Value of both ultrasonography and barium enema in diagnosis and reduction of intussusception in children

The aim of this study was to evaluate the values of both U/S and barium enema in diagnosis and hydrostatic reduction of acute non complicated intussusception in children. All these selected patients had no signs or symptoms of peritonitis with balanced serum electrolytes and the duration of symptoms was less than 48 hrs. Nasogastric tube inserted to decompress the stomach and IV cannula inserted for IV fluid replacement and sedated by diazepam. The diagnostic accuracy and sensitivity by both U/S and barium enema was 100% with positive sonographic target signs of intussusception [dough nut sign in TS and pseudo-kidney sign in LS]. 20 patients with non complicated acute intussusception were subjected to non- surgical reduction. They were divided into two groups for hydrostatic reduction of intussusception: Group A included ten patients subjected for reduction of intussusception by saline enema guided by U/S and Group B included also ten patients subjected for barium enema reduction under fluoroscopic guide. The results have shown that U/S was equal to barium enema in diagnosis of intussusception but U/S considered superior than barium enema in diagnosis and reduction of intussusception as it can detect another abdominal pathology that could not be diagnosed by barium enema as well as it can save the patient from the hazards of irradiation. Also, the results have revealed that hydrostatic reduction must be fulfilled to non complicated intussusception to save the patients from the hazards and cost of surgical treatment that must be done only in cases of failed hydrostatic reduction and in complicated cases

Ultrasonographic guided percutaneous needle aspiration and laparoscopic drainage of liver abscesses

This study included thirty patients [seventeen males and thirteen females], their ages ranged from 3 to 65 years with mean age 24.5 years. All patients were complaining of fever and Rt upper abdominal pain. The findings of this study have suggested that the medical treatment alone was attempted in patients with abscesses lesser than 2 cm, while, ultrasonographic guided percutaneous aspiration in combination with systemic antibiotics considering suitable, easy, cheep and reproducible method was used for cure abscesses from 2 to 20 cm or multiloculated abscesses

High anal fistula: an old disease and a new concept

This study has assessed the functional results of rectal advancement flap in association with or without core fistulectomy for complex perianal fistula. It has included sixteen patients [eight males and eight females] with complicated high anal fistula, their ages ranged 18-65 years with a mean age 38 years. The patients were submitted for thorough history, clinical, anal examination and fistulogram. All had documented idiopathic high trans-sphincteric fistula in ano, from which six were recurrent and ten were with primary high anal fistulae. Eight patients were treated with rectal advancement flap and core fistulectomy [group A], while the other eight patients were treated with flap advancement with excision of internal and external ostia, debridement of the fistulas track and closure of the internal ostium [group B]. Type, time and difficulties of the operations were recorded. The results have shown that management of fistula in ano whatever high or low must not left to the end of the operation list and must be done by experienced surgeons in order to decrease the rate of postoperative complications as recurrence of the anal fistula and disturbance of the anal continence. Also, the study has shown that flap advancement technique is considered safe and effective one stage procedure with good functional results and minimal or no disturbance of continence and should be considered for the treatment of high or complex perianal fistulae

Surgical management of symptomatized hyperparathyroidism

Our study included 12 patients [5 Males - 7 Females] their age ranged from 15 - 59 years. This study was performed in El Minia and El Mansoura University Hospitals from March 1991 to Jan 1993. All patients were complaining from urological symptomes with or without gastrointestinal or orthopedic manifestations. All patients were submitted to thorough clinical, laboratory, radiological examination, neck ultrasonography, Thallium 201 and Techneium 99 were used for detecting the site, the size and the relation of the parathyroid to The Thyroid gland. All patients proved to be hyperpara.thyroidism the majority were hypercalcaemic [66.7 percent] and 33.3 percent were normocalcaemic. Exploration of the neck was performed for all patients to explore the parathyroid glands which could be detected by its site, colour and amount of fat around it. Excision of the affected gland or glands have been done with surgical care to RLN and the speciments were subjected to histopathological study. Follow up of the patients ranged from 6-12 months by measuring the level of serum calcium, phosphorus. PUT, IVU, and bone x-ray were done every 3 months with encouraging results. It seems that surgical extirpation of the affected glands is the only method for pervention of recurrent renal stones, GIT symptoms and bony affection caused by hyperparathyroidism

value of cytological study of gastric juice in diagnosis of lower esophageal and gastroduodenal lesions

Recently cytological diagnosis of gastric aspirate has emerged as a definitive diagnostic modality in diagnosis of different gastric lesions. This study included 50 patients with different lower esophageal and gastroduodenal lesions, 38 [76 percent] patients were males and 12 patients [24 percent] were females as well as 10 healthy individuals as a control group. Preoperatively an over night fasting gastric wash was done and the aspirate centrifuged and stained by papanocula stain for cytological study for every patient and form the control group. Difinitive medical and surgical treatment was done and pathological examination of the biopsies taken either by endoscopy or during operation. A correlation between the preoperative cyto diagnosis, radiological, endoscopic diagnosis and post-operative pathological examination was done and statistically analyzed. This study revealed that cytological study was sensitive and true positive in diagnosis of 90 percent of patients of gastric cancer, in 82 percent of patients with peptic ulcer and in 77.8 percent of patients with other benin gastroduodenal lesions. The test was also, highly significant in excluding malignancy from both the control group and from the other benign gastroduodenal lesions and the specificity was 90 percent

Epidemiological study of breast masses in relation to Histo-pathological profiles, El-Minya, Egypt

Breast lesions usually take the form of palpable masses, sometimes painful, more often not. The epidemiological study of cancer breast could give a clue to the possible risk factors. This case series study was done on 296 cases with breast lesions randomly chosen. Benign and malignant masses of the breast are virtually limited to the females. In benign masses, fibro-adenosis is the commonest type [44.2%] and duct papilloma is the least common one [4.6%]. Fibro- adenosis was common in unmarried and nulliparous women [17.5% and 16.6%, respectively], while women have more than four children have the lowest incidence [5.9%]. Fibro-adenosis was common in women taking no pills [18.4%]. Benign lesions was common in the 4th decade, the mean age was 33.5 +/- 8.3 years and painless swellings were common with relevant past and family history [X 2 + 65 and P <0.05]. The right breast was the commonest site [58.5%] and estrogen level was highly significantly increased in fibro-adenosis [P <0.001]. Uterine tumors were commonly associated with fibro-adenosis [11.3%]. In malignant masses, infiltrating duct carcinoma was the commonest [77.2%], it is common in unmarried and nulliparous women [15.2% and 24.1%, respectively]. There is no significant difference in women with malignant masses taken or not taken pills [X 2= 8.4 and P >0.05]. The mean age of malignant lesions was 44.5 +/- 8.7, painless swellings were common and right breast was the commonest site of masses [63.3%]. Estrogen level was highly significantly increased in infiltrating duct carcinoma [P <0.001]. Also, uterine tumors were commonly associated with infiltrating duct carcinoma [7.6%]