Obstructed hemivagina and ipsilateral renal anomaly (OHVIRA), also known as Herlyn-Werner-Wunderlich syndrome, is a rare syndrome with only a few hundred reported cases described since 1922. Only a handful of these cases have been associated with pyocolpos. Mullerian duct anomalies have an incidence of 2-3%. While OHVIRA constitutes 0.16-10% of these Mullerian duct anomalies. Symptoms usually present shortly after menarche when hematocolpos develops during menstruation resulting in dysmenorrhea and a pelvic mass. The pelvic mass is the collection of blood products within the obstructed hemivagina. The first study in the diagnostic work-up is usually ultrasonography, which typically demonstrates a pelvic fluid collection which can simulate other disease processes thus confounding the diagnosis. MRI findings of the pelvis reveal a didelphic uterus. Imaging of the abdomen reveals agenesis of the ipsilateral kidney. MRI is beneficial in characterizing the didelphic uterus and vaginal septum for pre-operative planning. Understanding the imaging findings, in conjunction with the clinical presentation, is critical for early diagnosis in attempting to prevent complications such as endometriosis or adhesions from chronic infections with subsequent infertility.
CT is limited in the detection and differentiation of adenomyomatosis and gallbladder cancer, but the diagnosis of adenomyomatosis can be made with reasonable accuracy when thickening of the gallbladder wall is seen to contain small cystic-appearing spaces.
Chuan and Chia (1969) in Singapore and by Wu and Yang (1962) in Taiwan. Significant differences, however, are noted for FRC, TLC, RV, and RV/TLC between our findings and those of Chuan and Chia. Our series is unbalanced because of an uneven distribution of age groups. In fact in none of the reported studies on Chinese subjects, including that of da Costa (1971), is the series large or balanced. Clearly, further research is required in this ethnic group to get more reliable predictive formulae for lung volumes.In clinical practice, lung function is usually assessed by simple measurement of lung volumes and ventilation. Predicted, that is, 'normal', values are calculated from formulae derived from studies of healthy populations. There is evidence of ethnic differences, average values for Chinese subjects being below those for Caucasians. The present study was designed to explore further these reported ethnic differences in lung volumes. Material and methodsA total of 331 Cantonese subjects, ranging in age from 17 to 56 years, were studied. There were 134 male and 197 female subjects in the group. Most of the men were hospital employees who performed manual work but a number of young men, ranging in age from 18 to 25 years, were trainees from the Police Training College. The 197 women were nurses or manual workers in the hospital, and, of the total, 124 were young student nurses ranging in age from 17 to 25 years. All the subjects had normal chest radiographs within the sixmonth period before the testing and all were clinically free from chest diseases or any other disorders that could affect the results.A smoking history was obtained in all of the male subjects, 70 of whom were non-smokers (52%) while 64 (48%) smoked. The smokers were divided into three groups: smoked fewer than 10 cigarettes per day-light smokers; smoked 10 to 20 cigarettes per day-moderate smokers; and smoked more than 20 cigarettes per day-heavy smokers. Among the female subjects a smoking history was obtained in only a few subjects.Measurements of ventilatory capacity were made on the Pulmonet 114 apparatus which has a 9-litre spirometer bell of light weight. All subjects cooperated well in the tests which were performed with the subjects sitting after rest but not at basal condition.
BackgroundPulmonary sequestration is a congenital lung disease characterized by nonfunctioning pulmonary tissue that lacks normal communication with the bronchial tree and is supplied by a nonpulmonary systemic artery. Symptomatic bronchopulmonary sequestration is uncommon, seen more frequently in the pediatric population than in adults. It has traditionally been treated with surgical resection; however, a limited but growing number of cases have been treated with angiographic embolization. Given the inherent risks of cardiothoracic surgery, embolization of the anomalous vessel is an enticing alternative treatment. We present a case of a 56-year-old woman with known, symptomatic, intralobar pulmonary sequestration that was successfully treated with coil embolization.Case presentationA 56-year-old Pacific Islander woman with a history of chronic myeloid leukemia was admitted to the hospital with an episode of hemoptysis. Computed tomography of the chest demonstrated left lower lobe intralobar pulmonary sequestration fed by a large tortuous vessel branching off of the descending thoracic aorta. Surgical resection of the sequestration is the current standard treatment strategy of symptomatic intralobar pulmonary sequestration. The cardiothoracic surgeon noted that given the size and location of arterial blood supply, intervention would involve thoracotomy and lobectomy. The interventional radiologist offered embolization of the lesion as an alternative to surgery. Multiple coils, 6–13 mm in size, were used to embolize the sequestration. No considerable flow distal to the coils was noted postembolization.ConclusionsIntralobar pulmonary sequestration is a rare condition that typically requires surgical management. This case demonstrates the efficacy of coil embolization as an alternative management strategy. To date, limited case reports of adults treated with endovascular embolization exist. Treatment of symptomatic pulmonary sequestration with embolization can be considered as an alternative to surgical resection.
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