Intestinal volvulus is a common condition seen in infancy and adulthood, but small bowel volvulus is a rare condition affecting the fetus in utero. Very few cases have been reported describing the ultrasound findings of the same. We present a case report of a case of intestinal volvulus which was diagnosed prenatally based on the ultrasound features of whirlpool sign and coffee bean sign. An emergency caesarian section was performed, small bowel volvulus was confirmed on post-natal ultrasound, and the neonate was subsequently operated. Although these signs have been separately described previously in the literature, in our case both these signs were seen in the same patient. Our case is a rare presentation with the occurrence of volvulus without malrotation, the contrary being more common.

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In this study, we present a case of disseminated cysticercosis involving the brain, orbit, myocardium, muscle, subcutaneous tissues, pancreas, and spleen. Imaging studies are described with emphasis on pancreatic and splenic involvement which is a rare manifestation of a rather common disease and has been radiologically demonstrated only once previously. Although the involvement of the pancreas by parasites leading to pancreatitis has been described previously, in our case there was no clinical or biochemical evidence of pancreatitis due to infection by cysticerci.

BACKGROUND Chronic Suppurative Otitis Media (CSOM) is considered to be a slowly progressive destructive disease of the middle ear. It is the most commonly encountered middle ear pathology, which disrupts the normal anatomy and physiological functioning of the ear. Otoscopic evaluation is sufficient to establish the diagnosis of the disease; however, its extent can be determined only on the basis of a High Resolution Computed Tomography (HRCT) of the temporal bone. While the most common presentation of CSOM is a discharging ear. Its complications may be masked by the disease itself, thereby giving a false presentation of a limited extent. HRCT temporal bone can help quantify the extent of the disease and hence prioritise the patients who warrant an urgent management.The aim of this study is to establish the importance of HRCT temporal bone in a patient with unsafe CSOM, even in absence of clinical suspicion of ongoing complication to improve the surgical outcome. MATERIALS AND METHODSThis study has been conducted on 50 patients who have presented to the ENT OPD at RGMC, Kalwa. RESULTSOut of 50 patients who presented with complications, 20 patients (40%) did not have any history suggestive of impending complications. The HRCT temporal bone helped in establishing the presence of these complications and allowing for prompt treatment. CONCLUSIONIt was found that presence of HRCT helps in determining lurking complications and thus helps in deciding the urgency with which tympanomastoidectomy surgery needs to be performed. KEY WORDSHRCT, Temporal Bone, Mastoid, Cholesteatoma. HOW TO CITE THIS ARTICLE: Baviskar S, Mehta L, Gori T, et al. HRCT temporal bone-a mandatory preoperative investigation for improving surgical outcome in unsafe CSOM.

Hirayama's disease is a form of juvenile muscular atrophy affecting young individulas in their second to third decade. The underlying pathogenetic mechanism is believed to be an imbalanced growth between the individuals' vertebral column and the spinal canal contents, which causes abutment of the anterior spinal cord against the vertebral column and detachment of the posterior dura, leading to microcirculatory disturbances and ischemic changes in the cord. This mechanism is exiquisitely demonstrated on magnetic resonance imaging (MRI), but requires additional imaging, with the neck in the flexed position. Neurphysiological imaging studies have provided supporting evidence by demonstrating changes in the N13 potential, with neck flexion. Nonetheless, few studies have also reported contradictory findings with MRI and somatosensory evoked potentials, in Hirayamas Disease. This condition is underdiagnosed because most clinicians are not familiar with this disorder and do not request a flexion MRI. Early recognition of this entity and differentiation from other causes of focal cord atrophy is important, because limitation of neck flexion by using a simple neck collar can prevent its further progression. We report the classical MRI findings in a young patient with Hirayama's disease with neutral and flexion MRI.