Common left carotid bifurcation at C7-Th1 level: a rare anatomical variant.

The left common carotid artery usually bifurcates to the internal and external carotids at or near the superior border of thyroid cartilage. In head and neck surgery, the common carotid arteries are important landmarks, defining the plane of dissection during radical neck surgeries. According to the literature, many variations exist regarding the carotid bifurcation. Anatomical knowledge of these variants is important for surgical approaches in the head and neck regions, to avoid devastating complications that may occur, mainly during anterior neck dissections. We report an interesting case of a 75-year-old male patient with low bifurcation of the left common carotid artery, accidentally found during a routine carotid Doppler ultrasonography. Bifurcation was located at the C7-Th1 intervertebral disc height, approximately 4 cm from the aortic arch.

Sonographic detection of transient gas in the portal vein in an infant following abdominal surgery: a possible sign of adhesive small bowel obstruction.

We present a case of sonographically detected transient gas in the portal vein in a 4.5-month-old infant who had a history of two consecutive jejunectomies due to jejunal stenoses and was admitted to our hospital with clinical and laboratory findings consistent with a subacute small bowel obstruction and dehydration. Sonography excluded other pathologies and the patient was treated conservatively with success. The presence of gas in the portal vein could be a sign of an underlying mechanical obstacle, as another episode of small bowel obstruction 1 month later required surgical treatment of adhesive intestinal obstruction.

Ectopic intrathyroidal thymus misdiagnosed as a thyroid nodule: sonographic appearance.

An 11-year-old boy under suppression therapy for a solitary thyroid nodule was referred for sonographic examination. The diagnosis had been made at another institution, based only on sonography without cytopathologic verification. A small fusiform lesion, which was homogeneously hypoechoic with diffuse bright internal echoes, was demonstrated in the right lower pole of the thyroid. A normal elongated thymus with a cervical component was then found connected to the thyroid with an accessory lobe, which was embedded in the lower thyroid pole mimicking a solitary nodule. We discuss the developmental abnormalities of the thymus and their clinical significance in childhood with a brief review of the literature.

Ultrasonographic spleen dimensions in preterm infants during the first 3 months of life.

OBJECTIVE: The purpose of this study was to ultrasonographically evaluate spleen dimensions in healthy prematurely born neonates and infants during the first 3 months of life. METHODS: Ninety-six neonates and infants aged from 2 to 90 days, with gestational ages from 25 to 35 weeks, were prospectively examined between 2001 and 2003. None had either infectious or other serious diseases or congenital disorders. The relationships between the ultrasonographically measured spleen size parameters and postmenstrual age, sex, gestational age, and somatometric parameters (height, weight, and body surface area) were studied with linear regression models with backward selection. Spleen dimension growth curves and upper/lower limits defined by the upper/lower 95% confidence interval were presented in graphs by height, weight, and body surface area. In addition, spleen length was compared with recently published data on term peers. RESULTS: All spleen dimensions were positively correlated with postmenstrual age and somatometric parameters. Sex did not influence the variability of spleen dimensions. Spleen length had lower values and a smaller rate of growth in preterm than term neonates and infants. CONCLUSIONS: We have provided ultrasonographic spleen volumetric values in preterm neonates and infants during the first 3 months of life, giving reference standards applicable for clinical practice or research purposes.

Sonographic appearance of a late-diagnosed left bochdalek hernia in a middle-aged woman: case report and review of the literature.

A 53-year-old woman complaining of left upper lateral quadrant pain was first referred for an abdominal ultrasound. The spleen was disfigured, the suprasplenic echogenic line of the hemidiaphragm was fragmented, and part of bowel was inserted into the thorax. A diaphragmatic hernia was suggested and was further confirmed in a posterolateral position.

Spleen length in childhood with US: normal values based on age, sex, and somatometric parameters.

PURPOSE: To investigate with ultrasonography (US) normal spleen length in healthy children. MATERIALS AND METHODS: The study comprised 512 healthy children (274 girls) with ages ranging from 1 day (full-term neonate) to 17 years who were examined between 1996 and 2001. The main sample comprised 454 children (249 girls) with body measurements (weight and height) between the 5th and 95th percentiles of the relevant growth curves. The remaining 58 children (25 girls) with body measurements outside the normal ranges formed a separate sample used for cross-validation. None had a problem that could affect spleen size. The relationships between the US-measured spleen length and age and body parameters were studied with nonlinear regression and multiple (backward stepwise) regression techniques. Normal ranges and related statistics were estimated and tabulated according to age group and sex. Spleen length growth curves and upper limits defined by the 90% upper confidence limit (UCL) are presented in graphs according to height, weight, and body surface area (BSA). RESULTS: Spleen length was highly correlated with age, height, weight, and BSA; there was no statistically significant difference between the sexes. The exact pattern of these relationships was nonlinear (polynomial type of third order for age, height, and weight and exponential type for BSA). Multiple regression analysis indicated that age, height, and either weight or BSA had significant positive associations with spleen length. The spleen lengths among the sample of 58 children whose height and weight were outside the normal ranges of growth parameters did not influence the proposed upper limits (almost all were within the 90% UCLs with respect to height and weight for the main sample). CONCLUSION: Normal spleen lengths and ranges in childhood were obtained with US in a large sample of individuals.