Recurrent Scrotal Arteriovenous Malformation as a Slowly Increasing Left Testicular Swelling: A case report.

Arteriovenous malformations (AVMs) are benign vascular lesions. Although, the majority of AVMs occur in the central nervous system, there are published reports of AVMs involving all systems including the scrotum, kidney, and uterus. We report a 37-year-old male patient who presented to the urology clinic of a tertiary care hospital in Riyadh, Saudi Arabia, in 2021 with recurrent gradual scrotal swelling for four years attributed to scrotal AVM. Embolisation was performed; however, one year later his symptoms reoccurred. As a result, left partial scrotal wall excision was carried out without complications.

IgG4-Related Kidney Disease Associated With End-Stage Kidney Disease, Renal Pseudotumor, and Renal Vein Thrombosis.

IgG4 related disease (IgG4-RD) is a systemic autoimmune disease characterized by tissue invasion with IgG4-producing plasma cells, resulting in tissue dysfunction. IgG4-RD can affect the kidney in various forms, including renal mass, tubulointerstitial disease, and glomerulonephritis. IgG4-RD can mimic other autoimmune diseases and neoplasms, and as such, maintaining a high index of suspicion is the key to timely diagnosis and treatment. In this paper, we present a case of IgG4-RD that presented with pseudotumor and severe renal dysfunction that progressed to end-stage kidney disease (ESKD), associated with a rare finding of renal vein thrombosis (RVT).

Can the Body Mass Index Predict Varicocele Recurrence Post-Intervention?

Purpose In this study, we investigated the association between the body mass index (BMI) and varicocele recurrence post-intervention in our local Saudi population. We also explored the association between recurrence and other predictors such as age, laterality, indication for surgery, type of intervention, clinical grade, testicular delivery, and method of ligation. Methods We conducted a retrospective cohort study, including all patients who had microscopic varicocelectomy surgery or radiographic embolization for varicoceles over a five-year period. The data included demographic information and intervention-related variables. Descriptive and analytical statistics were used to analyze the data. Results We included 147 patients who had microscopic varicocelectomy surgery or radiographic embolization. We categorized the patients according to their BMI as underweight, normal, overweight, and obese. We found no statistical association between any BMI group and the recurrence of varicocele (P>0.05). However, there was a significant association between the clinical grade and recurrence (P<0.05). Conclusion This study did not show any significant correlation between height, weight, BMI, and varicocele recurrence after an intervention. The only predictor of varicocele recurrence was the clinical grade.

Artificial intelligence in radiology: does it impact medical students preference for radiology as their future career?

OBJECTIVE: To test medical students' perceptions of the impact of artificial intelligence (AI) on radiology and the influence of these perceptions on their choice of radiology as a lifetime career. METHODS: A cross-sectional multicenter survey of medical students in Saudi Arabia was conducted in April 2019. RESULTS: Of the 476 respondents, 34 considered radiology their first specialty choice, 26 considered it their second choice, and 65 considered it their third choice. Only 31% believed that AI would replace radiologists in their lifetime, while 44.8% believed that AI would minimize the number of radiologists needed in the future. Approximately 50% believed they had a good understanding of AI; however, when knowledge of AI was tested using five questions, on average, only 22% of the questions were answered correctly. Among the respondents who ranked radiology as their first choice, 58.8% were anxious about the uncertain impact of AI on radiology. The number of respondents who ranked radiology as one of their top three choices increased by 14 when AI was not a consideration. Radiology conferences and the opinions of radiologists had the most influence on the respondents' preferences for radiology. CONCLUSION: The worry that AI might displace radiologists in the future had a negative influence on medical students' consideration of radiology as a career. Academic radiologists are encouraged to educate their students about AI and its potential impact when students are considering radiology as a lifetime career choice. ADVANCES IN KNOWLEDGE: Rapid advances of AI in radiology will certainly impact the specialty, the concern of AI impact on radiology had negative influence in our participants and investing in AI education and is highly recommended.

Accessory Right Hepatic Artery Arising from Splenic Artery Supplying Hepatocellular Carcinoma Identified by Computed Tomography Scan and Conventional Angiography: A Rare Anatomic Variant.

Accessory right hepatic artery (ARHA) is a common anatomic variant. This variant has been frequently described in the literature. Here, we report a rare case of ARHA arising from splenic artery depicted during imaging work-up and transarterial hepatic chemoembolization of a 74-year-old gentleman with hepatocellular carcinoma. This patient's tumor was exclusively supplied by this variant artery. Splenic artery origin of the ARHA is extremely rare. This has been previously reported once in the literature on a cadaveric organ donor during dissection. To the best of our knowledge, our report is the first radiologically detected case of ARHA originating from splenic artery.

The use of endo-vascular balloon tamponade technique for the removal of a misplaced nephrostomy tube in the inferior vena cava: A case report.

INTRODUCTION: Inadvertent placement of a nephrostomy tube into the inferior vena cava (IVC) is an extremely rare complication with few reported cases in the literature. CASE PRESENTATION: We present a lady with obstructive uropathy in a solitary kidney in whom an attempt by the community radiologist to place a nephrostomy tube was complicated by wrong insertion into the IVC. This report illustrates how a safe non- surgical removal of this tube using an intravenous balloon tamponade technique was successfully applied. DISCUSSION: Intravenous placement of nephrostomy catheters into the inferior vena cava is extremely rare complication. A few case reports have been published in the literature. The majority of these cases were removed in the operating room under general anesthesia. Using Intravenous balloon tamponade technique for removal has not been previously reported. CONCLUSION: Intravenous balloon tamponade technique is effective and is a good minimally invasive alternative to surgical removal of misplaced nephrostomy tube from IVC.

Median sacral artery injury following a bone marrow biopsy successfully treated with selective trans-arterial embolization: a case report.

BACKGROUND: Iatrogenic arterial injury during bone marrow biopsy is an extremely rare complication. We present unreported complication of median sacral artery injury that was managed successfully with endovascular treatment. CASE PRESENTATION: A 22-year-old Caucasian man known to have end-stage renal disease secondary to Senior-Loken syndrome presented with anemia. He underwent an investigation with bone marrow biopsy that was complicated by hypotension and a further significant drop in his hemoglobin level. Cross-sectional imaging with computed tomography demonstrated a large abdominopelvic retroperitoneal hematoma and active bleeding of the median sacral artery. A successful lifesaving endovascular trans-arterial embolization was performed on an emergency basis and our patient was discharged in a stable condition a few days later. CONCLUSION: Iatrogenic arterial injury after a bone marrow biopsy is extremely rare. To the best of our knowledge, a median sacral artery injury has not been previously reported. Endovascular trans-arterial embolization is a safe, effective, and minimally invasive therapeutic option.