The objective of our study is to determine the surgical outcome, effectiveness and the complications of computer tomography guided drainage of pancreatic abscesses. Study Design: Descriptive case series. Setting: Tertiary care hospital in Karachi Pakistan. Period: Three years from November 2012 to October 2015. Methods: The patient population consisted of all those patients who were diagnosed as a case of pancreatic abscess both clinically and on radiographic analysis, and who had to have the computer tomography guided percutaneous drainage of the abscess. The drained fluid was sent for histopathologic and cytological analysis, and a drain was placed in the pancreatic tissue for further collection of the discharge material. Patients were followed for up to 40 days post operatively, and various complications were noted. Results: The patient population consisted of n=550 patients of acute pancreatitis, out of which n=30 (5.45%) were diagnosed cases of pancreatic abscess, out of these patients n=5 (16.67%) were males and n=25 (83.33%) were females, and the mean age of patients was 44 +/-11 years. In n=24 (80%) of patients the abscess resolved completely in 20 to 40 days. N=5 (20%) of patients had complications and had to undergo laparotomy. Conclusion: According to the results of our study, the computer tomographic guided drainage of the pancreatic abscess is a very safe and effective procedure for the treatment of pancreatic abscess. The rate of complications is low, and patients show swift recovery post operatively.
Objectives: The objective of our study is to determine the surgical outcome,effectiveness and the complications of computer tomography guided drainage of pancreaticabscesses. Study Design: Descriptive case series. Setting: Tertiary care hospital in KarachiPakistan. Period: Three years from November 2012 to October 2015. Methods: The patientpopulation consisted of all those patients who were diagnosed as a case of pancreatic abscessboth clinically and on radiographic analysis, and who had to have the computer tomographyguided percutaneous drainage of the abscess. The drained fluid was sent for histopathologicand cytological analysis, and a drain was placed in the pancreatic tissue for further collectionof the discharge material. Patients were followed for up to 40 days post operatively, and variouscomplications were noted. Results: The patient population consisted of n=550 patients ofacute pancreatitis, out of which n=30 (5.45%) were diagnosed cases of pancreatic abscess, outof these patients n=5 (16.67%) were males and n=25 (83.33%) were females, and the meanage of patients was 44 +/- 11 years. In n=24 (80%) of patients the abscess resolved completelyin 20 to 40 days. N=5 (20%) of patients had complications and had to undergo laparotomy.Conclusion: According to the results of our study, the computer tomographic guided drainageof the pancreatic abscess is a very safe and effective procedure for the treatment of pancreaticabscess. The rate of complications is low, and patients show swift recovery post operatively.
Background: Radiologists are always questioning the use of an imagine modality as compared to the other, this study helps answer that question for the diagnosis of Hepatocellular carcinoma. Objective: To compare the use of MRI imaging technique with ultrasonography for the diagnosis of hepatocellular carcinoma. Study Design: The type of study is a Prospective Cross-Sectional study. Settings: A large tertiary care hospital in Karachi, Pakistan. Duration: One year from July 2018 to July 2019. Methodology: The inclusion criteria was all the patients who were referred to us with symptoms for concern for hepatic tumors. For the MRI we used a 1.5 tesla machine, and for the ultrasound we used a conventional grey scale ultrasonography with a probe of 5 MHz. We performed multiphasic contrast enhanced MRI’s, with images taken both before the injection of the contrast and afterwards in the various phases such as the arterial phase, portal venous phase and finally the delayed phase respectively. Results: The study population consisted of n=110 patients having a mean age of 46.5 +/- 5.50 years. There were n= 78 (70.90%) males and n= 32 (20.09%) females. N= 101 (91.81%) patients had a diagnosis of hepatocellular carcinoma as per MRI scan, for ultrasound n= 47 (42.72%) patients were diagnosed as true positive, n= 2 (1.81%) were false positive, n= 54 (49.09%) were false negative, while n= 7 (6.36%) cases were truly negative. The specificity was 77.77% the sensitivity was 46.53%, the positive predictive value was 95.91%, negative predictive value was 11.4%, and accuracy was 49.09% respectively. Conclusion: We found that the specificity of ultrasound as a diagnostic modality for hepatocellular carcinoma as compared to the MRI scan is good, however it is only able to correctly identify about half the patients, hence care should be taken when interpreting the results of ultrasound for hepatocellular carcinoma.
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