Ajit Mahale

Herlyn-Werner-Wunderlich syndrome - Common presentation of an unusual variation: A Case Report

Herlyn-Werner-Wunderlich syndrome also known as uterus didelphys with obstructing hemivaginal septum and ipsilateral renal agenesis is a rare syndrome with only a few hundred reported cases described since 1922. Uterus Didelphys is a type of lateral fusion disorder of mullerian ducts. Mullerian duct anomalies have an incidence of 2–3%, while obstructing hemivaginal septum and ipsilateral renal agenesis constitutes 0.16–10% ofthese mullerian duct anomalies. A female case referred to our radiology department for evaluation of lower abdominal pain revealed Uterus Didelphys with Obstructing Hemivaginal Septum and Ipsilateral Renal Agenesis on imaging. Understanding the imaging findings, in conjunction with the clinical presentation, is critical for early diagnosis in attempting to prevent complications such as endometriosis or adhesions from chronic infections with subsequent infertility.Management depends on the presence or absence of an obstruction. Surgical removal of the vaginal septum is the preferred approach for relieving an obstruction.

MRI Sequence and Characteristic Features in ‘Giant Cell Tumor’ of Clivus

Giant cell tumours of the clivus are rare. These tumours present in the second and third decades of life and they are slightly more frequent in women than in men. We are presenting a case of a 20 years young patient who came with the complaints of headache, retro-orbital pain and recurrent transient bleeding from the nose since two and half months. MRI of the brain with contrast was done and its features were suggestive of a Giant cell tumour of the clivus. A transnasal endoscopic biopsy was done under general anaesthesia and the histopathology report suggested that the features were of a giant cell tumour. Excision of the mass was done by Transnasal endoscopy. Post operatively, the patient did not recover from the lateral rectus palsy which was there on the right side. The patient was discharged with an advice of a follow up and radiotherapy. Radiation therapy and chemotherapy may be effective as adjuvant treatments. Even though a recurrence usually occurs within 4 years of the initial treatment, these patients will need to be carefully followed for the remainder of their lives.

Variaton of nuchal translucency with increasing crown rump length and gestational age in normal singleton pregnancies

This study was undertaken to estimate ultrasound measurement of nuchal translucency (NT) thickness in normal fetuses between 11 and 13.6 weeks of gestation.The aim of this study was to establish normative data of nuchal translucency distribution in singleton pregnancies.600 fetuses with known normal outcome were included in this study. The distribution of median values of NT thickness with crown rump length(CRL) in 10 mm intervals and 95th percentile were calculated with linear regression method .False positive rates with increasing gestational age were studied. This study offers a normative data of fetal NT thickness in normal pregnancy, which can be used as a reference for screening chromosomal aberrations or other congenital abnormalities in the first trimester.

A rare case of pancreatic injury: A case report

Pancreatic injury occurs in less than 5% of major abdominal injuries [1]. Two thirds of pancreatic injuries are associated with penetrating abdominal trauma and one third associated with blunt abdominal trauma [2]. An early diagnosis of pancreatic trauma can be challenging and difficult because of the lack of correlation between the initial presenting features, radiological and laboratory findings, and the severity of the trauma. Caused by compression of the pancreas between the vertebral column and exteral compression, these injuries were extremely difficult to detect in the yesterdyears, but have now become easier to pick up with the advent of cross sectional imaging especially the computed tomography(CT) scan [3]. Morbidity and mortality increases with associated injury to other abdominal organs and vascular structures as well as with delay in diagnosis. We present a rare case of isolated pancreatic injury in a six- year old female.

Pancreatic tuberculous abscess mimicking as cystic neoplasm:A rare initial manifestation of AIDS‑defining illness

A pancreatic tuberculous abscess is extremely rare, considered to be an AIDS-defining illness in HIV-positive patients. It is even rare to present as an initial manifestation of AIDS. We present a case that presented with epigastric pain, fever, and reduced appetite. The cystic pancreatic lesion was identified and computed tomography-guided fine needle aspiration proved it to be a tuberculous abscess, confirmed by demonstration of acid fact bacilli in the pus aspirated. Although rare, it must be considered in the differentials in HIV-positive patients and can be confirmed by minimally invasive image-guided aspiration with microbiological or histopathological evaluation. Etiopathogenesis, presentation, and review of the literature is been summarized.

Silent Sinus Syndrome- A Blowout Fracture Mimic

The silent sinus syndrome, also known as imploding antrum and chronic maxillary sinus atelectasis, consists of painless enophthalmos, facial asymmetry with inward retraction of the ipsilateral maxillary sinus walls as seen on imaging studies. It is a well-recognized entity in the field of otolaryngology, but the syndrome remains relatively unknown among radiologists despite its characteristic radiological features. The chronic maxillary sinus atelectasis presenting to the Emergency Room with facial trauma, this entity may, to the radiologist unaware of its existence, be misdiagnosed as an orbital floor blowout fracture, especially when the trauma is ipsilateral. Features that distinguish it from the blow-out fracture are the associated deformities of the other maxillary walls, total opacification of the sinus (as opposed to an air-fluid level), and osteolysis of the sinus walls (if present). It can be definitively treated by creating an outlet for mucous drainage from the obstructed sinus, the goal of treatment being to arrest disease progression without development of further deformity. The purpose of this article is to acquaint the reader with the clinical and imaging features of the silent sinus syndrome.

Solid-pseudopapillary tumour of the pancreas: A report of a rare case

The solid pseudopapillary tumour (SPT) of the pancreas is an uncommon cystic pancreatic neoplasm mostly seen in young females. We present a large SPT in a 16-year-old female who presented with acute onset upper- and mid-quadrant abdominal pain associated with nausea and vomiting for 4 days. The lesion was demonstrated by abdominal ultrasound and by computed tomography, which was successfully removed surgically.