The first joint ESGAR/ ESPR consensus statement on the technical performance of cross-sectional small bowel and colonic imaging

Objectives: To develop guidelines describing a standardised approach to patient preparation and acquisition protocols for magnetic resonance imaging (MRI), computed tomography (CT) and ultrasound (US) of the small bowel and colon, with an emphasis on imaging inflammatory bowel disease. Methods: An expert consensus committee of 13 members from the European Society of Gastrointestinal and Abdominal Radiology (ESGAR) and European Society of Paediatric Radiology (ESPR) undertook a six-stage modified Delphi process, including a detailed literature review, to create a series of consensus statements concerning patient preparation, imaging hardware and image acquisition protocols. Results: One hundred and fifty-seven statements were scored for agreement by the panel of which 129 statements (82 %) achieved immediate consensus with a further 19 (12 %) achieving consensus after appropriate modification. Nine (6 %) statements were rejected as consensus could not be reached. Conclusions: These expert consensus recommendations can be used to help guide cross-sectional radiological practice for imaging the small bowel and colon. Key points: • Cross-sectional imaging is increasingly used to evaluate the bowel • Image quality is paramount to achieving high diagnostic accuracy • Guidelines concerning patient preparation and image acquisition protocols are provided

Voorradenbeheer : operationalisering van duurzaam bodembeheer op gebiedsniveau via voorraadbenadering

Binnen het project “Duurzaam bodembeheer middels voorraden” is een methode ontwikkeld om bodemthema’s zoals bodemdaling of verzilting om te zetten naar voorraden. Een voorraad heeft duidelijke ruimtelijke dimensies: een volume/omvang, die in de tijd kan veranderen en geografisch traceerbaar is. Zo wordt bijvoorbeeld duidelijk waar en hoeveel de bodem daalt binnen een gebied en waar de verzilting in een regio door een ingreep toe- of afneemt. De methode is een hulpmiddel bij de concretisering van bodemambities op provinciaal en gemeentelijk niveau en het toetsen van deze ambities. Publicatie in opdracht van Stichting Kennisontwikkeling Kennisoverdracht Bodem (SKB), TNO, Haskoning, Alterra, Provincie Zuid-Holland en H2Ruimt

A comparison of the Accuracy of Ultrasound and Computed Tomography in common diagnoses causing acute abdominal pain

Head-to-head comparison of ultrasound and CT accuracy in common diagnoses causing acute abdominal pain. Consecutive patients with abdominal pain for > 2 h and <5 days referred for imaging underwent both US and CT by different radiologists/radiological residents. An expert panel assigned a final diagnosis. Ultrasound and CT sensitivity and predictive values were calculated for frequent final diagnoses. Effect of patient characteristics and observer experience on ultrasound sensitivity was studied. Frequent final diagnoses in the 1,021 patients (mean age 47; 55% female) were appendicitis (284; 28%), diverticulitis (118; 12%) and cholecystitis (52; 5%). The sensitivity of CT in detecting appendicitis and diverticulitis was significantly higher than that of ultrasound: 94% versus 76% (p <0.01) and 81% versus 61% (p = 0.048), respectively. For cholecystitis, the sensitivity of both was 73% (p = 1.00). Positive predictive values did not differ significantly between ultrasound and CT for these conditions. Ultrasound sensitivity in detecting appendicitis and diverticulitis was not significantly negatively affected by patient characteristics or reader experience. CT misses fewer cases than ultrasound, but both ultrasound and CT can reliably detect common diagnoses causing acute abdominal pain. Ultrasound sensitivity was largely not influenced by patient characteristics and reader experience

Omental infarction in the postpartum period: a case report and a review of the literature

<p>Abstract</p> <p>Introduction</p> <p>Omental infarction is a rare and often misdiagnosed clinical event with unspecific symptoms. It affects predominantly young and middle aged women.</p> <p>Case presentation</p> <p>This is a case report of a 26-year-old Caucasian woman with spontaneous omental infarction two weeks after normal vaginal delivery.</p> <p>Conclusion</p> <p>Omental infarction is a differential diagnosis in the postpartum acute abdomen. As some cases of omental infarction, which are caused by torsion, can be adequately diagnosed via computed tomography, a conservative treatment strategy for patients without complications should be considered in order to avoid any unnecessary surgical intervention.</p

Standard Outpatient Re-Evaluation for Patients Not Admitted to the Hospital After Emergency Department Evaluation for Acute Abdominal Pain

The aim of the present study was to investigate the efficacy and safety of standard outpatient re-evaluation for patients who are not admitted to the hospital after emergency department surgical consultation for acute abdominal pain. All patients seen at the emergency department between June 2005 and July 2006 for acute abdominal pain were included in a prospective study using a structured diagnosis and management flowchart. Patients not admitted to the hospital were given appointments for re-evaluation at the outpatient clinic within 24 h. All clinical parameters, radiological results, diagnostic considerations, and management proposals were scored prospectively. Five-hundred patients were included in this analysis. For 148 patients (30%), the final diagnosis was different from the diagnosis after initial evaluation. Eighty-five patients (17%) had a change in management after re-evaluation, and 20 of them (4%) were admitted to the hospital for an operation. Only 6 patients (1.2%) had a delay in diagnosis and treatment, which did not cause extra morbidity. Standard outpatient re-evaluation is a safe and effective means of improving diagnostic accuracy and helps to adapt management for patients that are not admitted to the hospital after surgical consultation for acute abdominal pain at the emergency department.Vascular Surger

Fat, fibre and cancer risk in African Americans and rural Africans

Rates of colon cancer are much higher in African Americans (65: 100,000) than in rural South Africans (Peer reviewe

Fat, fibre and cancer risk in African Americans and rural Africans

Rates of colon cancer are much higher in African Americans (65: 100,000) than in rural South Africans (Peer reviewe