scholarly journals Abdominopelvic actinomycosis: spectrum of imaging findings and common mimickers

2014 ◽  
Vol 3 (2) ◽  
pp. 204798161452457 ◽  
Author(s):  
Charikleia Triantopoulou ◽  
Aart Van der Molen ◽  
Ad CMG Van Es ◽  
Maria Giannila
Keyword(s):  
Bowel Wall ◽  
Pelvic Mass ◽  
Wall Thickening ◽  
Inflammatory Infiltration ◽  
Cross Sectional ◽  
Contraceptive Devices ◽  
Intrauterine Contraceptive ◽  
Cross Sectional Imaging ◽  
Bowel Wall Thickening ◽  
Intrauterine Contraceptive Devices

Background Actinomycosis is a rare suppurative disease that may mimic other inflammatory conditions on imaging. Its invasive nature may lead to mass formation and atypical presentation thus making accurate diagnosis quite difficult. Purpose To describe the different aspects of abdominopelvic actinomycosis on cross-sectional imaging and indicate discriminative findings from other inflammatory or neoplastic diseases. Material and Methods In our study we analyzed 18 patients (15 women, 3 men; age range, 25–75 years; mean age, 50 years) with pathologically proved abdominopelvic actinomycosis. Contrast-enhanced abdominal computed tomography (CT) had been performed in all patients. Eleven patients had a history of using intrauterine contraceptive devices. Bowel site, wall thickness and enhancement degree, inflammatory infiltration, and features of peritoneal or pelvic mass were evaluated at CT. Results The sigmoid colon was most commonly involved. Most patients showed concentric bowel wall-thickening, enhancing homogenously and inflammatory infiltration of pericolonic fat was mostly diffuse. In 11 patients, one or more pelvic abscesses were revealed, while a peritoneal or pelvic mass adjacent to the involved bowel segment was seen in three cases. Infiltration into the abdominal wall was seen in three cases while in one case there was thoracic dissemination. Conclusion Actinomycosis is related not only to long-term use of intrauterine contraceptive devices and should be included in the differential diagnosis when cross-sectional imaging studies show concentric bowel wall-thickening, intense contrast enhancement, regional pelvic or peritoneal masses, and extensive inflammatory fat infiltration with abscess formation.

Prevalence of Complications after Interval Postpartum Intrauterine Device Insertion

2021 ◽  
Vol 15 (9) ◽  
pp. 2785-2788
Author(s):  
Saba Abbas ◽  
Sadia Anwar ◽  
Kalsoom Essa Bhattani ◽  
Zubaida Khanum Wazir ◽  
Rubina Babar
Keyword(s):  
Teaching Hospital ◽  
Intrauterine Device ◽  
Contraceptive Device ◽  
Expulsion Rate ◽  
Cross Sectional ◽  
Uterine Infection ◽  
Contraceptive Devices ◽  
Intrauterine Contraceptive ◽  
Intrauterine Contraceptive Devices

Background and Aim: Postpartum intrauterine device (PPIUD) is a reversible, long-term and effective technique of contraception. The intrauterine device (IUD) is inserted within 48 hours of delivery. The immediate insertion of an intrauterine device causes certain complications. The present study aimed to assess the prevalence of complications after Interval Postpartum Intrauterine Device Insertion. Materials and Methods: This cross-sectional study was carried out on 147 women who underwent postpartum IUD (PPIUD) insertions during from January 2021 to June 2021 at Gynecology department, Mufti Mehmood Memorial Teaching Hospital (MMMTH), Dera Ismail Khan and Muhammad Teaching Hospital Peshawar. All the women who delivered and showed willingness for PPIUCD insertion were enrolled and continuously follow-up for 4 to 6 weeks after delivery. Demographic, obstetric, and clinical parameters were recorded on pre-designed medical proforma. PPIUCD insertion after 6 weeks of delivery were followed-up for the evaluation of complications. Uterine infection, medical removal of IUD, IUD expulsion, perforation, and method discontinuation were the outcome variables. SPSS version 20 was used for data analysis. Results: Of the total deliveries, 147 women inserted the postpartum intrauterine contraceptive device (PPIUCD). Of the total, about 122 (83%) women returned for follow-up after 6 weeks. All the women underwent transvaginal insertion of intrauterine contraceptive devices. The PPIUCD insertion related complications with prevalence were uterine infection 26 (21.3%), overall method suspension 17 (13.9%), perforation 20 (16.4%), interceptive uterine device expulsions 25 (20.5%), and intrauterine device removal 32 (26.2%). The severe uterine infection was in 2 (1.7%) cases who were hospitalized. Conclusion: The postpartum intrauterine device cumulative expulsion rate was higher among women compared to the expulsion rate of insertions. The longer duration of bloody lochia flow and delivery intrauterine device insertions were the key risk factors for expulsion of PPIUCD. Women can safely utilize intrauterine contraceptive devices with low complications beyond four week. Keywords: Postpartum intrauterine device; Complications; Intrauterine device expulsion

scholarly journals Role of Multidetector Computed Tomography in Patients of Acute Mesenteric Ischaemia and its Comparison with Clinicosurgical Outcome: A Cross-sectional Study

2021 ◽  
Author(s):  
Narinder Salhotra ◽  
Ritu Dhawan ◽  
Anisha Galhotra ◽  
Arnav Galhotra ◽  
Chandan Kakkar ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Bowel Wall ◽  
Pneumatosis Intestinalis ◽  
Wall Thickening ◽  
Mesenteric Ischaemia ◽  
First Line ◽  
Cross Sectional ◽  
Acute Mesenteric Ischaemia ◽  
Bowel Wall Thickening ◽  
Bowel Dilatation

Introduction: Acute mesenteric ischaemia is an abdominal emergency occurring in nearly 1% of patients presenting with acute abdomen. Early diagnosis is very important for the improved survival of the patient. Acute mesenteric ischaemia frequently presents with non specific features such as vomiting, loose stools and abdominal distension. The classical triad of fever, haematochezia and abdominal pain is seen in only 30% of the patients so, it is difficult to diagnose clinically. Multidetector Computed Tomography (MDCT) is gold standard and first line test to diagnose intestinal ischaemia. Aim: To assess the efficacy of MDCT in the diagnosis of acute mesenteric ischaemia and to compare its outcome with surgical and/or clinical findings. Materials and Methods: In this cross-sectional descriptive study conducted from 1st November 2018 to 31st May 2020, MDCT was performed on 40 patients (23 male; 17 female, age range: 28-93 years). Axial and reconstructed images of each patient were evaluated for evidence of bowel wall thickening, bowel wall attenuation, abnormal wall enhancement, bowel dilatation, mesenteric stranding, ascites, solid organ infarcts, pneumatosis intestinalis or portomesenteric gas, and mesenteric arterial or venous thrombosis. Multidetector CT findings were compared with the surgical findings and clinical outcome. Results were expressed in terms of frequency and percentages. Results: Out of 40 patients, most common cause of acute mesenteric ischaemia was arterial thrombosis, seen in 20 patients (50%) while 13 patients (32.5%) had portomesenteric venous thrombosis and 7 (17.5%) patients were diagnosed with non occlusive mesenteric ischaemia. CT finding of bowel wall thickening and bowel dilatation however non specific were seen in majority of patients (62.5% and 70%, respectively). Mesenteric fat stranding and ascites were seen in 95% and 77.5% cases respectively. Specific signs of acute mesenteric ischaemia includes hypoenhancing and non enhancing bowel walls seen in 27 patients (67.5%). Pneumatosis intestinalis and portomesenteric pneumatosis in 20% patients. A total of 27 patients underwent surgery and 13 patients were managed conservatively. On comparing the CT findings with intraoperative/ histopathological findings, accuracy of MDCT in the diagnosis of acute mesenteric ischaemia in this study was 96.39%. Conclusion: MDCT should be the first line imaging modality to diagnose acute mesenteric ischaemia and to exclude other causes of acute abdomen. It is an excellent and fast modality to diagnose bowel ischaemia, as it can visualise both the bowel and mesenteric changes as well as accurately depict the mesenteric vasculature.

scholarly journals Abdominal Ultrasonogram in Typhoid Fever: A Useful Diagnostic Tool

2016 ◽  
Vol 5 (2) ◽  
pp. 58-63
Author(s):  
Kamrul Ahsan ◽  
Hosne Ara Begum ◽  
Mostafa Shamim Ahsan ◽  
Shamim Momtaj ◽  
Mirza Kamrul Zahid
Keyword(s):  
Lymph Node ◽  
Gall Bladder ◽  
Enteric Fever ◽  
Bowel Wall ◽  
Atomic Energy Commission ◽  
Wall Thickening ◽  
Diagnostic Features ◽  
Cross Sectional ◽  
Lymph Node Enlargement ◽  
Bowel Wall Thickening

Objectives: To See the use of abdominal ultrasonogrphic in the diagnosis of Typhoid fever.Materials and Methods: This cross sectional study on enteric fever was carried out during the period of July 2008 to June 2009 on 30 patients between 2 months 12 years of age of either sex admitted with the clinical diagnosis of enteric fever having positive hemoculture for Salmonella typhi or paratyphi and or significant Widal test. Abdominal USG was done at Centre for Nuclear Medicine and Ultrasound, Bangladesh atomic energy commission, Sir Salimullah Medical College & Mitford Hospital.Result: On ultrasonogram, hepatomegaly observed in 93.3% cases, splenomegaly in 53.3% cases, thickened bowel wall in 46.7% cases, enlarged mesenteric lymph node in 63.3% cases and 30% cases showed gall bladder changes. Ultrasonogram was done on first week of fever in 33.3% cases, on second week in 43.3% cases and third week in 23.3% cases. Out of them ultrasonogram done on first day of admission in 6.6% cases, on second day in 80% cases and third day in 13.3% cases. In first week the bowel wall thickening found in 10% cases, lymph node enlargement in 23.3% cases and gall bladder changes in 3.3% cases, in second week the bowel wall thickening found in 23.3% cases, lymph node enlargement in 26.6% cases and gall bladder changes in 20% cases, in third week the bowel wall thickening found in 13.3% cases, lymph node enlargement in 13.3% cases and gall bladder changes in 6.6% cases. Sonologic findings of bowel wall thickening, lymph node enlargement and gall bladder changes found in 23.33% cases in 1st week, 33.33% cases in 2nd week and 13.33% cases in 3rd week.Conclusion: In endemic areas like Bangladesh ultrasound findings of hepatomegaly, splenomegaly, mesenteric lymphadenopathy, bowel wall thickening, gall bladder changes are useful diagnostic features of typhoid fever.J. Paediatr. Surg. Bangladesh 5(2): 58-63, 2014 (July)

Correlation of Bowel Wall Thickening Seen Using Computerized Tomography With Colonoscopies

2017 ◽  
Vol 27 (3) ◽  
pp. 154-157 ◽  
Author(s):  
Arda Isik ◽  
Mehmet Soyturk ◽  
Sakir Süleyman ◽  
Deniz Firat ◽  
Kemal Peker ◽  
...  
Keyword(s):  
Computerized Tomography ◽  
Bowel Wall ◽  
Wall Thickening ◽  
Bowel Wall Thickening
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