Ultrasonography of the lower limbs for deep vein thrombosis at the University Hospital of the West Indies

A study was conducted on all patients referred to the ultrasound service of the radiology department of the University Hospital of the West Indies, Kingston, Jamaica, for evaluation of a clinical diagnosis of thrombosis of the deep veins of the lower limb, during the period January 1, 1995, to December 31, 1999. The calf veins were not routinely examined; this study was limited to the popliteal, superficial and deep femoral veins. Two hundred and seventy-four females and 104 males were referred. Seventy females and 32 males had ultrasound findings of deep thrombosis (DVT). The significant findings were that the male: female ratio for confirmed DVT was approximately 1:2; 26 percent of referrals had DVT on ultrasound; DVT was more common on the left and the popliteal vein (48 percent) and the superficial femoral vein (47 percent) accounted for most documented cases of DVT but thrombosis of the profunda femoral vein was unusual accounting for only 5 percent of cases. (AU)

Ameloblastoma in Jamaica: analysis of 47 cases [abstract]

OBJECTIVE: To analyse all the cases of ameloblastoma seen in two major public hospitals in Jamaica, over a 15-year period, and to compare our results with what has been previously documented. No such analysis has been carried out in Jamaica or elsewhere in the English-speaking Caribbean. MATERIALS AND METHODS: The case files of patients histologically diagnosed to have ameloblastoma at both the Kingston Regional Hospital and Cornwall Regional Hospital in Jamaica from 1980 to 1995 were retrieved and information about this odontogenic tumour was documented. RESULTS: A total of 47 new cases of ameloblastoma were recorded between 1980 and 1995. This number accounted for 16.03 percent of all jaw bone tumours in Jamaica, and 38.2 percent of jaw bone lesions of odontogenic origin. These cases of ameloblastoma accounted for 67 percent of odontogenic tumours with the exception of odontomas. The mean age was 29.1 years with a range of 13-67 years. The male-female ratio was 1:1.14 (an almost equal sex ratio). Only 3 cases presented in maxilla. CONCLUSION: The clinicopathological presentation of ameloblastoma in Jamaica is similar to what has been documented by other authors throughout the world. (AU)

A sonographic study of kidney dimensions in a sample of healthy Jamaicans

A sonographic study of 49 randomly selected healthy Jamaicans was conducted to establish a guide for renal dimensions in the population. The mean length of the right kidney was 9.7 ñ 0.7 cm and the left 10 ñ 0.7 cm. The left kidney was longer than the right in the overall group and in males. There was no difference in width between right or left kidneys in the groups as a whole or within either gender. There was a significant association between the weight of males and the width of their kidneys; however, this association was not seen in females. The lone association between weight of the participants and renal length occurred in females and only with respect to the left kidney. Lengths and widths of kidneys were not associated with height in either gender. Renal surface area (RSA) was similar between the genders and also between right and left kidneys. Similarly, there was no significant association between renal length and body surface area (BSA) overall or within the genders. Renal index (RI) which is more reliable at assessing renal parenchymal mass than renal length alone was 20.92 and 22.86 for the right and left kidneys, respectively in males. Similarly, RI for the right and left kidneys in females was 23.76 and 25.54, respectively.(AU)

A sonographic study of kidney dimensions in a sample of healthy Jamaicans

A sonographic study of 49 randomly selected healthy Jamaicans was conducted to establish a guide for renal dimensions in the population. The mean length of the right kidney was 9.7 ñ 0.7 cm and the left 10 ñ 0.7 cm. The left kidney was longer than the right in the overall group and in males. There was no difference in width between right or left kidneys in the groups as a whole or within either gender. There was a significant association between the weight of males and the width of their kidneys; however, this association was not seen in females. The lone association between weight of the participants and renal length occurred in females and only with respect to the left kidney. Lengths and widths of kidneys were not associated with height in either gender. Renal surface area (RSA) was similar between the genders and also between right and left kidneys. Similarly, there was no significant association between renal length and body surface area (BSA) overall or within the genders. Renal index (RI) which is more reliable at assessing renal parenchymal mass than renal length alone was 20.92 and 22.86 for the right and left kidneys, respectively in males. Similarly, RI for the right and left kidneys in females was 23.76 and 25.54, respectively.

Solid and Papillary epithelial neoplasm. Ultrasound and CT features of an unusual pancreatic tumour

The ultrasonographic and computed tomography features of four cases of solid and papillary epithelial neoplasm (SPEN) - a rare pancreatic tumour - are described. Although not diagnostic, the presence of these imaging features in the typical clinical setting may permit pre-operative radiological diagnosis and facilitate planning for curative surgery for this malignant tumour which has an excellent prognosis even without further adjuvant therapy.(Au)

Solid and Papillary epithelial neoplasm. Ultrasound and CT features of an unusual pancreatic tumour

The ultrasonographic and computed tomography features of four cases of solid and papillary epithelial neoplasm (SPEN) - a rare pancreatic tumour - are described. Although not diagnostic, the presence of these imaging features in the typical clinical setting may permit pre-operative radiological diagnosis and facilitate planning for curative surgery for this malignant tumour which has an excellent prognosis even without further adjuvant therapy.

Young patients with stroke at the UHWI - the CT findings - Poster presentation

There is not much data on young patients with stroke (< 50 yrs) from the Caribbean. This paper sought to identify the types of stroke seen in young, Caribbean patients, with a view to noting trends and suggesting intervention strategies. The study is a retrospective review of patients (<50 yrs with stroke who had Computerised Tomography (CT scans) of the brain at the UHWI, from January 1, 1998 to December 31, 1998. Data were collated from the CT register of the Xray Department of UHWI. Results were available for 81 patients (43 females and 38 males). Overall, 62 percent of study sample had infarct (71 percent males, 38 percent females), 27 percent intra-cerebral bleed (15 percent males, 34 percent females); 11 percent subarachnoid haemorrhages. In females 11 - 40 yrs, 61 percent of CVAs were on the right and 39 percent on the left; between 41 and 50 yrs. 92 percent of CVAs were left sided and 8 percent on the right. In males 11 - 40 yrs, 66 percent of CVAs were on the right and 33 percent on the left; between 41 and 50 yrs, 45 percent were on the right and 55 percent on the left. This preliminary study suggests that in the population reviewed, there is a similar incidence of CVAs in males and female. Infarcts are the most common results of a CVA followed by intra-cerebral bleed and subarachnoid haemorrhage. Infarcts are more common in males than females whilst intracerebral bleeds are more common in females. Under the age of 41 yrs, CVA is more common on the right than the left whilst between 41 and 50 yrs, they are more common on the left; this is more so in females in whom 92 percent of lesions were on the left in the age group 41 - 50 years.(AU)

Normal kidney dimensions in healthy Jamaicans: a sonographic study - Poster presentation

A sonographic study of 49 randomly selected healthy adult Jamaicans was conducted to establish a guide for renal dimensions in the population. The mean length of the right kidney was 9.7+/-0.7 cm and the left 10+/-0.7cm. The left kidney was longer than the right in the overall group and in males. There was no difference in width between left or right kidneys in the group as a whole or within either sex. There was a significant association between the weight of males and width of their kidneys; however, this association was not seen in females. The lone association between weight of participants and renal length occurred in females and only with respect to the left kidney. Lengths and widths of kidneys were not associated with height in either gender. Renal surface area (RSA) was similar between the sexes and also between right and left kidneys. Similarly, there was no significant association between renal length and body surface area (BSA) overall or within the sexes. The ratio of renal surface area to body surface area (BSA) which gives an indication of renal mass was positively correlated in males but not in females (AU)

Normal ultrasound in abdominal trauma - clinical outcomes

Imaging plays an increasingly important role in trauma and the access to CT scans in more advanced centres has decreased the number of exploratory laparotomies. Ultrasound has not been given the status of CT scanning in trauma centres because it does not give a panoramic view of the abdomen, is operator dependent and surgeons are not as "comfortable" with the images generated. It is however cheaper and more readily available than CTs, especially in developing countries. The aim of this study is to determine the negative value of abdominal ultrasound in trauma. A retrospective study was done using data from the Ultrasound register of the Radiology Department and the Trauma Registry of the Department of Surgery for the period 1st August 1998 to 28th February 1999. Sixty-four (64) patients had normal abdominal ultrasounds: twenty-four (24) for penetrating and forty (40) for blunt trauma. Fifteen (15) patients were female and forty-nine (49) male. Fifty-five (55) patients were discharged from A&E. Nine (9) patients were admitted to the ward of which eight (8) were subsequently discharged without surgical intervention. One (1) patient had an exploratory laparotomy which was negative for injury. No patient developed problems on follow-up. In this preliminary study, normal ultrasound in blunt or penetrating trauma had a 100 percent negative predictive value. We conclude that in competent hands, ultra-sound is useful in decreasing both the number of admissions to hospitals and the need for exploratory laparotomies.(AU)

CT appearance of the rapunzel syndrome: an unusual form of bezoar and gastrointestinal obstruction

The CT appearance oa an unusual type of trichobezoar which cause the Rapunzel syndrome are described. This syndrome is characterized by intestinal obstruction secondary to a bezoar possessing a tail which extends to or beyond the ileocecal valve. Most cases of bezoar are diagnosed with plain films or barium meal, but CT may be requested in patients who present with abdominal masses. The Rapunzel syndrome may be diagnosed with a combination of the CT findings and the history.(AU)

Hydrostatic reduction of acute intussusception: a prospective study

Data were collected prospectively on 57 Jamaican children presenting with 62 episodes of acute intussusception over a two year period, for whom operative and hydrostatic methods of reduction were employed. 31 (54 percent) of 57 episodes were reduced successfully using barium (42), saline (11) and air (4) hydrostatically. Among the 31 other episodes, 15 had ileo-colic intussusception, seven caeco-colic, six ileo-ileo-colic and one ileo-ileal. Two patients had spontaneous reduction discovered at surgery. There were two episodes of barium hydrostatic perforation of the colon leading to death in one patient. Hydrostatic reduction is recommended as the first therapeutic option for acute intussusception because it spares the patient a major operative procedure when successful(AU)

Autoimmune haemolytic anaemia, immune thrombocytopenia, and leucopenia - an unusual presentation of hodgkin's disease

We report an unusual case of modular sclerosing Hodgkin's disease in a 17 year old women presenting with intermittent fever, progressive weight loss and enlarged cervical and anxillary lymp nodes. Laboratory test revealed severe Coombs' positive haemolytic anaemia, and progressive thrombocytopenia and leucopenia, associated with erythroid, myeloid and megakaryocytic hyperplasia, but with no evidence of lymphomatous infiltration in the bone marrow. Transfusion of compatible blood became possible only after prednisone therapy and a single intravenous dose of vincristine. Appropriate chemotherapy led to normalization of the peripheral blood counts and a negative direct Coombs' test.(AU)