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Background: Abdominal pregnancy refers to a rare form of ectopic pregnancy that has been implanted in the peritoneal cavity. Clinical suspicion combined with ultrasound is important for early diagnosis. A surviving fetus from an abdominal pregnancy is extremely rare. Case Presentation: Herein we report on a case of advanced abdominal pregnancy in a Gravida-III Abortion-II mother who presented with worsening abdominal pain of 1 week duration associated with fetal movement and managed successfully with an outcome of a live neonate and no maternal complication. Conclusion: A live neonate from term abdominal pregnancy is a rare occurrence. Early diagnosis of abdominal pregnancy is crucial to avoid potentially catastrophic maternal complications even though our patient, fortunately, has a smooth postoperative course. A high level of suspicion combined with ultrasound is helpful in reaching a diagnosis. Skill advancement for radiologists and non-radiology professionals involved in obstetric ultrasound is recommended to avoid misdiagnosis, as in our case. Careful post-operative evaluation is important to look for maternal and fetal complications.
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Background: Intravenous (IV) iodine-based contrast agents are administered during computed tomography (CT) examination to enhance the density differences between lesions and surrounding parenchyma, which is important for lesion characterization, and to demonstrate vascular anatomy and vessel patency. Quality of contrast enhancement has a significant influence on diagnostic interpretation and subsequent management. In this study, we assessed the quality of portal venous phase abdominal CT scans performed with a manual injection of a fixed dose of contrast, which is the routine practice at Tikur Anbessa Specialized Hospital (TASH). The effect of age and sex was also assessed. Method: A hospital-based retrospective review was performed to identify patients who have had a precontrast and postcontrast abdominal CT scan from November 4, 2020, to September 30, 2022. All patients with abdominal CT scans having precontrast and portal venous phase scans were included in the study. All CT scans were reviewed by the principal investigator and the quality of contrast enhancement was assessed. Results: In this study, there were a total of 379 patients. The mean hepatic attenuations in precontrast and portal venous phase scans were 59.05 ± 6.69 HU and 103.73 ± 12.84 HU. The proportion of scans with less than 50 HU enhancement was 68% (n = 258). There was a significant association between age and sex with contrast enhancement. Conclusion: The hepatic contrast enhancement pattern of abdominal CT scan at the study institution reveals a concerning degree of image quality. This is evidenced by the high number of suboptimal contrast enhancement indices and the highly variable enhancement patterns across different patients. This can have a negative impact on the diagnostic performance of CT imaging and can adversely affect the management. Furthermore, both sex and age affect the pattern of enhancement.
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Background: Oculo-orbital tumors are frequently encountered pathologies and late diagnosis results in high morbidity and mortality in developing countries. This study aims to assess the computed tomography and magnetic resonance imaging patterns of pediatric oculo-orbital tumors with particular emphasis on retinoblastoma and compare agreement between imaging and histopathology diagnosis. Methods: A retrospective analysis of 101 pediatric patients with oculo-orbital lesions from February 2017 to January 2020 at Tikur Anbessa Specialized Hospital oncology center. Medical records were reviewed for clinical data, history, physical examination, pretreatment eye exam under anesthesia (EUA), computed tomography (CT) magnetic resonance imaging (MRI) and histopathology reports. The agreement between imaging and histopathology diagnosis was analyzed. Results: Malignant oculo-orbital tumors represented 97 (96.1%) cases. Age group 2-5 years had 56 (55.4%) cases of oculo-orbital tumors. Retinoblastoma accounted for 78 (77.2%) followed by rhabdomyosarcoma in 8 (7.9%) patients. The primary patient complaint was proptosis in 78 (77.2%) followed by leukocoria in 16 (15.8%). In 88 (89.7%) cases, there was agreement between imaging and histologic findings with 72 out of the 75 histopathology confirmed cases of retinoblastoma showing an agreement. Retinoblastoma patients presented at an advanced stage with orbital and intracranial extension. Conclusions: In conclusion, patients with oculo-orbital tumors presented with advanced stage of disease. Excellent imaging and histopathology agreement was demonstrated.
