Fast-Track Registration: A Way to Increase Efficiency in the IR Division.

PURPOSE: To evaluate changes in patient registration process at an academic 2-suite IR Division to determine if moving registration from the waiting room to the vascular holding area decreased amount of time patients spent in the Radiology Department and improved start times. MATERIALS AND METHODS: A data collection sheet was created by evaluating patient-related processes; event timestamps were recorded on the sheet. The control group consisted of 33 patients who registered using the traditional process. The fast-track group consisted of 29 patients who bypassed the traditional registration procedure and were registered by nurses in the vascular holding area. RESULTS: Total time between control and fast-track groups significantly decreased from an average time of 215 minutes to 178 minutes (P = .020). The average start time improved significantly from an average of 63 minutes after scheduled procedure start time for the control group to 33 minutes after the scheduled procedure start time for the fast-track group (P = .009). Start time (P = .022), time spent in recovery area (P = .006), and total time, after correcting for differences in laboratory test turnaround time, (P = .010) decreased in variability after implementation of fast-track registration. CONCLUSIONS: Implementing fast-track registration for outpatient subcutaneous port placement in the IR Division improved start times and decreased total time patients spent in the hospital, while also reducing variability in the process.

HISTOPATHOLOGICAL ANALYSIS OF SCHISTOSOMIASIS IN THE GASTROINTESTINAL TRACT WITH FIRST RECORD OF SCHISTOSOMAL APPENDICITIS FROM SOHAG, UPPER EGYPT.

Schistosomiasis is a chronic granulomatous inflammation that affects many systems in the body including the gastrointestinal tract. Appendiceal schistosomiasis is also described and can be a precursor lesion of schistosomal appendicitis. The present study was done to make a retrospective analysis of histopathological changes in the gastrointestinal tract affected by Sckistosoma mansoni among patients attending Sohag University Hospital, Sohag Governorate between June 2013 and June 2016. A total of 150 colon and 30 appendix specimens were collected through out the period from male infected pa- tients aged between 35-50 years and suffering from abdominal pain and dysentery. Histopathological examination of the tissue biopsies was performed. 5p tissue sections were prepared and examined microscopically. Ten specimens were documented to have intestinal schistosomiasis, nine of the colon 9/150 (6%) were diagnosed as chronic schistosomal colitis and one of the appendix 1/30 (3.3%) as chronic schistosomal appendicitis. Microphotographs of the tissue sections were prepared for histopathological observations. Histopathological examination of all specimens revealed degenerated pinkish and calcified bluish bilharzial eggs in the submucosa and even musculosa with surrounding granulomatous reaction. Bilharzial polyps of the colon were detected in two specimens (20%) and bilharzial worms within venules of the muscle layer in two specimens (20%). During the present study, S. mansoni was documented as a not uncommon cause of chronic colitis and for the first time from Sohag as a cause of chronic appendicitis. All specimens did not show any malignant or premalignant cells.

Unique Presentation of Hematuria in a Patient with Arterioureteral Fistula.

Active extravasation via an arterioureteral fistula (AUF) is a rare and life-threatening emergency that requires efficient algorithms to save a patient's life. Unfortunately, physicians may not be aware of its presence until the patient is in extremis. An AUF typically develops in a patient with multiple pelvic and aortoiliac vascular surgeries, prior radiation therapy for pelvic tumors, and chronic indwelling ureteral stents. We present a patient with a left internal iliac arterial-ureteral fistula and describe the evolution of management and treatment algorithms based on review of the literature.

Repair of a splenic artery aneurysm using a novel balloon-expandable covered stent.

We describe a case of endovascular exclusion of a splenic artery aneurysm. The repair utilized a novel balloon-expandable stent-graft.