Patient autonomy and doctor's concern - a case of intravenous drug abuser.

Intravenous substance abuse is often associated with physical and psychological harm, and often requires urgent medical attention. We report a case of a young male who presented with life-threatening complications of intravenous drug abuse, but refused to give details or agree to the proposed treatment, raising concerns for the team of doctors. A compos mentis patient has a right to decide what should be done to his body. Medical management or surgical interventions cannot be initiated without the patient's consent even if these are lifesaving procedures, or a procedure meant to benefit the patient. Medical practitioner can be liable for assault (criminal law), medical negligence (law of tort), damages (civil action) and even human rights issues may be raised if a patient's autonomy is not respected.

Role of delayed Tc-99m HMPAO labeled leukocyte scintigraphy in the diagnosis of coronary mycotic aneurysm.

Coronary mycotic aneurysms are rare with a poor prognosis. Atherosclerosis often predisposes to aneurysmal dilatation. In children, Kawasaki disease and in adults trauma, vasculitis, syphilis, dissection, and postcoronary angioplasty contribute to coronary mycotic aneurysms. Radiolabeled leukocytes have been used in the diagnosis of prosthetic valve endocarditis and vascular graft infections. Abnormal accumulation of radiolabeled leukocytes have also been reported in infra renal aortic aneurysms. We present a case of a coronary mycotic aneurysm where delayed Tc-99m HMPAO labeled leukocyte imaging played an important role leading to the diagnosis.

Bilateral retinal detachment in a patient with Vogt-Koyanagi-Harada syndrome.

We present a 38-year-old woman with bilateral serous retinal detachments and bilateral panuveitis on fundoscopic exam. CT of the orbits and MRI scans revealed bilateral ocular choroidal thickening and bilateral retinal detachments; however, no other CNS or meningeal lesion was detected. This patient met the clinical criteria for Vogt-Koyanagi-Harada (VKH) Syndrome. Review of VKH syndrome as well as the radiographic findings will be discussed.

Lower cervical dermal sinus tract and associated intraspinal abscess causing meningitis in a child.

Congenital dermal sinus tracts are frequently a cause of recurrent meningitis. We present a case of a rare lower cervical dermal sinus and an associated intraspinal abscess causing meningitis.

CT of small bowel obstruction secondary to a cocaine-filled condom.

Drug smuggling is prevalent in our society. It is now frequently seen in the emergency room as an acute life-threatening emergency. The following case describes one such patient with an emphasis on the CT findings in these cases.

Osteomyelitis mimicking a primary bone tumor in a patient with pulmonary arteriovenous malformation and Osler-Weber-Rendu disease.

Extremity pain is a common presenting symptom seen by the practitioner; the etiology may be related to problems in the bone, joint, soft tissues, or neurovascular bundle. The differential diagnosis is extensive for each, with a careful history and physical exam narrowing the list. Imaging begins with plain radiographs, reserving CT and MRI for further work-up. We report an unusual presentation of osteomyelitis mimicking a bone tumor in a patient with Osler-Weber-Rendu disease.

Adult intussuception as a cause of abdominal symptoms: a case report and review of literature.

Intussusceptions are frequently encountered in children. In adults, they are uncommon and have a different etiology. Our case is one such example of a rare, pathologically proven, recto-rectal intussusception due to an adenocarcinoma with characteristic CT findings.