1.Imaging in noncardiovascular thoracic emergencies: a pictorial review.
Singapore medical journal 2015;56(11):604-quiz 611
Cardiovascular and noncardiovascular conditions are commonly encountered in the emergency department. While the majority of patients have underlying cardiovascular aetiologies, such as acute myocardial infarction, congestive heart failure, aortic dissection and pulmonary embolism, a small subset of patients have underlying noncardiovascular conditions, although they present with similar symptoms of chest pain, dyspnoea, cough, haemoptysis and haematemesis. This article aims to describe the imaging findings in common noncardiovascular conditions of the chest that are frequently encountered in the emergency department, with a review of the existing literature.
Chest Pain
;
diagnosis
;
etiology
;
Diagnosis, Differential
;
Diagnostic Imaging
;
Emergencies
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Humans
;
Myocardial Infarction
;
complications
;
diagnosis
;
Pulmonary Embolism
;
complications
;
diagnosis
2.Tell Tale of Tablets in Bronchus
Trishna Shimpi ; Ashish Chawla ; Sumer Shikhare
The Medical Journal of Malaysia 2015;70(1):36-37
Foreign body (FB) aspiration is an emergency of concern at
all ages. However, in adults, it can present with atypical
symptoms such as shortness of breath, wheezing or rarely
cyanosis. Aspiration of oral medications is seen in the
elderly population with impairment of protective airway
mechanism. Treatment of choice is endoscopic removal of
the foreign body.
We report such a case of foreign body aspiration (potassium
chloride tablet), diagnosed on imaging and subsequently
developed bronchostenosis. There are a very few reported
cases of oral potassium supplement aspiration and
associated complications in the literature.
Foreign Bodies
3.CT Pulmonary Angiography Features of a Hepatopulmonary Syndrome.
Ashish CHAWLA ; Vishal GAIKWAD ; Niraj DUBEY ; Jerome BOSCO
Korean Journal of Radiology 2015;16(4):951-952
No abstract available.
4.Clinics in diagnostic imaging. 159. Jejunal intussusception due to Peutz-Jeghers syndrome.
Vijay KRISHNAN ; Ashish CHAWLA ; Eric WEE ; Wilfred C G PEH
Singapore medical journal 2015;56(2):81-quiz 86
A 21-year-old woman presented with acute onset of upper abdominal pain. A diagnosis of Peutz-Jeghers syndrome (PJS) was made based on the clinical picture of perioral pigmentation with imaging findings of transient jejunojejunal intussusceptions and small bowel polyps, and confirmed by characteristic histopathological appearances of Peutz-Jeghers polyps. PJS is a rare hereditary condition characterised by unique hamartomatous polyps, perioral mucocutaneous pigmentations, and increased susceptibility to gastrointestinal and extraintestinal neoplasms. Patients usually present with recurrent abdominal pain due to intussusception caused by polyps. Other modes of presentations include rectal bleeding and melaena. We describe the imaging findings of PJS and provide a brief review of bowel polyposis syndromes. The latter are relatively rare disorders characterised by multiple polyps in the large or small intestine, with associated risk of malignancies and other extraintestinal manifestations. Awareness of the manifestations and early diagnosis of these syndromes is crucial to prevent further complications.
Abdominal Pain
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Adult
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Barium
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chemistry
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Diagnostic Imaging
;
methods
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Female
;
Humans
;
Intussusception
;
diagnosis
;
diagnostic imaging
;
pathology
;
Jejunum
;
diagnostic imaging
;
pathology
;
Magnetic Resonance Imaging
;
Male
;
Middle Aged
;
Peutz-Jeghers Syndrome
;
diagnosis
;
diagnostic imaging
;
pathology
;
Polyps
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Tomography, X-Ray Computed
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Young Adult
5.Clinics in diagnostic imaging (178). Wünderlich syndrome and pseudoaneurysm.
Raymond CHUNG ; Ashish CHAWLA ; Wilfred Cg PEH
Singapore medical journal 2017;58(6):289-293
Wünderlich syndrome is a rare entity characterised by spontaneous retroperitoneal haemorrhage with renal origin. We present a case of Wünderlich syndrome secondary to clotting dyscrasia in a 64-year-old woman. The patient experienced a second Wünderlich haemorrhagic event with metachronous pseudoaneurysm formation, which was likely secondary to the large subcapsular haematoma stripping the renal capsule and tearing the cortical arteries. Selective pseudoaneurysm embolisations were successfully performed on both occasions. This clinical entity, its imaging differential diagnoses and management are discussed.
6.Clinics in diagnostic imaging (184). Fat embolism syndrome (FES).
Dinesh R SINGH ; Ashish CHAWLA ; Wilfred Cg PEH
Singapore medical journal 2018;59(3):159-162
A 23-year-old Indian man presented with shortness of breath and new-onset confusion along with a rash on his chest on Postoperative Day 2, following internal fixation of his femur fracture. Although computed tomography pulmonary angiography was negative for filling defects in the pulmonary vasculature, it showed mosaic attenuation changes with some interlobular septal thickening. Magnetic resonance imaging of the brain showed patchy signal abnormalities, predominantly in the grey-white matter junction region with extensive susceptibility artefacts, consistent with petechial haemorrhages. The laboratory work-up showed thrombocytopenia and anaemia. A diagnosis of fat embolism syndrome was established, based on the clinical presentation combined with laboratory and imaging findings. The clinical and imaging features of fat embolism syndrome are discussed.
Brain
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pathology
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Dyspnea
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Embolism, Fat
;
diagnostic imaging
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Femoral Fractures
;
diagnostic imaging
;
Humans
;
Hypoxia
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India
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Magnetic Resonance Imaging
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Male
;
Pulmonary Embolism
;
Thrombocytopenia
;
Tomography, X-Ray Computed
;
Young Adult
7.Imaging of acute cholecystitis and cholecystitis-associated complications in the emergency setting.
Ashish CHAWLA ; Jerome Irai BOSCO ; Tze Chwan LIM ; Sivasubramanian SRINIVASAN ; Hui Seong TEH ; Jagadish Narayana SHENOY
Singapore medical journal 2015;56(8):438-quiz 444
Acute cholecystitis is a common cause of right upper quadrant pain in patients presenting at the emergency department. Early diagnosis and recognition of associated complications, though challenging, are essential for timely management. Imaging studies, including ultrasonography, computed tomography and magnetic resonance imaging, are increasingly utilised for the evaluation of suspected cases of cholecystitis. These investigations help in diagnosis, identification of complications and surgical planning. Imaging features of acute cholecystitis have been described in the literature and are variable, depending on the stage of inflammation. This article discusses the spectrum of cholecystitis-associated complications and their imaging manifestations. We also suggest a checklist for the prompt and accurate identification of complications in acute cholecystitis.
Abdominal Pain
;
diagnosis
;
Adult
;
Aged
;
Cholecystitis
;
complications
;
diagnostic imaging
;
Cholecystitis, Acute
;
complications
;
diagnostic imaging
;
Diagnosis, Differential
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Emergency Medicine
;
methods
;
Emergency Service, Hospital
;
Female
;
Humans
;
Inflammation
;
Magnetic Resonance Imaging
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Male
;
Middle Aged
;
Tomography, X-Ray Computed
;
Ultrasonography
8.Clinics in diagnostic imaging (173). Scimitar syndrome with horseshoe lung.
Vishal GAIKWAD ; Ashish CHAWLA ; Tze Chwan LIM ; Wilfred Cg PEH
Singapore medical journal 2017;58(1):29-33
A 56-year-old Chinese man presented with giddiness and vertigo. Subsequent chest radiography showed the classic scimitar sign of an abnormal pulmonary venous return. Further evaluation with non-contrast computed tomography substantiated the finding of a partial anomalous venous drainage pattern and identified an associated rare lung anomaly, horseshoe lung. The imaging findings of scimitar syndrome and its association with horseshoe lung are reviewed.
Diagnosis, Differential
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Humans
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Lung
;
abnormalities
;
diagnostic imaging
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Male
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Middle Aged
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Radiography, Thoracic
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Scimitar Syndrome
;
diagnostic imaging
;
Tomography, X-Ray Computed
10.Clinics in diagnostic imaging (189). Acute phase cardiac sarcoidosis (CS).
Sumer Nrupendra SHIKHARE ; Ashish CHAWLA ; Ree Nee KHOO ; Wilfred Cg PEH
Singapore medical journal 2018;59(8):407-412
A 44-year-old man presented with breathlessness and episodes of palpitations for the last one year. The imaging diagnosis of cardiac sarcoidosis was made based on chest radiography and cardiac magnetic resonance (MR) imaging findings, and was further confirmed by biopsy. Cardiac sarcoidosis is an uncommon entity, yet is potentially fatal with nonspecific clinical manifestations, including sudden cardiac death. Hence, it is important to diagnose and treat this entity at an early stage to improve morbidity and mortality. Cardiac MR imaging plays a pivotal role in facilitating diagnosis and monitoring therapeutic response. We describe the MR imaging features of cardiac sarcoidosis and discuss imaging features of other cardiomyopathies that may mimic cardiac sarcoidosis.