Percutaneous treatment of hepatic hydatid cyst in pregnancy.

A 20 cm hepatic hydatid cyst with daughter cysts, was diagnosed in a primigravida in the fifteenth week of pregnancy and was managed percutaneously. No complications occurred and the patient subsequently gave birth to a healthy baby.

Percutaneous renal hydatid cyst treatment: long-term results.

BACKGROUND: To evaluate the effectiveness of percutaneous treatment of renal hydatid cysts. METHODS: Four male and one female (14-52 years old, mean = 37 years) patients with five renal cysts were treated percutaneously. All five cysts from the patients were pure fluid collections, which were consistent with type I hydatid cysts according to Gharbi's classification. After entering the cystic cavity under sonographic guidance, cystic fluid was aspirated, and the cavity was filled with hypertonic saline (15% NaCl). In three patients with cysts larger than 6 cm in diameter, catheterization was performed under fluoroscopic guidance, and the cavity was filled with 95% absolute alcohol to sclerotize the cyst walls. In two patients with cysts smaller than 6 cm in diameter, the procedure was carried out by a technique in which the cyst was puncture aspirated, hypertonic saline solution was injected, and the cyst was reaspirated. The patients were followed by ultrasonography and computed tomography. Follow up was 5-62 months (mean = 33.8 months). RESULTS: Sonographic follow-up examinations indicated a gradual decrease in cyst size and volume. The size reduction was significant (p < 0.05). The volume reduction rate was 55-95% (mean = 81%). During follow up, fluid components of all five cysts reduced gradually and finally disappeared, leaving a remnant that is called a "pseudotumor appearance." Neither mortality nor any dissemination was encountered during follow up. The only complication seen in this series was an abscess that was successfully treated with percutaneous drainage. CONCLUSION: According to the results of our study, percutaneous treatment of renal hydatid cysts avoids the morbidity of open surgery and preserves the residual function of the kidney.

Magnetic resonance imaging of posterior pituitary for evaluation of the neurohypophyseal function in idiopathic and autosomal dominant neurohypophyseal diabetes insipidus.

We investigated the role of MR imaging for evaluation of the functional status of the neurohypophyseal system in both idiopathic central diabetes insipidus (DI) and familial autosomal dominant neurohypophyseal DI. The patients and family with DI were analyzed retrospectively for the presence or absence of posterior pituitary gland hyperintense signal on MR images. A total of 19 adult patients with idiopathic central DI, 7 members of a family with autosomal dominant DI and 20 control subjects were included in the study. Diagnosis of idiopathic DI was based on the presence of central DI in the absence of any alteration that is known to be responsible for DI. The patients were studied retrospectively and the morphology and intensity of the posterior lobe by MR imaging was assessed by blinded reading. In all patients with idiopathic central DI and the affected members of the family, the posterior bright signal was absent while the stalk was normal on MR images. In contrast, normal posterior pituitary bright signal and stalk were found in unaffected members of the family and all control subjects. We conclude that MR imaging of the posterior pituitary lobe can be used to evaluate the functional status of the neurohypophyseal system in idiopathic central DI and familial autosomal dominant DI.

Location of the ostia of the renal arteries in the aorta.

A total of 30 adult abdominal aorta specimens dissected from cadavers was used in our study. The location of the ostium of the superior mesenteric a. relative to the ostium of the celiac trunk was identified on the aortic wall. Following this, the locations of the ostia of the renal aa. on the internal wall of the abdominal aorta were examined relative to the ostia of the arteries mentioned earlier. The ostium of the superior mesenteric a. was usually localized on the inferior-right side of the ostium of the celiac trunk. The mean value of the distance between the ostia was 17.9 mm. The ostium of the right renal a. was more cranial than the ostium of the left renal a. (53.3%). However, the ostia of both right and left renal aa. were at the same level in three cases (10%). Locations of the ostia of the renal aa. were usually on the lateral and anterolateral regions of the aortic wall. This study was carried out in order to contribute to selective angiography and surgical interventions for the removal and transplantation of organs, particularly of the kidney. Our results are compared with previous similar studies in man.

Prenatal diagnosis of autosomal recessive osteopetrosis, infantile type, by X-ray evaluation.

Prenatal diagnosis for infantile osteopetrosis was attempted during the third pregnancy of a first-cousin marriage whose family history revealed an affected previous child. At the 25th week of pregnancy, fetal X-ray evaluation revealed marked sclerosis of osteopetrotic bone and metaphyseal splaying and clubbing of both femurs. The pregnancy was terminated and repeated X-rays and histopathological examination of fetal bone (femur) confirmed the diagnosis.

CT-guided percutaneous drainage of psoas abscess.

Two cases of pyogenic psoas abscess were diagnosed and treated by CT-guided percutaneous catheter drainage. In these 2 patients there was rapid clinical improvement and tomographic disappearance of the masses. Image-guided percutaneous drainage of psoas abscess appears to be a safe and effective alternate to open surgical drainage.