Ruptured mediastinal pseudocyst with pancreaticopleural fistula formation in a 15-year-old boy presenting with white-out hemithorax: A case report

Pancreaticopleural fistula (PPF) is a rare complication of chronic pancreatitis described more commonly in adults with alcoholic and necrotizing pancreatitis. We report a rare case of ruptured mediastinal pseudocyst with the formation of PPF in a 15-year-old boy who presented with progressive dyspnea and large left-sided pleural effusion that recurred despite repeated drainage. On the basis of imaging findings and pleural fluid analysis, the diagnosis of PPF with ruptured mediastinal pseudocyst was made. The diagnosis of PPF should be considered in patients with non-resolving large left-sided pleural effusions. The diagnosis can be confirmed either by significantly raised amylase levels in pleural fluid or direct visualization of the fistula on Computed tomography/magnetic resonance cholangiopancreatography.

Verumontanum Polyp in an Adult Man: Diagnosis by Ultrasonography

The fibroepithelial polyp of the urethra is rare in adults. Hematuria and obstructive urinary symptoms are the most common findings. The investigation of these polyps usually includes imaging exams (voiding cystourethrography and ultrasonography) and urinary endoscopy. However, the diagnosis is primarily established by pathology. Ultrasonography can aid in diagnosis, as it can identify a polypoid lesion that can extend to the bladder neck, and cystourethroscopy allows the direct visualization of the lesion. We report this case of a polyp of the prostatic urethra in an adult male using prospective real-time sonographic diagnosis.

Manuscript Title: Characterization of Microannuli at the Cement-Casing Interface: Development of Methodology

Formation of microannuli at the interface of cement-casing can create well integrity issues. X-ray CT and Optical microscopy are technological trends that may have potential for direct visualization of microannuli. CT has an advantage of providing non-destructive visualization of microannuli, but its resolution suffers with increase in casing thickness. Conversely, Optical microscopy has the potential of providing higher resolution needed to detect smaller sized microannuli; however, information about microannuli is limited to only a few sections where samples have been sliced. The objective of the current article is to describe a methodology to examine the interface of cement-casing. Experimental work was combined with literature review. This includes both direct visualization methods, evaluation of current trends to better understand the characteristics and geometric variation of relevant leakage paths. We generate test specimens consisting of cement plugs, various steel casing thickness and nano-coated aluminium casings. Hydraulic sealability tests were conducted by injecting water at the cement-casing interface. Flow rates are then interpreted in terms of microannuli aperture and direct visualization of the cement plug-casing interface by CT and Optical microscopy was implemented. The experimental findings of this article will form a basis for studying geometry and size of microannuli as well as modelling of fluid migration.

ULTRASOUND - A BLESSING FOR REGIONAL ANAESTHESIA

Use of USG in regional nerve blocks is increasing day by day. With the help of USG clinician can view real time image of patient’s anatomy, which offers a new standard in nerve location and needle placement. It allows direct visualization of local anesthetic spread around the nerve. USG guided nerve blocks allow reliable and safe anaesthesia and analgesia. USG is a blessing in a way that, it offers high success rate with low complications, in regional nerve blocks.