1.Malignant obstruction of superior vena cava: Endovascular stenting using Y-configuration stent in stent technique
The Medical Journal of Malaysia 2018;73(6):407-409
Malignant intrathoracic disease is the commonest cause of
superior vena cava (SVC) obstruction. Life threatening SVC
obstruction with intense dyspnoea requires urgent
treatment. SVC stenting has been developed in recent years
which results in rapid relief of the obstruction. The Yconfiguration
technique has been reported to provide
support for all three limbs of the bifurcation to prevent
restenosis. At present, there are limited reports on the use of
Y-configuration stent in stent techniques for endovascular
stenting in malignant SVC obstruction. We share our clinical
experience of two patients who received balloon-mounted
stents using this technique
2.An Incidental Finding of Internal Jugular Vein Ectasia on Cervical Spine Magnetic Resonance Imaging
Malaysian Journal of Medicine and Health Sciences 2018;14(Supplement 1):82-84
Ectasia or abnormal dilatation of a vessel may affect any vein within the body including the neck region. Internal jugular vein (IJV) ectasia commonly presents as a painless, soft swelling on the neck which appears to be prominent with increased intrapleural pressure such as during Valsalva manoeuvre. To the best of our knowledge, the occurrence of venous ectasia is infrequent with limited number of reports on this anomaly available. However with the advancement of technology especially in imaging modalities, there is improvement in detecting this condition. We describe here an incidental finding of focal IJV ectasia in an elderly lady following a cervical spine magnetic resonance imaging (MRI) for bilateral hand numbness, and discuss the management of this rare presentation.
Cervical spine MRI
3.Lumbosacral osteosarcoma with dural spread, skip lesions and intravascular extension: A case report
Noor Khairiah A. Karim ; Mohamad Nazrulhisham Mad Naser ; John GEORGE
The Medical Journal of Malaysia 2018;73(2):116-118
Primary osteosarcoma of the spine is indeed rare and onlyseveral sporadic cases have been reported. It tends to occurin a slightly older age group than those with appendicularskeleton tumours. We present here an unusual case ofaggressive lumbosacral osteosarcoma in a young teenagercomplicated by extensive dural spread, skip lesions andintravascular extension. Although a histopathologicalexamination is mandatory to establish the diagnosis, thiscase emphasises the need of imaging to ascertain the fullextent of disease spread especially in deciding the type oftreatment to be instituted and to evaluate the response tothe treatment.
4.Pre-operative Non-Invasive Imaging for Neonatal Cholestasis in a Child with Extrahepatic Biliary Atresia
Siti Lenggogeni Zainal Rain Rancis ; Jazilah Abd Rahim ; Noor Khairiah A. Karim
Malaysian Journal of Medicine and Health Sciences 2022;18(No.4):227-229
Hepatobiliary iminodiacetic acid (HIDA) scintigraphy is a non-invasive, functional imaging of the hepatobiliary system that serves as an adjunct imaging modality for neonatal cholestasis work-up. In view of the urgency to diagnose
biliary atresia and restore bile flow through surgery, HIDA scintigraphy could help to distinguish between neonatal
cholestasis due to biliary atresia and neonatal hepatitis of various causes. We describe a full-term male infant with
jaundice beyond the physiological period in which HIDA scintigraphy showed absent tracer excretion from the
biliary system into the intestines up to 5 hours on follow-up imaging. The intraoperative diagnosis confirmed the
diagnosis of biliary atresia. The prognosis of the patient with biliary atresia depends on early surgical planning and
intervention. Therefore, non-invasive diagnostic tools play an important role in the evaluation of a child with neonatal cholestasis.
5.A Rare Case of Cystic Biliary Atresia
Ng Wei Lee ; Noor Khairiah A. Karim ; Preetvinder Singh A/L Dheer Singh
Malaysian Journal of Medicine and Health Sciences 2023;19(No.3):380-382
Biliary atresia is one of the commonest causes of prolonged jaundice in neonate, whereas cystic biliary atresia is
a rare form of biliary atresia with similar presentation, but a slightly different sonographic finding. Being able to
differentiate them radiologically is important as the surgical management is different for these two diagnoses. An
ultrasound examination was done for a 2-month-old baby girl with prolonged jaundice with the finding of a cyst
along the portal triad, which raised the suspicion for cystic biliary atresia. The diagnosis was confirmed with intraoperative cholangiography (IOC) and Kasai procedure was done. The patient was well after the surgery with resolution
of jaundice.