KEY WORDSbasket snare, foreign body, intravascular, ultrasound Percutaneous retrieval of intravascular foreign body is a safe and effective procedure with the use of various imaging modalities. However, fluoroscopy is used extensively in most of the procedures, because the broken fragments which gets retained in intravascular compartments are radiopaque. In our case, the broken fragment, which was retained in the internal jugular vein, was radiolucent. Retrieval of a radiolucent foreign body under fluoroscopy is not only difficult but also can lead to serious sequelae during retrieval. We report such a case of real time ultrasound-guided retrieval of the foreign body in adjunct with fluoroscopy. ª

INTRODUCTIONBarium follow through and enteroclysis were the radiological investigations of choice for evaluation of small bowel pathologies for many decades. They could display luminal and mucosal abnormalities well but could not demonstrate the state of the bowel wall and extension of the disease process outside the bowel. 1CT scan was able to overcome this particular limitation and demonstarte bowel well thickening and associated extraluminal changes such as inflammatory change, lymphadenopathy or local metastatic tumour spread from small bowel neoplasms. But conventional CT lacked the mucosal detail of small bowel barium studies CT enterography was first introduced by Raptopoulos et al, as modification to standard abdomino-pelvic CT examination to specifically examine the small bowel in detail, notably to assess the extent and severity of Crohn's disease.2 They combined neutral (low-density) oral contrast with "enteric phase" CT to optimize contrast resolution between mucosa and lumen, thereby maximizing conspicuity of abnormalities arising from the small bowel wall. ABSTRACTBackground: Radiology has been the primary investigation tool for small intestine because of technical challenges in endoscopy. Barium studies and computed tomography (CT) have been the most useful modalities over the years; however, neither is a complete investigation by itself. CT enterography offers the possibility of a single comprehensive radiological evaluation. The present study was undertaken to study the accuracy of CT enterography in characterising various small bowel pathologies. Methods: A total of 84 patients clinically suspected or known to have small intestinal disease underwent CT enterography on a 64 slice MDCT. The radiologic findings were correlated with clinical, endoscopy, histopathology and operative findings. Results: A wide variety of pathologies can be diagnosed accurately on CT enterography. In our study, majority of the patients had non-neoplastic pathologies (79%). Neoplastic lesions were detected in 21% of the patients of which 14% were malignant. There was good correlation between CT enterography and endoscopy, histopathology and operative findings. The ability of CT enterography to differentiate acute inflammation from chronic changes is valuable in management of Crohn's disease. Conclusions: CT enterography should be considered as the investigation of choice for radiological evaluation of small bowel pathologies as it provides a comprehensive evaluation of the disease process.

Background: Trauma is a leading cause of death in developing countries due to vehicular and railway accidents, of which abdominal trauma due to blunt injuries constitutes 13% mortality and 45% morbidity. The purpose of this study is to assess and diagnose the severity of those retroperitoneal injuries other than the common causes of abdominal trauma with multidetector computed tomography (MDCT) scanning with intravenous contrast being the gold standard diagnostic modality even in unstable patients.Methods: A total of 204 patients of these 147 patients were males (72%) and 57 were females (28%) were included of all age groups, who had sustained abdominal trauma due to vehicular, railways accidents and also due to trivial trauma and history of fall from heights.Results: Of the 204 patients included in our study, 110 patients (55%) had the maximum trauma affection to the kidneys, in which 48% constitutes grade I injury, which shows the high sensitivity of MDCT detecting early injuries. Nearly 12% patients had adrenal injuries, 24% had pancreatic injuries, although a small percentage also had delayed manifestation of pseudocyst formation in stable patients. Duodenal and colonic injuries constitute rest of 5% and 4% of the patients. All these patients had good correlation with the morphological MDCT grading of injuries and clinical correlation.Conclusions: MDCT is the imaging procedure of choice for early detection or ruling out the presence of retroperitoneal injuries in trauma patients, especially now with the newer faster MDCT, scanning can be performed more quickly, minimizing patient movement, respiratory motion and vascular pulsation.

Pulmonary arteriovenous malformations (PAVM) are rare anomalies of pulmonary vascular system which may be incidentally detected or can have manifestations resulting from right to left shunt. PAVM can cause various systemic implications including central nervous system complications like stroke, brain abscess due to paradoxical emboli which mostly seen in previously undiagnosed PAVMs indicating importance of early diagnosis and timely intervention in PAVM. Computed Tomography Pulmonary Angiography (CTPA) is the diagnostic method of choice in PAVM. We present here a unique case of complex multiple PAVM presented with refractory hypoxemia in a middle aged patient diagnosed in our centre initially evaluated for malignancy based on chest radiography & High Resolution Computed tomography(HRCT)thorax findings and symptoms, later on after CTPA was diagnosed to have complex PAVM which showed clinicoradiological improvement following pulmonary vascular plugging. This case shows clinical scenario, diagnostic & management methods and differential diagnosis to be discussed in similar clinicoradiological pattern and peculiarity of PAVM despite advanced age.