Ahmet Yiğit Göktay

Percutaneous Treatment of Hydatid Liver Cysts in Children as a Primary Treatment: Long-term Results

PURPOSE To evaluate the effectiveness and long-term results of percutaneous treatment for hydatid liver cysts in pediatric patients. MATERIALS AND METHODS Thirty-four pediatric patients (15 male, 19 female; ages 4-17 years; mean age, 9.4 years) with 51 hydatid liver cysts underwent ultrasound (US)-guided percutaneous treatment with albendazole prophylaxis. There were 15 type II lesions with membrane detachment and 36 type I lesions resembling simple hepatic cysts with pure anechogenic content or small echogenic reflections and a regular well-delineated wall. The method of US-guided puncture, aspiration, injection of hypertonic saline solution, and reaspiration was preferred for 21 lesions. For the remaining 30 larger cysts, the intervention was performed with the same percutaneous technique but followed by catheterization, drainage, control cystography, and sclerotherapy with ethanol. During follow-up, US examinations were performed at 1, 3, 6, and 12 months for the first year and yearly thereafter. RESULTS Percutaneous treatment of hepatic hydatid disease was successful in 33 patients (97.1%). During follow-up, US findings in the lesions changed significantly; at year 1, the inner content of the lesions became heterogeneous with a semisolid appearance, and the mean reduction in volume was 81.4%. At 2-year follow-up, most hydatid cysts had become solid in nature and the reduction in volume reached 65%-99% (mean, 85.1%). There were no recurrences or additional lesions after the follow-up of 1-6 years (mean, 3.1 years). Average hospital stay for the whole group in this study was 3.5 days. CONCLUSIONS The long-term results of percutaneous liver hydatid cyst treatment in children are in accordance with the results in adults. Percutaneous treatment of uncomplicated type I and type II liver hydatid cysts in pediatric patients is an efficient and safe treatment with short hospitalization.

Bilateral Epididymal Candida abscesses:Sonographic findings and sonographically guided fine‐needle aspiration

We report the case of a 67‐year‐old diabetic man who presented 2 months after transurethral prostate surgery with impaired consciousness, urinary incontinence, and recurrent urinary tract infections that did not respond to antibiotic treatment. Sonographic findings suggested abscess formation (enlarged, heterogeneous epididymides and a central hypoechoic area in the head of the left epididymis). Aspirates obtained from sonographically guided needle biopsy were purulent. Staining showed budding yeast forms, and Candida albicans grew in culture. Systemic candidiasis was diagnosed. The patient underwent bilateral epididymo‐orchiectomy, and pathologic analysis of resected specimens showed bilateral epididymal necrosis and disseminated abscess formation.

CT findings of non-functioning neuroendocrine pancreatic tumors.

Neuroendocrine tumors are rare neoplasms of the pancreas, representing 0.5% of all pancreatic tumors. Approximately, one-third of neuroendocrine tumors are hormonally inactive and called non-functioning neuroendocrine tumors. As these tumors remain clinically silent in their course of growth, they may attain great sizes without causing apparent clinical findings and commonly present in advanced stage. We report three cases of non-functioning neuroendocrine tumors with large sizes and discuss the radiological findings.

Aneurysmal dilatation of the paraumbilical vein in an infant

Abstract The paraumbilical veins are one of the most common collateral pathways developing in portal hypertension. Aneurysmal dilatation of a patent paraumbilical vein is a very unusual finding. We report the first infant case of a paraumbilical vein aneurysm and its Doppler ultrasound findings.

Endovascular Stent-Graft Treatment of Giant Celiac Artery Pseudoaneurysm

Summary Background Visceral artery aneurysms (VAAs) comprise an uncommon but life-threatening vascular disease. When rupture is the first clinical presentation, mortality rate reaches 70%. Increased use of cross-sectional imaging has led to a greater rate of diagnosis (40–80%) of asymptomatic VAAs. In the past, surgery was the treatment of choice for VAAs carrying high risk of mortality and morbidity. Case Report A 22-year-old man, who had undergone gastric, pancreatic and aortic surgery 2.5 years earlier, presented with progressive abdominal pain. Multidetector computed tomography scan revealed an 8-cm celiac pseudoaneurysm. We report a giant celiac pseudoaneurysm treated with stent-graft implantation. Conclusions Endovascular treatment of VAA is a safe and effective method alternative to surgery.

Vascular Disorders of the Kidney

Atherosclerotic renal artery stenosis results in renal ischemia which may lead to secondary hypertension and renal insufficiency. The second most common cause of RAS is fibromuscular dysplasia (FMD). Arteriovenous malformations of kidney can be congenital or acquired. A renal artery aneurysm (RAA) is defined as a dilated segment of renal artery that exceeds twice the diameter of a normal renal artery. Symptomatic renal artery aneurysms may present with hypertension, pain, hematuria, or renal infarction. Irrespective of its etiology, RAS is known to cause renovascular hypertension by stimulating excessive renin secretion of the ischemic kidney.

Asymptomatic ureteral varices : Detection by doppler sonography

Retroperitoneal ectatic or varicose veins may cause ureteral extrinsic pressure defects. Doppler sonography may be helpful in the characterization of these vascular lesions. We report the sonographic findings in a case of asymptomatic idiopathic left ureteral varices.