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Article ; Online: Successful interventional treatment of huge hepatic haemangioma in a neonate following failed medical approach.

Roy, Abhijeet / Yadav, Rajanikant R / Naranje, Kirti / Singh, Anita

BMJ case reports

2024 Volume 17, Issue 4

Abstract: An outborn male term neonate presented with a complaint of respiratory distress since birth on day 9 of life. On examination, baby was having tachypnoea, tachycardia and hepatomegaly. The baby was delivered at term gestation and cried immediately after ... ...

Abstract	An outborn male term neonate presented with a complaint of respiratory distress since birth on day 9 of life. On examination, baby was having tachypnoea, tachycardia and hepatomegaly. The baby was delivered at term gestation and cried immediately after birth. The chest X-ray showed cardiomegaly. The abdomen ultrasound showed a complex cystic vascular lesion suggestive of hepatic haemangioma. The echocardiography showed an atrial septal defect. The baby was initially treated conservatively along with specific treatment (steroids and propranolol) for haemangioma for 6 weeks. However, the symptoms persisted and there was non-resolution, therefore, particle embolisation of the right hepatic artery was performed. Subsequently, it resulted in complete resolution of the lesion.
MeSH term(s)	Infant, Newborn ; Infant ; Humans ; Male ; Hemangioma/diagnostic imaging ; Hemangioma/therapy ; Liver Neoplasms/diagnostic imaging ; Liver Neoplasms/therapy ; Propranolol/therapeutic use ; Hepatic Artery ; Ultrasonography
Chemical Substances	Propranolol (9Y8NXQ24VQ)
Language	English
Publishing date	2024-04-02
Publishing country	England
Document type	Case Reports ; Journal Article
ISSN	1757-790X
ISSN (online)	1757-790X
DOI	10.1136/bcr-2023-258909
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Article: Emergent Management of Gastric Variceal Bleed in the Setting of Acute Pancreatitis-Related Sinistral Hypertension With Partial Splenic Embolization: A Series of Two Cases.

Gautam, Avinash D / Sanket / Agarwal, Ayushi / Yadav, Rajanikant R

Cureus

2022 Volume 14, Issue 9, Page(s) e29002

Abstract: Sinistral portal hypertension in the setting of acute pancreatitis is a known complication owing to splenic vein thrombosis. It can lead to upper gastrointestinal bleeding due to the development of fundal gastric varices due to the shunting of blood via ... ...

Abstract	Sinistral portal hypertension in the setting of acute pancreatitis is a known complication owing to splenic vein thrombosis. It can lead to upper gastrointestinal bleeding due to the development of fundal gastric varices due to the shunting of blood via short gastric veins. However, in the setting of acute pancreatitis, surgical procedures can have high post-operative morbidity. Emergent management of cases with absent gastro-renal shunt can be done by partial splenic arterial embolization, as it is minimally invasive and can provide similar results. Herein, we report a case series of two cases of acute pancreatitis complicated with splenic vein thrombosis and gastric varices, which were managed by partial splenic artery embolization.
Language	English
Publishing date	2022-09-10
Publishing country	United States
Document type	Case Reports
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.29002
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Article ; Online: Response to comment on: Optic nerve sheath diameter in children with acute liver failure: A prospective observational pilot study.

Srivastava, Anshu / Yadav, Rajanikant R / Das, Mridul C

Liver international : official journal of the International Association for the Study of the Liver

2020 Volume 41, Issue 1, Page(s) 231–232

MeSH term(s)	Child ; Humans ; Liver Failure, Acute ; Optic Nerve/diagnostic imaging ; Pilot Projects ; Prospective Studies ; Ultrasonography
Language	English
Publishing date	2020-11-20
Publishing country	United States
Document type	Letter ; Comment
ZDB-ID	2102783-3
ISSN	1478-3231 ; 1478-3223
ISSN (online)	1478-3231
ISSN	1478-3223
DOI	10.1111/liv.14716
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Zs.A 1632: Show issues

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Article ; Online: Undifferentiated embryonal sarcoma of liver with macroaneurysms and arteriovenous shunt.

Israrahmed, Amrin / Ahmad, Sarfraz / Prasad, Pallavi / Yadav, Rajanikant R

BMJ case reports

2021 Volume 14, Issue 10

Abstract: Undifferentiated embryonal sarcoma (UES) is an uncommon primary hepatic tumour of childhood. The mass usually shows paradoxical features of being cystic on CT and solid on ultrasound. These lesions are usually hypovascular. Very rarely they may present ... ...

Abstract	Undifferentiated embryonal sarcoma (UES) is an uncommon primary hepatic tumour of childhood. The mass usually shows paradoxical features of being cystic on CT and solid on ultrasound. These lesions are usually hypovascular. Very rarely they may present as hypervascular liver masses with macroaneurysms and arteriovenous (AV) shunt, with only less than six cases reported in literature. We report a case of an 11-year-old child who presented with progressive abdominal distention, and CT revealed a large exophytic hypervascular mass of liver with multiple macroaneurysms, pooling of contrast and a high-flow AV shunt. Histopathology, along with immunohistochemistry, revealed the mass to be UES. The child underwent neoadjuvant chemotherapy followed by successful surgery. The prognosis of this tumour depends on prompt diagnosis and early intervention. We present this case to highlight the atypical presentation of UES, which will encourage radiologists to keep this differential in relevant clinical settings.
MeSH term(s)	Aneurysm ; Child ; Humans ; Liver/diagnostic imaging ; Liver Neoplasms/diagnostic imaging ; Neoplasms, Germ Cell and Embryonal/diagnostic imaging ; Neoplasms, Germ Cell and Embryonal/surgery ; Sarcoma/diagnostic imaging ; Sarcoma/surgery ; Ultrasonography
Language	English
Publishing date	2021-10-29
Publishing country	England
Document type	Case Reports ; Journal Article
ISSN	1757-790X
ISSN (online)	1757-790X
DOI	10.1136/bcr-2021-245112
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Article ; Online: Supraclavicular extra-renal angiomyolipoma: a challenging diagnosis.

Israrahmed, Amrin / Gupta, Aviral / Gupta, Archna / Yadav, Rajanikant R

BMJ case reports

2021 Volume 14, Issue 11

MeSH term(s)	Angiomyolipoma/diagnostic imaging ; Angiomyolipoma/surgery ; Diagnosis, Differential ; Hamartoma ; Humans ; Kidney Neoplasms/diagnostic imaging ; Kidney Neoplasms/surgery ; Nephrectomy
Language	English
Publishing date	2021-11-30
Publishing country	England
Document type	Case Reports ; Journal Article
ISSN	1757-790X
ISSN (online)	1757-790X
DOI	10.1136/bcr-2021-247358
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Article ; Online: Ileal duplication cyst with giant polypoidal gastric heterotropia.

Israrahmed, Amrin / Verma, Vikrant / Ahmad, Sarfraz / Yadav, Rajanikant R

BMJ case reports

2021 Volume 14, Issue 9

Abstract: Enteric duplication cysts (EDCs) are congenital malformations of the gastrointestinal tract. EDCs can present as tubular or spherical cystic lesions of the abdomen. The tubular variant of EDC arises as an outpouching from the bowel wall, whereas the ... ...

Abstract	Enteric duplication cysts (EDCs) are congenital malformations of the gastrointestinal tract. EDCs can present as tubular or spherical cystic lesions of the abdomen. The tubular variant of EDC arises as an outpouching from the bowel wall, whereas the spherical variant rarely shows bowel communication. EDCs are known to harbour heterotopic pancreatic parenchyma or gastric mucosa. We present a case of EDC of the ileum (tubular type) with heterotopic gastric mucosa in a 7-year-old child who came with malena and abdominal discomfort. CT revealed focal abnormal dilatation of the ileal loop with polypoidal mucosal thickening. Differential diagnosis of lymphoma, bowel polyps and Meckel's diverticula with gastric heterotopia (GH) were considered. Subsequent surgery followed by histopathology revealed it to be EDC with GH. We discuss this case to familiarise radiologists with the atypical imaging features of EDC, to prevent misdiagnosis and initiate prompt treatment in appropriate clinical settings.
MeSH term(s)	Child ; Cysts/diagnostic imaging ; Cysts/surgery ; Gastric Mucosa ; Humans ; Ileum/diagnostic imaging ; Ileum/surgery ; Meckel Diverticulum ; Stomach
Language	English
Publishing date	2021-09-07
Publishing country	England
Document type	Case Reports ; Journal Article
ISSN	1757-790X
ISSN (online)	1757-790X
DOI	10.1136/bcr-2021-245333
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Article: Shear Wave Elastography: A Reliable Secondary Parameter for Diagnosing Biliary Atresia in Infants With Neonatal Cholestasis.

Gautam, Avinash D / Yadav, Rajanikant R / Sarma, Moinak S / Mandelia, Ankur / Agrawal, Vinita / Lal, Richa / Gupta, Archna

Cureus

2023 Volume 15, Issue 4, Page(s) e37911

Abstract: Objective In this study, we aimed to optimize various grayscale, Doppler, and elastography parameters and evaluate their diagnostic performance in the preoperative diagnosis of biliary atresia (BA). Materials and methods A total of 158 infants aged <6 ... ...

Abstract	Objective In this study, we aimed to optimize various grayscale, Doppler, and elastography parameters and evaluate their diagnostic performance in the preoperative diagnosis of biliary atresia (BA). Materials and methods A total of 158 infants aged <6 months with neonatal cholestasis (NC) were enrolled in the study and sonography was performed after four hours of fasting. For comparison of elastography, 31 exclusively age-matched controls, not suffering from liver disease, were included separately. Triangular cord and gallbladder (GB) parameters were considered as primary parameters, while right hepatic artery (RHA) caliber, RHA-to-right portal vein (RPV) ratio, hepatic subcapsular flow (HSF), and shear wave elastography (SWE) were considered as secondary parameters. Diagnosis of infants with BA was confirmed on histopathology. Data were presented as mean ±standard deviation (SD) and frequency. Differences between groups were compared using the Chi-square test and the unpaired student t-test. Receiver operating characteristic (ROC) curve analysis was done for individual ultrasound/Doppler/SWE parameters to calculate the optimal cutoff value. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy were calculated for each parameter and their combinations. Results Of the primary parameters, GB contractility index (CI) and length showed the highest sensitivity and specificity respectively. A cutoff of 14 kPA was derived for SWE for the diagnosis of BA. Among secondary parameters, SWE had the best diagnostic performance, better than even the individual primary parameters. A combination of primary parameters with SWE in series showed the highest accuracy. Conclusion Among secondary parameters, elastography can prove to be highly useful. The highest accuracy in diagnosing BA can be obtained by combining primary parameters with SWE.
Language	English
Publishing date	2023-04-20
Publishing country	United States
Document type	Journal Article
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.37911
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Article ; Online: Direct Percutaneous Thrombolysis (DPT): A novel method of salvaging Thrombosed Native Arteriovenous Fistula.

Prasad, Raghunandan / Vignesh, Selvamurugan / Yadav, Rajanikant R / Sharma, Srishti / Hasani, Prerna / Yadav, Tanya / Israrahmed, Amrin / Lal, Hira

The journal of vascular access

2023 , Page(s) 11297298231153196

Abstract: Introduction: Thrombosed arteriovenous fistulas (AVFs) are either treated by thrombectomy or pharmaco-mechanical thrombolysis with or without percutaneous balloon angioplasty. In this study, we have described an effective and economical technique of ... ...

Abstract	Introduction: Thrombosed arteriovenous fistulas (AVFs) are either treated by thrombectomy or pharmaco-mechanical thrombolysis with or without percutaneous balloon angioplasty. In this study, we have described an effective and economical technique of salvaging these fistulae using a 20-22-gauge spinal needle and urokinase and have named it direct percutaneous thrombolysis (DPT). Materials and method: This prospective study comprised of 148 patients out of which 120 patients presented with AVF thrombosis and were divided into two groups; those with no obvious stenosis on ultrasound ( Results: In 38 patients who didn't have any stenosis, 32 AVFs were successfully thrombolysed by DPT, with technical success of 84.2%. Remaining six patients required angioplasty because of chronic nature of clot. In 82 patients who had venous stenosis, 80 cases were treated successfully by DPT followed by angioplasty with technical success of 97.5%. In third group ( Conclusion: Ultrasound guided DPT with urokinase is a safe and economical option for salvaging thrombosed AVF without vascular stenosis that does not need angioplasty.
Language	English
Publishing date	2023-02-07
Publishing country	United States
Document type	Journal Article
ZDB-ID	2252820-9
ISSN	1724-6032 ; 1129-7298
ISSN (online)	1724-6032
ISSN	1129-7298
DOI	10.1177/11297298231153196
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Zs.A 6414: Show issues

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Article ; Online: Visceral Fat Indices: Do They Help Differentiate Crohn's Disease and Intestinal Tuberculosis in Children?

Seetharaman, Jayendra / Srivastava, Anshu / Yadav, Rajanikant R / Singh, Sumit K / Mishra, Prabhakar / Sen Sarma, Moinak / Poddar, Ujjal

Journal of Crohn's & colitis

2023 Volume 17, Issue 12, Page(s) 2026–2032

Abstract: Background and aims: Crohn's disease [CD] and intestinal tuberculosis [ITB] are often difficult to differentiate. Mesenteric fat hypertrophy is a feature of CD. We evaluated the utility of fat indices (visceral fat [VF] and subcutaneous fat [SF]) in ... ...

Abstract	Background and aims: Crohn's disease [CD] and intestinal tuberculosis [ITB] are often difficult to differentiate. Mesenteric fat hypertrophy is a feature of CD. We evaluated the utility of fat indices (visceral fat [VF] and subcutaneous fat [SF]) in differentiating CD and ITB in children. Methods: Symptomatic children diagnosed to have CD or ITB based on recommended criteria were enrolled. Clinical, anthropometric, and laboratory details were noted. Abdominal fat was measured on computed tomography in supine position at the level of L4 vertebrae. VF and SF area was measured separately by a radiologist, blinded to the diagnosis. The sum of VF and SF was taken as total fat [TF]. VF/SF and VF/TF ratios were calculated. Results: Thirty-four (age 14 years [10.8-17.0], 14 boys) children were recruited: 12 had CD [seven boys, age 13.0 years] and 22 had ITB [seven boys, age 14.5 years]. VF area was higher in CD compared to ITB (18.34 cm2 [15.62-40.01] vs 6.48 cm2 [2.65-21.96]; p = 0.012). The SF and TF area was similar in ITB and CD. The ratios of VF/SF (0.82 [0.57-1.5] vs 0.33 [0.16-0.48]; p = 0.004) and VF/TF (0.45 [0.36-0.60] vs 0.25 [0.13-0.32]; p = 0.004) were significantly higher in CD. On comparing CD and ITB in boys and girls separately, the difference was significant for boys but not for girls. A VF/SF ratio of 0.609 predicted CD with a good sensitivity [75%] and specificity [86.4%] [area under the curve 0.795, 95% confidence interval 0.636-0.955; p = 0.005]. Conclusion: The VF/SF ratio is a simple, non-invasive, objective parameter to differentiate CD and ITB in children, particularly boys. Larger studies are needed to validate this in girls.
MeSH term(s)	Male ; Female ; Child ; Humans ; Adolescent ; Crohn Disease/diagnosis ; Intra-Abdominal Fat/diagnostic imaging ; Tuberculosis, Gastrointestinal/diagnosis ; Enteritis/diagnosis ; Tomography, X-Ray Computed ; Diagnosis, Differential
Language	English
Publishing date	2023-06-30
Publishing country	England
Document type	Journal Article
ZDB-ID	2390120-2
ISSN	1876-4479 ; 1873-9946
ISSN (online)	1876-4479
ISSN	1873-9946
DOI	10.1093/ecco-jcc/jjad109
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Zs.A 6634: Show issues

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Article ; Online: Jaundice in a Child with Sickle Cell Anemia: A Case Based Approach.

Vadlapudi, Srinivas Srinidhi / Srivastava, Anshu / Rai, Praveer / Singh, Rajneesh K / Sarma, Moinak Sen / Poddar, Ujjal / Yadav, Rajanikant R

Indian journal of pediatrics

2023 Volume 91, Issue 1, Page(s) 73–80

Abstract: Sickle cell anemia (SCA) is an autosomal recessive disorder caused by a mutation in beta globin gene. Hepatobiliary system is affected in 10-40% of patients with SCA and has a multifactorial etiology. The authors present a child with SCA and conjugated ... ...

Abstract	Sickle cell anemia (SCA) is an autosomal recessive disorder caused by a mutation in beta globin gene. Hepatobiliary system is affected in 10-40% of patients with SCA and has a multifactorial etiology. The authors present a child with SCA and conjugated hyperbilirubinemia due to biliary obstruction. He underwent endoscopic retrograde cholangiopancreatography (ERCP) and biliary stenting, had complications of post sphincterotomy bleed, retroperitoneal hematoma and post laparoscopic cholecystectomy sepsis with acute sickle hepatic crisis. He was managed successfully and is doing well on follow-up. Here authors discuss a stepwise approach in management of jaundice in a patient with SCA. Patients with SCA are prone to develop vaso-occlusive crisis (VOC) during periods of stress. VOC affects the liver as acute sickle hepatic crisis, acute hepatic sequestration or sickle cell intrahepatic cholestasis and is collectively termed as sickle cell hepatopathy. Hemolysis due to sickling results in cholelithiasis with its associated complications. These patients are vulnerable to viral hepatitis and hemochromatosis due to multiple blood transfusions. There may be a concomitant acute viral hepatitis, drug induced liver injury, Budd-Chiari syndrome or other chronic liver diseases. These conditions have considerable clinical overlap and may coexist, making the evaluation more challenging. Detailed history, examination and investigations are required for differentiation of etiology. Periods of stress must be tackled with proper hydration, oxygen supplementation, maintaining hemoglobin >10 g/dL, and a low hemoglobin S fraction. Patients with SCA and conjugated hyperbilirubinemia are "high-risk" and best managed by a multidisciplinary team. Preventive strategies like timely vaccinations, chelation, etc. must be practised.
MeSH term(s)	Male ; Child ; Humans ; Volatile Organic Compounds ; Jaundice/etiology ; Anemia, Sickle Cell/complications ; Cholestasis, Intrahepatic/complications ; Hyperbilirubinemia/complications ; Hepatitis, Viral, Human/complications
Chemical Substances	Volatile Organic Compounds
Language	English
Publishing date	2023-08-09
Publishing country	India
Document type	Editorial
ZDB-ID	218231-2
ISSN	0973-7693 ; 0019-5456
ISSN (online)	0973-7693
ISSN	0019-5456
DOI	10.1007/s12098-023-04747-x
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