Objectives: To determine the prevalence of superior mesenteric artery (SMA) syndrome in patients presenting with abdominal pains, and to evaluate computed tomographic (CT) findings needed for its diagnosis.Methods: This retrospective record-based study was carried out at the radiology department, from January 2016 to January 2021. All young patients (aged under 25) who underwent CT scans for abdominal pains were reviewed. Post-surgery, tumor, and trauma cases were excluded. Imaging findings for SMA syndrome were recorded as 'suggestive' (reduced aortomesenteric angle and distance with proximal duodenal dilatation), 'possible' (reduced angle and distance without proximal duodenal dilatation) and 'probable' (reduction of either angle or distance). Two radiologists interpreted the findings and consensus reporting was made. Diagnoses were confirmed on clinical grounds (symptomatic improvement by specific treatment and exclusion of other diagnoses), or barium studies. Imaging findings were compared to final diagnoses. McNemar's Chi-square test was used to determine association.Results: Out of 141 patients (mean age=10.8, standard deviation=4), 7 (4.9%) patients mostly females were having SMA syndromes based on 'suggestive' imaging criteria (p=0.0005), and one patient underwent surgery.
Conclusion:Superior mesenteric artery syndrome is not an uncommon condition and should be considered in differential diagnosis of acute abdomen in young patients after excluding other diagnoses.
Objectives: To determine the prevalence of May-Thurner syndrome (MTS) in left lower limb deep venous thrombosis (DVT) cases and to analyze the outcome of endovascular intervention in these patients.
Methods:A record-based descriptive study was carried out in Radiology Department, King Fahad Military Medical Complex, Dhahran, Saudi Arabia, including patients who underwent lower limb duplex ultrasounds between January 2015-2021. Patients with bilateral DVTs, known pelvic masses, and pelvic surgeries were excluded. All patients positive for DVTs were identified and further imaging was reviewed. Left common iliac vein compression of 50% or more on computed tomography (CT) was considered positive for MTS. Endovascular interventions (venoplasty alone or with stenting) were evaluated and success recorded by observing patency of vein on follow-up imaging or improvement of symptoms on follow-up visits.Results: Of 182 patients with left lower limb duplex studies, 51 patients were positive for DVTs. A total of 37 patients had CTs and 21 patients had MTS (17 females, 3 males). A total of 15 patients underwent endovascular interventions, 2 patients had venoplasties alone (one successful) and 13 patients had venoplasties with stenting (10 successful).
Conclusion:Patients with MTS as cause of DVT may benefit from early endovascular intervention.
Introduction: At the end of cochlear implant surgery impedance measurements are used to check the integrity of the implant. On occasions impedance results for one or more electrodes are abnormal. The implication of these abnormal results is unclear. Objectives: To determine if abnormal electrode impedance intra-operatively is associated with abnormal test results at subsequent appointments.
Material & methods:We reviewed the impedance records of 114 patients who underwent cochlear implantation with Clarion HiRes 90K or Freedom Contour advance implants in our department between 2001 and 2007. Results: 16 patients had a total of 80 electrodes with abnormal impedance on intra-operative testing. At follow up of these 16 patients only 8 still had electrodes with abnormal impedance, with a total of 9 abnormal electrodes. Clarion HiRes 90k implants were more likely than Freedom Contour advance implants to have electrodes with abnormal impedance on initial testing but their electrode impedance was more likely to have normalised by follow up. Conclusion: 89% of electrodes with abnormal intra-operative impedance testing will normalise eventually, but half of patients with abnormal electrodes when tested in theatre will have 1 or 2 non functioning electrodes long term.
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