Complications after biopsy of renal transplant - the role of ultrasound examination

Introduction: Kidney transplantation is the most effective method of renal replacement therapy - the transplanted organ is able to take over all the functions performed by a healthy kidney. The function of the kidney after transplantation should be regularly observed in laboratory tests and imaging examinations. However, in some patients, it is necessary to perform a posttransplant biopsy in order to clearly identify the pathology that may lead to damage to the function of the kidney or transplant rejection

Acute renal artery stenting recovered renal function after spontaneous rupture of renal artery aneurysm : case report

Purpose: Renal artery aneurysms (RAAs) are a rare vascular pathology with an estimated prevalence of 0.1% to 2.5%. Rupture of RAA is an extremely unusual cause of acute flank pain and haemodynamic instability with acute kidney failure and high mortality rate (20%). Case report: A 37-year-old male with no relevant history presented to the Emergency Room with acute right flank pain. Initial examination revealed BP 90/60 mm Hg and tachycardia. Initial blood testing was unremarkable, with a haemoglobin level of 9.4 g/dl. Urinalysis revealed moderate blood. Ultrasound (US) examination depicted aneurysm of the right renal artery 6 x 6 cm, with signs of blood extravasation visible in colour and power Doppler. The patient was referred for urgent computed tomography angiography, which revealed active bleeding from the ruptured aneurysm with haematoma spreading into the right retroperitoneum. He was subjected to emergency endovascular treatment. The patient was treated by successful implantation of a Viabahn stent (GORE, Daleware, USA). Selective nephrography revealed lack of flow through one of the segmental arteries resulting from vasospasm due to the placement of the guiding wire necessary for safe stent implantation. Conclusions: The authors present a rare case of spontaneous RAA rupture in a young male successfully treated with endovascular methods. Stent implantation required selective catheterisation of segmental arteries of the kidney, which resulted in the loss of one of them. However, control Doppler US disclosed no ischaemia and successful exclusion of the aneurysm

Diagnosis of vascular rejection of a transplanted kidney- a case report

Kidney transplantation is the method of choice for the treatment of renal failure. After such surgery some complications may occur including rejection of the new organ. The vascular rejection may be acute and is associated with a reduction in the lumen of the artery due to the presence of inflammatory exudate and chronic due to the dynamic proliferation of fibrous connective tissue in the inner membrane of the vessel. The aim of study was to evaluate the effectiveness of ultrasound in the diagnosis of vascular rejection of a transplanted kidney

Penetrating Crohn’s disease – adult vs pediatric patients

Crohn’s disease (CD) is increasing in prevalence worldwide, especially with young people. Magnetic resonance enterography (MRE) differs from routine magnetic resonance imaging (MRI) by oral administration of neutral fluid contrast before scanning. It allows for recognising and monitoring changes during therapy as well as assessing complications, which makes it valuable diagnostic modality

Third gender — the clinical image of Morris syndrome

Not required for Clinical Vignette

Endovascular embolisation strategies for pulmonary arteriovenous malformations

Purpose: To assess the immediate efficacy of distinct embolisation devices in the endovascular treatment of pulmonary arteriovenous malformations as well as to identify and analyse the possible determinants of the technical success of the procedure. Material and methods: Prospective analysis of 16 consecutive patients was carried out, who underwent transcatheter endovascular embolisation therapy for pulmonary arteriovenous malformations between 2005 and 2017. Pre- and post-procedural angiography studies were implemented to confirm the diagnosis and to evaluate the technical success defined as the complete occlusion of the feeding artery. Embolisation devices - coils, microcoils, occluders, or combination of the above - were used. All the patients were advised to conduct a follow-up computed tomography evaluation 12 months after the procedure. Results: A total of 40 pulmonary arteriovenous malformations (PAVMs) were observed and embolised. The immediate technical success was achieved in all (n = 40; 100%) treated PAVMs, as confirmed by the post-procedural angiographic result. The statistical analysis revealed no significant impact of the number of PAVMs per patient (p > 0.05), their angioarchitecture (p > 0.05), localisation within the lung (p > 0.05) or particular lobe (p > 0.05), and the selection of embolisation device (p > 0.05) on the procedural success rates. The procedure-related complication rate was equal to 6.25%. Conclusions: The immediate success rate of the transcatheter PAVM embolisation reached 100% in this study. The statistical model of logistic regression revealed no significant impact of the number of PAVMs per patient, their angioarchitecture, localisation, and distribution pattern, as well as device selection, on the immediate technical success of the procedure

Percutaneous extraction of residual post-cholecystectomy gallstones through the T-tube tract

Purpose: In the present study, the effectiveness and safety of minimally invasive percutaneous extraction of residual post-cholecystectomy gallstones through the T-tube tract were assessed. Material and methods: Between 2000 and 2015, 12 patients (seven women and five men, mean age 78 ± 8 years) after open cholecystectomy with common bile duct exploration and T-tube drainage underwent percutaneous extraction of residual gallstones through the T-tube tract. Results: The intervention was successful in 92% (11/12). In seven patients complete extraction of the retained gallstones was achieved, and in four cases partial extraction combined with passage of small residual fragments to the duodenum was obtained. In one case the extraction attempt was ineffective. Mild haemobilia was observed in two patients. No mortality or major complications were observed. Conclusions: Our findings are consistent with literature data and confirm that percutaneous extraction of residual post-cholecystectomy gallstones through the T-tube tract is an effective and safe treatment method. Although the presented technique is not a novel approach, it can be beneficial in patients unsuitable for open surgery or laparoscopic intervention when ERCP attempt occurs ineffective or there exist contraindications to ERCP

First-line ultrasound assessment of penetrating Crohn’s disease in pediatric patients

Introduction: Crohn’s disease is classified as chronic inflammatory bowel disease. The incidence in Europe ranges from 1 to almost 11.4 per 100,000 population per year. Ultrasound examination plays an important role in imaging diagnostics of inflammatory bowel lesions. It allows for assessing response to therapy as well as recognizing possible penetrating complications of the disease, i.e. fistula or abscess

Comparison of Magnetic Resonance Enterography Findings and Clinical Index of the Disease Activity Score in Crohn\u27s Disease

Introduction Crohn\u27s disease (CD) is a chronic inflammatory disease of the gastrointestinal tract. It usually affects younger people, with the peak of illness between the age of 15 and 25. MR enterography (MRE) is a proven and reliable modality in the evaluation of the lesion extent within this group of patients

Functional Magnetic Resonance Imaging and Obesity—Novel Ways to Seen the Unseen

Obesity remains a pandemic of the 21st century. While there are many causes of obesity and potential treatments that are currently known, source data indicate that the number of patients is constantly increasing. Neural mechanisms have become the subject of research and there has been an introduction of functional magnetic resonance imaging in obesity-associated altered neural signaling. Functional magnetic resonance imaging has been established as the gold standard in the assessment of neuronal functions related to nutrition. Thanks to this, it has become possible to delineate those regions of the brain that show altered activity in obese individuals. An integrative review of the literature was conducted using the keywords ““functional neuroimaging” OR “functional magnetic resonance “OR “fmri” and “obesity” and “reward circuit and obesity” in PubMed and Google Scholar databases from 2017 through May 2022. Results in English and using functional magnetic resonance imaging to evaluate brain response to diet and food images were identified. The results from functional magnetic resonance imaging may help to identify relationships between neuronal mechanisms and causes of obesity. Furthermore, they may provide a substrate for etiology-based treatment and provide new opportunities for the development of obesity pharmacotherapy