Right abdominal mass: keep an open mind

Amebic colitis is common in tropics, usually presenting with variable and non-specific symptoms. Amebomas occur rarely, usually in cecum and ascending colon, when they can masquerade as colon carcinoma. This report describes the case of a 27-year-old male who presented with right abdominal mass. Radiological examination prompted us to the differential diagnosis of ameboma and he was treated with metronidazole and broad-spectrum antibiotics for two weeks. Amebic colitis should be considered as a possible diagnosis when dealing with right-sided abdominal mass

Surgical management and length of hospital stay for diabetic foot

Diabetic foot diseases are one of the complications of chronic diabetes. They increase the length of hospital stay and the financial expenses. Diabetic foot cases are managed conservatively in the surgical department to heal ulcers and cure infection. Nevertheless, limb amputations are required in some circumstances. Is to determine the length of stay and the type of surgical management provided for diabetic foot cases. Medical records of all patients admitted to the General Surgery Department, Tripoli Central Hospital as diabetic foot disease were retrospectively studied. These admissions were from Jan 1st 2006 to Dec 31[th] 2007. Patient's demographics, type of surgical management and length of hospital admission were recorded. There were 203 diabetic foot cases; they represent 2.7% of the total admissions. Their mean age was 63.91 +/- 11.34 years. Males were 59.6% and females were 40.4%. Nearly 75% of cases were treated by debridement of dead tissue, ulcer dressing, incision and drainage. Amputation was inevitable for one quarter of diabetic foot patients. Among those, 45.1% had toe amputation, 31.4% had below knee amputation and 9.8% had above knee amputation. Lastly, the mean length of stay for diabetic foot patients was 11.44 days. It ranged from 1-48 days. Diabetic foot is associated with increased length of hospital stay. In spite of highly conservative approach, the surgical team performed different levels of lower limb amputation. Many of these amputations could have been salvaged by patient foot care education

Takayasu arteritis diagnosed by 16-row multidetector CT angiography

Takayasu's arteritis is a well-known systemic disease that involves the aorta, major aortic branches, and pulmonary arteries. Conventional catheter angiography remains the 'gold standard' for disease diagnosis, in correlation with clinical data and laboratory findings. Multislice computed tomography angiography [MSCTA] has the advantage of non-invasively providing the angiographic data and combining morphological mural assessment with luminal evaluation. We present 2 such cases diagnosed by 16-slice MSCTA

pattern of renal vessels in live related potential donors pool. A multislice computed tomography angiography review

To assess the renal vessel anatomy, compare the findings with the perioperative findings, to determine the sensitivity of multislice computed tomography [CT] angiography in the work-up of live potential donors and to discuss and compare the results of the present study with the reported results using single slice CT, magnetic resonance [MRI] and conventional angiography [CA]. Retrospective analysis of the angiographic data of 118 of prospective live related kidney donors was carried out from October 2004 to August 2005 at the National Organ Transplant Centre, Tripoli Central Hospital, Libya. All donors underwent renal angiography on multislice [16-slice] CT scan using 80 cc intravenous contrast with 1.25 mm slice thickness followed by maximum intensity projection [MIP] and volume rendering techniques [VRT] post-processing algorithms. The number of vessels, vessel bifurcation, vessel morphology and venous anatomy were analyzed and the findings were compared with the surgical findings. Multislice spiral CT angiography [MSCTA] showed clear delineation of the main renal arteries in all donors with detailed vessel morphology. The study revealed 100% sensitivity in detection of accessory renal vessels, with an overall incidence of 26.7%, which is the most common distribution in the parahilar region. The present study showed 100% sensitivity in the visualization and detection of main and accessory renal vessels. These results were comparable with conventional angiography which has so far been considered as the gold standard and were found superior in specificity and accuracy to the use of single slice CT [SSCT] and MR in the angiographic work-up of live renal donors. Due to improved detection of accessory vessels less than 2 mm in diameter, a higher incidence of aberrant vessels was seen on the right side as has been suggested so far

Trichobezoar

Trichobezoar is an uncommon condition often presenting, among other signs, with a history of trichotillomania and trichophagia. We report an unusual case of gastric trichobezoar with extension into jejunum in a patient with an unusual habit of ingesting hair plucked from other people's scalp

Congenital Renal Anomalies - A brief spectrum

Congenital anomalies of the renal tract are fairly common and are usually asymptomatic. These are more often detected incidentally by various imaging modalities like ultrasound and computed tomography. Anomalies of the vascular supply of the kidneys have recently been diagnosed preoperatively due to the advent of fast imaging techniques like multislice computed tomography [MSCTA] and contrast-enhanced magnetic resonance angiography [MRA]. We present a fresh perspective on four commoner congenital renal anomalies detected by MSCTA

Imaging of peripheral arteries by 16-slice CT angiography: a valuable tool?

To evaluate the efficacy of multislice [16-slice] computed tomography [MSCT] in imaging the upper and lower limb arterial tree in trauma and peripheral vascular disease. 33 patients underwent CT angiography of the upper or the lower limb on multislice [16-slice] CT scanner. The findings were retrospectively compared with the surgical outcome in cases of trauma with suspected arterial injuries; or with colour Doppler for patients with peripheral vascular disease, CT angiography allowed a comprehensive diagnostic work-up in all trauma patients with suspected arterial injuries. In the 23 cases of peripheral vascular diseases, CT angiography adequately demonstrated the presence of any stenosis or occlusion, its degree and extent, the presence of collaterals and distal reformation if any and the presence of plaques. Our initial experience of CT angiography with multislice [16 slice] CT scanner has clearly demonstrated its efficacy as a promising, new, fast, accurate, safe and non-invasive imaging modality of choice in cases of trauma with suspected arterial injuries; and as a useful screening modality in cases of peripheral vascular diseases for diagnosis and for grading

Isolated massive splenic hydatidosis

Hydatid disease or echinococcosis is fairly common worldwide and is endemic along the Mediterranean. It is still a serious health problem in Libya, where it is endemic. It commonly involves the liver and lungs. We report an unusual presentation of this common disease. The interest of this case lies in its rarity and huge size at presentation