Pankaj Nepal - Academia.edu (original) (raw)
Papers by Pankaj Nepal
Midline diastema is a space between maxillary central incisors. The incidence of midline diastema... more Midline diastema is a space between maxillary central incisors. The incidence of midline diastema varies greatly with age group, gender, population and race. Aim: To find the occurrence of midline diastema among children of different racial group, visiting
Endocrine Practice, May 1, 2022
Egyptian Journal of Radiology and Nuclear Medicine
Background Cephalad renal ectopia is rare. Ectopic kidneys besides being prone to various patholo... more Background Cephalad renal ectopia is rare. Ectopic kidneys besides being prone to various pathologies are occasionally associated with other congenital abnormalities. To the best our knowledge, at the time of this writing, only ten cases of bilateral subdiaphragmatic renal ectopia had been reported. Case presentation: We present a rare case of bilateral subdiaphragmatic ectopic kidneys incidentally discovered during evaluation of the abdominal pain. In addition, our patient had associated anomalies of the liver, spleen and mesocardia. Conclusions Recognition of this condition is important for accurate diagnosis, surgical and/or intervention planning, as well as identifying other associated anomalies.
The New England journal of medicine, Jan 25, 2016
Images in Clinical Medicine A 43-year-old man presented with a 1-month history of dysuria and int... more Images in Clinical Medicine A 43-year-old man presented with a 1-month history of dysuria and intermittent hematuria. Similar episodes had occurred several times in the 6 months preceding presentation, along with episodes of rectal bleeding. The physical examination was unremarkable. Laboratory investigations revealed an elevated albumin:creatinine ratio (96 mg of albumin per millimole of creatinine), with dysmorphic red cells in the urine. Two urine cultures were sterile. A serum schistosoma antibody titer was 1:256. Renal ultrasonography revealed mild hydroureteronephrosis. Computed tomography of the abdomen and pelvis without the administration of contrast material revealed hydroureteronephrosis of the right ureter and kidney, with faint mural calcification of the ureter (Panel A, white arrow) and smooth mural calcification of the bladder (Panels A, B, and C, yellow arrows). There was also calcification of the seminal vesicles (Panel B, red arrow) and the wall of the rectosigmoid bowel (Panels B and C, white arrows). This pattern of calcification is typical of chronic genitourinary and gastrointestinal schistosomiasis, in which the larvae of the schistosoma parasite are deposited on the walls of the organs and become calcified. Diagnosis is based on a history of exposure along with a strong clinical suspicion of infection and the characteristic radiographic findings. Tuberculosis may also cause calcification of the bladder wall and should be considered in the differential diagnosis.
Journal of Chitwan Medical College, 2014
Oral health is a vital part of overall infant health. An early dental visit is important in rende... more Oral health is a vital part of overall infant health. An early dental visit is important in rendering prevention oriented intervention and parental counselling regarding the oral health. To assess the age and common chief complaint of the children in their first dental visit. This was a retrospective study done using case records of 842 children, who reported to the Department of Pedodontics and Preventive Dentistry, chitwan medical college. The age groups were divided into four categories; less than 3 years, 3-6years, 7-11 years and 12-14 years. The various chief complaints of patient were categorized as follows; routine check up, dental caries, dental pain, deposits/bad breath, malocclusion, unerupted ,missing or extra tooth, oral habits, trauma, orientation to prevention and others (cleft lip, palate, natal/neonatal teeth, mobile teeth, soft tissue lesions and others). The age group and the most common complaint at the first dental visit were assessed. Majority of children who...
Journal of Chitwan Medical College, 2013
Peripheral giant cell granuloma is a benign reactive lesion of gingiva. It manifests as a firm, s... more Peripheral giant cell granuloma is a benign reactive lesion of gingiva. It manifests as a firm, soft, bright nodule, sessile or pedunculate mass. It is an infrequent exophytic lesion of the oral cavity, also known as giant cell epulis, osteoclastoma, giant cell reparative granuloma, or giant-cell hyperplasia. The aim in publishing this report is to present the clinical, histopathological features and treatment of a peripheral giant cell granuloma case, which was seen in gingiva of a 10 year old male child, with history of disturbed chewing functions due to its large size. Intraoral examination revealed a raised, round, sessile, smooth-edged mass of size 2x 1 cm2 and was located on the canine, deciduous first molar region. After initial periodontal treatment, excisional biopsy was performed under local anesthesia. The lesion was diagnosed as Peripheral Giant Cell Granuloma after clinical and pathological examination. DOI: http://dx.doi.org/10.3126/jcmc.v3i3.8635 Journal of Chitwan ...
Health Renaissance, 2014
Background: Cheiloscopy is a forensic investigation technique that deals with the identification ... more Background: Cheiloscopy is a forensic investigation technique that deals with the identification based on lip traces. Based upon the research, it was established that the arrangement of lines on the red part of human lips is unique for each human being. Objectives: To analyze and compare quadrant wise and sex wise predilection of lip print pattern. Methods: A total of 200 (18-25 years) Nepalese undergraduate students of BPKIHS were selected. Thin layer of lip-stick was applied on the lips of these sub-jects. The hinged por-tion of a folded paper was inserted between the lips and the sub-jects were asked to press their lips onto it. Only middle 10 mm of both upper and lower lips were taken as study area. The lip prints, thus obtained were stud-ied on the basis of Tsuchihashi’s classification. Chi square test was used to analyze and compare the lip print patterns in all the quadrants of males and females, with the level of significance p<0.05. Results: Type I pattern was predominan...
Chest, 1993
Pulmonary infections with secondary pleural involvement lead to considerable morbidity and mortal... more Pulmonary infections with secondary pleural involvement lead to considerable morbidity and mortality. Accepted management consists of systemic antibiotics and drainage of pleural cavity, achieved either by chest tube drainage or surgery. Open thoracotomy or video-assisted thoracoscopic surgery (VATS) achieve best drainage in gross empyema or loculated effusions but are limited by operative risk, cost and local availability. Intrapleural instillation of fibrinolytic agents like streptokinase dissolves fibrinous clots and membranes to prevent fluid sequestration and hence improve drainage. We report a case of 40 years old female with loculated empyema who was treated with adjunctive installation of serial intrapleural streptokinase after ultrasound guided pigtail insertion. Significant and early improvement of the symptoms and pathophysiology were achieved.
South African Journal of Radiology
The embryology of the inferior vena cava (IVC) is complex, involving the sequential appearance an... more The embryology of the inferior vena cava (IVC) is complex, involving the sequential appearance and regression of multiple segments that ultimately form the IVC. Any alteration in this process during embryogenesis can result in congenital anomalies of the IVC. This study aimed to recognise common as well as rare anomalies of the IVC and associated veins, and their clinical implications. The anomalies tend to have diverse appearances based on the timing and segments involved. The development of the IVC is intertwined with the development of other veins like the renal vein, azygos vein and portal vein, and these veins may also be anomalous. Additionally, IVC anomalies are associated with various other congenital anomalies including cardiac anomalies, the recognition of which may be important for patient care. The IVC tends to have multiple normal variants and anomalies because of a complex process involving multiple segments contributing to the adult IVC. Knowledge of these variants is...
Case Reports in Gastrointestinal Medicine, 2021
Sclerosing encapsulating peritonitis is a rare condition caused by a fibrotic membrane covering t... more Sclerosing encapsulating peritonitis is a rare condition caused by a fibrotic membrane covering the small bowel which may lead to abdominal pain or obstruction. The cause may be primary and idiopathic or secondary to several diseases, treatments, and/or medications. The condition typically presents with bowel obstruction, and only one previous case has described ascites as the presenting sign. Sclerosing encapsulating peritonitis is typically diagnosed intraoperatively. We present a case of a patient who presented with atypical clinical symptoms including respiratory distress, recurrent abdominal ascites, and failure to thrive who was diagnosed nonoperatively.
AJR. American journal of roentgenology, 2021
AJR. American journal of roentgenology, 2021
OBJECTIVE. The purpose of this article is to review the spectrum, etiopathogenesis, clinical pres... more OBJECTIVE. The purpose of this article is to review the spectrum, etiopathogenesis, clinical presentation, imaging features, differential diagnoses, and management of emphysematous infections of the abdomen and pelvis. CONCLUSION. Emphysematous infections are associated with high morbidity and mortality and thus need urgent medical and surgical interventions. CT is the most sensitive modality to detect gas; CT provides definitive diagnosis in most cases and can depict the extent of involvement.
Emergency Radiology, 2021
To look for the presence of “perifollicular rim sign” on non-contrast CT in surgically proven cas... more To look for the presence of “perifollicular rim sign” on non-contrast CT in surgically proven cases of ovarian or adnexal torsion. A retrospective analysis of abdominopelvic non-contrast CT examinations in surgically proven cases of ovarian or adnexal torsion was conducted seeking the presence of “perifollicular rim sign” in torsed ovaries. “Perifollicular rim sign” was defined as a complete ring of perifollicular hyperdensity around ovarian follicles with an attenuation value of > 50 HU and thickness > 1–2 mm. A positive sign was equated to the presence of perifollicular hemorrhage. Pre-operative non-contrast CT was available in 7 out of the 39 ovarian or adnexal torsions included in our study. “Perifollicular rim sign” was present in 5 out of the 7 ovarian torsions on pre-operative non-contrast CT. MRI correlation was available in one patient. Ovarian enlargement (>4 cm) was present in all 7 cases. In an appropriate clinical setting, presence of “perifollicular rim sign” ...
Iranian Journal of Medical Sciences, 2018
Poster: "ECR 2016 / C-1251 / Pearls and pitfalls in the diagnosis of ectopic pregnancy"... more Poster: "ECR 2016 / C-1251 / Pearls and pitfalls in the diagnosis of ectopic pregnancy" by: "S. Ramanathan1, P. Nepal1, D. Kumar1, Y. Palaniappan2, S. B. Ladumor3, H. Hena1, M. Khanna1, N. salah ahmed mohamed1, A. Choyi madathil1, A. SHEIKH4, M. Heidous1; 1Doha/QA, 2Puducherry/IN, 3Doha,Qatar, Doha/QA, 4Ottawa, ON/CA"
Abdominal Radiology, 2021
Jejunal and ileal atresia, traditionally grouped together as jejuno-ileal atresia, are rare and h... more Jejunal and ileal atresia, traditionally grouped together as jejuno-ileal atresia, are rare and have an incidence of 1 in 5000 live births [1, 2]. The etiology of jejuno-ileal atresia is attributed to an in-utero ischemic insult of formed bowel loops. In contrast, failure of recanalization is the favored etiology in duodenal atresia. The atretic segment may be solitary or multiple, and may be associated with other congenital malformations, such as gastroschisis, cardiac anomalies, malrotation with in-utero volvulus and cystic fibrosis in up to 20% of cases [3, 4]. Most common site of atresia is the distal ileum, followed by the proximal jejunum, distal jejunum, and proximal ileum [4]. Jejuno-ileal atresias are classified according to the Grosfeld classification: type I (mucosal web), type II (fibrous cord), type III a (mesenteric gap), type III b (apple peel/Christmas tree), and type IV (multiple atresia) [5]. Type IIIb (apple peel) atresia is the least common, which represents 5–10...
BJR | case reports, 2020
Proximal small bowel obstruction in the region of the duodenum is an uncommon clinical entity. Ou... more Proximal small bowel obstruction in the region of the duodenum is an uncommon clinical entity. Our case, which involves obstruction of the third portion of the duodenum due to an abdominal aortic aneurysm (AAA), is even more unusual. A review of the relevant literature regarding duodenal obstruction due to extrinsic compression includes features that differentiate aortoduodenal syndrome from superior mesenteric artery syndrome. Management of these conditions range from conservative to surgical, of which now includes a more recent role of metallic stents in some instances.
Clinical imaging, 2020
We present a case of asymptomatic chyluria in a 70-year-old man detected two years after microwav... more We present a case of asymptomatic chyluria in a 70-year-old man detected two years after microwave ablation of renal cell carcinoma. Chyluria is a rare complication of partial nephrectomy, but has not been previously reported after renal microwave ablation therapy. Recently, percutaneous thermal ablation techniques for T1a renal cancers are in surge due to comparable treatment efficacy, less invasive nature and lower complications. It is imperative to be aware of the post-ablation imaging findings and complications for correct diagnosis. Most patients with chyluria are clinically asymptomatic; therefore, serendipitous diagnosis on imaging detecting fat-fluid level may not be unusual.
Iranian Journal of Medical Sciences, 2018
Dear Editor, Mycetoma is a chronic indolent, slowly progressive granulomatous infection which eve... more Dear Editor, Mycetoma is a chronic indolent, slowly progressive granulomatous infection which eventually causes bone destruction.1 Its diagnosis is difficult until the advanced stage, which is characterized by sinus formation, discharge of dark-colored grains, extensive soft tissue, and bone damage with deformity often necessitating amputation. Although biopsy and microbiological culture provide definitive diagnosis, these are difficult to achieve consistently.2 Early diagnosis and prompt treatment can significantly limit disability and avoid amputation. MRI (magnetic resonance imaging) features of mycetoma are characteristic, especially the dot-in-circle sign, which allow early and confident diagnosis when typical clinical features such as sinuses and grains are not manifested or histopathological diagnosis and aspiration cytology are negative or indeterminate. A 30-year-old man from India visited the orthopedic clinic in Doha (Qatar) complaining of painless, progressive soft tissu...
Radiology Case Reports, 2021
Leprosy is a chronic granulomatous infection caused by Mycobacterium Leprae that predominantly af... more Leprosy is a chronic granulomatous infection caused by Mycobacterium Leprae that predominantly affects the skin and peripheral nerves. The disease is prevalent in developing countries of Asia and Africa, with occasional cases reported from United States. In this case report we highlight a 33-year-old man from Qatar, who presented with symptoms of progressive weakness in his left wrist and hand for six months and was later found to have a granuloma of the ulnar nerve secondary to leprosy. We will discuss the etiopathogenesis, clinical features, role of imaging, and management of neuropathy due to leprosy. Our case provides an excellent learning example of the utility of ultrasonography to characterize leprosy granulomas of the ulnar nerve.
Midline diastema is a space between maxillary central incisors. The incidence of midline diastema... more Midline diastema is a space between maxillary central incisors. The incidence of midline diastema varies greatly with age group, gender, population and race. Aim: To find the occurrence of midline diastema among children of different racial group, visiting
Endocrine Practice, May 1, 2022
Egyptian Journal of Radiology and Nuclear Medicine
Background Cephalad renal ectopia is rare. Ectopic kidneys besides being prone to various patholo... more Background Cephalad renal ectopia is rare. Ectopic kidneys besides being prone to various pathologies are occasionally associated with other congenital abnormalities. To the best our knowledge, at the time of this writing, only ten cases of bilateral subdiaphragmatic renal ectopia had been reported. Case presentation: We present a rare case of bilateral subdiaphragmatic ectopic kidneys incidentally discovered during evaluation of the abdominal pain. In addition, our patient had associated anomalies of the liver, spleen and mesocardia. Conclusions Recognition of this condition is important for accurate diagnosis, surgical and/or intervention planning, as well as identifying other associated anomalies.
The New England journal of medicine, Jan 25, 2016
Images in Clinical Medicine A 43-year-old man presented with a 1-month history of dysuria and int... more Images in Clinical Medicine A 43-year-old man presented with a 1-month history of dysuria and intermittent hematuria. Similar episodes had occurred several times in the 6 months preceding presentation, along with episodes of rectal bleeding. The physical examination was unremarkable. Laboratory investigations revealed an elevated albumin:creatinine ratio (96 mg of albumin per millimole of creatinine), with dysmorphic red cells in the urine. Two urine cultures were sterile. A serum schistosoma antibody titer was 1:256. Renal ultrasonography revealed mild hydroureteronephrosis. Computed tomography of the abdomen and pelvis without the administration of contrast material revealed hydroureteronephrosis of the right ureter and kidney, with faint mural calcification of the ureter (Panel A, white arrow) and smooth mural calcification of the bladder (Panels A, B, and C, yellow arrows). There was also calcification of the seminal vesicles (Panel B, red arrow) and the wall of the rectosigmoid bowel (Panels B and C, white arrows). This pattern of calcification is typical of chronic genitourinary and gastrointestinal schistosomiasis, in which the larvae of the schistosoma parasite are deposited on the walls of the organs and become calcified. Diagnosis is based on a history of exposure along with a strong clinical suspicion of infection and the characteristic radiographic findings. Tuberculosis may also cause calcification of the bladder wall and should be considered in the differential diagnosis.
Journal of Chitwan Medical College, 2014
Oral health is a vital part of overall infant health. An early dental visit is important in rende... more Oral health is a vital part of overall infant health. An early dental visit is important in rendering prevention oriented intervention and parental counselling regarding the oral health. To assess the age and common chief complaint of the children in their first dental visit. This was a retrospective study done using case records of 842 children, who reported to the Department of Pedodontics and Preventive Dentistry, chitwan medical college. The age groups were divided into four categories; less than 3 years, 3-6years, 7-11 years and 12-14 years. The various chief complaints of patient were categorized as follows; routine check up, dental caries, dental pain, deposits/bad breath, malocclusion, unerupted ,missing or extra tooth, oral habits, trauma, orientation to prevention and others (cleft lip, palate, natal/neonatal teeth, mobile teeth, soft tissue lesions and others). The age group and the most common complaint at the first dental visit were assessed. Majority of children who...
Journal of Chitwan Medical College, 2013
Peripheral giant cell granuloma is a benign reactive lesion of gingiva. It manifests as a firm, s... more Peripheral giant cell granuloma is a benign reactive lesion of gingiva. It manifests as a firm, soft, bright nodule, sessile or pedunculate mass. It is an infrequent exophytic lesion of the oral cavity, also known as giant cell epulis, osteoclastoma, giant cell reparative granuloma, or giant-cell hyperplasia. The aim in publishing this report is to present the clinical, histopathological features and treatment of a peripheral giant cell granuloma case, which was seen in gingiva of a 10 year old male child, with history of disturbed chewing functions due to its large size. Intraoral examination revealed a raised, round, sessile, smooth-edged mass of size 2x 1 cm2 and was located on the canine, deciduous first molar region. After initial periodontal treatment, excisional biopsy was performed under local anesthesia. The lesion was diagnosed as Peripheral Giant Cell Granuloma after clinical and pathological examination. DOI: http://dx.doi.org/10.3126/jcmc.v3i3.8635 Journal of Chitwan ...
Health Renaissance, 2014
Background: Cheiloscopy is a forensic investigation technique that deals with the identification ... more Background: Cheiloscopy is a forensic investigation technique that deals with the identification based on lip traces. Based upon the research, it was established that the arrangement of lines on the red part of human lips is unique for each human being. Objectives: To analyze and compare quadrant wise and sex wise predilection of lip print pattern. Methods: A total of 200 (18-25 years) Nepalese undergraduate students of BPKIHS were selected. Thin layer of lip-stick was applied on the lips of these sub-jects. The hinged por-tion of a folded paper was inserted between the lips and the sub-jects were asked to press their lips onto it. Only middle 10 mm of both upper and lower lips were taken as study area. The lip prints, thus obtained were stud-ied on the basis of Tsuchihashi’s classification. Chi square test was used to analyze and compare the lip print patterns in all the quadrants of males and females, with the level of significance p<0.05. Results: Type I pattern was predominan...
Chest, 1993
Pulmonary infections with secondary pleural involvement lead to considerable morbidity and mortal... more Pulmonary infections with secondary pleural involvement lead to considerable morbidity and mortality. Accepted management consists of systemic antibiotics and drainage of pleural cavity, achieved either by chest tube drainage or surgery. Open thoracotomy or video-assisted thoracoscopic surgery (VATS) achieve best drainage in gross empyema or loculated effusions but are limited by operative risk, cost and local availability. Intrapleural instillation of fibrinolytic agents like streptokinase dissolves fibrinous clots and membranes to prevent fluid sequestration and hence improve drainage. We report a case of 40 years old female with loculated empyema who was treated with adjunctive installation of serial intrapleural streptokinase after ultrasound guided pigtail insertion. Significant and early improvement of the symptoms and pathophysiology were achieved.
South African Journal of Radiology
The embryology of the inferior vena cava (IVC) is complex, involving the sequential appearance an... more The embryology of the inferior vena cava (IVC) is complex, involving the sequential appearance and regression of multiple segments that ultimately form the IVC. Any alteration in this process during embryogenesis can result in congenital anomalies of the IVC. This study aimed to recognise common as well as rare anomalies of the IVC and associated veins, and their clinical implications. The anomalies tend to have diverse appearances based on the timing and segments involved. The development of the IVC is intertwined with the development of other veins like the renal vein, azygos vein and portal vein, and these veins may also be anomalous. Additionally, IVC anomalies are associated with various other congenital anomalies including cardiac anomalies, the recognition of which may be important for patient care. The IVC tends to have multiple normal variants and anomalies because of a complex process involving multiple segments contributing to the adult IVC. Knowledge of these variants is...
Case Reports in Gastrointestinal Medicine, 2021
Sclerosing encapsulating peritonitis is a rare condition caused by a fibrotic membrane covering t... more Sclerosing encapsulating peritonitis is a rare condition caused by a fibrotic membrane covering the small bowel which may lead to abdominal pain or obstruction. The cause may be primary and idiopathic or secondary to several diseases, treatments, and/or medications. The condition typically presents with bowel obstruction, and only one previous case has described ascites as the presenting sign. Sclerosing encapsulating peritonitis is typically diagnosed intraoperatively. We present a case of a patient who presented with atypical clinical symptoms including respiratory distress, recurrent abdominal ascites, and failure to thrive who was diagnosed nonoperatively.
AJR. American journal of roentgenology, 2021
AJR. American journal of roentgenology, 2021
OBJECTIVE. The purpose of this article is to review the spectrum, etiopathogenesis, clinical pres... more OBJECTIVE. The purpose of this article is to review the spectrum, etiopathogenesis, clinical presentation, imaging features, differential diagnoses, and management of emphysematous infections of the abdomen and pelvis. CONCLUSION. Emphysematous infections are associated with high morbidity and mortality and thus need urgent medical and surgical interventions. CT is the most sensitive modality to detect gas; CT provides definitive diagnosis in most cases and can depict the extent of involvement.
Emergency Radiology, 2021
To look for the presence of “perifollicular rim sign” on non-contrast CT in surgically proven cas... more To look for the presence of “perifollicular rim sign” on non-contrast CT in surgically proven cases of ovarian or adnexal torsion. A retrospective analysis of abdominopelvic non-contrast CT examinations in surgically proven cases of ovarian or adnexal torsion was conducted seeking the presence of “perifollicular rim sign” in torsed ovaries. “Perifollicular rim sign” was defined as a complete ring of perifollicular hyperdensity around ovarian follicles with an attenuation value of > 50 HU and thickness > 1–2 mm. A positive sign was equated to the presence of perifollicular hemorrhage. Pre-operative non-contrast CT was available in 7 out of the 39 ovarian or adnexal torsions included in our study. “Perifollicular rim sign” was present in 5 out of the 7 ovarian torsions on pre-operative non-contrast CT. MRI correlation was available in one patient. Ovarian enlargement (>4 cm) was present in all 7 cases. In an appropriate clinical setting, presence of “perifollicular rim sign” ...
Iranian Journal of Medical Sciences, 2018
Poster: "ECR 2016 / C-1251 / Pearls and pitfalls in the diagnosis of ectopic pregnancy"... more Poster: "ECR 2016 / C-1251 / Pearls and pitfalls in the diagnosis of ectopic pregnancy" by: "S. Ramanathan1, P. Nepal1, D. Kumar1, Y. Palaniappan2, S. B. Ladumor3, H. Hena1, M. Khanna1, N. salah ahmed mohamed1, A. Choyi madathil1, A. SHEIKH4, M. Heidous1; 1Doha/QA, 2Puducherry/IN, 3Doha,Qatar, Doha/QA, 4Ottawa, ON/CA"
Abdominal Radiology, 2021
Jejunal and ileal atresia, traditionally grouped together as jejuno-ileal atresia, are rare and h... more Jejunal and ileal atresia, traditionally grouped together as jejuno-ileal atresia, are rare and have an incidence of 1 in 5000 live births [1, 2]. The etiology of jejuno-ileal atresia is attributed to an in-utero ischemic insult of formed bowel loops. In contrast, failure of recanalization is the favored etiology in duodenal atresia. The atretic segment may be solitary or multiple, and may be associated with other congenital malformations, such as gastroschisis, cardiac anomalies, malrotation with in-utero volvulus and cystic fibrosis in up to 20% of cases [3, 4]. Most common site of atresia is the distal ileum, followed by the proximal jejunum, distal jejunum, and proximal ileum [4]. Jejuno-ileal atresias are classified according to the Grosfeld classification: type I (mucosal web), type II (fibrous cord), type III a (mesenteric gap), type III b (apple peel/Christmas tree), and type IV (multiple atresia) [5]. Type IIIb (apple peel) atresia is the least common, which represents 5–10...
BJR | case reports, 2020
Proximal small bowel obstruction in the region of the duodenum is an uncommon clinical entity. Ou... more Proximal small bowel obstruction in the region of the duodenum is an uncommon clinical entity. Our case, which involves obstruction of the third portion of the duodenum due to an abdominal aortic aneurysm (AAA), is even more unusual. A review of the relevant literature regarding duodenal obstruction due to extrinsic compression includes features that differentiate aortoduodenal syndrome from superior mesenteric artery syndrome. Management of these conditions range from conservative to surgical, of which now includes a more recent role of metallic stents in some instances.
Clinical imaging, 2020
We present a case of asymptomatic chyluria in a 70-year-old man detected two years after microwav... more We present a case of asymptomatic chyluria in a 70-year-old man detected two years after microwave ablation of renal cell carcinoma. Chyluria is a rare complication of partial nephrectomy, but has not been previously reported after renal microwave ablation therapy. Recently, percutaneous thermal ablation techniques for T1a renal cancers are in surge due to comparable treatment efficacy, less invasive nature and lower complications. It is imperative to be aware of the post-ablation imaging findings and complications for correct diagnosis. Most patients with chyluria are clinically asymptomatic; therefore, serendipitous diagnosis on imaging detecting fat-fluid level may not be unusual.
Iranian Journal of Medical Sciences, 2018
Dear Editor, Mycetoma is a chronic indolent, slowly progressive granulomatous infection which eve... more Dear Editor, Mycetoma is a chronic indolent, slowly progressive granulomatous infection which eventually causes bone destruction.1 Its diagnosis is difficult until the advanced stage, which is characterized by sinus formation, discharge of dark-colored grains, extensive soft tissue, and bone damage with deformity often necessitating amputation. Although biopsy and microbiological culture provide definitive diagnosis, these are difficult to achieve consistently.2 Early diagnosis and prompt treatment can significantly limit disability and avoid amputation. MRI (magnetic resonance imaging) features of mycetoma are characteristic, especially the dot-in-circle sign, which allow early and confident diagnosis when typical clinical features such as sinuses and grains are not manifested or histopathological diagnosis and aspiration cytology are negative or indeterminate. A 30-year-old man from India visited the orthopedic clinic in Doha (Qatar) complaining of painless, progressive soft tissu...
Radiology Case Reports, 2021
Leprosy is a chronic granulomatous infection caused by Mycobacterium Leprae that predominantly af... more Leprosy is a chronic granulomatous infection caused by Mycobacterium Leprae that predominantly affects the skin and peripheral nerves. The disease is prevalent in developing countries of Asia and Africa, with occasional cases reported from United States. In this case report we highlight a 33-year-old man from Qatar, who presented with symptoms of progressive weakness in his left wrist and hand for six months and was later found to have a granuloma of the ulnar nerve secondary to leprosy. We will discuss the etiopathogenesis, clinical features, role of imaging, and management of neuropathy due to leprosy. Our case provides an excellent learning example of the utility of ultrasonography to characterize leprosy granulomas of the ulnar nerve.