Transferrin saturation studies in male adults showing high prevalence of iron deficiency

Estimation of serum iron, total iron binding capacity (TIBC) and transferrin saturation was performed in 62 apparently healthy male medical students. All had haemoglobin over 140 g/1. Low serum iron, elevated level of TIBC and transferrin saturation under 20% indicating iron deficiency state was found in 2 subjects. Elevated values of TIBC was found in 25 (40.32%) students as evidence of latent iron deficiency. Such high prevalence of iron deficiency in an affluent group indicates widespread iron deficiency in the general population.     

Imaging of chronic pancreatitis (including groove and autoimmune pancreatitis)

Multiple disorders may cause chronic pancreatitis (CP) through recurrent inflammation of the pancreatic parenchyma. Chronic calcifying pancreatitis caused by excessive alcohol intake accounts for most cases of CP. However, there are multiple other causes of CP, including obstructive chronic pancreatitis, autoimmune pancreatitis, groove pancreatitis, tropical, and hereditary pancreatitis. This article reviews the multiple imaging techniques, some of which are accepted as first-line modalities in patients with suspected CP, and the imaging features associated with the different causes of CP.     

What is the current state-of-the-art imaging for detection and staging of cholangiocarcinoma?

Cholangiocarcinoma is an adenocarcinoma that arises from the bile duct epithelium and is the second most common primary hepatobiliary cancer, after hepatocellular cancer, with approximately 2,500 cases annually in the U.S. However, cholangiocarcinoma remains a relatively rare disease, accounting for <2% of all human malignancies. Although the entire biliary tree is potentially at risk, tumors involving the biliary confluence or the right or left hepatic ducts (hilar cholangiocarcinoma) are most common and account for 40%-60% of all cases. Most patients present with advanced disease that is not amenable to surgical treatment. The median survival time for patients with intrahepatic cholangiocarcinoma without involvement of the hilum varies among centers from 18-30 months. The median survival time for patients with perihilar cholangiocarcinoma is slightly less, varying from 12-24 months. Despite the overall poor prognosis, survival after surgical treatment of hilar cholangiocarcinoma has improved during the past 10-15 years. This review highlights the imaging features of cholangiocarcinoma, with particular emphasis on the imaging techniques that can best assess tumor resectability and guide the surgeon regarding the potential extent of resection required in operable candidates.     

Protocol modifications for CT perfusion (CTp) examinations of abdomen-pelvic tumors: Impact on radiation dose and data processing time

Purpose  

To evaluate the effect of CT perfusion (CTp) protocol modifications on quantitative perfusion parameters, radiation dose and data processing time.     

Causes of renal forniceal rupture

Study Type – Diagnostic (exploratory cohort) Level of Evidence 2b What’s known on the subject? and What does the study add? Renal forniceal rupture is a common finding in patients with ureteral obstruction. It is thought to be due to increased renal pelvis pressure from backup of urine, causing one or more renal fornices to leak urine. This phenomenon has not been systematically studied. Herein we retrospectively review the causes and associated clinical findings in over 100 cases of renal forniceal rupture.

OBJECTIVE

? To perform a retrospective review aiming to identify causes of renal forniceal rupture.

PATIENTS AND METHODS

? A retrospective review was performed of the longitudinal medical record and CT records for patients identified as having renal ‘forniceal rupture’ or ‘calyceal rupture’ using a radiological database.

RESULTS

? In total, 108 patients were identified with the CT diagnosis of renal ‘forniceal’ or ‘calyceal’ rupture. ? Forniceal rupture was caused by ureteric stones in 80 cases (74.1%), malignant extrinsic ureteric compression in nine cases (8.3%), benign extrinsic ureteric compression in two cases (1.9%), pelvic‐ureteric junction obstruction in two cases (1.9%), vesico‐ureteric junction (VUJ) obstruction in one case (0.9%), bladder outlet obstruction in one case (0.9%) and iatrogenic causes in four cases (3.7%). ? No definitive cause was found in nine cases (8.3%). For patients in whom a ureteric stone was the cause of forniceal rupture, the level of obstruction was proximal ureter in 24.3% of cases, distal ureter in 17.6% of cases and VUJ in 58.1% of cases. ? Mean (sd ) stone size was 4.09 (2.0) mm. Mean (sd ) stone size was 5.34 (1.87) mm for proximal stones, 4.08 (1.69) mm for distal stones and 3.53 (1.96) mm for VUJ stones (P= 0.005). ? Urinary tract infection was present in five out of 97 patients (5.2%) in whom data were available for analysis.

CONCLUSION

? The most common aetiology of renal forniceal rupture is obstruction caused by distal ureteric stones followed by malignant extrinsic ureteric compression.     

Immunological diseases of the pancreatico-hepatobiliary system: update on etiopathogenesis and cross-sectional imaging findings

Immunological diseases of the hepatobiliary system and the pancreas include a broad spectrum of disorders that manifest characteristic histopathology/serology and variable clinical features and imaging findings. Recent studies have thrown fresh light on the complex role of genetics and autoimmunity in the pathogenesis and natural history of these diverse disorders that include autoimmune hepatitis, primary biliary cirrhosis, primary sclerosing cholangitis, IgG4-related cholangitis, overlap/outlier syndromes, and autoimmune pancreatitis.