A Migrated-mesenteric Lymphangioma: An Unusual Case of Intrabdominal Cystic Lesion in a New-born

Abdominal lymphangioma is a rare presentation of abdominal cystic lesions. They generally arise from small bowel mesentery. Migration of abdominal masses is an uncommon entity and usually occurs due to gossypiboma. There have been many reports of the radiologic appearance and unusual complications of mesenteric lymphangioma. However, to our knowledge, migration of mesenteric lymphangioma has not been reported in the literature. We present imaging findings of migrated-mesenteric lymphangioma from the intrauterine to postnatal period with histopathological correlation

The Relationship Between The Bronchial Situs Anomalies and Lung Parenchyma Findings in Children

Background: Bronchial situs defines the position of the cardiac atria, lungs, liver, stomach, andspleen relative to the midline. Bronchial situs anomalies (BSA) are classified as situs inversus andsitus ambiguus (right isomerism and left isomerism). The aim of our study is to evaluate therelationship between BSA and its subtypes and lung parenchymal findings.Materials and Methods: By retrospectively scanning the archives of our hospital between 2010 and2022, 31 patients in the 0-18 age group who were diagnosed with BSA in thorax CT angiographyexamination were identified. The BSA type of 31 patients was grouped as situs inversus, rightisomerism, and left isomerism. The lung parenchyma was divided into two categories as "presenceof a finding" and "no finding". The lung parenchymal findings of the patients were classified as"mosaic perfusion", "consolidation", "ground glass density", "peribronchial thickening","subsegmental atelectasis", and "other". Chi-square test was used in statistical analysis. A P valueof &lt;0.05 was considered significant.Results: The ages of 31 pediatric patients were between 0-84 months (mean: 13.03 ± 22.04). Thedistribution of 31 patients was situs inversus n=7 (22.5%), right isomerism n=13 (41.9%), leftisomerism n=11 (35.4%). There were 10 patients (32.2%) without findings in the lung parenchymaand 21 patients (67.7%) with findings. Lung parenchymal findings; mosaic perfusion (n=21),consolidation (n=9), ground glass density (n=9), peribronchial thickening (n=7), subsegmentalatelectasis (n=6), other=3 (millimetric calcific nodule n=1 , interlobular septal thickening n=1, air cystn=1). When the relationship between BSA type and findings in the lung parenchyma was evaluated,a significant relationship was found between situs inversus (p = 0.012) and right isomerism (p =0.004). There were no findings in 5 of 7 patients with situs inversus (71.4%). All 11 patients with rightisomerism had parenchymal findings. Significant relationships were detected between both situsinversus and right isomerism and mosaic perfusion (p=0.012, p=0.004, respectively).Discussion and Conclusion: According to our study, a significant relationship was found betweenBSA types and findings in the lung parenchyma. While parenchymal findings were less common insitus inversus, parenchymal findings were more common in right isomerism. While situs inversus,one of the BSA types, has a more benign course, the frequency of other organ anomalies (especiallycongenital heart diseases) accompanying situs ambiguus may be related to this conditions.&nbsp;</div

SONOGRAPHIC AND FLUOROSCOPIC PERITONEAL DIALYSIS CATHATER PLACEMENT, POST PROCEDURAL OUTCOMES

SONOGRAPHIC AND FLUOROSCOPIC PERITONEAL DIALYSIS CATHATER PLACEMENT, POST PROCEDURAL OUTCOMES&nbsp;&nbsp;Purpose: Peritoneal dialysis (PD) cathaters may be inserted surgically, blindly or&nbsp; by fluoroscopic approach. Adding ultrasound-assistance&nbsp; to fluoroscopic technique ensures entry into abdominal cavity under direct ultrasound visualization. In this way, complications such as intestinal perforation due to puncture or damage to the superficial epigastric vessels can be significantly prevented. The aim of our<span class="NormalTextRun SCXW237730061 BCX4" style="margin: 0px; padding: 0px; -webkit-user-select: text; -webkit-user-drag: none; -webkit-nbsp-mode:

The Relationship Between Patellar Chondromalacia and Patellofemoral Joint Anatomical Variation

AbstractIntroduction and Purpose: The knee joint is a complex joint consisting of the tibiofemoral andpatellofemoral joints. Morphological variations are common in the knee joint, due to the articulation ofanatomically incompatible bones. These variations may lead to various pathologies, mostly in thepatellofemoral joint. One of the most common pathologies and an important cause of knee pain ischondromalacia. In this study, we aimed to investigate the relationship between lateral patellar tilt angle(LPTA), lateral patellofemoral angle (LPFA), patella-patellar tendon angle (PPTA), and lateral trochlearinclination angle (LTI), which are anatomical variations in the patellofemoral joint, and patellarchondromalacia.Materials and Methods: Cases who underwent knee magnetic resonance imaging (MRI) between Juneand October 2022 were analyzed retrospectively. Fifty patients with and without patellarchondromalacia were included randomly from these MRIs. Cases with a history of knee surgery,arthroscopy and high-energy trauma were excluded. Two groups were formed with and without patellarchondromalacia. LPTA, LPFA, PPTA and LTI were measured on knee MRIs. Demographic data andanatomical measurements between the two groups were evaluated with Mann-Whitney U and continuitycorrected chi-square test.Results: The median age of the patients included in the study was 45 (Interquartile Range [IQR]: 18.5).There were 58 women and 42 men. In the patellar chondromalacia group, 17 (34%) patients had low-grade chondromalacia and 33 (66%) patients had high-grade chondromalacia. The median age was 49(IQR: 61) in the patellar chondromalacia group and 37.5 (IQR: 38) in the normal group (p&lt;0.001). Therewas no statistically significant difference in gender distribution between the two groups (p=0.156). Themedian lateral patellar tilt angle was 6.76 (IQR: 15.15) in the patellar chondromalacia group and 6.92(IQR: 19.25) in the normal group (p=0.610). The median lateral patellofemoral angle was 7.86 (IQR:41.86) in the patellar chondromalacia group and 7.90 (IQR: 17.37) in the normal group (p=0.471).Median patella – patellar tendon angle was 142.96 (IQR: 32.14) in the patellar chondromalacia groupand 145.87 (IQR: 27.77) in the normal group (p=0.006). The median lateral trochlear inclination anglewas 19.11 (IQR: 19.30) in the patellar chondromalacia group and 20.39 (IQR: 20.16) in the normalgroup (p=0.127).Discussion and Conclusion: The patellofemoral joint is an important component of the extensormechanism. It distributes the load on the knee joint more homogeneously during extension. It has beendescribed that anatomical differences in the patellofemoral joint can cause damage to the patellarcartilage by affecting the load distribution. We found a statistically significant difference between thegroups in terms of median PPTA and median age. The median age of the patients in the chondromalaciagroup was higher. This may have been due to degenerative cartilage changes. The lower detection ofmedian PPTA in the chondromalacia group indicates that the angular position of the patella may haveincreased the load on the patellofemoral joint, leading to cartilage damage. In conclusion, it should bekept in mind that demographic differences and anatomical variations may be a cause of patellarchondromalacia.</div

Renal artery stenting using CO2 gas angiography in patients with chronic renal insufficiency

ABSTRACTBackground: Renal artery stenosis (RAS) is the most common cause of secondary hypertension.Significant stenosis causes poor control of hypertension, worsening of renal function, left ventriclehypertrophy and heart failure. The goal of renal artery revascularization is to preserve renal function,improve the blood pressure (BP) control and prevent cardiovascular complications. Renal artery (RA)stenting proved to be a safe minimally invasive treatment, which may improve BP control andpreserve renal function. Contrast-induced nephropathy (CIN) is one of the most seriouscomplications caused by iodinated contrast angiography. Because the feasibility and safety of CO2angiography-guided renal artery stenting have been reported, CO2 angiography is expected toreduce CIN. The aim of this study was to evaluate the safety of CO2 as contrast agents duringangiography in the diagnosis and percutaneous treatment of RAS in patients with chronic renalinsufficiency.Materials and Methods: Patients who underwent renal artery stenting using CO2 angiography withchronic renal insufficiency (serum creatinine level &gt; 1.5 mg/dL) in a single center were retrospectivelyreviewed. Patients were referred for angiography and potential percutaneous revascularization onthe basis of the clinical history, physical and radiologic examination. The diagnostic CO2angiography was performed as previously described. Arterial access was obtained via the commonfemoral artery. The collection syringe volume was typically set at 20 ml for flush aortograms (todeliver 60 ml of CO2) with a two-way stopcock. Angioplasty procedures using balloon-expandablestents were performed according to standard interventional techniques. Baseline and follow-upclinical data including patient demographics, comorbidities, laboratory tests, number and types ofanti-hypertensive medications, indications for the procedure and complications were collected fromthe medical notes and hospital information system.Results: A total of 35 patients (26 males and 9 females; mean age 71.97 ± 7.42) were incorporatedinto the study. Diabetes mellitus was present in 31.5% of patients. Creatinine level and mean eGFRat baseline were 1.8 and 37.7 mL/min/1.73m2 respectively. The procedural and angiographicsuccess rate was 100%. There were no severe complications. One puncture site complication(hematoma) occurred. One patient developed chest pain but recovered uneventfully. After theprocedure, eGFR increased to 42.30 ml/ min/1.73m2 and serum creatinine level decreased to 1.66.Discussion and Conclusion: The use of CO2 as an angiographic contrast agent in pa- patientswith suspected renal artery stenosis and ischemic nephropathy is a safe alternative to the use ofiodinated contrast material. CO2 does not result in an increase in the incidence of complicationscompared with iodinated contrast material.&nbsp;</div

Transvaginal Color Doppler Ultrasonography in The Identification of Pelvic Mass Lesions

AbstractIntroduction and Purpose: Currently, ultrasonography is the most frequently used technique todiagnose pelvic lesions. More specifically, transvaginal ultrasonography provides further data whencompared to transabdominal ultrasonography because of the shorter distance between the probe and thetarget. Transvaginal Doppler ultrasonography enables detailed evaluation of vascularization of pelviclesions and arterial flow patterns. This study was conducted to detect various lesions which form massin the pelvic area of the female patients and to identify the efficiency of transvaginal Dopplerultrasonography in determining the benign or malignant nature of lesions.Materials and Methods: This study was conducted in 128 patients aged between 18 and 83, and themedian age of them was 44.8. Also 80 of the patients were premenopausal (62.5%) and 48 werepostmenopausal (37.5%). Patients with emptied bladders were examined by transvaginal Doppler USG.Those cases with lesions were further studied in terms of their vascularization. Doppler parameters wereoptimized to detect low flow. Resistive Index (RI), Pulsatility Index (PI) and acceleration profile weremeasured when there was arterial flow. Each lesion was measured at least three times and the lowest RIand PI values were taken into consideration in the assessment. The limit value for displaying malignitywas accepted to be 0.45 for RI and 0.60 for PI. 27 of the total 128 were taken as control group and theyhad normal sonographic findings and their ovarian, tubal and uterine arterial measurements wererecorded. Out of 101 patients with lesions, 71 were diagnosed with histopathology. 30 Non-operatedpatients remained on 3 to 6 times monthly interval tracking during when lesions were observed via TVultrasonography and were found stable or regressed and accepted benign.Results: 98 (77%) of the total 128 cases were vascular, 30 were avascular. 55 (56%) of the 98 vascularcases had benign values whereas 43 (44%) had malign values. Vascularization was detected in 24 (89%)of the 27 patients of the control group and 23 (96%) of them had benign values whereas 1 (4%) hadmalign values. Vascularization was detected in 29 (83%) of 35 patients with malign diagnosis and 7(24%) had benign values and 22 (76%) had malign values. Vascularization was detected in 45 (68%) of66 benign cases and 25 (56%) had benign values whereas 20 (44%) had malign values. Demographicdata and Doppler measurements between malign and benign groups were evaluated via TA and TVDoppler measurements. There was not any statistically difference among the groups in terms ofvascularity presence. However, statistically significant differences between the groups in terms of RIand PI values (p-value&lt;0.05) (Kruskal –Wallis test) were observedConclusion: Transvaginal Doppler ultrasound is a noninvasive technique which is potentially effectivein the diagnosis of pelvic masses. Transvaginal Doppler evaluation of the arterial flow in pelvic massescan be helpful in the distinction of malignancy. RI and PI values can be used to differentiate benign andmalign pelvic lesions.&nbsp;</div