Thrombosed Fusiform Dilatation of Persistent Median Artery with Normal Median Nerve

Carpal tunnel syndrome can be produced by abnormal mass effect due to trauma, ganglion cysts, various soft tissue tumors, musculotendinous variants, and aberrant vascular structures. Persistent median artery is one of the causes of the carpal tunnel syndrome. Thrombosed persistent median artery usually accompanies the anomaly of the median nerve and causes a sudden onset of severe pain and paresthesia. In contrast to previous literature, we report the rare case of gradual onset and mild symptom of a 53-year-old man with a thrombosed persistent median artery but without anomaly of the median nerve and abnormal finding of electrophysiologic study.

Focal Caroli’s Disease Presenting as Fusiform Dilatation of Intrahepatic Biliary Radicles.

Background Caroli's disease is a rare congenital disorder characterized by segmental, non obstructive, cystic dilatation of intra hepatic bile ducts. It belongs to the spectrum of fibropolycystic liver disease which results from in utero malformation of ductal plate. Two forms of this disorder have been described, the less common 'Pure' form involves only the large intrahepatic bile ducts and the more 'complex' form is associated with congenital hepatic fibrosis (CHF), and is known as Caroli's Syndrome. Case A young female presented with features of cholangitis and in addition to all the routine investigations, non invasive imaging in the form of ultrasonography, computed tomography and magnetic resonance imaging was done. Diagnosis Final diagnosis of focal Caroli's disease with cholangitis was made on clinical and imaging findings. Treatment Conservative treatment was given and patient referred to gastro surgery department for partial hepatectomy. Conclusion An early recognition of Caroli's disease with non invasive imaging can bring down the morbidity.