Pulmonary embolism (PE) is a blockage of the main artery of the lung or one of its branches by a substance that has travelled from elsewhere in the body through the bloodstream (embolism).
PE most commonly results from deep vein thrombosis (a blood clot in the deep veins of the legs or pelvis) that breaks off and migrates to the lung, a process termed venous thromboembolism (VTE). A small proportion of cases are due to the embolization of air, fat, talc in drugs of intravenous drug abusers or amniotic fluid. The obstruction of the blood flow through the lungs and the resultant pressure on the right ventricle of the heart lead to the symptoms and signs of PE. The risk of PE is increased in various situations, such as cancer or prolonged bed rest.
Symptoms of pulmonary embolism include difficulty breathing, chest pain on inspiration, and palpitations. Clinical signs include low blood oxygen saturation and cyanosis, rapid breathing, and a rapid heart rate. Severe cases of PE can lead to collapse, abnormally low blood pressure, and sudden death.
Diagnosis is based on these clinical findings in combination with laboratory tests (such as the D-dimer test) and imaging studies, usually CT pulmonary angiography. Treatment is typically with anticoagulant medication, including heparin and warfarin. Severe cases may require thrombolysis with drugs such as tissue plasminogen activator (tPA) or may require surgical intervention via pulmonary thrombectomy.
Postprimary tuberculosis occurs in someone who has previously been infected and has retained a degree of acquired immunity; it can result from endogenous reactivation or, less commonly, exogenous reinfection. Although delayed progression of latent infection may occur at any seeded site in the body, lung foci account for the majority of cases. Predilection of postprimary disease to involve the upper lung zones is likely due to a combination of factors including the relatively higher oxygen tension and impaired lymphatic drainage in this region. Have a look at the images here.
Abdominal aortic aneurysm (also known as AAA, or “triple-a”) is a localized dilatation (ballooning) of the abdominal aorta exceeding the normal diameter by more than 50%, and is the most common form of aortic aneurysm. Approximately 90% of abdominal aortic aneurysms occur infrarenally (below the kidneys), but they can also occur pararenally (at the level of the kidneys) or suprarenally (above the kidneys). Such aneurysms can extend to include one or both of the iliac arteries in the pelvis.
The major complication of abdominal aortic aneurysms is rupture, which is life-threatening, as large amounts of blood spill into the abdominal cavity, and can lead to death within minutes.
Surgery is recommended when the aneurysm is large enough (>5.5 cm in diameter) that the risk of surgery (1% to 6%) is less than the risk of rupture.
Basal ganglia calcification (or basal nuclei calcification) is quite common, and is seen in approximately 1% of all CT scans of the brain, depending on the demographics of the scanned population. It is seen more frequently in older patients and is considered a normal incidental and idiopathic finding in an elderly patient. There are many causes of calcification, including: Fahr disease, AIDS, CNS toxoplasmosis, TORCH, chemotherapy and various inherited and metabolic causes.
Mustard Procedure allows total correction of transposition of the great vessels. The procedure employs a baffle to redirect caval blood flow to the left atrium which then pumps blood to the left ventricle which then pumps the deoxygenated blood to the lungs. In a normal heart, de-oxygenated blood is pumped into the lungs via the right ventricle. Then it is distributed throughout the body via the left ventricle. In the Mustard procedure, blood is pumped to the lungs via the left ventricle and disseminated throughout the body via the right ventricle.
A case of Zenker’s Divertilulum 6 CAT images:
Pharyngoesophageal diverticulum or as it’s best known as Zenker’s diverticulum, is a false diverticulum of the mucosa of the pharynx, just above the cricopharyngeal muscle which was named by German pathologist Friedrich Albert von Zenker.
A case of Right-sided Aortic Arch has been added.
Right-sided aortic arch is a rare anatomical variation with a prevalence among adults of about 0.01% in which the aortic arch is on the right side rather than on the left.
52 new images of a Mesenteric abscess.
Mesenteric abscess is an important and serious problem in surgical practice. Appropriate treatment is often delayed because of the obscure nature of many conditions resulting in abscess formation, which can make diagnosis and localization difficult.
A better understanding of intra-abdominal abscess pathophysiology and a high clinical index of suspicion should allow earlier recognition, definitive treatment, and reduced morbidity and mortality.