Amit Kumar Dey

Benign Multicystic Peritoneal Mesothelioma: A Rare Tumour of the Abdomen

Benign multicystic peritoneal mesothelioma: a rare tumor of the abdomen, is a diagnostic dilemma. This report emphasizes the importance of diagnostic laparoscopy in the diagnosis of the tumour.

Radiological Illustration of Spontaneous Ovarian Hyperstimulation Syndrome

Summary Background The role of radiology is of utmost importance not only in diagnosing s-OHSS but also in ruling out other cystic ovarian diseases and to determine the underlying etiology and course of the disease. We presented a radiological algorithm for diagnosing the various causes of s-OHSS. Case Report A 26-year-old female, gravida one was referred to radiology department with history of lower abdominal pain, nausea and vomiting since 2 days which was gradual in onset and progression. The patient had no significant medical and surgical history. Conclusions This article illustrates and emphasizes that diagnosis of s-OHSS and its etiology can be completely evaluated radiologically. Biochemical markers will confirm the radiological diagnosis.

Spontaneous ovarian hyperstimulation syndrome – understanding the dilemma

Abstract Ovarian hyper-stimulation syndrome (OHSS) is an uncommon identity due to variable number of causes, gestation and gestational disease being more common than thyroiditis and other causes. The role of radiology and biochemical markers are of utmost importance in not only diagnosing spontaneous ovarian hyper-stimulation syndrome (sOHSS) but also ruling out other cystic ovarian diseases and to determine the underlying aetiology and course of the disease. Understanding its pathophysiology and genetics holds the key to unravel the mysteries of this condition. Chinese abstract 卵巢过度刺激综合征（OHSS）是一种由多种原因引起的罕见疾病，病因中妊娠与妊娠期疾病比甲状腺与其他疾病更为常见。放射学与生物化学标志物起到极为重要的作用，不但可以诊断自发性卵巢过度刺激综合征（sOHSS），还能够排除其他卵巢囊性疾病，进而找到发病原因，了解发病过程。了解该疾病最关键的是研究其病理生理学和遗传学机制。

A Series of Congenital High Airway Obstruction Syndrome – Classic Imaging Findings

Congenital high airway obstruction syndrome (CHAOS) is a very rare entity with very poor prognosis in which upper airway is intrinsically obstructed, the most common reason being laryngeal atresia. In summary prenatal early diagnosis of patients with CHAOS is necessary so that perinatal management can be undertaken successfully or elective termination of pregnancy can be undertaken. The fetoscopic approach may be a life saving modality in a subset of CHAOS patients. Involving a multidisciplinary team comprising of paediatricians, radiologists, obstetricians and anaesthesiologists increases the efficiency of management.

Strangulated Morgagni’s Hernia: A Rare Diagnosis and Management

Morgagni hernia is a rare type of congenital diaphragmatic hernia. It accounts for only 3% of all diaphragmatic hernias. The defect is small and hernia being asymptomatic in the majority presents late in adulthood. Obstruction or incarceration in Morgagni hernia is uncommon. We report a rare occurrence of strangulated Morgagni hernia. A 40-year-old gentleman presented to our emergency department with features of intestinal obstruction. Computed tomography of the chest and abdomen showed a strangulated right Morgagni hernia. An exploratory laparotomy was performed with resection of the ischemic bowel segment with anastomosis and a primary repair of the diaphragmatic defect. Postoperative recovery was uneventful and asymptomatic at follow-up.

Hemangioma of Rib: A Different Perspective

Summary Background Hemangiomas are one of the common primary benign tumors of the intraosseous and soft tissue compartments in humans. Vertebral hemangiomas being the most common of all are seen in daily radiological practice. Hemangioma of the rib is rarely seen. Case Report We reported on a case of a rib lesion which had a classic imaging pattern of hemangioma. We highlighted the use of pre-operative embolization of such a vascular rib lesion before surgically removing the lesion by thoracotomy to reduce the risk of bleeding. Conclusions We also emphasized overt complications of overzealous needling of such a vascular lesion for histopathological diagnosis as in our case.

Use of imaging in diagnosis of Herlyn–Werner–Wunderlich syndrome, a case report

Herlyn–Werner–Wunderlich (HWW) syndrome is a very rare congenital anomaly characterised by a triad of obstructed hemivagina, didelphys uterus and renal agenesis, which was first reported in 1922 by Purslow (Fedele et al. 2013). It is an anomaly of Mullerian duct that also involves the Wolffian duct. It is a combination of Type III Mullerian anomaly associated with mesonephric duct anomaly and vaginal septum (Buttram and Gibbons 1979). The incidence of Mullerian duct anomaly in the general population is 0.1–3.8% and the incidence of uterine didelphys in Mullerian duct anomalies is 11%. In cases of uterine didelphys, the incidence of accompanying transverse vaginal septum is 75% (Junqueira et al. 2009). The incidence of uterine didelphys in HWW syndrome varies from 1/200 to 1/28,000 and the incidence of accompanying unilateral renal agenesis is 43% (Zurawin et al. 2004). The triad of didelphic uterus, obstructed hemivagina and ipsilateral renal agenesis is a very rare presentation constituting 0.16–10% of all Mullerian duct abnormalities. (Cox and Ching 2012) HWW syndrome was classified into two distinct types and subtypes (completely or incompletely obstructed hemivagina) in the year 2015 (Zhu et al. 2015). This paper is written with an objective to report a very rare case with the description of typical imaging features.

Pseudoaneurysm Arising from Mitral Aortic Intervalvular Fibrosa (P-MAIVF) Communicating with Left Atrium (LA): Multiple Detector Computed Tomography (MDCT) Evaluation.

Summary Background The entity pseudoaneurysm arising from the mitral aortic intervalvular fibrosa (P-MAIVF) is a rare cardiac finding caused by multiple factors. This entity is usually diagnosed with echocardiography and confirmed with cardiac computed tomography (CT). Case Report We presented a case of congenital P-MAIVF communicating with the left atrium (LA) and an aberrant right subclavian artery, misdiagnosed as primary mitral regurgitation (MR) in transthoracic echocardiogram (TTE) due to relative contraindications to transesophageal echocardiogram (TEE), revealed in a hemophilic patient, and diagnosed with cardiac CT. Conclusions In conclusion, cardiac CT plays a definitive role not only in anatomical assessment and confirmation of the lesion but also in primary diagnostics in patients suspected of MAIVF – especially those with relative and absolute contraindications to TEE.

An Association of Chronic Hyperaldosteronism with Medullary Nephrocalcinosis.

Summary Background An association between chronic hyperaldosteronism and medullary nephrocalcinosis has rarely been made, with only a handful of cases described in literature. Case Report We describe five cases of hyperaldosteronism with a long- standing history in whom associated medullary nephrocalcinosis was established. Conclusions We infer that a chronic hyperaldosteronic status, whether primary or secondary, is a causal factor in the etiopathogenesis of medullary nephrocalcinosis. This article illustrates and summarizes various postulated theories that support our proposed association between hyperaldosteronism and nephrocalcinosis. We conclude that chronic hyperaldosteronism should be included as one of the causes of nephrocalcinosis and that our case series emphasizes the need of a well-organized retrospective study to prove it further.

Unruptured Noncoronary Sinus of Valsalva Aneurysm Associated with Atrial Septal Defect (ASD).

Sinus of Valsalva aneurysms are rare cardiac anomalies. Incidence of this anomaly is higher in Asian population with male preponderance. Our case highlights a rare association between unruptured sinus of Valsalva aneurysm and atrial septal defect (ASD). Rarely diagnosis of sinus of Valsalva aneurysm is missed on two dimensional echocardiography. Multi slice CT scan is done to confirm echocardiographic findings and to detect any missed complications, other cardiac abnormalities and anatomy for a precise surgical approach.