Multifocal Nodular Fatty Infiltration of the Liver: A Case Report of a Challenging Diagnostic Problem.

Background: Fatty infiltration of the liver usually has a diffuse pattern, but in very rare cases it presents as multiple focal lesions of the liver, mimicking metastases. A correct diagnosis is crucial to address prognosis and eventual treatment.

Case Report: We present the case of a completely fit and asymptomatic patient referred for multiple bilateral liver metastases of unknown origin.

Extensive vulval oedema secondary to severe pelvic infection.

A 17-year-old female developed a complex pelvic abscess a few weeks post-surgical abortion. Despite surgical drainage, a debilitating infection induced a low albumen. The resulting pelvic oedema caused gross vulval oedema that was difficult to manage.

Exercise training for claudicants: changes in blood flow, cardiorespiratory status, metabolic functions, blood rheology and lipid profile.

Objective: Exercise training improves the walking distance of claudicants. The aim of this study was to investigate factors associated with the improvement in the maximum walking distance (MWD) in respect to cardiovascular, respiratory and metabolic adaptations.

Methods: Forty claudicants were studied.

Cavernous haemangioma of the nasal bones: an alternative management option.

The authors present a case of bilateral cavernous haemangiomas affecting the posterior ends of both inferior turbinates of the nose. The condition was treated by angiographically controlled embolization. Review of the literature back to 1967 has revealed no other report of embolization being used specifically for this condition.

The effect of pregnancy on the lower-limb venous system of women with varicose veins.

Objectives: to assess the effect of pregnancy on the lower-limb venous system of women with varicose veins. Design a longitudinal prospective study of 11 pregnant women, with varicose vein disease.

Methods: eleven pregnant women with varicose veins were recruited as part of a larger study.

Serial colour flow duplex scanning of the veins of the lower limb throughout pregnancy.

Objective: To examine changes in diameter and reflux in normal veins of the lower limb throughout pregnancy.

Methods: Fifty-seven women were recruited into the study and 43 completed the full assessment to six weeks postpartum. Thirteen had pre-existing venous disease and are reported elsewhere.

A case of intractable epistaxis.

The surgical management of intractable epistaxis by external carotid artery ligation may become complicated if there is a high bifurcation of the common carotid artery. Occlusion of the bleeding vessels by catheter embolization is described in a patient in whom exploration of the neck had failed to locate the external carotid artery.

Carotid artery duplex scanning: does plaque echogenicity correlate with patient symptoms?

In this study we have investigated the relationship between plaque sonolucency and ipsilateral hemispheric symptoms in 116 patients at risk of cerebrovascular disease (75 symptomatic patients, 41 asymptomatic patients). Our results indicate that plaque sonolucency is significantly associated with the incidence of patient symptoms at presentation. Twice as many symptomatic vessels contained the predominantly sonolucent plaque types (types 1 and 2) compared to contralateral asymptomatic vessels (p = 0.

Magnetic resonance imaging facilitates assessment of perianal Crohn's disease.

Three illustrative cases of magnetic resonance imaging (MRI) in patients with perianal Crohn's disease are presented. Modern MRI techniques provided excellent visualization of perineal anatomy, inflammatory tissues and an anorectal stricture. It also allowed detailed delineation of the patho-anatomy of fistulous abscess and any communication to more proximal bowel.

Pulmonary scintigraphy in suspected pulmonary embolism: how often does it change clinical management?

The effect of pulmonary scintigraphy on patient management in suspected pulmonary embolism has been assessed in 158 patients. A change in management occurred in 30% following scintigraphy. The major effect was a reduction in the total number of patients who were anticoagulated.

Transjugular intrahepatic portocaval shunt (TIPS) and hepatic vein-to-caval stenting as salvage treatment of portal hypertension secondary to neoplasm.

A percutaneous transjugular intrahepatic portocaval shunt (TIPS) was successfully performed using Wallstents in a 53-year-old man with neoplastic disease causing portal hypertension and life-threatening variceal hemorrhage. Shortly afterwards, recurrent hemorrhage was investigated by shunt venography which showed that extrinsic narrowing of the hepatic vein and hepatic vena cava was causing shunt thrombosis. Shunt thrombosis was cleared by balloon occlusion of the shunt and forceful retrograde flushing of thrombus into the portal circulation.

Iodixanol in femoral arteriography (phase III): a comparative double-blind parallel trial between iodixanol and iopromide.

Iodixanol is a new non-ionic, dimeric contrast medium (CM) which is formulated to be isotonic with blood in all clinically relevant concentrations. This is a report of a parallel, double-blind study comparing the safety and efficacy of iodixanol with iopromide (Ultravist) in aortofemoral arteriography. One hundred consecutive, eligible patients scheduled to undergo peripheral arteriography were entered into the study and randomly allocated to receive one or other CM.

Accidental subdural catheterization: radiological evidence of a possible mechanism for spinal cord damage.

We describe the inadvertent subdural insertion of a lumbar extradural catheter in a primiparous woman in labour. A small quantity of local anaesthetic resulted in extensive motor and sensory block. Computed tomography performed after contrast injection demonstrated unequivocally that the catheter was in the subdural space.

Can serum prostate-specific antigen replace bone scintigraphy in the follow-up of metastatic prostatic cancer?

Bone scintigraphy is the most sensitive imaging technique for the initial detection of bone metastases and is widely used in the staging of prostatic cancer. This study was performed to assess whether the development of further bone metastases can be detected by serial measurements of the serum glycoprotein prostate-specific antigen (PSA) as an alternative to follow-up scintigraphy. The bone scintigrams and PSA levels of 101 patients with metastatic prostate cancer entered into two therapeutic trials have been reviewed.

The radiological imaging of bronchial atresia.

The clinical and radiological findings in three cases of bronchial atresia are presented. Bronchial atresia has a characteristic plain radiographic appearance in the majority of cases. Computed tomography may be required to confirm the diagnosis.

The effect of iodixanol, a new isotonic contrast agent, on femoral blood flow in man.

Both ionic and non-ionic contrast media (CM) injected intra-arterially produce peripheral vasodilatation and a sensation of heat or even pain. This effect has been considered to be predominantly related to the osmolality of the CM used. Iodixanol is a non-ionic dimeric CM which can be made isotonic with blood at iodine concentrations up to 400 mg/ml.

The ocular effects of hyoscine-n-butylbromide ("Buscopan") in radiological practice.

"Buscopan" (hyoscine-n-butylbromide, HBB) is a smooth muscle relaxant regularly used in radiological and endoscopic procedures. One unwanted effect is temporary impairment of visual accommodation. Near and distance vision were assessed in 100 patients undergoing barium meal and barium enema studies.

The hemipelvis: an unusual site of osteonecrosis. A report of two cases.

Osteonecrosis or aseptic necrosis is well-recognised in certain sites. We report two patients, both with predisposing factors, who developed avascular necrosis of the hemipelvis which was bilateral in one case. In each patient the diagnosis was not suspected clinically.