IOTA simple ultrasound rules were highly sensitive and specific in predicting ovarian malignancy preoperatively yet being reproducible, easy to train and use.

Superior Mesenteric Artery (SMA) syndrome is one of the rare cause of proximal small bowel obstruction wherein, the third part of the duodenum is compressed between the SMA at its origin and abdominal aorta due to decreased angulations in these two vessels. This decreased angulation exerts a compression effect on third part of the duodenum, resulting in duodenal obstruction which may be complete or partial. There are number of causes which can lead to this entity and will be discussed briefly. Here we report imaging findings of such a rare cause of proximal small bowel obstruction in a young male patient who presented to the emergency surgical department with non specific symptoms of pain abdomen and abdominal fullness. Patient was evaluated under the standard protocol in management of abdominal pain. General physical examination, erect and supine radiograph were taken. On barium meal follow-through examination, there was paucity of contrast agent distal to the second part of duodenum with proximal dilation of stomach, first and second part of duodenum which raised us the possibility of SMA syndrome. Reconstructed CECT abdomen confirmed the decreased angulation between SMA and abdominal aorta and diagnosed it as SMA syndrome. Findings were correlated on duodenojejunostomy anastomotic surgical procedure. Diagnosing and reporting such a case of SMA syndrome is of utmost importance because the clinical presentation being non-specific pertaining to small bowel obstruction which may pose a diagnostic difficulty to the surgeon and with the further delay in diagnosis, patients may end up with chronic symptoms and complications of the disease, repeated hospital visits and electrolyte abnormalities.

Introduction: Small bowel obstruction (SBO) is a common clinical entity that occurs secondary to mechanical or functional obstruction of the small gut, preventing normal passage of its contents. It constitutes 20% of all surgical emergencies for acute abdominal pain and a common cause for hospitalization. Plain abdominal X-ray and ultrasonography were used for initial examination. Now, Computed tomography is the modality of choice for preoperative evaluation of SBO. Aims and Objectives: To evaluate the diagnostic accuracy of various imaging modalities namely plain x-rays of abdomen, ultrasound and computed tomography in the diagnosis of intestinal obstruction with reference to a) The presence or absence of obstruction b) The level of obstruction c) The cause of obstruction. Materials and Methods: It was a hospital based prospective study in which X-Ray and ultrasonography were done as an initial modality for screening and Multi Detector Computed Tomography (MDCT) scan was done later on for detailed evaluation. Relevant history, clinical examination and routine investigations were done. Results: Acute intestinal obstruction: CT scan was found to be superior in predicting a fully correct diagnosis (78%) when compared to ultrasound (29%) which in turn was found to be superior to plain films which provided fully correct diagnosis only in 10% of the cases. Subacute intestinal obstruction-In 62.5% cases of sub acute intestinal obstruction CT scan provide fully correct diagnosis whereas in none of the cases did ultrasound or plain films provide fully correct diagnosis. Conclusion: CT was found to be superior to ultrasound and plain films in finding out the presence, level as well as cause of obstruction.

Background: The aim of this study is to elucidate the spectrum of commonly encountered anomalies affecting fetal genito-urinary system (GUS) on fetal MRI and examine its utility in providing better morphological information resulting in improved diagnostic accuracy and in detecting additional malformations. The study also aims to highlight the promising role of fetal MRI in the detection and characterization of renal fusion anomalies like the horseshoe kidney or developmental abnormalities such as renal agenesis/ectopia. Results: The mean age of study participants was 29 years ± 3 years. The gestation age of pregnant mothers ranged from 18 weeks and 1 day to 39 weeks and 0 day. Amniotic fluid was reduced or absent in 41% (N = 13) and normal in 59% (N = 18) of participating mothers. Overall, urinary obstruction was the commonest anomaly encountered (29%) followed by the multicystic dysplastic kidney (MCDK) (22%). Bilateral renal disease was seen in all mothers having features of anhydramnios {B/L MCDK (N = 3), autosomal recessive polycystic kidney disease (ARPKD) (N = 2), posterior urethral valves (PUV) (N = 2), B/L renal agenesis (N = 3), and megacystis (N = 1)}. Fusion anomalies (horseshoe kidney) and rotation anomaly (malrotation) were detected in one case each. Additional extrarenal findings were seen on fetal MRI in 35% (N = 11) cases. Conclusions: Fetal MRI improves diagnostic accuracy in anomalies affecting the fetal kidney and genito-urinary systems by better morphological delineation. It has the ability to detect additional extra-renal malformations and perform a more accurate assessment of associated pulmonary hypoplasia. The diffusion-weighted sequence is particularly useful in confirming the diagnosis of renal agenesis/ectopia.

Introduction: CNS anomalies are the most serious congenital abnormalities. Ultrasound is an effective and non invasive modality of prenatal diagnosis of these anomalies. The purpose of the current study was to determine the frequency of CNS anomalies and its postnatal outcome. Objectives: Present study was undertaken to find out the incidence of CNS anomalies in utero by ultrasound and to confirm them by autopsy or postnatal examination. Materials and Methods: Ultrasound scanning of 5761 pregnant w omen was performed. Pregnancies with ultrasound findings of CNS anomalies were followed up. Prenatal findings were compared with postnatal findings and confirmed by autopsy wherever possible. In case of live birth post natal findings were noted. Results: Ultrasound detected 50 anomalies in 42 cases. Ultrasound findings were exactly matching in 90%. 4 cases had variations 3 on autopsy & 1 on postnatal USG. Conclusion: The incidence of CNS malformations on ultrasound was 0.73%. Autopsy and postnatal findings showed high degree of correlation with prenatal ultrasound findings.