An Update on Patient-Reported Outcomes in Interventional Radiology: The Future Measure of Our Success.

The field of interventional radiology continues to expand rapidly, offering an increasing range of alternatives to open surgical procedures. This minimally invasive imaging-guided approach promises faster recovery times and a theoretically improved patient experience; however, there is limited evidence documenting that these promises are actually delivered. Patient-reported outcomes are a way of collecting data on the patient experience increasingly used in clinical trials and the provision of surgical services and informing clinical practice across a range of elective procedures. Currently underutilised in interventional radiology, patient-reported outcomes have the potential to significantly impact how we deliver care by allowing evaluation of the perceived benefit derived by a patient after undergoing a procedure and to permit comparison with more invasive open procedures from the patient perspective.

Scurvy: an unusual complication of paediatric cancer treatment.

Scurvy is a disease that is rarely encountered in modern medicine. A condition that was classically associated with sailors, its incidence has decreased dramatically since the discovery of its association with vitamin C deficiency. We present the case of a 2-year-old boy, whose treatment for neuroblastoma was complicated by gastrointestinal disease, which necessitated enteral feeding. While still undergoing treatment, he started to complain about increasing pain in his lower limbs, which appeared to be markedly tender on palpation. Radiographic findings suggested a diagnosis of scurvy, which was subsequently confirmed on serum biochemistry. This was an unexpected finding, as the child had been receiving adequate vitamin C in his enteral feeds. However, his absorption had become severely impaired due to pseudomembranous gastritis and enteritis, leading to his deficient state. He significantly improved after intravenous ascorbic acid replacement and demonstrated a full recovery, both clinically and radiologically. This case highlights the importance of considering scurvy in the differential diagnosis for at-risk patients. Early recognition can facilitate the simple treatment of this potentially serious condition.

Bleeding meckel's diverticulum: A study of the accuracy of pertechnetate scintigraphy as a diagnostic tool.

BACKGROUND: The reported accuracy of pertechnetate scintigraphy (Meckel scan) in investigating children with a bleeding Meckel's diverticulum has increased steadily since it was first introduced into clinical practice in 1970. Recent studies have indicated that the examination has a sensitivity of up to 94% and a specificity of up to 97% in this scenario. There have also been several misleading reviews from Departments of Surgery, suggesting that the Meckel scan has a poor predictive value, and should not be relied upon to exclude a bleeding Meckel's Diverticulum (MD). OBJECTIVE: The aim of this study was to assess the accuracy of pertechnetate scintigraphy performed at Our Lady's Hospital for Sick Children, Crumlin (OLCHC) on children with clinical suspicion of a bleeding MD. METHOD: This was a retrospective study of all the Meckel scans performed over a 10year period (2005-2015) in OLCHC, 144 in total. RESULTS: Of the total 144 scans performed, 22 were considered to be positive, and all patients were found to have a MD at surgery. 122 were negative, and in 53 of these patients, an alternative cause for symptoms was found, often at endoscopy. In the remaining 69 patients, no cause was found, despite full medical work-up. In all of these cases, symptoms resolved, and have not yet recurred, making MD very unlikely. DISCUSSION: Pertechnetate scintigraphy, when performed using meticulous technique, can provide up to 100% sensitivity CI [85.1, 100.0] and 100% specificity CI [93.2, 100.0] in diagnosing a bleeding MD in a paediatric population. This examination is seldom of value in children with no history of rectal bleeding.