Clinical outcomes and management of contrast hypersensitivity in patients requiring repeated computed tomography imaging.

Introduction: In collaboration with the Department of Rheumatology, Allergy and Immunology, our study aims to review the outcomes of and propose an improved workflow for the management of patients with prior hypersensitivity reactions to iodinated contrast media (ICM).

Method: Outpatients coming for contrast-enhanced computed tomography (CECT) were stratified into 3 categories (definite, unconfirmed and inaccurate) based on likelihood of their contrast hypersensitivity label. Patients could be offered a different ICM, receive the same ICM, or be referred to an allergist for further evaluation.

Isolated Systemic Arterial Supply to Normal Lung with Aneurysm Formation: A Rare Entity with An Even Rarer Complication.

BACKGROUND Isolated systemic arterial supply to normal (unsequestered) lung (ISSNL) without associated pulmonary malformation is rare, and lies towards the milder end of the spectrum of congenital lung abnormalities. Aneurysmal dilatation of the anomalous artery is an infrequent complication, with only 5 published cases thus far. CASE REPORT We present the case of a 61-year-old man whose screening chest radiograph showed a retrocardiac mass.

Safety of a rapid outpatient hydration protocol for patients with renal impairment requiring intravenous iodinated contrast media for computed tomography.

Introduction: Patients receiving intravenous iodinated contrast media for computed tomography (CT) are predisposed to contrast-induced nephropathy. Chronic kidney disease is an important risk factor, and hydration is the mainstay of prevention. While inpatients can undergo intravenous hydration, limited knowledge exists regarding regimens for outpatients.

Malignant Tumours Mimicking Complicated Appendicitis and Discovered upon Follow-Up after Percutaneous Drainage: A Case of Two Patients.

The conservative management of periappendiceal abscesses is gaining favour due to decreased morbidity and improved clinical outcomes for patients. Occasionally however an abscess can mask underlying sinister pathology. In this article, we highlight two cases of appendiceal adenocarcinoma that were initially diagnosed as periappendiceal abscesses and managed conservatively with percutaneous drainage.

Clinics in diagnostic imaging (176). Acute embolic occlusion of the coeliac artery.

A 52-year-old man, who had a background of chronic heart disease and atrial fibrillation, as well as non-compliance with warfarin therapy, presented with a two-week history of worsening upper abdominal pain. Computed tomography mesenteric angiography showed complete embolic occlusion of the coeliac artery with resultant segmental splenic infarction, and thrombus within the left ventricle. A decision was made to proceed with catheter-directed thrombolysis.

Congenital incomplete fusion of superior mesenteric artery mimicking dissection.

Background: Both spontaneous SMA dissection and anatomical variants of GIT vasculature are well known entities. We present a case initially diagnosed as an SMA dissection on CT, but upon detailed review of the imaging findings was considered to be incompletely fused ventral segmental arteries--a rare anatomic variant not well described before. This finding is clinically significant, as it can mimic a vascular dissection and such a wrong diagnosis will lead to unnecessary investigation and intervention.

Angioplasty of the anterior tibial artery through an incidentally discovered persistent sciatic artery.

The persistent sciatic artery (PSA) is a rare arterial variant. Patients may present with a spectrum of atherosclerotic disease, but aneurysm formation with thromboembolic complications is more common. Although no intervention is required for asymptomatic individuals, stenting for stenosis, thrombolysis for occlusion and even utilisation of the PSA for intrapelvic embolisation have been reported.

An innovative modification of the retrograde approach to angioplasty and recanalization of the superficial femoral artery.

Endovascular therapy has been performed for chronic limb ischemia since 1964, with intraluminal and subintimal angioplasty of the superficial femoral artery (SFA) gaining popularity in the last decade (1). SFA occlusions can be managed by retrograde contralateral or antegrade ipsilateral approaches (2, 3); when these approaches fail, some practitioners resort to using a re-entry device (4, 5). The retrograde popliteal approach was initially fraught with limitations and served as a backup option (1, 4, 6).

Improved method of double-J ureteric stenting.

Double-J ureteral stents and antegrade stenting have been performed by radiologists for years. Various methods have been described, dependent on available equipment as well as technical expertise. As such, there is no definite consensus with regards to deployment of these stents.

An uncommon case of haemorrhagic enteric fever treated successfully with super-selective embolisation using polyvinyl alcohol particles and coils.

Lower gastrointestinal haemorrhage due to enteric fever is uncommon and potentially fatal. The majority of patients recover with conservative treatment, with surgery reserved for life-threatening bleeding. Given the advances in radiologically guided procedures, there have been numerous reports of successful embolisation for gastrointestinal haemorrhage, although few of these involved enteric fever as the causative agent.

Effectiveness of an algorithm in reducing the number of unnecessary ultrasound scans for deep vein thrombosis: an evaluation report.

Introduction: Patients with suspected deep vein thrombosis (DVT) pose a diagnostic dilemma to the Emergency Department (ED) clinician. This study aimed to implement a known algorithm incorporating the modified Wells criteria and D-dimer testing to guide the ED clinician, thus reducing unnecessary ultrasound scans (USS).

Methods: Patients who presented to the ED between August 2008 and April 2009 with suspected DVT underwent Wells scoring.