Central pontine myelinolysis is an acquired demyelinating disease. It is commonly associated with chronic alcoholics, electrolyte imbalance and chronically debilitated patients. It has predilection for involvement of central portion of basis pontis; however, it may involve axons in the putamina, caudate nuclei, thalami, cerebellum, splenium of the corpus callosum and subcortical white matter. [1] The term "osmotic demyelination syndrome" is similar to "central pontine myelinolysis," but also includes areas outside the pons. [2] It is characterised by loss of myelin and oligodendroglia with relative neuron sparing.
BACKGROUNDVolvulus of wandering spleen is a rare clinical occurrence with fewer than 500 cases reported and an incidence of less than 0.2%. We present a case of a 27-year-old man, who complained of a short history of severe abdominal pain with the background of recurrent abdominal pain. Ultrasound revealed wandering spleen with splenic vein thrombosis. An abdominal contrast enhanced computerized tomography scan revealed a torted wandering spleen with splenic vein thrombosis with infarction. This required a splenectomy due to splenic infarction. This report highlights the investigations including USG and CECT necessary for a patient who presents with an ischaemic torted wandering spleen.
BACKGROUND Acute pancreatitis is a common condition with variable clinical course. Imaging studies play an important role in diagnosis a nd management of acute pancreatitis. Computed Tomography (CT) is undertaken to determine the role of CT in acute pancreatitis, to differentiate between oedematous and necrotising pancreatitis and to evaluate the complications and severity using Modified Computed Tomography Severity Index (MCTSI). MATERIALS AND METHODS This is a prospective observational study. Sixty patients with clinical suspicion of acute pancreatitis underwent contrast enhanced CT during two years period. MCTSI score for acute pancreatitis was calculated which includes assessment of pancreatic inflammation, necrosis and extrapancreatic complications. RESULTS Peripancreatic fat stranding was the common feature seen in 90% patients. Extrapancreatic complications were noted in 32 (53%) patients and pancreatic necrosis in 20 (33%) patients. CONCLUSION CECT of abdomen in acute pancreatitis helps in differentiating between oedematous and necrotising pancreatitis. The MCTSI helps in evaluating the percentage of pancreatic necrosis and to predict the possibility of developing local and systemic complications. Depending upon the MCTSI grading, the treatment plan can be implemented more effectively and accurately.
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