Living-related liver transplantation.

We report here, the first pediatric living-related liver transplant in Saudi Arabia and the Middle East. Our patient is a 2 year old girl with a diagnosis of progressive familial intrahepatic cholestasis, causing intractable pruritus and failure to thrive requiring liver transplantation. The child was successfully transplanted using a segment of her mother's liver for living-related liver transplantation. Two years post-transplantation the patient is doing well. With the ongoing crises in cadaveric organ availability and the high prevalence of pediatric liver disease, living related liver transplantation is an ideal solution to this difficult and challenging problem.

Rare bone infections "excluding the spine".

Bone infections are usually due to haematogenous spread from distant infected organs. Spread of local sepsis or contamination of open wounds are less frequent routes of infection. The commonest cause of osteomyelitis is Staphylococcus aureus. The term rare bone infections refers to diseases where only a few percent affect bone or diseases which are essentially rare; these include bacteria, fungi, parasites and non-specific conditions. Common examples are tuberculosis, salmonellosis, brucellosis, hydatidosis, madura, actinomycosis, aspergillosis and American fungal infections. Certain bone infections have become exceedingly rare, particularly atypical mycobacteria, viral embryopathies and spirochaetes. Rare bone infections are encountered in many parts of the world commonly in the tropics and in the U. S. Immunocompromise and ease of travel can lead to increased incidence. A high index of clinical suspicion is necessary for diagnosis. Specific laboratory diagnosis is not always possible. Radiographs, computed tomography, isotope studies and magnetic resonance are useful but may not make the diagnosis. Aspiration or biopsy is necessary. Rare bone infections may simulate non-infective bone lesions.

Isolated hepatic mucormycosis in an immunocompetent child.

A case of isolated localized hepatic mucormycosis in an immunocompetent 3 1/2-yr-old girl with concomitant acute toxoplasmosis is described. Mucormycosis is rare in immunocompetent patients, and hepatic mucormycosis has so far been described only in the context of disseminated disease. The infection resolved spontaneously without surgical debridement and/or appropriate medical therapy with amphotericen B.

Role of CT and MR imaging in the management of tuberculous spondylitis.

Tuberculous spondylitis is an infection involving one or more of the components of the spine, namely the vertebral body, intervertebral disc and ligaments, paravertebral soft tissues, and the epidural space. The causative organism belongs to one of the different strains of Mycobacterium tuberculosis. The role of CT and MR imaging in the diagnosis and management of tuberculous spondylitis is reviewed, and the differential diagnosis of these appearances is discussed. The possible impact of HIV infection on the number of reported cases and their mode of presentation also is considered. The need for prompt diagnosis is emphasized.

Imaging features of musculoskeletal brucellosis.

Brucellosis is endemic in certain parts of the world. Musculoskeletal involvement is the most common complication of brucellosis, and the spine is most frequently affected. Between November 1985 and March 1993, 334 patients with radiologically proved musculoskeletal brucellosis were seen. Involvement of the spine was either focal or diffuse, with a predilection to the lumbar region. Erosions and sclerosis in vertebral end plates, changes of inflammation at scintigraphy or magnetic resonance (MR) imaging, and intact disks were hallmarks of the focal form. Osteomyelitis of neighboring vertebrae, involvement of the intervening disk, and moderate epidural extension were features of diffuse brucellar spondylitis. The great majority of joints with scintigraphic evidence of disease demonstrated normal radiographic findings. Evidence of osteomyelitis or destructive arthritis was encountered in only a few cases. Although radiography is sufficient for demonstrating focal brucellosis, MR imaging is better for assessing diffuse disease.

Case report: investigation of chyluria.

We present a case of chyluria in which the demonstration of abnormal lymphaticourinary communication was established by conventional lymphangiography. Radiocolloid lymphoscintigraphy failed to demonstrate the site of leakage, probably due to technical factors which are discussed.

Premature tracheobronchial, laryngeal and costochondral cartilage calcification in children.

Two children with premature tracheobronchial, laryngeal and costochondral cartilage calcification are described. Both patients had associated congenital cardiovascular anomalies; one of them having features of Keutel syndrome.