Showing 2 Abstracts.
Umbilical catheters provide intravascular access in the neonatal period that is lifesaving and relatively easy to obtain. However, they are associated with numerous complications related to their placement and use. These may occur because of injuries to vessels and adjacent structures at the time of or following catheter placement; an example is a liver hematoma caused by focal perforation of the umbilical or portal veins during attempted passage of the catheter into the ductus venosus. Complications may also arise from the use of a malpositioned catheter. Pleural effusions and ascites composed of total parenteral nutrition solutions may result from the use of an umbilical venous catheter that terminates in the portal venous system. Complications may be caused by otherwise well positioned, normally functioning catheters, which are innately thrombogenic and may cause thrombosis of the aorta and branches, portal venous system, or caval tributaries, with potentially devastating consequences. Finally, catheter-associated blood stream infection is always a risk during placement and subsequent use. The resulting bacteremia can lead to life-threatening sepsis and additional complications such as septic thrombosis and mycotic aneurysm. This educational review presents a spectrum of complications related to umbilical catheters, organized according to the framework outlined above. The review includes images of cases illustrating both common and unusual entities and a discussion of their salient imaging and clinical features. Read More
Meeting name: SPR 2017 Annual Meeting & Categorical Course , 2017
Authors: Graeber Brendon, Silva Cicero
Sickle cell disease (SCD) is characterized by repeated episodes of vaso-occlusion and hemolysis beginning in the pediatric period that result in serious multi-organ system complications. In particular, renal complications are often the cause of morbidity and reduced life expectancy of patients with SCD. Therefore, it is essential that radiologists be able to identify the imaging features early to help guide prompt and appropriate treatment. Sequelae in pediatric patients include sickle cell nephropathy, infarction and papillary necrosis, and assorted glomerulopathies. These in turn can lead to altered hemodynamics, impaired urinary concentrating ability, hematuria, proteinuria, and acute and chronic kidney injury. Children with SCD are also at increased risk of asymptomatic bacteriuria and urinary tract infection. Even those children and young adults who only have sickle cell trait (SCT) rather than SCD may develop chronic kidney disease later in life and carry markedly increased risk for renal medullary carcinoma. Segmental testicular infarction can compromise fertility in patients with both SCD and SCT. The genitourinary manifestations of SCD and SCT in the pediatric patient will be reviewed in this educational exhibit, with an emphasis on radiologic appearances. For each entity, the clinical presentation, pathophysiology, and differential diagnosis of the imaging findings will also be briefly reviewed. The renal complications covered will include renal infarction, papillary necrosis, renal vein thrombosis (as a complication of nephrotic syndrome), urinary tract infection, hematuria, renal medullary carcinoma, and acute and chronic kidney disease. Testicular and penile sequelae of SCD including segmental testicular infarction and priapism will also be discussed. A variety of imaging modalities will be used to illustrate the various complications, including ultrasonography, computed tomography, and magnetic resonance imaging. Read More
Meeting name: SPR 2018 Annual Meeting & Postgraduate Course , 2018
Authors: Taylor Erin, Graeber Brendon, Ehrlich Lauren
Keywords: Sickle, Renal, Genitourinary