ABSTRACT
OBJECTIVE: The aim of this study was to evaluate the utility of the Pulsatility Index (PI) of the right hepatic artery, measured by color Doppler sonography, in the diagnosis of acute cholecystitis. METHODS: Seventy-five subjects were included in this study and divided into three groups, each consisting of 25 subjects: the cholecystitis group, the asymptomatic cholelithiasis group, and normal controls. Patients with acute cholecystitis fulfilled all the diagnostic criteria as stated in the latest Tokyo Guidelines. In all patients, the right hepatic artery was detected by color Doppler ultrasound and the PI was measured. RESULTS: Patients with acute cholecystitis were found to have significantly higher PI values compared to both normal controls and cholelithiasis patients. Regression analysis revealed a significant positive correlation between the PI and the cholecystitis outcome. CONCLUSION: Measurement of PI by color Doppler ultrasound represents a useful aid in the diagnostic process of acute cholecystitis. More studies are needed before this method is incorporated in the relevant guidelines.
Subject(s)
Cholecystitis, Acute/diagnosis , Hepatic Artery/pathology , Ultrasonography, Doppler, Color/methods , Aged , Cholecystitis, Acute/diagnostic imaging , Cholecystitis, Acute/pathology , Female , Hepatic Artery/diagnostic imaging , Humans , Male , Middle Aged , UltrasonographyABSTRACT
OBJECTIVE: The aim of our article is to highlight the importance of the immediate treatment of lower extremity degloving injuries, in order to prevent complications. CASES PRESENTATION: Here we present two cases of degloving injury of the lower extremity, both resulting from motorway accidents. The first one concerned a 65-year-old man suffering from multiple limb fractures and a degloving injury of the right thigh, which was immediately treated with extensive debridement and primary full-thickness skin graft re-approximation. The second case involved a 63-year-old woman who presented with cervical vertebrae fractures and a degloving injury of the left posterior leg, which, due to the severity of her condition, was treated with a delayed approach resulting in skin necrosis, which required surgical debridement, alginate dressing and foam cover. CONCLUSIONS: The optimal approach to treatment of degloving injuries is challenging and they warrant immediate surgical attention. An early diagnosis and the evaluation of tissue viability are important in order to prevent limb-threatening situations.
