Rajeev Jain

Sonographic appearances and percutaneous management of primary tuberculous liver abscess

Primary tuberculous liver abscesses are rare. We report on 3 patients who presented with a nonresolving abscess in the liver. Clinical presentation and sonographic findings in each case were nonspecific. A diagnosis of tuberculosis was established with microbiologic examination of pus in 2 cases and examination of an excised abscess wall in 1 case. Needle aspiration (1 patient) and short‐term (72 hours) catheter drainage (1 patient) were unsuccessful, and surgical excision was required in these patients. In the third patient, continuous catheter drainage over 18 days resulted in cure, indicating that long‐term catheter drainage with antituberculous chemotherapy may be a viable alternative to surgery in the management of primary tuberculous liver abscess.

Retroperitoneoscopic Managementof Infected Cysts in Adult Polycystic Kidney Disease

Conservative measures are the mainstay of therapy in adult polycystic kidney disease (APKD). Pain, infection and obstructive uropathy are the major indications for intervention. Chronic pain has been treated with narcotic analgesics, needle aspiration of dominant cysts, and open renal cyst decortication. Laparoscopic cyst decortication, by either transperitoneal or retroperitoneal access, is a new emerging option with similar efficacy to open surgery and less morbidity. Cyst infection in these patients responds poorly to commonly used antibiotics. Patients with refractory cyst infection may even require nephrectomy. Herein, we present 2 cases with APKD that were treated by retroperitoneoscopic decortication for painful and infected cysts. Both patients showed prompt and sustained improvement in symptoms, with minimal morbidity and short convalescence. This approach has not hitherto been described for infected cysts in APKD. The retroperitoneoscopic route should be preferred in the presence of infected cysts so as to prevent intraperitoneal contamination.

Real-time sonography of orbital tumours, Colour Doppler characterization: initial experience.

Abstract Fifty‐seven patients with orbital tumours were examined with 3.5 MHz and 5 MHz real‐time sector sonography. The lesions were evaluated for their echomorphology, relationship to anatomical structures of the orbit, and extra‐orbital extension. Twenty‐two patients were further evaluated by Colour Doppler Flow Imaging (CDFI).

Vehicular entrapment and heat stroke in three children: is it a form of child neglect?

The medical records of three children who were entrapped inside vehicles are reviewed and their outcome following the incidents were assessed in this report. The children developed heat stroke following the incidents and survived after several days in coma but with severe cognitive functions impairment. Two of the children were left with hyperactivity and attention deficit, while the third had active epilepsy.Vehicular entrapment heat stroke is one of the preventable brain injuries in children. Several children get entrapped in cars or other vehicles yearly and survivors are left with significant brain damage. The usual cause for brain damage is heat stroke the lesson learned was to never leave children unattended in cars. Therefore, it is essential to double check that doors are locked when leaving children unattended near vehicles.