Retrograde Transvenous Thoracic Duct Embolization for Tubercular Chylothorax.

This case study documents the clinical profile of a 27-year-old male patient who visited the medical facility two months ago with complaints of dry cough, fatigue, weight loss, and occasional fever. He had been treated for ascites and pleural effusion in the hospital before presentation and returned with an intercostal drain in place. A detailed examination revealed symptoms of respiratory disorders, including fluid in both lungs, fever, and dyspnea. His fluid levels showed multiple deviations from the normal range, according to the report's findings and lab test results. It was determined that the patient had chylothorax, which resulted from hemophagocytic lymphohistiocytosis (HLH) and abdominal tubercular lymphadenopathy. His anti-tubercular treatment (AKT4) was initiated, along with octreotide for his management. Initial management included non-invasive ventilator (NIV) support, intravenous antibiotics, nebulization, and an intercostal chest drain (ICD). Later, the patient underwent retrograde transvenous thoracic duct embolization (TDE) using N-butyl cyanoacrylate (NBCA) glue. The removal of the drainage tube and the patient's stable discharge were made possible through regular monitoring and collaboration between specialists.

Carotid body tumor imaging: MRI, ultrasound, and elastography with surgical management.

A carotid body tumor is an uncommon tumor that develops from the carotid body. Carotid body tumor, also called paraganglioma, is often benign in nature and mostly found in the neck. They make up 0.5% of all body tumors and resemble glomus jugulare, glomus tympanicum, and pheochromocytoma, which are paragangliomas of the body. We present a case of a 22-year-old male patient who presented to the medical outpatient department with complaints of swelling in the left carotid triangle for 1 month. The patient had hoarseness of voice with odynophagia and dysphagia. We found out the diagnosis of carotid body tumor when the patient came for ultrasound, and the diagnosis was later confirmed on magnetic resonance imaging. The gold standard treatment for carotid body tumors is surgery. The surgical categorization by Shamblin et al. marks a turning point in the evaluation of these tumors' resectability and is still used to predict vascular morbidity, and according to it, our patient later underwent sub adventitial tumor excision.

Radiological Diagnosis of Crouzon Syndrome: A Case Study.

Crouzon syndrome, distinguished by a classic trio of an atypical skull structure, distinctive facial features, and protruding eyes, ranks among the most prevalent types of craniofacial dysostosis. Therefore, patients presenting with dental abnormalities are under-reported in medical literature despite the developmental neurological defects. We report a rare case of Crouzon syndrome in a four-year-old girl who had forward displacement of the lower jaw, bulging eyes, undeveloped upper jaw, and dental abnormalities. She was evaluated with cranial computed tomography with three-dimensional reconstruction; genetic studies confirmed the findings.

Emergent Management of Growing Teratoma Syndrome: A Case Presentation.

Growing teratoma syndrome (GTS) represents a rare yet significant complication following treatment for non-seminomatous germ cell tumors (NSGCT), characterized by the growth of mature teratoma elements despite prior chemotherapy. We present the case of a 30-year-old male who, following orchidectomy for NSGCT and subsequent chemotherapy, developed acute abdominal pain and pulmonary metastasis. Despite normal serum tumor markers, imaging revealed a large retroperitoneal mass encasing significant vessels. Surgical excision led to symptom resolution. This case underscores the diagnostic challenges GTS poses, the importance of imaging in diagnosis, and the efficacy of prompt surgical intervention in achieving favorable outcomes.

The Diagnostic Value of CT Scan in Identifying Adenoid Hypertrophy in Adults: A Case Report.

The utility of computed tomography (CT) scan in diagnosing adenoid hyperplasia in adults. A 22-year-old woman presented with persistent bilateral nasal obstruction, anterior nasal discharge, mouth breathing, and snoring over the past three months. Despite attempts with both local and systemic decongestants, there was no improvement, and flexible nasopharyngoscopy could not be conducted. CT scans revealed a heterogeneously enhancing space-occupying mass in the nasopharynx, and a rare diagnosis of adult adenoid hypertrophy was reported. The patient responded to a combination of painkillers, antibiotics, and nasal decongestants. Adenoid hyperplasia in adults is quite rare and inadequate examination by indirect posterior rhinoscopy may lead to misdiagnosis and mismanagement. A CT scan not only provides a clearer view of the nasopharyngeal space and adenoids but also reveals details about the nature of lesions, including their extension and potential bone destruction, suggesting the presence of a malignant tumor. Additionally, a CT scan proves valuable in diagnosing chronic sinusitis.

Percutaneous Vesselplasty for the Treatment of Vertebral Osteoporotic Collapse Fractures.

A 78-year-old woman with vertebral compression fractures (VCFs) and chronic back pain was the subject of this case study. To treat symptomatic VCFs, less invasive procedures such as balloon kyphoplasty and vertebroplasty were developed. Vertebroplasty involves injecting polymethylmethacrylate (PMMA) into the vertebral body to mechanically stabilize it. However, there was a risk that PMMA could leak, potentially causing a pulmonary embolism or neurological problems. A modified vertebroplasty called balloon kyphoplasty reduced the chance of leakage but was not without complications. It used a high-pressure balloon to create a cavity before cement injection. An alternative procedure, called vesselplasty, aimed to reduce bone filler leakage, minimize void formation, and restore vertebral height. When vesselplasty was introduced, bone cement was held in place by a polyethylene terephthalate (PET) balloon container that expanded inside the vertebral body to lower the risk of leakage. Vesselplasty was shown to be a more secure and successful treatment for VCFs, especially in osteoporotic patients with peripheral wall injury. Vesselplasty was a potentially effective treatment for osteoporotic VCF patients in correcting kyphosis, restoring vertebral height, and reducing pain. During a six-month follow-up period, post-operative examinations following vesselplasty demonstrated considerable pain reduction, improved vertebral height, and superior overall health outcomes.

Isolated Renal Hydatid Cyst: A Rare Case.

Hydatid disease is a parasitic infection caused by a cestode from the Taeniidae family, by Echinococcus multilocularis or Echinococcus granulosus, predominantly occurring in the lungs and liver. Although the kidney can be involved in hydatid cysts, isolated kidney hydatidosis is very rare. Most cases present with non-specific complaints or remain asymptomatic for years. Hence, imaging is very useful in the diagnosis. Here, we report an isolated hydatid cyst involving the right kidney.

A Rare Presentation of Duodenal Diverticulum Causing Obstructive Jaundice: Lemmel's Syndrome.

Lemmel syndrome is an uncommon pancreaticobiliary consequence of duodenal diverticula. We herein present a case of an 80-year-old male who presented with upper abdominal discomfort. Based on lab values and relevant clinical history, a diagnosis of obstructive jaundice was made. A contrast-enhanced CT scan of the abdomen revealed gross dilatation of intra-hepatic and extra-hepatic bile duct, cystic duct, common bile duct, major and minor pancreatic duct. A contrast-filled outpouching was seen from the medial wall of the second part of the duodenum with duodenal diverticulum and papilla within it. The abrupt termination of the common bile duct and main pancreatic duct adjacent to the thickened wall of the diverticulum was the cause of the patient's pancreaticobiliary obstruction. In the absence of cholelithiasis or tumor, the duodenal diverticulum that manifests as obstructive jaundice is known as Lemmel syndrome. Prompt identification of Lemmel syndrome can avoid dangerous complications and unnecessary investigations. Gallstones, cholangitis, and bile duct stones are more common in patients with duodenal diverticula. Treatment depends on patient presentation and may involve conservative management, surgical procedures in the form of excision of the diverticulum, or even endoscopic sphincterotomy or stenting.

Acquired Parkinson's Disease in Alcoholic Cirrhosis: The Rarest Association.

Hepatic encephalopathy is the most common neurologic complication of liver cirrhosis, whereas acquired hepatocerebral degeneration (AHD) is an underappreciated neurologic manifestation. Parkinsonism, ataxia, and neuropsychiatric symptoms are its defining characteristics. In individuals with chronic parenchymal liver disease with portosystemic shunting, it is an underrecognized etiology of psychomotor retardation. It has been hypothesized that the etiology of AHD is due to manganese buildup in the basal ganglia. This case report details a hepatocerebral degeneration (AHD) case in a patient with chronic parenchymal liver disease who improved after taking a dopamine agonist.

Hematuria as a Sign of Kidney Stone Disease Evaluated Using Computed Tomography: A Review.

Kidney stone is a common cause of acute pain in the abdomen in patients presenting to casualty. Being present in roughly 12% of the world's population makes it the most prevalent pathology of the urinary system. The ureters, kidneys, and bladder frequently develop calculi, resulting in hematuria. The most effective imaging technique for evaluating calculi is unenhanced helical computed tomography. The population, intervention, control, and outcomes (PICO)-formatted question was used to generate methodological medical subject heading (MeSH) phrases, which increased the search strategy's sensitivity in finding research. Some of these names ("hematuria") included "renal calculi" (MeSH) and "cone-beam computed tomography" (MeSH). Studies that satisfied these requirements were subjected to critical evaluation. The merits of the listed studies were evaluated using a unique quality assessment scale. The most accurate imaging diagnostic test for people with hematuria is multidetector computed tomography. If a patient over 40 presents with microscopic hematuria, a non-contrast computed tomography or ultrasound study should be performed, and if gross hematuria is observed, cystoscopy should be added. Pre- and post-contrast computed tomography scans and cystoscopy should be carried out on elderly patients.

Ectopic Crossed Testis: A Rare Anomaly of Testicular Migration.

Ectopic crossed testis is a rare condition in which both testes descend through the same inguinal canal. The most common presentation is an ipsilateral inguinal hernia with contralateral cryptorchidism. This is a case report of a six-year-old male child who had an empty right scrotal sac. Diagnostic laparoscopy is useful for both diagnosis and management. Management is determined by the anatomy of the vas, vessels, and testis discovered during surgical exploration. Transseptal contralateral orchidopexy results in good tension-free testicular fixation in the scrotum.

Large Unruptured Perineal Epidermoid Cyst: A Rare Case.

Perineal epidermoid lesions are uncommon, with only a few research papers accessible on the subject. Because these lesions are varied in origin and can range from benign to malignant, it can be difficult to tell them apart. A wide variety of lesions are evaluated in the differential diagnosis of perineal cystic lesions, however perineal epidermoid cyst is uncommon. An epidermoid cyst is a benign ectodermal congenital abnormality. Epidermoid cysts can be found all over the body, however, they are uncommon in the perineal area. We discuss a case of a perineal epidermoid cyst in an adult female presenting to the general surgery department with painful perineal swelling. The patient was advised for an ultrasound (US) and MRI for further evaluation and the findings are reported.

Hourglassing of Prolapsed Membranes With Fetal Parts Within 22 Weeks Primigravida: A Rare Presentation.

Three clinical scenarios, premature labor; inescapable abortion; and incompetent cervix, result in the dilatation of endocervical canals before term. Ultrasonography is the modality of choice for confirming the above conditions. Here, we discuss a case of preterm primigravida with complaints of bleeding per vagina with the dilated cervix and prolapsed membranes with fetal parts within.

Elastographic Imaging of Anaplastic Seminoma of Testis With Its Ultrasound and Doppler Correlation: A Case Report.

The commonest solid tumour in men between the ages of 15 and 44 is testicular cancer. Germ cell tumours, which are then subdivided into seminomatous and non-seminomatous tumours, are its primary histological kind. In the fourth decade of a man's life, seminoma accounts for 55% of testicular cancer. Anaplastic seminoma, which accounts for 5% to 15% of testicular seminoma, is an uncommon kind of seminoma. The anaplastic variant of classical seminoma is an uncommon type of seminoma. In order to increase confidence in diagnosing and differentiating benign from malignant lesions and localising lesions in the testis, tissue elastography has arisen as a definite, important supplementary method. We present a case report of anaplastic seminoma with its classical imaging findings on strain elastography and its correlation with ultrasound and doppler.

Giant Abdominal Pseudoaneurysm Secondary to Recurrent Pancreatitis: Imaging and Endovascular Intervention.

Chronic or necrotizing pancreatitis is characterized by repeated inflammation of the pancreas, leading to multiple complications, a few of which are vascular, such as splanchnic venous thrombosis and arterial pseudoaneurysms. Even though the frequency of pseudoaneurysm formation in patients with pancreatitis is as high as 10%, there is not much importance given to its management in the radiologic literature. The splenic artery is the most common visceral artery affected by pseudoaneurysms, followed by the gastroduodenal and pancreaticoduodenal arteries. Usually, pseudoaneurysms occur due to the erosion of a peripancreatic or pancreatic artery into a pseudocyst, but this can also occur without the development of a pseudocyst. Pseudoaneurysms may be asymptomatic (usually the ones less than 5 cm), but some of them may pose a threat due to spontaneous rupture and subsequent fistulization into other organs. Therefore, early diagnosis and management are of prime importance. Here, in this article, we present a case of pseudoaneurysm of the gastroduodenal artery with characteristic imaging features and preferred, recent techniques of management.

Ureterovaginal Fistula Post Vaginal Hysterectomy.

Middle-aged women with ureterovaginal fistula (UVF) after hysterectomy represent a painful condition for the patients in the community. Accurate diagnosis and proper planning before surgery are essential for effective outcomes. CT urography is the modality of choice in diagnosing ureterovaginal fistula. CT urography helps in evaluating the fistula as well the associated renal complications following the condition. Here we present a case of ureterovaginal fistula reported with a history of vaginal hysterectomy for subserosal fibroid in December 2021.

Rare presentation of autosomal dominant polycystic kidney disease in horseshoe kidney ultrasound evaluation: a case report.

Horseshoe kidney is a renal fusion anomaly during embryogenesis and adult polycystic kidney disease is a hereditary disorder which is transmitted in autosomal dominant pattern. Polycystic and horseshoe kidney are two separate disease entities, only about 20 cases of polycystic kidney disease in horseshoe kidney disease have been described in the literature, with an incidence ranging from 1 in 134 000 to 1 in 8 000 000 live births. We are presenting ultrasound findings of a patient who was incidentally diagnosed with polycystic horseshoe kidney on routine screening.

Post-COVID-19 Myositis Based on Magnetic Resonance Imaging: A Case Report.

The severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2) causes COVID-19, which is known to cause fever, dry cough, exhaustion, headache, and loss of taste and smell. Although fever, sore throat, and cough have historically been the utmost characteristic symptoms of the illness, published case reports have recently started to emphasize additional uncommon and unusual presentations of infection with the coronavirus. In COVID, the musculoskeletal system is seldomly involved. In addition to reviewing the causes and imaging characteristics of COVID-19-related illnesses of the musculoskeletal system, we elaborate on a case of a middle-aged man who developed myositis as sequelae to the COVID-19 infection.

Clinico-radiological evaluation and management of type II radial ray defect in a young female from rural India: case report.

Radial Ray Defect (RRD) is a rare disorder, and the etiology of this disorder is still under discussion. RRD is associated with many medical conditions for which prenatal counselling is of paramount importance. Any association with the family history is still unknown. The patient is a 16-year-old female who came to the orthopaedic clinic complaining of tingling and weakness in the right forearm. On examination, there was a gross deformity in the right forearm with radial deviation of the hand. An X-ray revealed radial ray defect type-2. She previously had a history of perinatal infection during early childhood. Surgery was successfully achieved, and positive results were accomplished. Radial Ray Defect can be focal or associated with other clinical manifestations. The timing of antenatal ultrasound for detecting this musculoskeletal anomaly is crucial. When RRD is associated with other syndromes, counselling to the parents about the quality of life and morbidity comes into play. Treatment is primarily surgical.