patients with scrotal pain and/or scrotal swelling were examined with Grey Scale and Color Doppler Sonography of the scrotum. In acute testicular lesions, including testicular torsion [15%] and acute epididymo-orchitis [47.5%], Color Doppler Sonography was more sensitive than Grey Scale Sonography, reaching up to 100% sensitivity in differentiating the two conditions. In chronic testicular lesions, there was an overlap in the vascular pattern and Doppler indices between chronic inflammatory lesions [20%] and malignant lesions [12.5%], that limit the role of Color Doppler Sonography to differentiate between these lesions. In cases of testicular trauma [5%], Color Doppler Sonography was able to demonstrate uninterrupted blood supply and avascular nature of testicular contusion. Color Doppler Sonography was very accurate in the diagnosis of acute testicular lesions, while its role in chronic testicular swellings still in need of further research on large number of patients

Assessment of emphysema and bronchial asthma by computed tomography density mask program and correlation with pulmonary function tests

The aim of this work is to assess the presence and extent of emphysema using "CT density mask" program and to find out if CT scans can differentiate emphysema from bronchial asthma, correlation of the CT scan finding of emphysema with pulmonary function test was tried