ABSTRACT
Background: To assess the extent of Ultrasound (USS) abdomen findings in acute viral hepatitis and further assess the role of USS as a prognostic marker.Methods: From May 2013 to September 2016, a total of 220 patients of acute Enterogenic viral hepatitis were studied by routine USS within first seven days of onset of symptoms, followed by routine USS between 10 to 15 days and follow up scan after 12 weeks. Only patients with acute Enterogenic viral hepatitis (Hepatitis A and Hepatitis E) were included. All patients with chronic liver disease and other form of acute hepatitis i.e. Hepatitis B, C and D were excluded from the study.Results: Among 220 patients of acute viral hepatitis routine USS findings including hepatomegaly, bright liver and thickened GB wall and periportal adenopathy were in isolation or in combination up to varying degrees. The commonest routine USS finding in acute phase was thickened GB wall (80%). 14 patients exhibited triad of enlarged Portal Vein (PV), Splenomegaly and Ascites. These 14 patients had prolonged stay in hospital and 11 patients had deranged liver function tests at 12 wks. interval and three patients developed hepatic encephalopathy including one patient who went into fulminant hepatic failure. Out of the patients who did not exhibit this triad 72 patients still had deranged LFT at 12 weeks and maximum of these patients had a combination of USS markers at presentation.Conclusions: USS has very little if any role in the diagnosis of acute viral hepatitis. It can however play an important role as a prognostic marker during the acute phase where it can detect enlarged portal vein, splenomegaly and ascites. This triad of USS findings is suggestive of transient portal hypertension likely due to hepatic congestion. Also, other USS markers if seen in combination at presentation can reliably predict a poorer prognosis
ABSTRACT
Background: The purpose of present study was to identify sonologically, the cystic and non-cystic renal mass lesions, to attempt differentiating benign lesions from the malignant ones and to correlate ultrasound findings with ultra sonographically guided cytological or pathological findings.Methods: In this hospital based prospective observational study, all the patients with confirmed renal mass were subjected to USG guided fine needle aspiration cytology (FNAC). All the patients presenting with lump in abdomen, haematuria or pain in abdomen, wherein the clinical diagnosis of renal mass was being considered by the clinician, were enrolled for the study. Total 54 participants were enrolled. Those with confirmed renal mass were subjected to USG guided FNAC and which was carried out in supine position by transabdominal route in all patients.Results: About 42 participants were retained for final analysis; since FNAC was not possible in 12 patients. Pain in abdomen (36, 85.7%), mass in abdomen (34, 81%) were the most predominant clinical findings. Mixed echogenicity was the commonest echo pattern (42, 77.7%) on ultrasonography. Histopathologic/cytologic examination of the 39 malignant cases confirmed renal cell carcinoma (18, 46.5%) to be the commonest malignancy, followed by Wilms’ tumour (10, 26%). Out of the 39 cases in which clinico-radiological diagnoses were correlated with histo-cytological diagnoses, it was found to be consistent in 30 (77%) cases and inconsistent in 9 (23.1%) cases.Conclusions: Fine needle aspiration cytology/biopsy performed under ultrasonography guidance demonstrates high diagnostic accuracy. It is hence recommended as part of fundamental approach to the diagnosis of non-cystic renal mass.