Biomedical subjects
Publications and source records attributed to Y Barki.
Prenatal ultrasonic diagnosis of a rare case of radial ray aplasia and crossed renal ectopy is described in an affected sibling of a family where the father and his son suffer from this rare syndrome. The prenatal diagnosis enabled early pregnancy termination.
A 12-year-old boy presented with a 2-month history of abdominal pain and distention. A diagnosis of Wilson's disease was established, and D-penicillamine therapy was initiated. An associated pancreatitis was diagnosed on presentation, based on elevated serum amylase and an enlarged pancreas ultrasonically. Subsequently, an 18-month follow-up disclosed no abdominal pain, with repeatedly normal serum amylase level and a normal pancreas on ultrasonography. Since abdominal pain is a common symptom in Wilson's disease on presentation, this possibility should be considered in untreated patients. It is concluded that pancreatitis may be associated with Wilson's disease, possibly because of copper deposition in the pancreas, and is probably responsive to copper chelation therapy.
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A young psychiatric patient presented with a purulent collection in the lower abdominal wall. Simple drainage failed to heal the abdominal wall abscess, and the presence of a primary septic focus was suspected. Full investigation showed a right renal pelvis calculus with xanthogranulomatous pyelonephritis complicated by a retroperitoneal abscess. Recovery was complete after a nephrectomy. A review of the published literature demonstrated the rarity of this presentation, although even more curious cases have been described, including a urinobronchial fistula, as well as catastrophic cases presenting with a massive haemorrhage. Authors are unanimous that ultrasonography should be the first examination, the scanner being also of primordial value for the diagnosis and demonstration of the retroperitoneal spaces ans fascia. Treatment requires both rapid and radical surgical intervention.
Ultrasound is a relatively inexpensive, widely available noninvasive method of investigation. Although there is extensive documentation on the use of ultrasound in abdominal lesions, it appears to have been underutilized in the evaluation of neck masses. Ultrasound enables detection of thyroidal and extrathyroidal masses, and definition of their boundaries and their relationship to great vessels. The traditional and exclusive use of ultrasound to separate cystic from solid lesions is outdated. High resolution new-generation real-time machines allow recognition of secondary changes in the structure of basically solid or cystic masses. Infected cystic masses may give the impression of a solid neoplasm. Although partial or total necrosis within a lymph node may simulate a branchial cleft cyst, ultrasonography can in many cases recognize such a "cystic-looking" malignant lymph node and thus prevent a premature biopsy that could transform an initially curable disease into an incurable one.
The first case of pyogenic liver abscess during pregnancy is described. Despite its rarity, this severe complication has to be considered when a febrile illness accompanied by upper abdominal pain and hepatomegaly occurs during pregnancy and puerperium. Diagnostic methods and treatment are suggested.