BackgroundDistribution of coronary artery calcium (CAC) has been determined in different heterogeneous populations in the Multi-Ethnic Study of Atherosclerosis (MESA). Based on findings showing that geography and culture can influence CAC scoring beyond traditional race groups, we determined the distribution of CAC in a homogenous black African population to provide an initial basis for a larger CAC score study in Africa.Methods and resultsThis is a preliminary study using computed tomography to determine the CAC scores within a black African population who were referred to our center. Other information on patients were recorded through a combination of one-on-one interviews and medical records. A total of 170 patients were involved in our study, including 60.6% males, with an average age of 53.9 ± 9.2 years. The majority (78.8%) had a zero calcium score, with patients within the age group of 55–64 years dominating the non-zero calcium score population. Males were found to have higher calcium levels compared to females, and coronary artery calcification and prevalence steadily rose with the increasing age. However, P-values of 0.328 and <0.001 were observed with distribution of CAC according to gender and age, respectively.ConclusionFindings from this study showed that the distribution of CAC was markedly affected by the age of our study population, which will be more apparent in a larger study.

The concurrence of wandering spleen, organoaxial gastric volvulus, and pancreatic volvulus is very rare. They have been associated with symptoms such as severe abdominal pain, abdominal distention, and vomiting. However, the diagnosis remains complicated and any delay can result in ischemia and necrosis of the organs involved. In this case presentation, we present a unique case involving a 14-year-old girl who presented initially with acute abdominal pain. Assessment with enhanced computed tomography scan led to the diagnosis of wandering spleen, organoaxial gastric volvulus, and pancreatic volvulus, in addition to cholestasis, making it the first study to report on the simultaneous occurrence of this triad and cholestasis.

Coarctation of the aorta (CoA) with arterial tortuosity syndrome (ATS) is a rare hereditary condition characterized by elongation and tortuosity of the medium-and large-sized arteries, pulmonary hypertension, pulmonary artery stenosis, and constriction or narrowing of the aorta. Considering the non-specific indications and the overlap of ATS with other disorders of the connective tissue such as Williams Beuren syndrome (elastin), Marfan syndrome (fibrillin-1) and Ehlers Danlos syndrome (Type III collagen), it is vital to keep a high diagnostic suspicion in the analysis of the condition. We therefore report on a rare occurrence of coarctation of the aorta with arterial tortuosity syndrome in a teenage female who initially presented with severe resistant hypertension, providing additional literature to aid in the differential diagnosis of COA with ATS. Cinematic rendering delivered a markedly enhanced view of the condition, allowing for greater accuracy in the diagnosis.

Purpose With several studies recording a higher percentage of complications in the first hour of post‐biopsy, this study sought to evaluate the safety in the reduction in post‐biopsy patient monitoring time after computed tomography (CT)‐guided thoracic biopsies, providing a basis for further research. Materials and Methods This was a retrospective study involving patients who were referred to our centre for CT‐guided thoracic biopsies from January 2010 to December 2017. Patients who presented with no complications immediately after the post‐biopsy CT scan were given 30 min of post‐biopsy care after which they were discharged, and given a hot line to call in case of any complication. There was also a follow‐up call by a nurse after 24 h to inquire about any complication and general condition of the patients. Results A total of 440 core needle thoracic biopsies were performed within the period of the study. The most common thoracic region indicated for biopsy was mediastinal (n = 240, 54.5%), followed by lung (n = 185, 42.0%). Complications were recorded at a rate of 6.4% (n = 28), with 4.1% (n = 18) been pneumothorax and pulmonary haemorrhage and haemoptysis accounting for 2.3% (n = 10). No relevant complications were recorded in patients who presented with no complications immediately after the post‐biopsy CT scan (n = 374, 85%). Conclusions Findings from this initial study have shown that thirty minutes of post‐biopsy care could be sufficient for patients present with no complications immediately after a post‐procedural scan in CT‐guided thoracic biopsies; providing a basis for similar algorithms to be explored in a randomised control study to substantiate the observation.

A 78-year-old black woman with a 10-year history of diabetes mellitus was admitted to the intensive care unit. Upon admission, she presented with chills, nausea, and left flank pain. The presence of hyperglycemia (fasting blood glucose, 19.7 mmol/L) and an altered consciousness required immediate treatment with insulin analog. Laboratory investigations and enhanced computed tomography scan led to the diagnosis of bilateral emphysematous pyelonephritis (EPN). The patient responded well to conservative treatment with antibiotics, and was finally discharged after 22 days when the computed tomography scan showed resolution of all the pockets of air. This case and associated literature review of 25 previously reported cases of bilateral EPN show the changing trend of EPN management from emergency nephrectomy toward conservative treatment with potent antibiotics and/or percutaneous drainage, and has been associated with higher survival rates compared to emergency nephrectomy.