Diagnostic Imaging Procedures Research Articles

Can multidisciplinary approach win the battle against metastatic rectal cancer?

Introduction. Colorectal cancer is the third most common cancer and one of the leading causes of cancer-related deaths in men and women worldwide. The contemporary multidisciplinary approach has decreased rates of local recurrence and improved outcomes in metastatic colorectal cancer. We present a case of a primarily metastatic rectal cancer patient who underwent multidisciplinary planned treatment and showed complete response with now three years disease-free survival. Case outline. A 61-year-old female was diagnosed with a T4N2M1a rectal adenocarcinoma at the age of 58. She underwent six cycles of systemic chemotherapy capecitabine-oxaliplatin plus bevacizumab with partial response confirmed by diagnostic imaging procedures. According to multidisciplinary board decision, preoperative radiotherapy treatment was administered with concomitant capecitabinebased chemotherapy. A 50.4 Gy total dose was delivered with 1.8 Gy fraction dose. After concomitant chemoradiotherapy treatment, two more cycles of systemic chemotherapy capecitabine-oxaliplatin plus bevacizumab were administered. One month after completion of systemic chemotherapy, primary rectal cancer was operated with a complete response on histopathologic specimens. Six weeks following previous surgery, metastasectomy of lung deposits was performed; histopathology confirmed metastatic adenocarcinoma of colorectal origin. Three more cycles of postoperative chemotherapy capecitabineoxaliplatin plus bevacizumab were administered. Conclusion. On regular follow-up, no evidence of disease was shown, with disease-free survival of three years. The treatment improved the patient?s quality of life.

Imaging of Degenerative Pathologies of the Lumbar Spine: Professional Habits in Some Hospitals in Cameroon

Background: The lumbar spine is the portion most frequently involved in degenerative pathologies. Everyone will suffer one day from “low back pain”. These pathologies are very frequent: epidemiological studies have shown that 65% to 90% of the general population could be affected by low back pain (lumbago) which could become chronic at acertain stage or could be complicated (2% to 4%) of cases could end up affecting nerve roots. Chronic low back pain causes a major public health problem in terms of morbidity and socioeconomic repercussions. Purpose: The overall purpose of this study is to evaluate the professional habits of exam applicants in case of degenerative pathologies of the lumbar spine, to Appreciate the knowledge of clinicians on the usefulness of medical imaging techniques in the event of suspicion of a degenerative pathology of the lumbar spine and finally to evaluate if the professional habits of requesting examinations in Cameroon comply with the Recommendations for Clinical Practice. Methods: A cross-sectional and descriptive study was used and was based on questionnaires distributed to those practitioners who requested for these diagnostic medical imaging studies and procedures at Yaounde General Hospital (HGY), Yaounde Central Hospital, La Cathedrale Medical Center, Yaounde University Teaching Hospital, the Douala General Hospital, the Laquintinie Hospital of Douala, the Military Hospital of Douala, the Daniel Muna Memorial Clinic of Douala, the International Center for Clinical and Medicine Imaging, the Ngaoundere Regional Hospital and the Protestant Hospital of Ngaoundere (HPN), from April 2020 to March 2021. Data collected was processed and analyzed via Epi Info version 12.0 and the statistical test used for correlation was Chi2. Results: 137 practitioners were retained among whom, 90 were male and 47 females, their average age being 46 years with working experience less than 5 years (35.8%). The results obtained show that parameters such as availability and accessibility of the required diagnostic medical imaging modalities could greatly influence the examination prescription. On the contrary, few prescribers were less interested in the costs and secondary effects due to irradiation and the invasiveness of these examinations. Professional habits of those who requested these examinations were in majority closer in line with the recommended clinical practices. However, an average of 43.78% of prescribers never followed recommendations nor applied them. On the other hand, knowledge and the application of these recommendations increased as the prescriber’s working experience too increased. Up to 54.47% of prescribers were not aware of those recommendations about requesting these examinations. Conclusion: Our results indicate that Medical Diagnostic Imaging techniques are not judiciously and optimally exploited in the diagnosis of degenerative pathologies of the lumbar spine and it would be necessary to establish recommendations for clinical practice adapted to Cameroonian realities.

Методика оценки радиационных рисков медицинского облучения на примере многократного прохождения компьютерной томографии

Currently the application of diagnostic imaging procedures is extended. After the COVID-19 out-break the number of radiological examinations have increased significantly. The number of re-peated radiological examinations increased as well. Although the risk of cancer from single radi-ological scanning is small, risk from multiple imaging has not been estimated yet. The develop-ment of methodology for assessment of cancer risks from multiple radiological examinations is needed. This paper presents the procedure for assessment of radiation risks from multiple radio-logical examinations of any type. The validity of the developed approach was tested on the ex-ample of assessment of lifetime attributable risk (LAR) of cancer incidence from multiple com-puted tomography (CT) examinations, the results are discussed in the paper. The authors devel-oped the method for estimating radiation detriment from multiple radiological CT scans for re-maining life years. The method is based on equivalent radiation doses to organs and tissues of a patient’s body. Tables of LARs values per dose unit for males and females within the age range 0-95 years and a step of 5 years were designed. The tables were computed for the following cancer sites: bladder, breast, colon, bone marrow, liver, lungs, esophagus, ovary, stomach, thy-roid and other solid. The authors estimated cancer risks for a female, she was exposed to radia-tion from CT scanning. The female’s risks assessed with the developed methodology were com-pared with radiation risks estimated with mathematical model ICRP (Publication 103). The com-parison showed that the difference between risks estimated with the developed method and the risks estimated with the ICRP model did not exceed 12%. In models sex and age were account-ed, medical and demographic data applicable to the Russian population were taken into account as well.

Declining interest in clinical imaging during the COVID-19 pandemic: An analysis of Google Trends data

ObjectiveCurrent evidence suggests a decrease in elective diagnostic imaging procedures during the COVID-19 pandemic with potentially severe long-term consequences. The aim of this study was to quantify recent trends in public interest and related online search behavior for a range of imaging modalities, and “nowcast” future scenarios with respect to imaging use. MethodsWe used Google Trends, a publicly available database to access search query data in systematic and quantitative fashion, to search for key terms related to clinical imaging. We queried the search volume for multiple imaging modalities, identified the most common terms, extracted data for the United States over the time range from August 1, 2016 to August 1, 2020. Results were given in relative terms, using the Google metric ‘search volume index’. ResultsWe report a decrease in public interest across all imaging modalities since March 2020 with a subsequent slow increase starting in May 2020. Mean relative search volume (RSV) has changed by −19.4%, −38.3%, and −51.0% for the search terms “Computed tomography”, “Magnetic resonance imaging”, and “Mammography”, respectively, and comparing the two months prior to and following March 1, 2020. RSV has since steadily recuperated reaching all-year highs. ConclusionDecrease in public interest coupled with delays and deferrals of diagnostic imaging will likely result in a high demand for healthcare in the coming months. To respond to this challenge, measures such as risk-stratification algorithms must be developed to allocate resources and avoid the risk of overstraining the healthcare system.

Investigation into the Energy and Scatter Response of OSLDs at Diagnostic Energies Using a C-arm System.

Optically stimulated luminescent dosimeters (OSLDs) are radiation detectors commonly used in a clinical setting to monitor the dose to patients undergoing imaging or interventional procedures, especially those involving fluoroscopy. In dose tracking using OSLDs, it is important to consider that photons at the diagnostic energy range are prone to energy spectrum shifts from scattering interactions in the medium and that OSLDs have been reported to yield a somewhat strong energy-dependent response in the diagnostic energy range. This study examines the response of OSLDs exposed to a spectrum of photons in the diagnostic energy range (60-120 kVp), both free-in-air and on the surface of a PMMA phantom, within and just outside of the exposure field. From these measurements, it was observed that the response differs substantially (as high as 30%) in OSLDs irradiated under identical exposure settings but with differences in beam quality and scattering conditions. Furthermore, this study devises a method of weighted averages to calculate the calibration factors for OSLDs exposed to both primary and scatter photons, which were approximately 2-5% less than their corresponding measured values. This study emphasizes the need to develop different calibration factors in the clinical use of OSLDs for diagnostic imaging procedures, especially for procedures in which more precise dose measurements may be necessary.

Anesthetic risk during subsequent anesthetic events in brachycephalic dogs that have undergone corrective airway surgery: 45 cases (2007-2019).

To determine whether previous corrective upper airway surgery in brachycephalic dogs would decrease perianesthetic complications in subsequent anesthetic events. 45 client-owned dogs. Brachycephalic dogs undergoing any combination of staphylectomy, nasal alaplasty, or laryngeal sacculectomy that were anesthetized at a later date for additional surgical procedures or imaging from August 2, 2007, to February 8, 2019, had their medical records reviewed during both anesthetic events for signalment, American Society of Anesthesiologists status, perianesthetic drug administration, anesthetic duration, presence and total time of positive-pressure ventilation, procedure invasiveness, and perianesthetic complications such as bradycardia, hypothermia, hypotension, cardiac arrhythmias, hypertension, vomiting or regurgitation, dysphoria, respiratory distress, hypoxemia, reintubation, and prolonged periods of recovery. The odds of having complications during the postanesthetic period following subsequent anesthetic events were decreased by 79% in dogs having previous surgical intervention to correct clinical signs of brachycephalic airway syndrome. Intra-anesthetic bradycardia increased the odds of developing a postanesthetic complication by 4.56 times. Every 15-minute increase in anesthetic duration increased the odds of having a postanesthetic complication by 12% and having an intra-anesthetic complication by 11%. Previous corrective upper airway surgery decreased odds of postanesthetic complications in brachycephalic dogs that underwent subsequent anesthetic events. Findings in this study indicated that corrective upper airway surgery for brachycephalic dogs may reduce postanesthetic complications following subsequent anesthetic events, which may reduce perianesthetic morbidity in patients undergoing multiple surgical or diagnostic imaging procedures.

Comparison between thoracic ultrasonography and thoracic radiography for the detection of thoracic lesions in dairy calves using a two-stage Bayesian method

Infectious bronchopneumonia is a lower respiratory tract disease with major economic consequences in dairy calves. Thoracic radiography (TR) and thoracic ultrasonography (TUS) are two imaging diagnostic procedures available in bovine medicine for identifying thoracic lesions. However, no study has investigated whether one of these tests is superior to the other or if they provide comparable results for the detection of thoracic lesions in calves. The objective of this study was therefore to estimate and to compare the performances of TUS and TR for the detection of thoracic lesions in dairy calves. A prospective cross-sectional study was performed in a hospital setting. A total of 50 calves (≥7 days old; ≤100 kg; standing; pCO2 ≥ 53 mmHg; any reason of presentation) were enrolled. Every calf underwent TUS and TR. Only calves with thoracic lesions on TUS and/or TR were controlled by thoracic computed tomography (CT) (the gold standard). Calves without lesions were not controlled by CT. A two-stage Bayesian framework was used. The sensitivities (Se) and specificities (Sp) of both tests individually and used in series or parallel were estimated. The Se and Sp of TUS were 0.81 (95 % BCI (Bayesian Credible Interval): 0.65; 0.92) and 0.90 (95 % BCI: 0.81; 0.96), respectively. The Se and Sp of TR were 0.86 (95 % BCI: 0.62; 0.99) and 0.89 (95 % BCI: 0.67; 0.99), respectively. This study did not reveal any differences between both tests. Using TUS and TR in series was more specific than using both tests in parallel. The performances of TUS alone were not different from the performances of both tests in series or in parallel. In conclusion, TUS and TR were equivalent in detecting thoracic lesions in this study. Using TUS alone allowed an accurate detection of thoracic lesions in dairy calves. Further studies enrolling a larger sample (> 400 calves) and allowing adequate power to be achieved would be necessary to confirm these results.

Gadolinium In Medicine-An Evaluation and Update

Gadolinium-Based Contrast Agents (GBCA) are intravenous drugs used in diagnostic imaging procedures to enhance the quality of Magnetic Resonance Imaging (MRI) or Magnetic Resonance Angiography (MRA). FDA alerts concerning potential side effects increased patient and medical concerns. More recent FDA information indicate that ionic gadolinium is released from some GBCAs, potentially causing gadolinium toxicity. We checked if gadolinium is excreted renally without intervention after previous administration of GBCAs, and if chelating agents are effective in removing gadolinium that may have remained in the body after GBCA administration. Through the evaluation of our internal database and the studies of others, we concluded that no clear consensus exists at this time. While the DTPAs may be the choice of chelators for the removal of gadolinium from the human body, further studies are needed to prove this. It seems clear, however, that microcyclic GBCAs provide a lesser risk of causing gadolinium retention and gadolinium toxicity symptoms.

Cutaneous Radiation Injuries: Models, Assessment and Treatments.

Many cases of human exposures to high-dose radiation have been documented, including individuals exposed during the detonation of atomic bombs in Hiroshima and Nagasaki, nuclear power plant disasters (e.g., Chernobyl), as well as industrial and medical accidents. For many of these exposures, injuries to the skin have been present and have played a significant role in the progression of the injuries and survivability from the radiation exposure. There are also instances of radiation-induced skin complications in routine clinical radiotherapy and radiation diagnostic imaging procedures. In response to the threat of a radiological or nuclear mass casualty incident, the U.S. Department of Health and Human Services tasked the National Institute of Allergy and Infectious Diseases (NIAID) with identifying and funding early- to mid-stage medical countermeasure (MCM) development to treat radiation-induced injuries, including those to the skin. To appropriately assess the severity of radiation-induced skin injuries and determine efficacy of different approaches to mitigate/treat them, it is necessary to develop animal models that appropriately simulate what is seen in humans who have been exposed. In addition, it is important to understand the techniques that are used in other clinical indications (e.g., thermal burns, diabetic ulcers, etc.) to accurately assess the extent of skin injury and progression of healing. For these reasons, the NIAID partnered with two other U.S. Government funding and regulatory agencies, the Biomedical Advanced Research and Development Authority (BARDA) and the Food and Drug Administration (FDA), to identify state-of-the-art methods in assessment of skin injuries, explore animal models to better understand radiation-induced cutaneous damage and investigate treatment approaches. A two-day workshop was convened in May 2019 highlighting talks from 28 subject matter experts across five scientific sessions. This report provides an overview of information that was presented and the subsequent guided discussions.

Cutaneous Radiation Injuries: Models, Assessment and Treatments.

Many cases of human exposures to high-dose radiation have been documented, including individuals exposed during the detonation of atomic bombs in Hiroshima and Nagasaki, nuclear power plant disasters (e.g., Chernobyl), as well as industrial and medical accidents. For many of these exposures, injuries to the skin have been present and have played a significant role in the progression of the injuries and survivability from the radiation exposure. There are also instances of radiation-induced skin complications in routine clinical radiotherapy and radiation diagnostic imaging procedures. In response to the threat of a radiological or nuclear mass casualty incident, the U.S. Department of Health and Human Services tasked the National Institute of Allergy and Infectious Diseases (NIAID) with identifying and funding early- to mid-stage medical countermeasure (MCM) development to treat radiation-induced injuries, including those to the skin. To appropriately assess the severity of radiation-induced skin injuries and determine efficacy of different approaches to mitigate/treat them, it is necessary to develop animal models that appropriately simulate what is seen in humans who have been exposed. In addition, it is important to understand the techniques that are used in other clinical indications (e.g., thermal burns, diabetic ulcers, etc.) to accurately assess the extent of skin injury and progression of healing. For these reasons, the NIAID partnered with two other U.S. Government funding and regulatory agencies, the Biomedical Advanced Research and Development Authority (BARDA) and the Food and Drug Administration (FDA), to identify state-of-the-art methods in assessment of skin injuries, explore animal models to better understand radiation-induced cutaneous damage and investigate treatment approaches. A two-day workshop was convened in May 2019 highlighting talks from 28 subject matter experts across five scientific sessions. This report provides an overview of information that was presented and the subsequent guided discussions.

Lead exposure in clinical imaging – The elephant in the room

PurposeRadiation Protection Apparel (RPA) is used during diagnostic imaging and interventional procedures to minimise incidental radiation exposure. The majority of RPA in use are lead-containing, which has until now been considered safe. A recent single-centre study has demonstrated that the external surface of 63 % of RPA was contaminated with lead dust. The purpose of this study was to reproduce this investigation with a larger sample size across Europe and assess whether decontamination procedures were possible. MethodThe routine RPA Quality Control (QC) process was adapted to include lead dust contamination tests and decontamination if present. The presence of lead dust was determined using a commercially available colorimetric method. RPA that failed initial QC or could not be decontaminated were removed from use. ResultsFrom June to October 2019, 728 RPA from 85 imaging centres from five countries underwent initial QC. Of these, 712 were tested for lead dust contamination which was present on 162 (23 %). Following cleaning, 85 (12 %) remained contaminated and were removed from use. Linear regression analysis shows a significant correlation between type of RPA and contamination, (p = 0.0015). There was no correlation between contamination and imaging department, year of manufacture, country and RPA condition (p-values 0.98, 0.90, 0.94 and 0.14 respectively). ConclusionsLead dust contamination is present on 23 % of RPA that would pass routine QC procedures. Approximately half were not amenable to decontamination and were removed from use. Procedures were introduced for the routine handling of RPA, and updated QC steps for assessment and cleaning. Lead-free RPA should be considered.

18F-DCFPyL PET/CT for primary staging in 160 high-risk prostate cancer patients; metastasis detection rate, influence on clinical management and preliminary results of treatment efficacy.

Prostate-specific membrane antigen (PSMA) PET/CT shows better diagnostic performance for detection of lymph node and bone metastases as compared to conventional imaging. Studies of PSMA PET/CT in primary staging comprise highly selected patient cohorts. This study evaluates 18F-DCFPyL PET/CT as first-line imaging modality for primary staging of high-risk prostate cancer. From February 2018 until April 2019, all patients with high-risk prostate cancer received 18F-DCFPyL PET/CT for staging of prostate cancer. Baseline characteristics, findings at 18F-DCFPyL PET/CT, number and type of required additional diagnostic procedures, findings at additional diagnostic procedures, and effects of therapy on PSA levels for all patients treated with curative intent were collected and evaluated. One hundred-sixty patients were included in the study of which 90 (56%) had evidence of metastasized disease (N1, M1a, M1b and, M1c in 49%, 28%, 31%, and 3% respectively). Additional diagnostic imaging was needed in 2/160 patients (1%) because of equivocal findings on 18F-DCFPyL PET/CT. Eighty-one patients had evidence of PSMA-positive lymph node metastases, of whom 39 (48%) had no enlarged lymph nodes on CT; 18F-DCFPyL PET detected additional metastatic lymph nodes in 41/42 patients that had evidence of lymph node metastases on CT. 18F-DCFPyL PET altered patients' management in 17% of patients. 18F-DCFPyL PET/CT can be used as first-line imaging modality for therapy selection in patients with primary high-risk prostate cancer, without need for further diagnostic imaging procedures in the majority of patients.

Knowledge and Associated Factors of Medical Students Regarding Radiation Exposure from Common Diagnostic Imaging Procedures at the University of Gondar, Ethiopia.

Physicians' knowledge about radiation exposure and risks was previously reported as inadequate. Therefore, the aim of this study was to assess knowledge and associated factors regarding radiation exposure among medical students from common diagnostic imaging procedures at the University of Gondar. A cross-sectional study was conducted to assess knowledge and associated factors regarding radiation exposure among medical students. A total of 473 medical students (first through sixth years of study) completed a structured questionnaire. Univariate and multi-variable binary logistic regression was used to see the factors associated with knowledge of medical students on radiation sources, exposure and risks. Variables with p-value <0.2 during the bivariable binary logistic regression were tested in the multivariable binary logistic regression. P-value<0.05 was used to declare significant association at the final model. Response rate was 100%. Two hundred fifteen (45.5% 95% confidence interval (CI )(41.0%-50.3%)) participants had good knowledge regarding radiation exposure from diagnostic imaging procedures. Only 177(37.4%) participants correctly knew that Computer Tomography (CT) use X-ray. However, subjects incorrectly named magnetic resonance imaging (MRI) as if it used x-ray (12.1%) and source of ionizing radiation (19.5%). Being female [Adjusted-odds-ratio (AOR)=1.57,95% CI(1.05,2.36)], 18-20 years of age [AOR=2.18, 95% CI(1.26, 3.76)], and 1st to 3rd year of study [AOR=3.64, 95% CI(2.23,5.95)] were predictors of knowledge identified. The results highlight that medical students need to be trained well with sufficient radiological education that enable them later to adhere to safe practices.

Determining the thermal characteristics of breast cancer based on high-resolution infrared imaging, 3D breast scans, and magnetic resonance imaging

For over the three decades, various researchers have aimed to construct a thermal (or bioheat) model of breast cancer, but these models have mostly lacked clinical data. The present study developed a computational thermal model of breast cancer based on high-resolution infrared (IR) images, real three-dimensional (3D) breast surface geometries, and internal tumor definition of a female subject histologically diagnosed with breast cancer. A state-of-the-art IR camera recorded IR images of the subject’s breasts, a 3D scanner recorded surface geometries, and standard diagnostic imaging procedures provided tumor sizes and spatial locations within the breast. The study estimated the thermal characteristics of the subject’s triple negative breast cancer by calibrating the model to the subject’s clinical data. Constrained by empirical blood perfusion rates, metabolic heat generation rates reached as high as 2.0E04 W/m3 for normal breast tissue and ranged between 1.0E05–1.2E06 W/m3 for cancerous breast tissue. Results were specific to the subject’s unique breast cancer molecular subtype, stage, and lesion size and may be applicable to similar aggressive cases. Prior modeling efforts are briefly surveyed, clinical data collected are presented, and finally thermal modeling results are presented and discussed.

Effects of low dose radiation on immune cells subsets and cytokines in mice.

Whole-body exposure to low-dose radiation due to diagnostic imaging procedures, occupational hazards and radiation accidents is a source of concern. In this study, we analyzed the effects of single and long-term low-dose irradiation on the immune system. Male Balb/c mice received a single whole-body dose of irradiation (0.01, 0.05, 0.2, 0.5 or 1Gy). For long-term irradiation, mice were irradiated 10 times (total dose of 0.2, 0.5 or 1Gy) over a period of 6weeks. Two days after single or long-term irradiation, the numbers of splenic macrophages, natural killer cells and dendritic cells were reduced, and the spleen organ coefficient was decreased. At 2Days after long-term low-dose irradiation, the number of white blood cells in the peripheral blood of the mice decreased. Between 7 and 14Days after long-term low-dose irradiation, the number of immune cells in the thymus and spleen began to increase and then stabilized. Th1/Th2 cytokines and reactive oxygen species-related proteins first decreased and then increased to a plateau. Our results show a significant difference in the effects of single and long-term low-dose irradiation on the immune system.

Giant Ovarian Cysts: A Case Series

Giant ovarian cysts are rare and are almost no longer reported in medical literature. Except where good diagnostic imaging procedure is performed, they could be mistaken for massive abdominal ascites. Here we report 2 cases which were diagnosed at a medical missions facility during a free medical outreach program in March 2017. The patients presented with gross abdominal distention. Ultrasound scan revealed cystic ovarian tumors in both cases with no suspicious finding for malignancy. Salpingo-ophorectomies were carried out at laparatomies through midline incision extending from below the epigastric to just above the suprapubic. Patients were treated with postoperative antibiotics and analgesics and discharged home after 7 days on admission. They were followed up for 2 years and both recovered well without recurrence. Cystectomy without pre-operative drainage remains the modality of treatment in our environment.

Giant Ovarian Cysts: A Case Series

Giant ovarian cysts are rare and are almost no longer reported in medical literature. Except where good diagnostic imaging procedure is performed, they could be mistaken for massive abdominal ascites. Here we report 2 cases which were diagnosed at a medical missions facility during a free medical outreach program in March 2017. The patients presented with gross abdominal distention. Ultrasound scan revealed cystic ovarian tumors in both cases with no suspicious finding for malignancy. Salpingo-ophorectomies were carried out at laparatomies through midline incision extending from below the epigastric to just above the suprapubic. Patients were treated with postoperative antibiotics and analgesics and discharged home after 7 days on admission. They were followed up for 2 years and both recovered well without recurrence. Cystectomy without pre-operative drainage remains the modality of treatment in our environment.

Giant Ovarian Cysts: A Case Series

Giant ovarian cysts are rare and are almost no longer reported in medical literature. Except where good diagnostic imaging procedure is performed, they could be mistaken for massive abdominal ascites. Here we report 2 cases which were diagnosed at a medical missions facility during a free medical outreach program in March 2017. The patients presented with gross abdominal distention. Ultrasound scan revealed cystic ovarian tumors in both cases with no suspicious finding for malignancy. Salpingo-ophorectomies were carried out at laparatomies through midline incision extending from below the epigastric to just above the suprapubic. Patients were treated with postoperative antibiotics and analgesics and discharged home after 7 days on admission. They were followed up for 2 years and both recovered well without recurrence. Cystectomy without pre-operative drainage remains the modality of treatment in our environment.

Giant Ovarian Cysts: A Case Series

Giant ovarian cysts are rare and are almost no longer reported in medical literature. Except where good diagnostic imaging procedure is performed, they could be mistaken for massive abdominal ascites. Here we report 2 cases which were diagnosed at a medical missions facility during a free medical outreach program in March 2017. The patients presented with gross abdominal distention. Ultrasound scan revealed cystic ovarian tumors in both cases with no suspicious finding for malignancy. Salpingo-ophorectomies were carried out at laparatomies through midline incision extending from below the epigastric to just above the suprapubic. Patients were treated with postoperative antibiotics and analgesics and discharged home after 7 days on admission. They were followed up for 2 years and both recovered well without recurrence. Cystectomy without pre-operative drainage remains the modality of treatment in our environment.

Giant Ovarian Cysts: A Case Series

Giant ovarian cysts are rare and are almost no longer reported in medical literature. Except where good diagnostic imaging procedure is performed, they could be mistaken for massive abdominal ascites. Here we report 2 cases which were diagnosed at a medical missions facility during a free medical outreach program in March 2017. The patients presented with gross abdominal distention. Ultrasound scan revealed cystic ovarian tumors in both cases with no suspicious finding for malignancy. Salpingo-ophorectomies were carried out at laparatomies through midline incision extending from below the epigastric to just above the suprapubic. Patients were treated with postoperative antibiotics and analgesics and discharged home after 7 days on admission. They were followed up for 2 years and both recovered well without recurrence. Cystectomy without pre-operative drainage remains the modality of treatment in our environment.