Surgicel on the post-operative CT: an old trap for radiologists

Percutaneous drainage of post-operative collections following abdominopelvic surgery has become standard practice and is a routine procedure in many interventional radiology (IR) departments. Such collections are commonly diagnosed on CT studies where the presence of Surgicel ® can mimic an abscess and lead to unnecessary procedures. We present a case where a duodenal perforation was masked by post-operative Surgicel in the gallbladder fossa, which in turn was mistaken for an infected biloma and referred for percutaneous interventional radiology drainage. Careful imaging review, correlation with operative notes and good diagnostic radiological technique led to a correct diagnosis and avoided unnecessary intervention.

Features of the displaying of the dentoalveolar region with intraoral periapical radiography

The most commonly used radiological technique in dentistry is intraoral periapical radiography, which is used alone or in combination with other x-ray techniques. Intraoral periapical radiography is a complex tech-nique for obtaining and interpreting images. The features of this technique manifest by distortions of the image of the shape and size of anatomical parts and pathological zones, vertical relationships of anatomical parts between themselves and with the zones of bone destruction. It is not always accurate to determine the number of root canals of the teeth and the degree of their obturation, measurements and densitometric calculations are not reliable. These factors contribute to diagnostic errors. Essential in the x-ray process is the correct interpretation of the image, which can be based on knowledge about the laws of the x-ray pattern in the normal and pathological processes in the dentoalveolar region. The results of the analysis of the radiological features of intraoral periapical radiography are presented. X-ray images of more than 750 patients aged 18 to 70 years with periodontitis, periosteal inflammatory bone cavities of small sizes were analyzed. The features of their implementation, interpretation, use in diagnosis and treatment are discussed in detail. The characteristic errors made during periapical radi-ography and interpretation of its results are presented and discussed.

Road Map fluoroscopy successfully guides endoscopic interventions in the esophagus

Background and study aims Road Map (RM) fluoroscopy is a radiological technique that enables visualization of anatomic structures using image subtraction at peak opacification. RM fluoroscopy has never previously been evaluated for use in endoscopy. The aim of this study was to evaluate the usefulness of RM in guiding endoscopic intervention in the esophagus. Patients and methods This was a monocentric observational trial of consecutive patients with esophageal strictures in a university hospital. Twenty-seven investigations using RM were performed in 24 patients undergoing esophageal endoscopy. Indications for the procedure were balloon dilatation (n = 7 including 2 pneumatic balloon dilatations for treatment of achalasia), bougie dilatation (n = 7) and diagnostic endoscopy (n = 1). In addition, 12 stents, 7 partially covered and 5 fully covered, were placed using RM as a guide for determination of stent length and diameter. Stents were deployed under RM guidance. Results In all procedures, RM successfully guided the intervention. Endoscopic control endoscopy confirmed adequate stent placement in all cases.The feeling of resistance during bougie dilation matched the RM-predicted location of the stenosis. With the help of RM imaging, dilatation balloons were easily centered inside the stenosis and thus slipping of the balloon was avoided. There were no adverse events. Conclusion RM allows permanent and accurate radiographic imaging of stenoses and esophageal anatomic changes. It is an easy and safe method of guiding endoscopic interventions that require radiological imaging.

“NECESSITY IS THE MOTHER OF INVENTION”: INNOVATIVE RADIOLOGICAL TECHNIQUE FOR DETECTION OF URINARY LEAK FROM URETER

<p>“Necessity is the mother of invention” and the quote very much holds true in modern day clinical practice which is very demanding both in terms of technology and intellect. Here, we are presenting a simple but effective radiological method to detect leak from the ureter in an operated case of pelvic resection.</p>