Abdominal pregnancy is a unique type of ectopic pregnancy that can be easily missed in routine obstetric practice. Current studies estimate an incidence of 1.3% (1-4). This type of pregnancy can be classified as primary or secondary, based on whether fertilization occurs in the peritoneal cavity followed by peritoneal implantation or whether normal fertilization is followed by rupture of the uterine or tube wall, leading to secondary implantation in the peritoneal cavity (5-7). The affected woman may not have any major complaints other than some discomfort. The abdomen enlarges, just as in normal pregnancy. To an unsuspecting radiologist doing a routine ultrasonography, the growing intra-abdominal fetus may appear quite healthy and have normal systemic development. We present the case of a 24-yearold patient who presented with loss of fetal movement at 26 weeks and subsequently was diagnosed with abdominal pregnancy by magnetic resonance imaging (MRI). We emphasize the importance of MRI in suspected abdominal pregnancies. In our case, the MRI both provided a definitive diagnosis and revealed the significant anatomical relationships of the intra-abdominal organs, thus aiding in the surgical management. Case reportA 24-year-old female (gravida 2, para 1, living 1) presented with a sixmonth history of amenorrhea, vague abdominal pain, and loss of fetal movements for 10 days. She had no history of vaginal bleeding or passage of clear fluid. She had undergone a caesarean section for her first child one year previously. There was no history of contraceptive use. The patient consulted a local hospital after she noticed reduced fetal movement, and an intra-uterine fetal demise was diagnosed following an ultrasound scan. Medical induction for delivery of the non-viable fetus was attempted, but despite adequate doses of an inducing agent, there were no signs of progress into labor. There was history of some form of attempted instrumentation. Following the unsuccessful induction, the patient was referred to our institute.On examination, the patient was pale with a heart rate of 90/min and blood pressure of 110/68 mmHg. An obstetric examination revealed a fundal height corresponding to 28 weeks, with a transverse lie and easily palpable fetal parts. The fetal heart could not be auscultated. The external os was closed on vaginal and speculum examination, and minimal bleeding was noted. Apart from mild anemia (hemoglobin, 11 g/dL), the laboratory results were within normal limits.A preliminary ultrasound scan with a 3-5 MHz curvilinear probe (Siemens Sonoline G50, Siemens Medical Solutions, Issaquah, Washington, USA) at our institute revealed a non-viable fetus with a transverse lie (Fig. 1). A normally echogenic uterine wall was not noted, which raised the suspicion of an abdominal pregnancy. The placental ABSTRACT Secondary abdominal pregnancy is a rare type of ectopic pregnancy. Following fertilization, the blastocyst escapes from the uterine cavity and implants in the peritoneal cavity. The early antenatal diagnosis and i...

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Background:Spinal cord/nerve root compression secondary to a tubercular epidural abscess leads to neurological deficit. Depending on the extent and duration of compression, the end result after treatment may vary from complete recovery to permanent deficit. ASIA has been used extensively to correlate between MRI and neurological status due to traumatic spine injuries. MRI has stood as an invaluable diagnostic tool out of the entire range of current imaging modalities. However, inspite of considerable literature on the applications of MRI in spinal tuberculosis, there have been few studies to assess the relationship between the MRI findings and the neurological deficit as assessed by clinical examination.Aims:The objective of this study was to ascertain whether the findings of magnetic resonance imaging (MRI) correlate well with the actual neurological recovery status using the American Spinal Injury Association impairment scale (ASIA) in patients with spinal compression secondary to tuberculous spondylitis.Materials and Methods:60 patients (mean age 43.6 years) diagnosed as spinal tuberculosis by MRI/cytology/histopathology were examined and classified into ASIA impairment scale A-E based on the ASIA and again reclassified after 6 months of therapy to assess functional recovery. Similarly, they underwent MR imaging at the start and at the completion of 6 months of therapy to assess the structural recovery. The MRI features of recovery were correlated with the actual neurological recovery as ascertained by the ASIA.Results:Before starting treatment 1 patient (2.08%) was in ASIA A, 2 (4.16%) were in ASIA B, 9 (18.75%) were in ASIA C, 36 (75%) were in ASIA D and 12 (20%) were in ASIA E. There was a significant difference in the epidural abscess thickness, thecal compression and cord compression between ambulatory (ASIA D and ASIA E) and non ambulatory patients (ASIA A, ASIA B and ASIA C). After 6 months of therapy 30 (90%) patients in ASIA D and 5 (55.5%) in ASIA C had complete neurological recovery. Both patients from ASIA B improved to ASIA D. Single patient who was in ASIA A before treatment remained non ambulatory (ASIA C) after treatment. Overall 33 (78.5%) patients showed complete recovery at final followup. Out of all the MRI features, only size of epidural abscess was found to be a poor prognostic factor for recovery of neurological deficit.Conclusions:There are several parameters on MRI which correlate with the severity of neurological impairment according to ASIA score and resolution of those features on treatment is also correlated well with neurological recovery.

Abscess of the tongue is rare owing to the rich vascularity and muscularity of the tongue and anti-infective properties of saliva. An abscess limited only to one half of the tongue is even more rare. We report a case of hemilingual abscess in a 17-year-old girl who presented with high-grade fever and a swollen and immobile tongue. Ultrasound (US) through floor of mouth showed inflammatory changes and collection within the right half of the genioglossus muscle. Magnetic resonance imaging (MRI) confirmed this finding, and isolated right-sided involvement was identified. US-guided aspiration of the collection yielded pus that showed gram-positive cocci on microscopy. The patient was managed conservatively, and repeat US showed resolution of the abscess. The importance of US as a quick, inexpensive, and versatile imaging technique and the precision of MRI regarding the extent of abscess of tongue are stressed.

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