Aims: We aimed to obtain pyloric measurements of our patients with infantile hypertrophic pyloric stenosis (IHPS) using ultrasonography (US) and to evaluate the correlations between age, weight and pyloric size, pyloric ratio (PR). Material and methods: We designed a retrospective study including 20 term infants with surgically proven IHPS and studied the ultrasonographically obtained pyloric muscle thickness (PMT), pyloric diameter (width) (PD), pyloric length (PL) and PR (PMT/PD) to determine if there were statistically significant associations between patient age/weight and pyloric measurements. Results: The mean age of the infants was 38.7±17.3 days (range, 9-76 days) and their mean weight was 3688.5±772.7 g (range, 2810-6000 g), at referral. Mean PMT was 4.98±1.04 mm (range, 3.5-6.8 mm). Mean PD was 14.04±2.39 mm (range, 10-18 mm). Mean PL was 22.16±4.02 mm (range, 16-31.5 mm) and mean PR was 0.35±0.04 (range, 0.29-0.42). The correlation between age and PMT (r=0.654, p<0.05) and the correlation between age and PD (r=0.747, p <0.05) were significant. Age and weight were not significantly correlated with PR (p>0.05). Conclusions: The PMT and PD are age dependent parameters. The PR is age and weight independent and therefore, when combined with PMT, PD and PL, it can be useful in the diagnosis of IHPS in infants with early onset disease and/or in those with a lower weight.

Thyroid hemiagenesis is a rare congenital anomaly in which one lobe of thyroid gland fails to develop. It is much rarer in males. There is a higher incidence of associated thyroid disorders in patients with thyroid hemiagenesis; therefore early and prompt diagnosis is important for children. We present the ultrasonographic and scintigraphic findings of thyroid hemiagenesis in an eight-year-old-boy. On ultrasonography (US), left lobe of the thyroid gland could not be demonstrated and the right lobe showed minimal hyperplasia. Its echogenicity was normal and no nodule was seen. On thyroid scintigraphy, left lobe of thyroid gland or any ectopic thyroid tissue could not be demonstrated, while the right lobe showed minimal hyperplasia. Without performing any invasive procedure, we enrolled the child in a follow-up program with the guidance of US and scintigraphy, which were effective both in making the final diagnosis of thyroid hemiagenesis and in evaluating the current status of the present thyroid tissue. In conclusion, if only one thyroid lobe is detected in a pediatric case initially with US or scintigraphy, the diagnosis of thyroid hemiagenesis should be suggested and, before any unnecessary or invasive attempt, the other complementary method (scintigraphy/US) should be performed.

No abstract

Our aim was to investigate the utility of conventional fluoroscopic contrast studies in detecting, localizing the upper and lower gastrointestinal (GI) fistulas and seeing their extensions. Our study included 24 patients between 1 month to 75 years of ages who were clinically suspected to have various types of GI fistulas. We administered water soluble iodinated contrast agents orally, percutaneously and rectally in an appropriate way in each case to demonstrate the fistulas. The cases were etiologically classified. We were able to demonstrate orocutaneous/thyroglossal (n=1), tracheoesophageal (n=4), esophagopleural (n=4), gastrocolic (n=1), duodenorenal (n=2), duodenocutaneous (n=1), enterocutaneous (n=2), enterovesical (n=1), colocutaneous (n=1), colovesical (n=1), rectovesical (n=1), rectovaginal (n=1), anorectocutaneous (n=4) fistulas and their extensions effectively. Iatrogenic etiologies (surgery, radiotherapy etc.) were found to be the leading cause of GI fistulas by 11 patients out of 24 (45.8%). Since we are able to see contrast material flow real-time, make selective studies and get highest spatial resolution images in different projections, we conclude that conventional fluoroscopic contrast studies remain to be the radiologic method of choice particularly for the initial imaging of various types of GI fistulas.

ÖzAmaç: Skleroderma olgularındaki terminal falanks değişikliklerini direkt radyografi ile ortaya koymayı amaçladık. Yöntem: Skleroderma tanısı ile izlenen ve yaş ortalaması 36.4 yıl olan (aralık, 22-48 yıl), hepsi kadın sekiz olgunun el-el bilek radyografileri akral (terminal falanks) patolojileri ve diğer el-el bileği değişiklikleri yönünden retrospektif olarak incelendi. Bulgular: Bilateral el-el bileği radyografilerinde olgularının 5'inde (%62.5) değişik derecelerde fleksiyon kontraktürleri ve 2'sinde (%25.0) pençe el-pençe el gelişim süreci, 6'sında (%75.0) interkarpal, karpometakarpal, metakarpofalangeal ve interfalangeal eklemlerde değişik lokalizasyonlarda ve derecelerde artritik ve dejeneratif değişiklikler, değişik derecelerde periartiküler osteoporoz izlendi. Olguların 2'sinde (%25.0), parmakların distalinde yumuşak doku kalsifikasyonları saptandı. Olguların 5'inde (%62,5) değişik derecelerde terminal falanks rezorpsiyonları (akroosteoliz), erozyon görüldü. Bu periosteal rezorpsiyon ve erozyonların, taftların palmar taraflarını daha çok etkilediği saptandı. Olguların 2'sinde (%25.0) akroosteoliz daha hafif ve sınırlı olup, 3'ünde (%37.5) terminal falankslarda belirgin sivrileşmeler şeklinde görüldü. Sonuç: Direkt radyografi, kronik skleroderma olgularında başta akroosteoliz olmak üzere terminal falanks patolojilerini göstermede yararlı bulunmuş olup bu konuda başvurulacak ilk görüntüleme yöntemi olmalıdır. Abstract Aim: We aimed to reveal the terminal phalangeal changes in scleroderma patients by plain radiography. Method: Bilateral hand-wrists radiographs of eight women with a mean age of 36.4 years (range, 22-48 years) who were on follow-up with the diagnosis of scleroderma were retrospectively evaluated for acral (terminal phalanx) pathologies and other hand-wrist changes. Results: On bilateral hand-wrist radiographs, flexion contractures with different degrees in five (62.5%) of the all cases, claw hand and claw hand development process in two (25.0%) of cases, arthritic and degenerative changes with varying degrees in various localizations of the intercarpal, carpometacarpal, metacarpophalangeal, interphalangeal joints, and various degrees of periarticular osteoporosis in six (75.0%) of cases were observed. Yazının geliş tarihi:17.09.2018 Yazın kabul tarihi:05.11.2018 Sorumlu Yazar: Mehmet Ercüment Döğen,Mersin Şehir Eğitim ve Araştırma Hastanesi Radyoloji ABD, Mersin.