- Email: [email protected]
1068: Ultrasound Evaluation of Abdominal Organs in Young Patients with Sickle Cell Disease
S116
Ultrasound in Medicine and Biology
hospital. On examination he was no pale, no jaundiced and afebrile, with deep tenderness in the right upper guardant of abdomen. Laboratory test were within normal limits. 2D ultrasound showed that there was a relative hyperechonic heterogeneous mass which was the around tissues in the gallbladder fossa. A pulsate echo-free space was observed inside the mass. Color Doppler ultrasound demonstrated a narrow jet of turbulent of high velocity flow from hepatic artery to echo-free space. 3D ultrasound indicated a tube-like communication between the echofree space and the hepatic artery wall. The diagnosis of HAP was established by ultrasound and further confirmed by selective hepatic artery angiography. Conclusions: Stress the identification of sonographic features in HAP patients avoiding the mistakenly diagnosis. A combination of 2D, 3D and Color Doppler was a convenient and reliable method of detecting HAP. 1068 Ultrasound Evaluation of Abdominal Organs in Young Patients with Sickle Cell Disease Kishor B Taori, Government Medical College, Nagpur, India Bipin R Kulkarni, Government Medical College, Nagpur, India Aims and Objectives: To study various spectrums of changes in abdominal organs in young patients of sickle cell disease presenting with abdominal pain. Materials and Methods: Prospective observational study was done in young patients (⬍30yrs) of sickle cell disease (n⫽100), presenting with abdominal pain over the period of two years. All the patients had undergone sickling & electrophoresis and were evaluated by ultrasound abdomen. Patients undergone for splenectomy and cholecystectomy were excluded. Results: Spleen was the most commonly involved organ (91%) amongst all abdominal organs. Hepatomegaly was the commonest finding (67%), followed by spleenomegaly (53%), and cholelithiasis (28%). Focal splenic lesions were as common as splenomegaly and comprised of infarcts, abscess and nodular lesions of preserved spleen. Ultrasound when used as single parameter was found to be less specific to differentiate between infarcts and abscesses. Cholelithiasis was found more commonly in patients of ⬎ 10 years. In all the pathologies, SS group was more commonly involved and second decade patients outnumbered others. Conclusions: Ultrasound is effective method to study various spectrums of changes in abdominal organs in patients presenting with Sickle Cell Disease. 1069 Cases of Giant Cystic Lymphangioma in Abdominal Cavity Masanori Yoshino, Musashikosugi Hospital Nippon Medical School, Japan Masao Ogata, Musashikosugi Hospital Nippon Medical School, Japan Kyoji Kondo, Musashikosugi Hospital Nippon Medical School, Japan Osamu Komine, Musashikosugi Hospital Nippon Medical School, Japan Satoshi Mizutani, Musashikosugi Hospital Nippon Medical School, Japan Masanori Watanabe, Musashikosugi Hospital Nippon Medical School, Japan Akira Tokunaga, Musashikosugi Hospital Nippon Medical School, Japan Cystic lymphangioma is a rare congenital malformation of the lymphatic system. While the lesion is frequent in the neck and axilla, abdominal localization is rare and difficult to diagnose preoperatively.
Volume 35, Number 8S, 2009 We report a case each of giant cystic lymphangioma of the pancreas and of the colon. A 28-year-old man with no past history of disease, including gallbladder lithiasis and acute/chronic pancreatitis, or abdominal trauma, presenting with severe abdominal pain and a mass in the left hypochondrium was referred to our institution for detailed examination. Abdominal ultrasonography showed the presence of a large, septated, multilocular anechoic mass in the tail of the pancreas. Based on the results of further examination, a serous cystic tumor or lymphangioma of the pancreas was suspected, and tumor excision with distal pancreatectomy while preserving the spleen was performed. A 59-year-old woman with a history of hypertension who presented with abdominal pain and a mass on the right side of the abdomen was admitted to our institution. Abdominal ultrasonography showed the presence of a large, septated, multilocular anechoic mass located behind the ascending colon. Based on the results of further examination, lymphangioma originating from the retroperitoneum was suspected, and tumor excision with colectomy was perfomed. Microscopical finding revealed the tumor originating from the ascending colon. In both cases, immunohistochemical investigation of the resected tumor specimens showed positivity for D2-40 and negativity for cytokeratin. The postoperative course in both patients was uneventful and the patients still remain alive.
1070 The Accuracy of Ultrasound Diagnosis of Endometrial Polyps John A Short, Christchurch Women’s Hospital, New Zealand Aims: To evaluate the accuracy of ultrasound diagnosis of endometrial polyps. Methods: Casenote review of all consecutive attendees at an outpatient hysteroscopy clinic over a 9 month period. Data was collated for presenting complaint, ultrasound findings, hysteroscopy findings and final histology. A “2x2” chart was constructed and the following were calculated for ultrasound diagnosis of endometrial polyps- sensitivity, specificity, positive and negative predictive value. The cohort was subdivided according to presenting complaint and sensitivities and positive predictive values were calculated for each. Results: Data was available for 157 patients- tabulated as follows; hysteroscopy: -polyp. -no polyp scan: -polyp 14 17 -no polyp 8 118 overall analysis- sensitivity 0.64, specificity 0.87 PPV 0.45, NPV 0.94 complaint specific analysisintermenstrual or postmenopasusal bleeding: - sensitivity 0.8, PPV 0.61 heavy or frequent menstruation: - sensitivity 0.33, PPV 0.31 asymptomatic women - sensitivity 0.5, PPV 0.25 all polyps were benign Conclusions: Overall, ultrasound is not accurate for the prediction of endometrial polyps, but is quite accurate for the exclusion of endometrial polyps. Ultrasound appears to be more accurate for the prediction of polyps if the presenting complaint is intermenstrual or postmenopausal bleeding. This is important because polyps are probably a more significant finding in these women. Endometrial polyps are rarely malignant. Ultrasound reports of endometrial polyps should be interpreted with caution and any decison for further investigation should reflect the clinical situation. these findings are based on a small sample and studies on larger cohorts are indicated.
Ultrasound in Medicine and Biology
hospital. On examination he was no pale, no jaundiced and afebrile, with deep tenderness in the right upper guardant of abdomen. Laboratory test were within normal limits. 2D ultrasound showed that there was a relative hyperechonic heterogeneous mass which was the around tissues in the gallbladder fossa. A pulsate echo-free space was observed inside the mass. Color Doppler ultrasound demonstrated a narrow jet of turbulent of high velocity flow from hepatic artery to echo-free space. 3D ultrasound indicated a tube-like communication between the echofree space and the hepatic artery wall. The diagnosis of HAP was established by ultrasound and further confirmed by selective hepatic artery angiography. Conclusions: Stress the identification of sonographic features in HAP patients avoiding the mistakenly diagnosis. A combination of 2D, 3D and Color Doppler was a convenient and reliable method of detecting HAP. 1068 Ultrasound Evaluation of Abdominal Organs in Young Patients with Sickle Cell Disease Kishor B Taori, Government Medical College, Nagpur, India Bipin R Kulkarni, Government Medical College, Nagpur, India Aims and Objectives: To study various spectrums of changes in abdominal organs in young patients of sickle cell disease presenting with abdominal pain. Materials and Methods: Prospective observational study was done in young patients (⬍30yrs) of sickle cell disease (n⫽100), presenting with abdominal pain over the period of two years. All the patients had undergone sickling & electrophoresis and were evaluated by ultrasound abdomen. Patients undergone for splenectomy and cholecystectomy were excluded. Results: Spleen was the most commonly involved organ (91%) amongst all abdominal organs. Hepatomegaly was the commonest finding (67%), followed by spleenomegaly (53%), and cholelithiasis (28%). Focal splenic lesions were as common as splenomegaly and comprised of infarcts, abscess and nodular lesions of preserved spleen. Ultrasound when used as single parameter was found to be less specific to differentiate between infarcts and abscesses. Cholelithiasis was found more commonly in patients of ⬎ 10 years. In all the pathologies, SS group was more commonly involved and second decade patients outnumbered others. Conclusions: Ultrasound is effective method to study various spectrums of changes in abdominal organs in patients presenting with Sickle Cell Disease. 1069 Cases of Giant Cystic Lymphangioma in Abdominal Cavity Masanori Yoshino, Musashikosugi Hospital Nippon Medical School, Japan Masao Ogata, Musashikosugi Hospital Nippon Medical School, Japan Kyoji Kondo, Musashikosugi Hospital Nippon Medical School, Japan Osamu Komine, Musashikosugi Hospital Nippon Medical School, Japan Satoshi Mizutani, Musashikosugi Hospital Nippon Medical School, Japan Masanori Watanabe, Musashikosugi Hospital Nippon Medical School, Japan Akira Tokunaga, Musashikosugi Hospital Nippon Medical School, Japan Cystic lymphangioma is a rare congenital malformation of the lymphatic system. While the lesion is frequent in the neck and axilla, abdominal localization is rare and difficult to diagnose preoperatively.
Volume 35, Number 8S, 2009 We report a case each of giant cystic lymphangioma of the pancreas and of the colon. A 28-year-old man with no past history of disease, including gallbladder lithiasis and acute/chronic pancreatitis, or abdominal trauma, presenting with severe abdominal pain and a mass in the left hypochondrium was referred to our institution for detailed examination. Abdominal ultrasonography showed the presence of a large, septated, multilocular anechoic mass in the tail of the pancreas. Based on the results of further examination, a serous cystic tumor or lymphangioma of the pancreas was suspected, and tumor excision with distal pancreatectomy while preserving the spleen was performed. A 59-year-old woman with a history of hypertension who presented with abdominal pain and a mass on the right side of the abdomen was admitted to our institution. Abdominal ultrasonography showed the presence of a large, septated, multilocular anechoic mass located behind the ascending colon. Based on the results of further examination, lymphangioma originating from the retroperitoneum was suspected, and tumor excision with colectomy was perfomed. Microscopical finding revealed the tumor originating from the ascending colon. In both cases, immunohistochemical investigation of the resected tumor specimens showed positivity for D2-40 and negativity for cytokeratin. The postoperative course in both patients was uneventful and the patients still remain alive.
1070 The Accuracy of Ultrasound Diagnosis of Endometrial Polyps John A Short, Christchurch Women’s Hospital, New Zealand Aims: To evaluate the accuracy of ultrasound diagnosis of endometrial polyps. Methods: Casenote review of all consecutive attendees at an outpatient hysteroscopy clinic over a 9 month period. Data was collated for presenting complaint, ultrasound findings, hysteroscopy findings and final histology. A “2x2” chart was constructed and the following were calculated for ultrasound diagnosis of endometrial polyps- sensitivity, specificity, positive and negative predictive value. The cohort was subdivided according to presenting complaint and sensitivities and positive predictive values were calculated for each. Results: Data was available for 157 patients- tabulated as follows; hysteroscopy: -polyp. -no polyp scan: -polyp 14 17 -no polyp 8 118 overall analysis- sensitivity 0.64, specificity 0.87 PPV 0.45, NPV 0.94 complaint specific analysisintermenstrual or postmenopasusal bleeding: - sensitivity 0.8, PPV 0.61 heavy or frequent menstruation: - sensitivity 0.33, PPV 0.31 asymptomatic women - sensitivity 0.5, PPV 0.25 all polyps were benign Conclusions: Overall, ultrasound is not accurate for the prediction of endometrial polyps, but is quite accurate for the exclusion of endometrial polyps. Ultrasound appears to be more accurate for the prediction of polyps if the presenting complaint is intermenstrual or postmenopausal bleeding. This is important because polyps are probably a more significant finding in these women. Endometrial polyps are rarely malignant. Ultrasound reports of endometrial polyps should be interpreted with caution and any decison for further investigation should reflect the clinical situation. these findings are based on a small sample and studies on larger cohorts are indicated.