SUMMARY
A case of alkaline encrusted cystitis is reported not only because of the rare tuberculous etiology but also because of the presence of multiple calculi impacted in the encrusted bladder mucosa.
Purpose: Pelvic angiography and embolization has been shown to be the definitive treatment for arterial hemorrhage in pelvic trauma. The Eastern association for the Surgery of Trauma (EAST) states that arterial extravasation on CT angiogram is an indication for pelvic angiography and embolization. The purpose of this study is to evaluate the efficacy of CTA in detecting arterial hemorrhage in pelvic trauma. Materials and Methods: Institutional review board approved retrospective study of 106 pelvic trauma patients who underwent CT angiograms (CTA) who subsequently underwent pelvic angiography between January 2011 and December 2016. Pelvic fractures were graded based on the Young-Burgess Classification. Both groups were combined for analysis of differences using T tests. Significance level was defined at P < 0.05 Results: Twenty-three of 106 patients (21.7%) had negative CTAs. Of those, 8 had arterial extravasation on subsequent pelvic angiography. The overall specificity, sensitivity, positive, and negative predictive values for CTA in this study were 57.7%, 85.9%, 50%, and 65.2%. Based on hemodynamic factors four (50%) of the patients with false negative CTA were in class III/IV shock. The average transfusion requirement for these 8 patients was 3 units of PRBS (SD 2.82). Five (33%)patients in this group had high-grade pelvic fractures. CT findings showed a pelvic hematoma in 6/8 (75%) of the positive group and 9/15 (60%) in the CTA negative group. Angiographic findings showed that 4(50%) had extravasation in the iliolumbar, sacral, or sacral branches of the superior gluteal arteries. The other 4 (50%) had extravasation in the internal pudendal, superior gluteal, and obturator arteries. Conclusions: The negative predictive value of CTA in pelvic trauma is 65.2% and therefore if there are signs of continued bleeding or hemodynamic instability in patients with negative CTA, definitive procedure such as angiography should be considered.
50 children who were referred for radiological surgery, which amounts to 100% diagnostic accuracy. The single best view is the prone transexamination with a clinical diagnosis of intestinal obstruction were reviewed. In addition to the lateral view of the abdomen. routine supine and upright abdomen films, prone translateral, prone postero-anterior views were also taken. The routine supine and erect films were often misleading. Using the available gas in the gastro-intestinal tract, the prone films confirmed or excluded intestinal obstruction. In the prone position the highest part of the large bowel is the rectum and any air present will tend to fill it. In obstruction, no air will be seen in the rectum. Diagnosis in all the cases was made entirely on prone films, especially cross table lateral films.When there was no obstruction, air pockets were visualised in the rectum. 23 children out of the 36 radiologically negative cases, who in the normal course would have been subjected to laprotomy, were saved from unwarranted laprotomy. In the other 13 negative cases, laprotomy was not contemplated. AU of the 14 radiologically positive cases of intestinal obstruction were confirmed at : 632 004. INDIA. FIGURE la.-Plain x-ray abdomen erect showing distended coils of small intestine in a child who presented with vomiting and distension of abdomen.
Isolated cerebellar malformations are relatively rare CNS anomalies, when they do occur they are frequently symptomatic. Some cases of asymptomatic cerebellar malformations have been reported. Unilateral cerebellar hypoplasia is one such entity. We describe a case of unilateral cerebellar hypoplasia presenting with non-specific neurological complaints.
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