Showing 2 Abstracts.
In this exhibit, we will describe the synergistic effect of urodynamics and imaging. Bladder dysfunction, a common problem in children, accounts for up to 40 percent of pediatric urology clinic visits. Urodynamics is a key study to determine the etiology of bladder dysfunction yet, many radiologists are unfamiliar with this exam. Urodynamics is a fluoroscopic evaluation of the bladder with contrast during which abdominal and bladder pressures are measured while the bladder fills and empties. It uses a combination of electromyogram to evaluate pelvic floor contractions, cystometrogram to evaluate bladder pressures and capacity, and voiding cystourethrography to evaluate lower urinary tract anatomy. This exhibit will explain the indications for urodynamics, the basics of its interpretation including detrusor function and pressure flow studies, and the types of pathologies which may be diagnosed. Neurogenic bladder, congenital abnormalities, and how to differentiate between subsets of overactive bladder and underactive bladder will be explained. We will show imaging findings which correlate with these urodynamic diagnoses and describe ways to enhance voiding cystourethrograms and sonograms to better evaluate children with lower urinary tract dysfunction. Read More
Meeting name: SPR 2019 Annual Meeting & Postgraduate Course , 2019
Authors: Sellers Emily, Stahoviak Katherine, Ong Seng, Feinstein Kate
In this exhibit we will describe a fairly new surgical procedure - total pancreatectomy and islet autotransplant (TPIAT). TPIAT is an uncommon procedure performed in children who suffer from chronic or recurrent acute pancreatitis. The purpose of the exhibit is to learn about the selection criteria, the surgery itself, and the imaging features of surgical complications. Candidates are selected for surgery based on a multitude of factors including severity and chronicity of pain, laboratory evaluation of pancreatic exocrine and endocrine function, and imaging features of chronic pancreatitis on MRCP and/or endoscopic ultrasound. In the surgical procedure, the pancreas and duodenum are resected, islet cells are isolated and then infused through the portal vein into the liver. A splenectomy is performed and continuity of the GI tract restored. Patients may spend three weeks in the hospital after surgery. Months after the infusion, the islet cells will be embedded within the liver and begin to produce insulin. The primary goal of this procedure is to relieve debilitating pain and improve quality of life, for which this procedure is around 90% successful. The secondary goal of the procedure is to retain islet cell function. In this regard, approximately 40% of the pediatric patients will regain complete islet cell function, 30% will regain partial function while 30% will have no islet cell function. Follow up imaging may also be performed on these patients for evaluation of complications such as delayed gastric emptying, small bowel obstruction, surgical site infections, bile leak, and intra-abdominal hemorrhage. Complications seen in our hospital, including small bowel obstruction, delayed gastric emptying, and prolonged ileus will be highlighted. Read More
Meeting name: SPR 2019 Annual Meeting & Postgraduate Course , 2019
Authors: Groene John, Wieck Minna, Ong Seng, Zaritzky Mario, Feinstein Kate
Keywords: total pancreatectomy and islet autotransplant, TPIAT, islet cell transplantation