An Improved technique for transabdominal pelvic ultrasound - abstract

Most textbooks and ultrasound manuals describe the technique for doing transabdominal pelvic ultrasound as simply doing longitudinal and transverse scans through the pelvis in the midline and in the transverse plane, angling 15§ cephalad for the ovaries and caudal angulation for the pelvic musculature. To scan the right adnexa, moving the transducer to the right is described, and to the left for the left adnexa. Occasional mention is made of scanning obliquely. For longitudinal scans, the transducer from the midline is angled towards the right or left for the ovaries. An improved technique for scanning the adnexa is demonstrated, which consists of scanning through the bladder from the opposite side, angling acutely 45§ or less towards the side of interest. For instance, the left adnexa is scanned from the right side of the abdomen, the transducer being placed to the right of the right lateral edge of the bladder and then angled towards the left. This is done both for longitudinal and for transverse scanning of the adnexa. This technique routinely gives a clearer picture and should become part of the standard procedure used and taught by sonographers (AU)

Eosinophilic granuloma of the cervical and thoracic spine in a child

A case of eosinophilic granuloma affecting a cervical vertebra, thoracic vertebra and pelvis in a child is reported. We present this case because multifocal eosinophilic granuloma lesions of the spine are rare and can present as this case did with both diagnostic and therapeutic problems. Preoperative diagnosis may be made by X-ray, isotope bone scan and needle biopsy, avoiding unnecessary surgical intervention (AU)

Fractures of the pelvis classification and treatment of a life-threatening condition - abstract

Fractures of the pelvis have long presented an enigma in classification, diagnosis and treatment. Traditional radiographs done in A.P. and lateral projection do little to demonstrate the three dimensional problems presented in these injuries. A method of radiographical investigation easily done by traditional X-ray equipment readily available in all hospitals is presented which allows the understanding of these injuries. A classification of the different types of fracture is presented and a treatment method for the fractures is identified. The Pennal classification of pelvic fractures into the following categories allows an understanding of the mechanism of the process producing the injury, of the displacement of the fragments and allows the development of techniques of treatment. Fractures are classified in relation to the deforming forces as follows:- (1) A.P. compression fractures (2) Lateral compression (i) without rotation (ii) with rotation (3) Vertical shear fractures. Techniques of reduction - closed and open - are demonstrated to be effective methods with which to reduce and maintain reduction. Fracture fixation allows control of the otherwise unstable situation and allows mobilization of the patient with attendant reduction in morbidity and mortality (AU)

A simple approach to the disrupted posterior urethra - abstract

Road traffic, farm and forestry accidents result in numbers of patients with fractured pelvis and disrupted posterior urethra. These patients present a formidable challenge to the urological services. A simple repair of the disrupted posterior urethra is presented. It avoids any difficult extensive perineal dissection which can injure an already compromised sphincteric mechanism, requires no special instruments and is easily performed and taught to others. The technique is a modification of the Blandy-Leadbetter 2-page posterior urethroplasty and utilizes a novel, simple method of flap introduction and fixation. Five men had successful repair, in that they can control passage of urine and are free of drainage catheters. Two of the 5 have proceeded to successful second stage repair and control the passage of urine via the penis. One of the 2 is able to ejaculate normally (AU)