Unilateral agenesis of internal carotid artery (ICA) with intercavernous anastomosis is a rare congenital anomaly. We present a case of a 25-year-old female with 2-month history of holocranial headache. Neurological examination was unremarkable. Magnetic resonance imaging (MRI) with magnetic resonance angiography (MRA) showed absence of left ICA with an abnormal intercavernous vessel in the sella. Computed tomography (CT) showed absence of the left carotid canal. Doppler ultrasonography (USG) showed high resistance flow in the left common carotid artery (CCA). Since no hemorrhage or aneurysm was seen, patient was managed conservatively and is on regular follow-up. Based on our knowledge, this is the first case to demonstrate the features of unilateral agenesis of ICA with intercavernous anastomosis in X-ray, Doppler USG, CT, and MRI scans of the brain.
Duplication of gall bladder is a rare congenital anomaly of the hepatobiliary system. It is a very important entity in clinical practice as preoperative diagnosis plays a significant role in the management and to avoid unnecessary bile duct injury during surgery. We report a case of duplicated gall bladder presenting as acute cholecystitis.
Chronic renal diseases have been on rise with most patients requiring renal transplantation. With advances in treatment, patients undergo hemodialysis through arteriovenous (AV) fistulas and grafts. Thrombosis in these fistulas and grafts are more common and may result in failure. Interventional radiology plays an important role in managing these thromboses through catheter-directed thrombolysis. With success rate of more than 80%, catheter-directed thrombolysis has become the treatment of choice. However, the need of trained personnel, well-equipped catheter laboratories, and expensiveness are its disadvantages. We share our initial experience in two patients in whom we have performed ultrasound-guided percutaneous pulse-spray pharmacomechanical thrombolysis as a day-care procedure. This technique is less expensive, can have a wider outreach, and patients can be benefitted early to avoid new access.
BACKGROUNDWith the advent of computed tomography (CT), CT enterography has become the investigation of choice for evaluating small bowel disorders, as it allows better visualization of the bowel wall. As a result, CT enterography is becoming the first line of modality in the evaluation of suspected bowel diseases especially those due to inflammatory pathology. 1 CT enteroclysis, on the other hand, allows better bowel distension, thus, depicting the mucosal detail, especially in Crohn's disease. This plays an important role in the clinical staging of the disease.
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