Investigation of high-resolution computed tomographic (HRCT) outcomes associated with chronic pulmonary microaspiration (CPM) in Tehran and Zahedan, Iran

Background: In patients with chronic pulmonary microaspiration (CPM) the recognition of high-resolution computed tomographic (HRCT) findings and their pattern is important. Objective: To investigate the HRCT detections in patients with CPM. Materials and Methods: This descriptive study enrolled 100 consecutive patients with CPM underwent HRCT of the lungs between 2017 and 2018 in Tehran and Zahedan Hospitals and private centers. The required variables were recorded for each patient with a questionnaire. Subsequently, HRCT was performed and abnormalities were then reported by two radiologists. Results: Most of patients exhibited bronchial thickening in 33.6% of cases, followed by ground-glass opacity (12.4%), em- physema (11.1%), and bronchiectasis (8.5%). In addition, the most common HRCT findings were found in left lower lobe (LLL) (37.1%), followed by right lower lobe (RLL) (35.9 %), right upper lobe (RUL ) (6,2%), and left upper lobe (LUL) (6%). Conclusion: Our data showed the most common findings in HRCT were bronchial thickening ground-glass opacity, em- physema, and bronchiectasis, where these findings was dominantly found in LLL, RLL, RUL, and LUL, indicating its high tendency to dependent areas. Keywords: Imaging; high-resolution computed tomographic; chronic lung microaspiration.

Diagnostic workflow for small intestine diverticulitis: case series and systematic review.

Objective: to assess new strategies in order to promptly diagnose small intestine diverticulitis. Methods: we thoroughly analyzed a case series of small intestine diverticulitis in order to describe three of the typical presentations of such disease (intestinal perforation, intestinal obstruction and obstruction developing perforation). A systematic review of the literature was then conducted in five different scientific databases using six different keywords. Imaging technique's sensitivity for small intestine diverticulitis was assessed, as well as the frequency of signs and symptoms of such pathology. A complete description of the signs and symptoms of acute abdomen-type pathologies was also investigated in order to provide differential traits to distinguish small intestine diverticulitis. Results: No pathognomonic signs or symptoms were detected for the pathology, although we found that all the other pathologies in the “acute abdomen” type of diseases have distinguishing traits that could be used to perform a differential diagnosis of small intestine diverticulitis. Moreover, contrast-enhanced computed tomography is the best imaging technique for the confirmation of such disease, when guided by an initial suspicion. Conclusion: Small intestine diverticulitis cannot be diagnosed by clinical exploration only, but patients that have acute abdomen characteristics, and are negative to signs and symptoms that are characteristic of the other diseases in its type should be suspected for such disease. The aforementioned suspicion may guide a better imaging technique selection and exploration through it.