scholarly journals ULTRASOUND, CT-SCAN, AND LAPAROSCOPY

2008 ◽  
Vol 15 (01) ◽  
pp. 171-174
Author(s):  
SUMAIRA KANWAL ◽  
MUHAMMAD ZUBAIR ◽  
SULTAN MEHMOOD ◽  
Riaz Hussain Dab

Objective: To evaluate the comparative diagnostic efficacy of Ultrasound,CT-Scan, and Laparoscopy in the diagnosis of non-palpable undescended testes in pediatric patients. Design:Comparative study.Setting: Surgical and pediatric surgical department of B V Hospital (QAMC) Bahawalpur and AlliedHospital Faisalabad. Period: From April 2006 to April 2007. Materials & Method: A total forty boys with non palpabletestis were subjected to Ultrasound, CT-Scan and diagnostic laparoscopy in a period of one year. The patients above12 years and with cardiovascular anomalies were excluded from the study. Laparoscopy was performed under generalanesthesia and findings were compared with Ultrasound and CT-Scan. Sensitivity and specificity of each werecalculated. Results: Diagnostic accuracy of Ultrasound was 25%, CT-Scan was 64% and Laparoscopy was 100%.Sensitivity was found to be 20%, 63% and 100% and specificity was 10%. 50%and 100%forUltrasound, CT-Scan andLaparoscopy, respectively. Conclusion: Diagnostic laparoscopy is far more superior as compared to Ultrasound andCT-Scan in the diagnosis of non palpable testis.

2021 ◽  
Vol 10 (3) ◽  
pp. 205846012198931
Author(s):  
Nis E Larsen ◽  
Eva Mikkelsen ◽  
Anders R Knudsen ◽  
Lars P Larsen

Background One of the main concerns using low-dose (LD) CT for evaluation of patients with suspected intestinal obstruction or pneumoperitoneum is the potential need to make an additional standard-dose (SD) CT scan (retake) due to insufficient diagnostic accuracy of the LD CT. Purpose To determine the frequency of retakes and evaluate the diagnostic accuracy of LD CT for the assessment of intestinal obstruction and pneumoperitoneum. Material and Methods This retrospective study registered all LD CT scans over a one-year period at Aarhus University Hospital, Denmark in patients with suspected intestinal obstruction or perforation, comprising a total of 643 LD CT scans. A retake was defined as a SD CT scan of the abdomen and pelvis performed with or without intravenous contrast within 72 h after the initial LD CT due to either continued suspicion of intestinal obstruction or perforation or due to unclarified secondary findings. The sensitivity and specificity of LD CT for diagnosing intestinal obstruction and pneumoperitoneum compared to the discharge diagnoses of the scanned patients were determined. Results The frequency of retakes was 3%. The overall LD CT sensitivity and specificity for assessment of patients with suspected intestinal obstruction and pneumoperitoneum was 83% and 99%, respectively, but higher in certain subgroups. Conclusions LD CT led to few retakes and had a high diagnostic accuracy for diagnosing intestinal obstruction and pneumoperitoneum. Thus, LD CT can be recommended as the examination of choice in patients with suspected intestinal obstruction or perforation in order to reduce radiation dose.


2019 ◽  
Vol 17 (3.5) ◽  
pp. HSR19-110
Author(s):  
Leigh Selesner ◽  
Gabrielle Gauvin ◽  
Dorotea Mutabdzic ◽  
Eileen O’Halloran ◽  
Maxwell Kilcoyne ◽  
...  

Introduction: Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CS/HIPEC) has led to improved survival in select patients with peritoneal surface malignancies. Predicting the volume of disease and any unresectable disease is important for determining CS candidacy. Computed tomography (CT) scan is the preoperative assessment of choice, and diagnostic laparoscopy (DL) is also supported in the literature but has not been widely adopted. In this study, we report our experience comparing and evaluating the role of imaging and DL in the preoperative assessment of patients being considered for CS/HIPEC. Methods: Patients considered for CS/HIPEC at our tertiary cancer center between January 2012 and December 2017 were included. Diagnostic modality sensitivity and specificity were calculated by comparing findings on CT scan and DL to findings at the time of laparotomy and on final pathology. Specificity and sensitivity of the 2 modalities were compared using the McNemar Chi-square test. Results: Our analysis included 71 patients (60.5% male, mean age of 54.9) seen in consultation for CS/HIPEC. Primary cancer diagnosis was 57.7% colorectal cancer, 25.4% pseudomyxoma peritonei, 8.5% mesothelioma, and 8.5% adenocarcinoma of unknown primary. DL was done in 42.3% of patients (median time of 30 days between CT and DL) and an open procedure was done directly after CT in 39.4% (median interval time of 39 days). Findings of DL identified 70% as being unresectable and hence ineligible for HIPEC. The median interval time between 2 operations was 29 days (range, 16–42). When comparing diagnostic modalities to open surgery and final pathology, CT had a sensitivity and specificity of 48.2% and 76.4% and DL, 68.2% and 88.9%, respectively. DL was significantly more sensitive and specific than CT (χ2=5.54; P<.0186) at predicting ascites, small bowel, omental, liver, and lymph node involvement. Conclusion: Our results support the recommendation for performing DL prior to open exploration in patients considered for CS/HIPEC. In our cohort, DL was significantly more sensitive and specific than CT in predicting disease volume and distribution. While there is obviously greater risk to an invasive modality compared to non-invasive CT scan, routine performance of DL can potentially avoid laparotomy without CS/HIPEC in a large proportion of patients. These results will be used to inform the next phase of our study: a prospective clinical trial.


2020 ◽  
Vol 4 (1) ◽  
pp. 52-57
Author(s):  
Noflih Sulistia ◽  
Bambang Soeprijanto ◽  
Indrastuti Normahayu ◽  
Lenny Violetta

Renal trauma in children is more common than in adults. Clinically in pediatric patients with renal trauma do not always describe the degreeof trauma. Radiological examination, especially abdominal CT-scan with contrast, can help evaluate the damage to the kidneys so that it candetermine the degree of trauma.


2018 ◽  
Vol 2 (S1) ◽  
pp. e000125
Author(s):  
Khyati Vaja ◽  
Mukesh Suvera

Aims and Objectives: To know the most common surgical problems in pediatric patients presented with inguino-scrotal swellings and management done routinely. Methodology: This study was carried out in the department of general surgery, Sharadaben hospital and pediatric surgery of VS hospital, Ahmedabad. The cases were studied for a period of about one year (January, 2017 to Dec, 2017) and all children below 12 years of age, presenting to us with inguinoscrotal swellings were included in this study. The information was analysed in terms of age, diagnosis, procedure carried out and outcome. Results: Amongst the 150 children under the age of 12 years, 143 patients were males and 7 were females. Among these 150, 52 cases were of hydrocoele, 70 cases of hernia (of which 63 were males and 7 were females), 25 cases of undescended testis and 3 cases of epididymo orchitis were documented. All cases underwent simple herniotomy for hernia and hydrocoele, orchidopexy for undescended testis. The length of hospital stay ranged from 2-4 days with mean of 2.46 days. 11 children in the study were documented to have short term complications, all of which were recognised in the hospital and managed with good results. Conclusion: Hernia and Hydrocoele in children are often congenital and diagnosed clinically (history and examination). Indirect inguinal hernia are more common than other groin hernias. Open herniotomy is the operation of choice for inguinal hernia in children.


2019 ◽  
Vol 11 (1) ◽  
pp. 22-25
Author(s):  
Mangal Mahajan ◽  
◽  
Amol Bandgar ◽  
Priscilla Joshi ◽  
John Dsousa ◽  
...  
Keyword(s):  
Ct Scan ◽  

2020 ◽  
Vol 13 (4) ◽  
pp. 184-190
Author(s):  
Muhammad Irfan ◽  
Abdul Rasheed Qureshi ◽  
Zeeshan Ashraf ◽  
Muhammad Amjad Ramzan ◽  
Tehmina Naeem ◽  
...  

ABSTRACT Background: Conventionally Pleural effusions are suspected by history of pleuritis, evaluated by physical signs and multiple view radiography. Trans-thoracic pleural aspiration is done and aspirated pleural fluid is considered the gold-standard for pleural effusion. Chest sonography has the advantage of having high diagnostic efficacy over radiography for the detection of pleural effusion. Furthermore, ultrasonography is free from radiation hazards, inexpensive, readily available  and feasible for use in ICU, pregnant and pediatric patients. This study aims to explore the diagnostic accuracy of trans-thoracic ultrasonography for pleural fluid detection, which is free of such disadvantages. The objective is to determine the diagnostic efficacy of trans-thoracic ultrasound for detecting pleural effusion and also to assess its suitability for being a non-invasive gold-standard.   Subject and Methods: This retrospective study of 4597 cases was conducted at pulmonology  OPD-Gulab Devi Teaching Hospital, Lahore from November 2016 to July 2018. Adult patients with clinical features suggesting pleural effusions were included while those where no suspicion of pleural effusion, patients < 14 years and pregnant ladies were excluded. Patients were subjected to chest x-ray PA and Lateral views and chest ultrasonography was done by a senior qualified radiologist in OPD. Ultrasound-guided pleural aspiration was done in OPD & fluid was sent for analysis. At least 10ml aspirated fluid was considered as diagnostic for pleural effusion. Patient files containing history, physical examination, x-ray reports, ultrasound reports, pleural aspiration notes and informed consent were retrieved, reviewed and findings were recorded in the preformed proforma. Results were tabulated and conclusion was drawn by statistical analysis. Results: Out of 4597 cases, 4498 pleural effusion were manifested on CXR and only 2547(56.62%) pleural effusions were proved by ultrasound while 2050 (45.57%) cases were reported as no Pleural effusion. Chest sonography demonstrated sensitivity, specificity, PPV, NPV and diagnostic accuracy 100 % each. Conclusions: Trans-thoracic ultrasonography revealed an excellent efficacy that is why it can be considered as non-invasive gold standard for the detection of pleural effusion.


2021 ◽  
pp. 1-11
Author(s):  
Bing-Jie Xiang ◽  
Min Jiang ◽  
Ming-Jun Sun ◽  
Cong Dai

<b><i>Objective:</i></b> Fecal calprotectin (FC) is a promising marker for assessment of inflammatory bowel disease (IBD) activity. However, the utility of FC for predicting mucosal healing (MH) of IBD patients has yet to be clearly demonstrated. The objective of our study was to perform a meta-analysis evaluating the diagnostic accuracy of FC in predicting MH of IBD patients. <b><i>Methods:</i></b> We systematically searched the databases for studies from inception to April 2020 that evaluated MH in IBD. The methodological quality of each study was assessed according to the Quality Assessment of Diagnostic Accuracy Studies checklist. The extracted data were pooled using a summary receiver operating characteristic curve model. Random-effects model was used to summarize the diagnostic odds ratio, sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio. <b><i>Results:</i></b> Sixteen studies comprising 1,682 ulcerative colitis (UC) patients and 4 studies comprising 221 Crohn’s disease (CD) patients were included. The best performance of FC for predicting MH in UC was at cut-off range of 60–75 μg/g with area under the curve (AUC) of 0.88 and pooled sensitivity and specificity of 0.87 and 0.79, respectively. The pooled sensitivity and specificity values of cutoff range 180–250 μg/g for predicting MH in CD were 0.67 and 0.76, respectively. The AUC of 0.79 also revealed improved discrimination for identifying MH in CD with FC concentration. <b><i>Conclusion:</i></b> Our meta-analysis has found that FC is a simple, reliable noninvasive marker for predicting MH in IBD patients. FC cutoff range 60–75 μg/g appears to have the best overall accuracy in UC patients.


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