RESUMO
Aims and Objectives: The aim of the study was to study ultrasound feature of hypoxic-ischemic encephalopathy (HIE) andintracranial hemorrhage.Materials and Methods: It was a non-interventional prospective cross-sectional observational study done over a period of1.5 years in the Department of Radiodiagnosis of Seth Gordhandas Sunderdas Medical College and King Edward MemorialHospital.Results: A total of 66 cases were evaluated during the study. There were a total of 36 male (54.5%) and 30 female (45.5%)neonates. The difference between a number of males and females was not found to be statistically significant. About 69.7% ofthe neonates were in the category of very low birth weight (LBW), which was significantly higher than that of LBW (P < 0001).In cases of intracranial bleed, the sensitivity and specificity of transcranial ultrasound were found to be 88.89% and 95.83%,respectively, with a diagnostic accuracy of 93.94%. The mean gestational age in patients with intracranial bleed was 29.83± 2.20 weeks. Early gestational age was significantly associated with intracranial bleed in neonates. In cases of HIE, thesensitivity and specificity of transcranial ultrasound were 83.33% and 92.59%, respectively, with a diagnostic accuracy of90.91%. Prevalence of preeclampsia in the mother was highest among the preterm neonates, which suggest that preeclampsiais a significant risk factor for prematurity. The proportion of cases that had vaginal delivery was significantly higher than that ofthose born through lower segment cesarean section (LSCS) in preterm neonates. The neonatal risk factors that were found tobe significantly associated with intracranial bleed and hypoxic encephalopathy were LBW, prematurity, and Apgar score is <6at 1 min and 5 min after birth. Preeclampsia and intrauterine growth restriction were found to be important maternal risk factorsfor intracranial bleed in preterm neonates. Preeclampsia and LSCS as the mode of delivery were observed to be importantmaternal risk factors for HIE in preterm neonates.Conclusion: Although the sensitivity and specificity of transcranial ultrasonography (USG) are less than that of magneticresonance imaging, (which is the gold standard in detecting HIE and intracranial bleed in preterm neonates) considering itssensitivity and specificity it can be still considered as the first-line imaging modality of choice for screening preterm neonatesfor HIE and intracranial bleed. Transcranial ultrasound can, therefore, be used as a routine screening imaging modality forpreterm neonates born before 37 weeks of gestational age. The ideal timing for first transcranial USG is on day 3 of life.Follow-up scans should be done on days 7, 14, and 30 to detect persistently abnormal periventricular echogenicity, and cysticchanges in HIE. In intracranial bleed follow-up, scans are needed to detect the resolution or progression of hemorrhage andventricular enlargement.
RESUMO
Esophageal cancer is the third most common gastrointestinal malignancy and is among the ten most prevalent cancersworldwide. Common malignant neoplasms of esophagus include squamous cell carcinoma and adenocarcinoma. Squamouscell carcinoma is more common than adenocarcinoma, but the incidence of adenocarcinoma is on the rising trend nowadaysand found to be predominant in newly diagnosed patients and in cases with Barrett’s esophagus. Dysphagia and weight loss arethe principal complaints in the patient with carcinoma esophagus. Intussusception causing acute obstruction of small bowel andcolon is known. Few cases of gastroesophageal intussusception due to eating disorders, congenital obstructions like superiormesenteric artery syndrome, physical exertions like weight lifting, peptic ulcer disease, and pregnancy due to hyperemesisgravidarum are known. Our case, a 52-years-old gentleman presented to gastroenterology OPD with complaints of dysphagia tosolids and emaciation. For these complaints, upper GIscopy was advised. Gastroenterologists were unable to pass endoscopeso patient was referred for computed tomography of thorax and abdomen, which revealed circumferential irregular thickeningretro cardiac segment esophagus and lumen within lumen appearance of esophagus with metastasis to lymph nodes and liver.In adults, intussusceptions of bowel usually have a lead point, for example, mesenteric lipoma or a neoplastic process; in ourcase, it was carcinoma of esophagus