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Jayati Joshipura ◽  
Vani H.N. ◽  
Nabanita Kora

Tumour-induced hypoglycaemia is a rare complication/condition mainly seen in adults. It is caused due to increased production of insulin or insulin-like growth factor (IGF) 2 tumour cells. We present a 3-year-old paediatric patient with non-islet cell tumour induced hypoglycaemia (NICTH) secondary to rhabdomyosarcoma. She presented with abdominal mass and refractory hypoglycaemia, requiring high glucose infusion and steroids. Critical sample analysis during hypoglycaemia showed suppression of insulin, IGF-1, C-peptide, growth hormone, and ketones, with a high cortisol level. CT scan of abdomen and pelvis showed a huge retroperitoneal mass, later diagnosed as rhabdomyosarcoma. In a resource-limited setting, where IGF-2 is not possible, low serum insulin and IGF-1 levels during hypoglycaemia aids in diagnosis of NICTH. This is one of the first few reported paediatric cases with NICTH from India, and we believe that reporting this case would add more information to the existing literature. Thus, NICTH should be suspected in all malignancies presenting with intractable hypoglycaemia irrespective of their age.

2021 ◽  
Vol 14 (12) ◽  
pp. e246646
Crystal Nguyen ◽  
Murugan Athigaman ◽  
Abdul Qureshi

Leiomyosarcoma (LMS) of the colon accounts for <1% of all colorectal malignancies. Our patient was a 72-year-old man with a history of aortic valvular disorder and congestive heart failure, who presented with an abdominal mass and no constitutional symptoms. The CT scan finding suggested a large tumour with both solid and cystic components. Intraoperatively, a portion of the involved colon was resected along with the tumour. Microscopically, the tumour was found to invade the muscularis propria layer of the transverse colon. The final diagnosis was LMS, FNCLCC grade 2 of 3 based on the histology and immunochemistry.

2021 ◽  
Vol 8 ◽  
Marco Pace ◽  
Damiano Vallati ◽  
Elena Belloni ◽  
Marco Cavallini ◽  
Mohsen Ibrahim ◽  

Background: A bilateral diaphragmatic rupture is a rare event that occurs in cases of blunt thoracic-abdominal trauma.Case Presentation: We report the case of a 56-year-old female patient with pelvic fracture and second-stage bilateral rupture of the diaphragm due to a car accident. After a chest and abdominal contrast-enhanced computed tomography (CT) scan, the patient underwent emergency suturing of the left hemidiaphragm. On postoperative day (POD) 4, a CT scan performed due to the sudden onset of dyspnea revealed rupture of the right hemidiaphragm, which was not detected on the preoperative CT scan. On POD 9, the right hemidiaphragm was repaired with mesh during a right thoracotomy. The patient recovered 14 days after surgery. However, the postoperative course was complicated by an asymptomatic COVID-19 infection that significantly delayed her discharge from the hospital.Conclusions: Difficulties in preoperative diagnosis and treatment, together with the lack of data in the literature, make this type of trauma a challenge for all acute care and general surgeons.

2021 ◽  
pp. 110076
Elton Dajti ◽  
Antonio Colecchia ◽  
Nicolò Brandi ◽  
Rita Golfieri ◽  
Matteo Renzulli

2021 ◽  
Vol 46 ◽  
pp. S573-S574
I. Ruiz García ◽  
F.J. Sánchez Torralvo ◽  
V. Contreras Bolívar ◽  
I. González Almendros ◽  
G. Olveira Fuster
Ct Scan ◽  

2021 ◽  
Vol 12 (12) ◽  
pp. 120-125
Raju Singha ◽  
Chanchal Kumar Dalai ◽  
Deblina Sarkar

Background: Knee osteo-arthritis is widely prevalent in the elderly population in our society and associated with significant morbidity and poor quality of life. Early diagnosis of the condition can enable timely and proper care for the patients. Magnetic Resonance Imaging, CT Scan, Ultrasonography and plain radiography are the different modalities of imaging that are commonly used for detection and diagnosis of knee osteo-arthritis. Aims and Objectives: To find out the early osteoarthritic changes of knee by Magnetic Resonance Imaging and compare those findings with conventional radiography, high frequency USG and CT scan findings. Materials and Methods: Patients suffering from knee osteoarthritis (OA) as per American College of Rheumatology guideline criteria (n=56) underwent imaging of the knee using plain radiography, ultrasonography, CT scan and MRI. The imaging findings studied in the patients were joint space narrowing (JSN), meniscal abnormality, Baker’s cyst, cruciate ligament abnormality, knee effusion, subchondral cyst, and loose bodies. A comparison between radiography, CT scan and USG was done for the imaging findings with MRI as the reference standard. Z-test of proportionality was used to find statistically significant difference for the three imaging modalities. A P<0.05 was deemed statistically significant. Results: The mean age of the patients was 61 years (38 males). The tibiofemoral compartment was most commonly affected. CT scan was more sensitive than radiography in detecting sub-chondral cyst (P=0.018) and loose bodies (P=0.004). USG and MRI were equally sensitive in detecting knee effusion (P=0.22) and synovial thickening (P=0.10). CT scan and MRI were equally sensitive in detecting subchondral cyst (P=1.00) and loose bodies (P=0.22). Conclusion: While CT imaging was more sensitive for detection of subchondral cysts and loose bodies than conventional radiography, it was as sensitive as MRI in detecting these findings in the study group. Additional study is warranted to assess diagnostic performance of CT scan and MRI in the diagnosis and progression of knee OA.

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Bo Cui ◽  
Yan Liu ◽  
Shuxiang Chen

Objective. To analyse the X-ray and computed tomography (CT) findings of 128 patients with sports-related knee fractures and to improve the diagnosis rate based on the existing methods of diagnosis of sports knee fractures on X-ray and CT images. Method. In this study, we retrospectively analyse the medical records of 128 cases of sports-related fractures in the hospital, analyse the results of X-ray examination and CT imaging of patients with sports knee fractures, and compare the results obtained by the two examination methods, while referring to MRI images performed. Results. CT examination of knee fractures, tibial plateau fractures, and knee joint free body results were compared with X-ray results ( P < 0.05 ), while CT examination of patella fractures and X-ray results were compared. The difference was not statistically significant ( P > 0.05 ). Conclusion. For imaging examination of knee fractures, a single ordinary X-ray or CT scan should be selected according to the specific situation of the patient. For patients with suspected unstable fractures, when the patient’s informed consent and the condition are not allowed, ordinary X-ray film combined with CT examination is used to improve the accuracy of diagnosis and avoid the existence of hidden fractures, resulting in medical accidents.

2021 ◽  
Vol 28 (12) ◽  
pp. 1869-1873
Sajid Malik ◽  
Gul e Lala ◽  
Abdullah Khan

Omental torsion is a rare cause of acute abdominal pain. Diagnosis of omental torsion is usually difficult because clinical signs and symptoms are similar to other common causes of abdominal pain. The most common preoperative diagnosis is acute appendicitis and the proper preoperative diagnosis is important for the appropriate treatment option. Diagnosis of omental torsion is difficult and mainly based on ultrasound and computed tomography (CT) scan analysis. Case Presentation: A 26 years old male patient presented to emergency department with acute abdomen mimicking acute appendicitis. The chest and abdominal X-rays were normal. Due to intense clinical signs and worsening of the symptoms the patient underwent an operation with the probable diagnosis of acute appendicitis. In this case patient explored via gridiron incision, the omentum was found to be gangrenous that had encased the appendix so midline incision given. Post-operative recovery was uneventful. Conclusion: Omental torsion is highly uncommon cause of right lower abdominal pain and difficult to diagnose preoperatively. It presents with non-specific symptoms, mimicking other abdominal conditions presenting a similar clinical settings. CT scan is very helpful in diagnosis. Surgical treatment is the procedure of choice with laparoscopy being the preferable approach. 

Soundariya R.S. ◽  
Tharsanee R.M. ◽  
Vishnupriya B ◽  
Ashwathi R ◽  

Corona virus disease (Covid - 19) has started to promptly spread worldwide from April 2020 till date, leading to massive death and loss of lives of people across various countries. In accordance to the advices of WHO, presently the diagnosis is implemented by Reverse Transcription Polymerase Chain Reaction (RT- PCR) testing, that incurs four to eight hours’ time to process test samples and adds 48 hours to categorize whether the samples are positive or negative. It is obvious that laboratory tests are time consuming and hence a speedy and prompt diagnosis of the disease is extremely needed. This can be attained through several Artificial Intelligence methodologies for prior diagnosis and tracing of corona diagnosis. Those methodologies are summarized into three categories: (i) Predicting the pandemic spread using mathematical models (ii) Empirical analysis using machine learning models to forecast the global corona transition by considering susceptible, infected and recovered rate. (iii) Utilizing deep learning architectures for corona diagnosis using the input data in the form of X-ray images and CT scan images. When X-ray and CT scan images are taken into account, supplementary data like medical signs, patient history and laboratory test results can also be considered while training the learning model and to advance the testing efficacy. Thus the proposed investigation summaries the several mathematical models, machine learning algorithms and deep learning frameworks that can be executed on the datasets to forecast the traces of COVID-19 and detect the risk factors of coronavirus.

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