Background: Langerhans cell histiocytosis (LCH) is common in adult smokers but exceedingly rare in children with very few cases reported in the literature of children <12 years who had been reported as having isolated pulmonary LCH. Case Report: 4-year-old unvaccinated Amish boy, otherwise healthy with no significant past medical history who presented with acute respiratory distress, found to have recurrent bilateral pneumothoraces status post bilateral chest tubes placement. Read More

Meeting name: SPR 2023 Annual Meeting & Postgraduate Course , 2023

Authors: Dhangana Pinky, Tadros Sameh

Keywords: Langerhans cell histiocytosis

The female anatomic equivalent of the male processus vaginalis is the canal of Nuck. The canal is formed from a small peritoneal protuberance from the round ligament that extends through the inguinal ring, into the inguinal canal, and terminates in the labia majora. Obliteration of the canal occurs in a superior to inferior direction and usually completes within the first year of life. Non-closure results in a persistent canal of Nuck. Very rarely herniation of abdominal and pelvic contents into the canal of Nuck can occur, much less commonly in females than in the male equivalent. Hernias can present at any age but are most common in children. Recognition of this entity is especially important in cases of ovarian herniation due to the risk of incarceration. We will provide a review normal anatomy, potential canal contents, the imaging appearance on ultrasound, CT, as well as MRI, and discuss differential diagnosis using cases of canal of Nuck hernia in 4 patients aged 22 days though 17 years. Read More

Meeting name: IPR 2016 Conjoint Meeting & Exhibition , 2016

Authors: Abdulla Sarah, Tadros Sameh, Squires Judy

Keywords: Canal of Nuck, hernia, ultrasound, MRI, CT

Vascular compression syndromes of the abdomen, including median arcuate ligament syndrome, superior mesenteric artery syndrome, and nutcracker syndrome, are challenging clinical entities with imaging findings that may be confusing. Imaging plays a decisive role in the diagnostic algorithm in children because clinical findings alone can be nonspecific and functional abdominal pain is common. Findings of angiography, CT, MRI, and fluoroscopy for these syndromes have been widely described and provide useful information to aid in the diagnosis of these syndromes. Sonographic findings have also been described in the literature, but are less known and possibly perplexing, with variable diagnostic criteria in children. Ultrasound is therefore likely underutilized in evaluating these abnormalities despite its ability to provide anatomic, physiologic, and most importantly, dynamic information in a cost-effective manner without the use of ionizing radiation. The purpose of this exhibit is to review the clinical features of vascular compression syndromes in the abdomen, review ultrasound imaging findings and discuss diagnostic criteria. Read More

Meeting name: SPR 2017 Annual Meeting & Categorical Course , 2017

Authors: Llorens Carlos, Scholz Stefan, Tadros Sameh, Squires Judy

Keywords: median arcuate ligament syndrome, superior mesenteric artery syndrome, nutcracker syndrome