Feasibility of a low-cost magnet tracking device in confirming nasogastric tube placement at point of care, a clinical trial.

An affordable and reliable way of confirming the placement of nasogastric tube (NGT) at point-of-care is an unmet need. Using a novel algorithm and few sensors, we developed a low-cost magnet tracking device and showed its potential to localize the NGT preclinically. Here, we embark on a first-in-human trial. Six male and 4 female patients with NGT from the general ward of an urban hospital were recruited. We used the device to localize the NGT and compared that against chest X-ray (CXR). In 5 patients, with the sensors placed on the sternal angle, the trajectory of the NGT was reproduced by the tracking device. The tracked location of the NGT deviated from CXR by 0.55 to 1.63 cm, and a downward tracking range of 17 to 22 cm from the sternal angle was achieved. Placing the sensors on the xiphisternum, however, resulted in overt discordance between the device's localization and that on CXR. Short distance between the sternal angle and the xiphisternum, and lower body weight were observed in patients in whom tracking was feasible. Tracking was quick and well tolerated. No adverse event occurred. This device feasibly localized the NGT in 50% of patients when appropriately placed. Further refinement is anticipated.ClinicalTrials.gov identifier: NCT05204901.

Rectosigmoid intussusception due to large submucosal lipoma mimicking rectal prolapse.

Rectosigmoid intussusception is a rare cause of bowel obstruction, accounting for only approximately 1%-2% of all bowel obstruction cases. While intussusception in adults typically occurs intra-abdominally and presents with signs and symptoms of intestinal obstruction, in rare cases, it can mimic a rectal prolapse if the intussusceptum protrudes through the anal canal. We herein report a case where an octogenarian woman presented with rectosigmoid intussusception through the anal canal, due to a sigmoid colon submucosal lipoma, who eventually required an open Hartmann's procedure. Patients with rectal prolapse symptoms should be carefully examined to rule out intussuscepting masses as a differential, as it would necessitate earlier surgical intervention.

Omental venous malformation: a rare cause of spontaneous haemoperitoneum.

Spontaneous haemoperitoneum is a rare condition with a variety of aetiologies. Regardless of the cause, it is invariably a life-threatening condition that requires urgent diagnosis and management. The most common causes of spontaneous haemoperitoneum include gynaecological, hepatic, splenic and vascular causes. However, here, we present a rare case of spontaneous haemoperitoneum secondary to idiopathic omental venous malformation.Our patient presented with acute onset of right iliac fossa pain, and a CT scan revealed a massive haemoperitoneum. A laparoscopic converted to open laparotomy was performed to diagnose and treat the patient. We discuss the management approach for such patients with spontaneous haemoperitoneum.

Teach a man to fillet: gastrointestinal and extra-gastrointestinal complications related to fish bone ingestion.

Accidental ingestion of fish bone is a common occurrence in populations that consume unfilleted fish. Although most ingested foreign bodies pass through the gastrointestinal tract uneventfully within a week, less than 1% of patients unfortunately develop gastrointestinal perforation. Occasionally, some patients who are unaware of an episode of fish bone ingestion may present sub-acutely with symptoms mimicking inflammatory conditions or pyrexia of unknown origin. Computed tomography (CT) is the definitive imaging modality in the diagnosis of fish bone foreign body and its complications. This pictorial essay aims to illustrate the various complications related to fish bone ingestion, broadly divided into gastrointestinal related complications and extra-gastrointestinal complications related to migration of fish bone. Radiologists should be familiar with the myriad of possible complications, and take heed that a relevant history of fish bone ingestion is often absent.

Clinics in diagnostic imaging (205). Baxter's neuropathy.

A 48-year-old woman presented with chronic right heel pain and paraesthesia over the foot. Magnetic resonance imaging of the right foot demonstrated isolated atrophy of the abductor digiti minimi. A diagnosis of Baxter's neuropathy was made and the patient was managed successfully via surgical release. We describe the clinical and radiological features of Baxter's neuropathy and, with brief examples, outline other causes of chronic heel pain.