Most common developmental anomalies of bronchial tree include accessory cardiac bronchus (ACB) and tracheal bronchus (TB). Minor bronchial anomalies include variants of TB, displaced segmental bronchi, and bronchial agenesis. We present CT-bronchoscopy and CT-bronchography findings of three cases with either ACB or TB. Recognition of these anomalies is important, as associated clinical complications, including recurrent episodes of infection, hemoptysis, and perhaps malignancies may be anticipated in a small percentage of patients.
Objective:We wanted to present the results of percutaneous management of ureteral injuries that were diagnosed late after cesarean sections (CS).
Materials and Methods:Twenty-two cases with 24 ureteral injuries that were diagnosed late after CS underwent percutaneous nephrostomy (PN), antegrade double J (DJ) catheter placement and balloon dilatation or a combination of these. The time for making the diagnosis was 21 50.1 days. The injury site was the distal ureter in all cases (the left ureter: 13, the right ureter: 7 and bilateral: 2). Fifteen complete ureteral obstructions were detected in 13 cases. Ureteral leakage due to partial (n = 4) or complete (n = 3) rupture was noted in seven cases. Two cases had ureterovaginal fistula. All the cases were initially confirmed with antegrade pyelography and afterwards they underwent percutaneous nephrostomy. Balloon dilatation was needed in three cases. Antegrade DJ stents were placed in 10 cases, including the three cases with balloon dilatation. Repetititon of percutaneous nephrostomy with balloon dilatation and DJ stent placement was needed in one case with complete obstruction. All the cases were followed-up with US in their first week and then monthly thereafter for up to two years.Results: Eighteen ureters (75%) were managed by percutaneous procedures alone. A total of six ureter injuries had to undergo surgery (25%).
Conclusion:Percutaneous management is a good alternative for the treatment of post-CS ureteral injuries that are diagnosed late after CS. Percutaneous management is at least preparatory for a quarter of the cases where surgery is unavoidable.ost ureteral injuries are iatrogenic, and they arrise as potential complications of urological, abdominal or pelvic operations; these injuries have an overall incidence of 0.5 1% (1 3). Ureteral injury caused by obstetric or gynecologic surgery is rare, though ureteral injury caused by just gynecologic surgery is much more common (1). Ureteral injury during performance of cesarean section (CS) is very rare, with an incidence of 0.10 0.27% (4 6). Although the surgical management of ureteral injuries is simple and successful once they are recognized during performing a CS, these injuries are generally missed in 67 89% of all cases (6, 7). A delayed diagnosis may complicate the injury and this can result in a poor outcome.Interventional radiology can offer some options to improve this outcome. We would like to present our experience wth percutaneously managing post-CS ureteral injuries.
There are several studies addressing regression of residual nasopharyngeal angiofibroma after surgery, but spontaneous regression of this tumor has been reported in only 2 cases. We present a case of nasopharyngeal angiofibroma that has involuted spontaneously in the last 5 years. The tumor had been diagnosed at another institute. Computed tomography taken in 2002 had revealed the tumor occupying the entire sphenoid sinus and the pterygopalatine fossa, extending to the cavernous sinus and the infratemporal fossa on the right side. The vascularization of the tumor had been mainly from the internal maxillary artery on angiography. The internal maxillary artery had been occluded with a coil, but branches of internal carotid artery could not be embolized due to high risks of complications. In 2004 the patient was seen at our institute, and this time, repeated angiography revealed rich vascularization from the internal carotid artery. The patient did not accept any treatment and was put on follow-up. He had no complaint in January 2007. The tumor was seen to disappear completely, except a little remnant at the right pterygopalatine fossa on computed tomography. This is the third reported case in the literature with spontaneous regression of nasopharyngeal angiofibroma.
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