Partial splenic embolization [PSE] in Egyptian patients with thalassemia major

The work is a trial to assess the value of partial splenic embolization as a new method of radiological interventional procedures that may be an alternative to surgical splenectomy in thalassemia major, the commonest hemolytic anemia in Egypt. In this work, PSE was done in six patients with thalassemia major including one case of sickle beta thalassemia. They included 4 males and 2 females with ages ranging from 3 to 12 years. Embolization was done using Gelfoam in five cases and an autologous blood clot in one case by superselective catheterization of the splenic artery. The extent of embolization was from 70% to 80% in five cases and 35% in one case. Follow up was done for periods up to 22 months by clinical and laboratory evaluation, ultrasound isotopic scanning and CT. PSE was successfully done in five of them with different responses. Three cases showed dramatic improvement with marked reduction of blood transfusion rate, decrease in the splenic size and improvement of the growth rate of the patient. One case had subintimal injection of contrast in the splenic artery which resulted in thrombosis of the splenic artery and extensive infarction of the spleen that gave good results in the follow up period. One case was complicated by a refluxing embolus resulting in small perforation in the lesser curvature of the stomach that necessitated laparotomy and splenectomy. In one case, the extent of embolization was not sufficient to give good results

Transmyometrial pelvic venography N pill-users

Transmyometrial pelvic venography in pill-users [18 cases], revealed normal venograms in 4 cases [22%], while abnormal venograms were detect in the remaining 14 cases [78%]. The commonest abnormal venous pattern noted was bilateral pelvic varicocele and stasis in 8 cases [57%]. It was specially marked in the pampiniform plexus of veins. The next common abnormal venographic finding was uterine congestion which was found in 5 ladies [35%]. This was found in the group of Para 5 or more. A very important abnormal venographic finding found in 3 ladies [22%] was ovarian vein thrombosis. This should he seriously considered. It occurred irrespective of the duration of use of pills. Abnormal venograms were minly found in those above 30 years of age. Pelvic venography is recommended in pill-users, especially those a bove 30 years of age, those of high parities, those with lower limb varicosities and cases who have used pills for 5 years or more

Transmyometrial pelvic venography in intrauterine contraceptive device [IUCD] wearers

Transmyometrial pelvic venography was done 18 cases wearing the lippes loop and 18 cases wearing the TCu 200, B, while 10 cases were taken as control. Norma1 venograms were detected in only 22.5% of cases wearing the lippes, loop as compared to 50% of cases wearing the TCu 200 B. Abnormal venograms, showing both varicosities and stasis, were observed in 77.5% of cases wearing the Lippes loop, as compared to only 50% of cases wearing the TCu 200 B. The latter eases showed only stasis without dilatation or varicosities. The main bulk of abnormal venographic findings was observed in those of high parities, and those using the IUCD for more than 3 years. Increased menstrual blood loss was seen in 10 cases wearing the Lippes loop, as compared to only 6 cases wearing the TCu 200 B, and this could be explained by the higher incidence of both varicosities, stasis and uterine congestion associated with the Lippes loop. Thus, another mechanism for the increased menstrual blood loss with IUCD's was introduced, primarily based on the abnormal pelvic venographic findings which were of higher incidence with the Lippes loop variety

Ultrasound diagnosis of abdominal lymphadenopathy

In this work, the usefullness and limitations of U.S. as compared with lymphography, in the investigation of retroperitonial nodal disease were studied. 30 patients with suspected retroperitoneal nodal involvement were examined by both methods. The results and accuracy of each method was analyzed and discussed