Hepatocellular carcinoma directly invading the duodenum

Recurrent gastrointestinal bleeding from hepatocellular carcinoma HCC invading the duodenum is very rare. We present a case of 50-year-old male who was admitted with a history of recurrent upper gastrointestinal tract UGIT bleeding, weight loss and anemia. The patient was known to have a chronic hepatitis C. Endoscopic examination showed grade-2 non-bleeding esophageal varices, and a large ulcerated duodenal mass partially obstructing the duodenal bulb outlet and causing recurrent UGIT bleeding. Pathological evaluation of the mass revealed HCC

value of computed tomography and ultrasound guided needle aspiration in suspected thoraco-abdominal abscess

The purpose of this study is to evaluate retrospectively the usefulness of computed tomography [CT] and/or ultrasound [US] guided interventions in patients with suspected thoracic/abdominal sepsis. Between January 2000 and May 2002, 135 patients [mean age 37 years [range 9-78]] underwent CT [GE Light Speed QXI Helical CT] and/or ultrasound [GE Logic 700] guided puncture, aspiration and drainage involving a mostly one-step Trocar and Seldinger technique. Most interventions were within the abdominal cavity and yielded fluid collections pyogenic in nature. Periappendicular abscesses were treated in 24 patients. There were 35 patients with suspected liver abscesses, two being found to consist of sterile haemtoma. In 11 patients abscesses were confirmed to be amoebic in origin. Percutaneous cholecytostomy was performed in 16 patients. Pleurocentesis was carried out in 21 patients with different pyogenic infections; in 4 patients tuberculosis [TB] was identified. In addition, TB was diagnosed in two of 8 patients with psoas abscesses. In 10 patients with septicaemia, considered to be at high surgical risk, our intervention was believed to be life saving. No serious complications were observed [two patients required additional analgesia for severe pain following percutaneous cholecystostomy]. CT guided interventions were especially suitable in complicated abscesses, allowing 2 and 3D, and other suitable projections for an optimal approach

Usefulness of radiology and MRI in caudal regression syndrome

We report three patients with sacral and coccygeal agenesis based on observations of painful haematuria, urinary tract infection, and urine incontinence. All patients were examined by conventional radiology [urography and micturating urethrography] and imaging such as ultrasound and MRI. Neuropathic urinary bladder and pronounced reflux to the kidneys were observed. MRI of spine revealed conus medullaris located high [Th 11 and Th 12] and different from the expectations with respect to the patients' age. Neither tether cord nor intrathecal tumours were observed in our patients. In one patient, deformed and bulky cauda equina was described and in another the cauda equina was small and atrophic. In all patients, absence of a part of sacrum and coccyx and nerve roots innervating urinary bladder and sphincters were observed. MRI revealed good anatomical and pathological check up of kidneys and urinary tracts in the children suffering from chronic urosepsis

Childhood lipoid pneumonia due to animal fat aspiration diagnosed by MRI

A case of a goats milk fat product [ghee] aspiration pneumonia is described in a 5 month old Saudi boy. The clinical course and radiological features assessed by plain chest x-ray, computerized tomography [CT] and magnetic resonance imaging [MRI] are presented. An MRI Signa 1.5 T apparatus was used with Tl and T2 weighted images and a fat saturation technique for the diagnosis of lipoid pneumonia. This technique is presented as being superior to other diagnostic modalities