Giant mesenteric cyst.
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Biomedical subjects
Publications and source records attributed to Omer Onbas.
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BACKGROUND: Although some studies evaluated venous thromboembolism (VTE) prevalence in patients with chronic obstructive pulmonary disease (COPD), they contain no detailed description of the patients' characteristics. OBJECTIVES: It was the aim of this study to investigate the frequency and clinical characteristics and outcomes of VTE in patients with COPD exacerbation. METHODS: Between October 2004 and February 2005, 120 consecutive patients were included in the study. On admission, Doppler examination of lower extremities in all cases and spiral computed tomography of the thorax in cases with a suspicion of pulmonary thromboembolism were performed. A questionnaire was used to take a detailed history. In addition to routine laboratory tests, chest X-ray, postbronchodilator spirometry, arterial blood gas analysis and serum levels of D-dimer and C-reactive protein were evaluated, as well as dyspnea score and performance status before exacerbation. The hospitalization durations and mechanical ventilation requirements were also recorded. RESULTS: VTE was determined in 16 cases (13.3%). In patients with VTE, the travel history was higher (p < 0.001), the dyspnea score worse (p = 0.005), the duration of hospitalization longer (p < 0.001) and the mechanical ventilation requirement increased (p < 0.001); a change in mental status was highly associated with the presence of VTE (p < 0.001). CONCLUSIONS: It seems that VTE occurrence was higher in the presence of a risk factor causing immobility such as travel history and increased dyspnea. The cases with severe disease are more likely to have VTE. Preventive measures may be considered in such patients because their hospitalization stay and mechanical ventilation requirement are increased.
PURPOSE: Dysphagia lusoria (DL) is described in the literature as difficulty in swallowing caused by vascular abnormalities. The most common cause is an aberrant right subclavian artery (SCA) which passes behind the esophagus and is also called arteria lusoria (AL). Our aim was to demonstrate the use of multidetector computed tomography (MDCT) in the diagnosis of AL, as there is no comprehensive study investigating the role of MDCT in such cases. MATERIAL AND METHODS: A total of 38 consecutive patients, comprising of 23 females (61%) and 15 males (39%), who had extrinsic compression were included in the study. These patients are selected from the cases who were admitted due to their gastrointestinal symptoms, such as dysphagia, epigastric pain, chronic nausea, vomiting, etc. The mean age of patients was 40 +/- 25 years (range 15-65). Following barium esophagogram and then endoscopy performed, MDCT angiography was carried out on the same or the following few days. MDCT sections were examined to determine the following: presence of vascular abnormality; the diameter and angle of that vascular structure; and the compressed area of esophagus. Radiological findings and dysphagia scores were also compared. RESULTS: In each of 15 cases, there was a compression due to vascular abnormality which were all located between the esophagus and the spine. There was an esophageal compression in each of 12 cases, due to right aberrant SCA, in one case due to right superior aortic arch and in two cases due to both right aortic arch and left SCA with Kommerell's diverticulum. The mean diameter and the angle of AL were 16.4 mm and 48.8 degrees , respectively, and the mean area of pressured esophagus was 194.7 mm2. Dysphagia scores of the cases was 1 in thirteen cases and 2 in two cases. However, dysphagia scores were not correlated with these parameters. CONCLUSIONS: MDCT angiography is a useful diagnostic tool for evaluation of patients with dysphagia, especially caused by a vascular abnormality.
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OBJECTIVE: The aim of this study was to evaluate the incidence of myocardial bridging in 626 patients examined with MDCT angiography of the coronary arteries. MATERIALS AND METHODS: Six hundred twenty-six patients who were referred to Florence Nightingale and Atatürk University Hospitals were involved in this study. These patients had atypical chest pain, symptoms suggestive of coronary artery disease, or no significant cardiac complaint. Patients were in sinus rhythm and were premedicated with metoprolol tartrate (5 mg/mL IV bolus) to decrease the heart rate and nitroglycerin (5 mg sublingual 1 min before the examination) to dilate the coronary arteries. MDCT was performed on two different 16-MDCT scanners. RESULTS: Among the 626 patients, 22 cases (3.5%) of myocardial bridging were detected. Fifteen cases of myocardial bridging (2.4%) were located at the middle third of the left anterior descending coronary artery (LAD), five (0.8%) were at the distal third of the LAD, and two (0.3%) were at the proximal third of the LAD. In these patients, the length of tunneled artery was between 6 and 22 mm, with a mean of 17 mm, and the depth of tunneled artery was between 1.2 and 3.3 mm, with a mean of 2.5 mm. CONCLUSION: We found the incidence of myocardial bridging in this patient group to be 3.5%. This result is in agreement with some of the angiographic studies in the literature. Our study showed that MDCT is a reliable and noninvasive tool for diagnosing coronary myocardial bridging. After evaluating resource axial images, it is necessary to also evaluate the sagittal multiplanar reconstruction images for myocardial bridging.
The incidence of intestinal tuberculosis (ITB) has been increasing in the West, due to the AIDS epidemic, transglobal immigration, IV drug abuse, an aging population, and an increase in the number of immunocompromised patients. Obstruction and perforation of the intestine are the most common and serious complications of ITB. Another complication, tuberculous liver abscess (TLA), is rare and usually associated with foci of infection in the lung or gastrointestinal tract. We report a case of a 17-year-old boy with Down syndrome who presented with multiple TLAs secondary to obstructive and multiple perforated ileal tuberculosis.
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There are asymmetries in the sizes of transverse sinus and intraocular pressure. The purpose of this study was to investigate possible relationships between the asymmetry of transverse sinuses in TOF MR venography and intraocular pressures of right and left eyes. In this study, subjects were 63 male and 42 female medical school students, aged 18-21 years (mean+/-SD; 19.72+/-0.67 years). Subjects with neurological and ophthalmologic disease, particularly dural sinus thrombosis, myopia, trauma and glaucoma, were excluded the study. Subjects were divided into five groups according to the magnitudes of the right- and left-transverse sinuses in MR venography results. There is a functional relation between intraocular pressures of the right and left eyes and asymmetry of the transverse sinus. If the transverse sinus on one side is larger and its venous drainage is greater, the intraocular pressure of the eye on this side is lower. It can be speculated that the transverse sinus size may be associated with pathogenesis of diseases with increased intraocular pressure such as glaucoma. We aim to determine the relation between the size and drainage of transverse sinuses in TOF MR venography and intraocular pressure in patients with open-angle glaucoma in our next study.
We present magnetic resonance imaging findings in Millard-Gubler syndrome. In our case, Millard-Gubler syndrome was described first by magnetic resonance angiography findings. MR imaging revealed an infarct in the left side of the ventral pons. Clinical examination and MR imaging revealed Millard-Gubler syndrome.
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Time-of-flight (TOF) magnetic resonance venography (MRV) is often used to examine the intracranial dural sinuses, particularly in the evaluation of dural sinus thrombosis. The goal of the study was to evaluate the use of TOF MRV in assessing the normal anatomy of dural sinuses and their variations as sources of potential pitfalls in the diagnosis of venous sinus thrombosis. Cerebral TOF MRV obtained in 105 persons with normal MR studies were reviewed to determine the presence, aplasia and hypoplasia of the transverse sinuses. Twenty-one (20%) aplasias of the left sinus, 41 (39%) hypoplasia of the left sinus, 33 (31%) symmetric, 6 (6%) hypoplasia of the right sinus, and 4 (4%) aplasias of the right sinus cases were determined in the asymmetry in sizes of transverse sinuses. These results suggested that transverse sinus flow gaps or aplasias can be observed in approximately 24% of normal population on MR imaging. The rate of these gaps in normal subjects must be kept in mind because it can be a source of misdiagnosis in cases of suspected dural sinus thrombosis.
Spinal hydatid cyst is an uncommon but serious condition. Intradural presentation is extremely rare. The case reported herein describes an unusual recurrent hydatidosis with progression of recurrence and spreading into intradural extramedullary field.
Cerebral air embolism may be caused by iatrogenic or post-traumatic introduction of air into arterial or venous systems. It is usually revealed by computerized tomography. In this paper, we report a case with thorax trauma and loss of consciousness, in whom cerebral massive air embolism was detected and its distribution was demonstrated by using 3D spiral CT reconstruction. To our knowledge, this is the first case in whom 3D spiral CT reconstruction was used for demonstration of cerebral arterial air embolism.
With the advent of functional endoscopic sinus surgery (FESS) and coronal computed tomography (CT) imaging, considerable attention has been directed toward paranasal region anatomy. Detailed knowledge of anatomic variations in paranasal sinus region is critical for surgeons performing endoscopic sinus surgery as well as for the radiologist involved in the preoperative work-up. To be in the known anatomical variants with some accompanying pathologies, directly influence the success of diagnostic and therapeutic management of paranasal sinus diseases. A review of 512 (1024 sides) paranasal sinus tomographic scans was carried out to expose remarkable anatomic variations of this region. We used only coronal sections, but for some cases to clear exact diagnosis, additional axial CT scan, magnetic resonance imaging (MRI) and nasal endoscopy were also performed. In this pictorial essay, rates of remarkable anatomic variations in paranasal region were displayed. The images of some interesting cases were illustrated, such as the Onodi cell in which isolated mucocele caused loss of visual acuity, agger nasi cell, Haller's cell, uncinate bulla, giant superior concha bullosa, inferior concha bullosa, bilateral carotid artery protrusion into sphenoid sinus, maxillary sinus agenesis, bilateral secondary middle turbinate (SMT) and sphenomaxillary plate. The clinical importance of all these variations were discussed under the light of the literature. It was suggested that remarkable anatomic variations of paranasal region and their possible pathologic consequences should be well defined in order to improve success of management strategies, and to avoid potential complications of endoscopic sinus surgery. The radiologist must pay close attention to anatomical variations in the preoperative evaluation.
Replacement lipomatosis of the kidney is the result of severe atrophy or destruction of the renal parenchyma, often caused by calculous disease with secondary marked proliferation of renal sinus, renal hilus, and perirenal fatty tissue. Different diagnostic tools have been used to define this entity, with ultrasonography (US), i.v. pyelography (IVP) and computed tomography (CT) used most commonly. We report MR urography and MR appearance of replacement lipomatosis in a 38-year-old man. We think that it combines the advantages of IVP, US and CT.
Anaphylactic shock as a result of trauma is very rare. We report the clinical and radiologic findings of a 10-year-old boy who developed systemic anaphylaxis due to traumatic rupture of hepatic hydatid cyst into a pericystic blood vessel. In regions where hydatid disease is endemic, rupture of a hydatid cyst might be taken into consideration in patients who have post-traumatic anaphylactic shock. Likewise, this pathology should be kept in mind when evaluating an immigrant from an endemic area in nonendemic regions.
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