Traditionally, minimal potential organ donor referrals emanate from general medicine departments. We use a clinical vignette to draw attention to challenges related to referral of potential organ donors from general internal medicine departments. In addition, we provide potential solutions to overcome challenges and reflect on the ethical issues of non-referral of potential organ donors. It is hoped that this paper will increase the awareness of organ donation in the medical fraternity in Africa and thus mitigate critical shortages of organs for transplantation.
Intrahepatic portosystemic venous shunts are rare vascular anomalies that may be detected in asymptomatic patients, given the recent advances in radiological imaging techniques. Accurate shunt evaluation and classification can be performed with ultrasound and multi-detector computed tomography. We report an unusual case of an intrahepatic portosystemic venous shunt with an incidental finding of neurofibroma.
Modern radiological technology has transformed the way that adrenal lesions are currently investigated. The contemporary radiologist has been catapulted to the forefront in the management of adrenal disease. With the increasing use of cross-sectional imaging, adrenal lesions are being serendipitously discovered in radiological studies undertaken for non-adrenal-related conditions -the so-called adrenal 'incidentaloma' . This review discusses the imaging modalities available for characterising these lesions, highlighting current concepts and controversies in differentiating benign from malignant pathology. The article also provides a brief overview of the spectrum of adrenal pathology commonly encountered in the adult population.
A 16-year-old girl with no past medical or surgical history presented with a 3-month history of abdominal pain and distension with weight loss. Computerised tomography (CT) scans (Figs 1 and 2) of the abdomen revealed a well-defined heterogeneous intraluminal gastric mass with interspersed air bubbles conforming to the shape of the stomach. No further intestinal lesions were noted. A diagnosis of gastric bezoar was made. A trichobezoar was confirmed on endoscopy, with subsequent successful surgical removal. A history of trichophagia was elicited post-surgery and the patient was subsequently referred for psychiatric evaluation and supportive psychotherapy to treat the impulse control disorder and prevent bezoar recurrence.
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