Neglected areas on thorax computed tomography evaluation in patients with chronic obstructive pulmonary disease: Paravertebral muscles and para-aortic adipose tissue.

INTRODUCTION: This study, investigated the para-aortic adipose tissue cross-sectional area, a novel predictor of cardiovascular diseases and degenerative changes in the paravertebral muscles, in patients with chronic obstructive pulmonary disease (COPD). METHOD: One hundred cases diagnosed as COPD and 50 healthy individuals with similar demographic characteristics were evaluated. Para-aortic adipose tissue cross-sectional area (mm2 ), subcutaneous adipose tissue thickness (mm), paravertebral muscle area (mm2 ) and fat deposition in muscle tissue were assessed radiologically. RESULTS: Paravertebral muscle mass was lower in the patient group compared to the healthy individuals (471.41 ± 157.71 mm2 and 561.58 + 151.03 mm2 , respectively; P = 0.001). Paravertebral muscle attenuation values were also lower in the patient group, and the grade of deposition increased (P = 0.012 and P = 0.045, respectively). Although subcutaneous adipose tissue thicknesses were similar in the patient and control groups, para-aortic adipose tissue cross-sectional area was higher in the patients with COPD than in the control group (439.34 ± 267.17 mm2 and 333.82 ± 165.23 mm2 , respectively, P = 0.012). The correlation between subcutaneous adipose tissue and para-aortic adipose tissue observed in the healthy group was not present in the subjects with COPD. CONCLUSION: Chronic obstructive pulmonary disease causes morphological changes in paravertebral muscles and para-aortic adipose tissue. Degenerative changes in the paravertebral muscles occur secondary to systemic inflammation, comorbidity and drugs used in COPD. Factors such as insulin resistance and steroid use result in an increase in para-aortic adipose tissue mass.

Amyand's hernia detected incidentally in two patients.

The appendix is rarely present inside the inguinal hernia sac. The risk of appendicitis increases in these patients since the blood supply to the appendix can be impaired. The condition is frequently asymptomatic, and even if symptomatic it gives rise to non-specific symptoms. There is no specific laboratory finding. Diagnosis is frequently made with radiological imaging. We report two cases diagnosed as Amyand's hernia with CT.