ABSTRACT
The CT scan of a 77-year-old woman showed hypodense structures in the spine called vacuum phenomenon as an incidental finding. The cause in the majority of cases is the degeneration of tissue but vacuum phenomenon is also associated with other disorders. It is important to distinguish between benign causes and malignant causes. Unfamiliarity with this vacuum phenomenon may lead to suboptimal treatment.
Subject(s)
Intervertebral Disc/diagnostic imaging , Spinal Diseases/diagnostic imaging , Aged , Female , Humans , Incidental Findings , Spinal Diseases/etiology , Tomography, X-Ray Computed , VacuumABSTRACT
Two neonates, a girl born at 40 2/7 weeks weighing 4165 g and a boy born at 37 6/7 weeks weighing 4040 g, received umbilical venous catheters to help manage hypoglycaemia. The catheter was ineffective or only effective when high doses of glucose were used, due to what later appeared to be arterial positioning of the catheter. Both patients recovered without consequences. Persistent hypoglycaemia is a common problem in newborns and can cause severe neurological sequelae. A relatively uncommon cause is malpositioning of the umbilical catheter. Positioning in an artery leads to direct infusion of glucose into the pancreas, which causes hyperinsulinaemia and can lead to potentially dangerous nonketotic hypoglycaemia. Arterial positioning of the umbilical catheter should be ruled out at an early stage. Correct catheter positioning can be determined using careful inspection of the umbilical veins, radiological examination of the catheter position, blood gas analysis or vascular pulsation.