No abstract

Introduction: The involvement of the blood vessels around the pancreas in pancreatitis may result in devastating complications. The proteolytic enzymes secreted by the inflamed pancreas can directly erode the walls of arteries in and around the pancreas, resulting in haemorrhage or pseudoaneurysms formation. On the other hand, the inflamed tissue may compress or thrombose adjoining veins. Multidetector Computed Tomography (MDCT) serves as an excellent tool for diagnosis and evaluation of complications of pancreatitis and can detect most vascular complications. Aim: To evaluate the MDCT findings of vascular complications associated with pancreatitis. Materials and Methods: This cross-sectional study was conducted on 60 patients at the Department of Radiology in the Tertiary Care Hospital attached to Mysore Medical College and Research Institute, Mysore, India for 12 months from 1st August 2019 to 31st July 2020. Each patient was subjected to unenhanced and contrast-enhanced CT to characterise the vascular complications associated with pancreatitis. The results were tabulated and evaluated descriptively by Microsoft excel 2016 and presented in figures and tables. Results: Of the 60 patients included, Splenic Vein Thrombosis (SVT) was seen in 39 (65%), followed by Portal Vein (PV) thrombosis in 17 (28.3%), Superior Mesenteric Vein (SMV) thrombosis in 14 (23.3%), all the three vein thrombosis was seen in 7 (11.6%) and arterial pseudoaneurysms was seen in 3 (5%). Conclusion: Vascular complications in pancreatitis are not uncommon but should be evaluated in all cases of pancreatitis. Contrast-enhanced CT is the main imaging modality for originally identifying local complications. SVT is one of the most frequently found vascular complications seen in patients of pancreatitis.

No abstract

The scrotum and its contents are normally accessible for clinical examination under normal conditions. Physical examination may be limited by tenderness or swelling. Gray scale and Doppler ultrasound imaging supplements the clinical examination, as an accurate means of evaluating diverse scrotal diseases. It permits differentiation between the lesions like torsion that require urgent surgical management from orchitis which can be managed conservatively. Material and methods: The study was conducted on 70 patients presenting to the outpatient department of Mysore Medical College and Research Institute, Mysore with symptoms pertaining to the scrotum during a period of 12 months. They were subjected to scrotal ultrasound examination. Frequency and proportion were calculated using Epi Info TM for Windows version 7. Results: The most commonly involved age group was 31 to 40 years (n = 23; 32.9%). Swelling was the most common symptom. On USG, the most common scrotal pathology encountered was hydrocele (n=22; 19.80%) followed by epididymal cyst (n=18; 16.2%), epididymo-orchitis (n=15; 13.60%) and epididymitis (n = 10; 9%). The pathologies were more common on left side (n=48, 43.24%). Conclusion: High frequency ultrasonography with Color Doppler study serves as an excellent diagnostic imaging modality in the evaluation of scrotal diseases. It is the investigation of choice since it is highly sensitive, easy to perform, widely available, repeatable and involves no risk of ionizing radiation. Periodic follow-up USG scans are recommended for patients with inflammatory scrotal lesions to monitor response to treatment and to reveal the development of complications.

Introduction: Acute inflammation process of the pancreas with or without involvement of surrounding tissues and remote organ systems is termed as Acute Pancreatitis (AP). Contrast Enhanced Computed Tomography (CECT) if performed immediately may underestimate the severity. Therefore, ultrasound examination remains the first imaging diagnostic method in suspected cases of AP. The sensitivity of B-mode sonography for the early diagnosis of AP can be increased by the detection of an increase in pancreatic tissue stiffness with Shear Wave Elastography (SWE). Aim: To evaluate the efficacy of SWE in the analysis of AP. Materials and Methods: A cross-sectional study was conducted in Tertiary Care Hospital attached to Mysore Medical College and Research Institute, Mysuru, Karnataka, India, from August 2019 to September 2019. The pancreatic parenchyma of 30 patients with symptoms of AP that included acute onset of severe central epigastric pain, poorly localised tenderness and pain increased by supine positioning radiating to the back. The study also included 40 healthy, asymptomatic volunteer who were examined using B-mode sonography and SWE. Computed Tomography (CT) was performed in all patients with AP with a SEIMENS SOMATOM DEFINITION EDGE 128 slice CT scanner. Elastographic measurements were performed and quantitative SWE values represented in kilopascal (kPa) of the patients and asymptomatic volunteers group were compared. Patients’ amylase and lipase levels were done by biochemical tests. Descriptive and Inferential statistical analysis was carried out in the present study. Student’s t-test (two tailed, independent), Leven’s test for homogeneity of variance and Chi-square test was used to find the significance of study parameters. Results: The mean SWE values for the asymptomatic volunteers with normal pancreatic parenchyma were 9.53±2.62 kPa. The mean SWE values for the pancreatic parenchyma of the patients with AP were 17.23±6.24 kPa. The mean SWE value for the patients with AP was significantly higher than the value for the control group (p<0.001). A SWE cut-off value of 13.5 kPa was associated with 70% sensitivity and 92.5% specificity for diagnosis of AP. Conclusion: For the diagnosis of AP at initial hospital admission, SWE can be used as it is a rapid, radiation-free, and non- invasive tool. It is a useful imaging method with high sensitivity and specificity for the diagnosis of AP.