ABSTRACT
Purpose In patients with massive or recurrent gastrointestinal bleeding (GIB) which is not amenable to endoscopic therapy, angiographic interventions are often employed. We report our ten-year experience of empiric transcatheter arterial embolization (TAE) for patients with massive or recurrent GIB. Methods All patients who had undergone empiric TAE at our hospital between March 2004 and June 2015 were identified using the institutional radiology information system. A retrospective chart review was performed using a structured pro forma. Technical success rate, 30-day clinical success rate, 30-day mortality rate, and rate of procedural complications were computed. Statistical analysis was performed using Statistical Package for Social Sciences (SPSS) version 20. Results A total of 32 patients had undergone empiric TAE for GIB during the study period. The median age of subjects was 56 years and two-thirds of them were male (68.7%). Gastroduodenal (n=24), ileocolic (n=3), left gastric (n=2), right gastroepiploic (n=1), and branches of superior and middle rectal arteries (n=1) were embolized using microcoils (n=25), polyvinyl alcohol particles (n=25), and gelatin sponge (n=3)--either alone or in combination. Technical and 30-day clinical success rates were 96.9% (31/32) and 71.9% (23/32), respectively. The 30-day mortality rate for our cohort was 21.9% (7/32). One patient developed re-bleeding at two days after the initial procedure and required repeat embolization. Coil migration (n=3) and access site hematoma (n=1) were the observed procedural complications. Conclusion Empiric TAE can be a useful treatment option for selected patients with massive or recurrent GIB that is not amenable to endoscopic therapy.
ABSTRACT
Crossed or "crisscross" pulmonary arteries (CPA) are a result of an anomalous origin and course of both the pulmonary arteries from the main pulmonary trunk in which the left pulmonary artery (PA) ostium usually lies directly superior and to the right PA ostium after which they cross each other and supply their respective lungs. This condition is usually associated with conotruncal malformations and genetic syndromes. We describe a case report of an infant, suspected to have Down syndrome, who was diagnosed with CPA and coarctation of aorta on computed tomography (CT) angiography. Our case is unusual because in our patient the right PA ostium was superior and to the left of the left PA suggesting a variant of CPA that has not been documented before. Three-dimensional (3D) CT reconstruction has shown to improve the understanding of this anomaly and its unique 3D display of various angles may enhance anatomical comprehension of such complex cases.
ABSTRACT
BACKGROUND: Trauma remains one of the most frequent presentations in emergency departments. Imaging has established role in setting of acute trauma with ability to identify potentially fatal conditions. Adequate knowledge of health professionals regarding trauma imaging is vital for improved healthcare. In this work we try to assess knowledge of medical students regarding imaging in trauma as well as identify most effective way of imparting radiology education. METHOD: This cross-sectional pilot study was conducted at Aga Khan University Medical College & Khyber Girls Medical College, to assess knowledge of medical students regarding imaging protocols practiced in initial management of trauma patients. RESULTS: Only 40 & 20% respectively were able to identify radiographs included in trauma series. Very few had knowledge of correct indication for Focused abdominal sonography in trauma. Clinical radiology rotation was reported as best way of learning radiology. CONCLUSION: Change in curricula & restructuring of clinical radiology rotation structure is needed to improve knowledge regarding Trauma imaging.
Subject(s)
Curriculum , Diagnostic Imaging , Education, Medical/methods , Educational Measurement/methods , Radiology/education , Students, Medical , Wounds and Injuries/diagnostic imaging , Adult , Cross-Sectional Studies , Female , Humans , Learning , Male , Pilot Projects , RadiographyABSTRACT
Acinar cell carcinoma is a rare tumour arising from pancreatic acinar cells. Typical radiological patterns associated with it may suggest the unusual diagnosis even before final confirmation by histopathology. We present a case of an 8 year old boy who presented to clinic with symptoms of abdominal pain without associated jaundice or vomiting. Imaging revealed an atypical mass arising from head of the pancreas. Histopathology confirmed the diagnosis of acinar cell carcinoma. An idea about atypical and rare pancreatic masses is necessary to help direct the diagnosis and guide the pathologist for suspecting atypical pathology.
