This lady who is 45 years old and has a complete family with two kids complained of pain abdomen. She was advised for ultrasound abdomen. Previously, the lady had undergone caesarean section too for one of the pregnancies. On ultrasound examination, she had two uterus, a condition known as uterus didelphys. In her case, both the uterus appeared normal and of equivalent size with normal endometrial stripe. It was a surprise for her to have discovered this condition at that age.
Missed Hole in Heart
It was an old known case of heart attack. The gentleman was 55 years old. Recently he started developing pedal edema, that is swollen feet. Apparently, all else was ok. The patient had undergone FDG PET nuclear imaging scan for his condition and also echocardiography. He was diagnosed with apical and septal myocardial ischaemia. That was 7 years ago and since then he was on treatment. Now had he reported to his family clinician for his current condition. The physician advised for fresh echocardiography to look into condition of the heart. The patient arrived at ARDISS IMAGING AND DIAGNOSTIC CENTRE for the same. On scanning, the right ventricle and atrium were dilated. The IVC was also dilated with reduced inspiratory collapsibility. The Left ventricle showed mild reduced pumping capacity with regional wall motion abnormality in the apical and septal region. The flow rates were higher at tricuspid valve and pulmonary artery compared to the bicuspid valve and aorta. Hemodynamically, things were not explainable. A second look into colour images was taken. And, there it was, a defect in the wall separating the two upper chambers, the atria. Flow was noted from Left to Right atria through this 9 mm sized atrial septal defect, giving the right sided chambers extra amount of blood to handle. That caused the dilatation of the right atrium, right ventricle and IVC. That also caused high flow through lungs resulting in raised pulmonary arterial pressure. All this led to the oozing of fluid, causing the pedal edema. Thus, the mystery was solved.
HOW COMMON IS ABSENT KIDNEY
How common can be the absence of a kidney? 1 in 1000 cases. If two such cases occur on the same day. What probability exists? 1 probability in 1000000 cases. Today I observed two such cases on a single day at ARDISS IMAGING & DIAGNOSTIC CENTRE. That makes it interesting. A boy aged approximately 21 years had complaints of pain abdomen. He appeared for ultrasound at Ardiss Imaging Centre, Greater Noida, one of the centres of excellence for such investigations. Absence of a kidney shocked him. He was not ready for the news. His mother accompanied him, and she continued conversation multiple times to ensure that what was being conveyed was true. His father made a call and again confirmed. They were so anxious to know the further implications of the condition. I made them comfortable by giving factual positioning of the case that they need not worry. It happens and generally does not cause any untoward outcome, though risk for infection or renal stone increases. Therefore, to be on safe side, general precautions have to be taken for keeping the kidney healthy. In the evening, another case landed. He was a 34 years old man and had developed dengue. For him it was a news that a kidney was absent. He was not much anxious. He was only worried that whether his insurance payment for dengue will be affected or not. But it was a day ONE in TEN LACS. When two people appeared on the same day and both had a single congenitally absent kidney.
DROWNING HEART
The gentleman was middle aged. He had some generalised complaints about his stomach. However, no chest complaints were present. He was referred for ultrasound of the abdomen to ARDISS IMAGING & DIAGNOSTIC CENTRE, the renowned ultrasound centre with the best available senior radiologist in Greater Noida. While scanning the left lobe of liver, glimpses of the heart from subxiphoid position prompted the experienced radiologist to look into the parasternal and apical views of the heart. On ultrasound, his abdomen was mostly good. No gross disease was noted there. And there was moderate amount of pericardial effusion, a condition where the heart is surrounded with excess amount of fluid, that compresses the heart and hinders its normal pumping process. It may lead to cardiac tamponade, a serious life-threatening condition. The condition may develop due to viral or bacterial infections or autoimmune diseases. Early diagnosis leads to prompt treatment and relief to the patient, before it is too late to salvage the heart.
That harmless lump saved
There was this 50-year-old lady, who presented to the physician with lump in left breast near axilla. There was no associated pain, but only a little discomfort. Apart from this ailment she was in a good health. The patient was referred for ultrasound to the ARDISS IMAGING & DIAGNOSTIC CENTRE, the best imaging centre with state-of-the-art technology and most experienced radiologist located in Greater Noida. The lesion that the patient was referring to, was a harmless lump of breast, also known as a breast mouse. Another less than one centimetre sized similar focus was noted in the medial upper quadrant. These were benign lesions. They only required follow ups over a period of time. A highly suspicious lesion in the same breast was noted medial to the nipple. It was only about less than two centimetres in size, but had all the malicious sonographic characteristics. The sonographic impression was that of a breast malignancy. The patient was advised to go through further imaging and histopathological investigations to confirm exact nature of the lesion. The disease was caught early, before it could spread all over the body and grow incurable. Breast cancer is the most common cancer in women. It causes millions of deaths annually all over the world. Early detection and timely diagnosis with comprehensive management is essential to avert breast cancer deaths.
HIDED IN HEART
This is the story of a masked life-threatening ailment. It was almost the closing time for the clinic after a busy day. A 22 years old boy came with history of abdominal discomfort and dyspepsia. The treating physician had advised Ultrasound of abdomen. The boy had reported to the ARDISS IMAGING & DIAGNOSTIC CENTRE, Greater Noida, for the advised examination. While performing the abdominal ultrasound, it was noted that the boy had accumulated little amount of fluid in his thorax, known as Pleural effusion in medical lexicon. The suspicious finding prompted the senior experienced radiologist to place the probe in the subxiphoid region directed towards heart. The findings were alarming. There was almost complete closure of one of the heart valves, namely the mitral valve, that is the connecting door between the two left sided cardiac chambers. The valve was thickened. Very little flow of blood was observed from one into the other chamber of the heart, namely from left atrium to left ventricle. There was evidence of back pressure into the lungs that was causing stagnation of fluid inside the thorax. And now, why the boy was having intermittent little dry cough was convincingly explained by the findings. The retention of fluid in the lungs was causing the airway symptoms. The abdominal symptoms were spurious. They were a distraction. The actual ailment was in the heart. Ultrasound at the ARDISS IMAGING & DIAGNOSTIC CENTRE solved the physician’s diagnostic uncertainty. Timely detection saved a lot of invaluable time and suffering for the patient.
I-phone battery swallowed in Greater Noida
It was month of May in the year 2025. There was this little 7-year-old girl residing in a multi-storey building of Greater Noida. While playing, she swallowed the battery of an I-phone. It had been three days since, when she narrated the incident to the parents. The child was taken to the nearest super-specialty hospital, where X-ray chest and X-ray abdomen erect was advised by the emergency medical officer. For the amazement of the doctors, the metallic battery was seen in the upper abdomen in the chest X-ray. When the abdomen erect X-ray was taken, the battery was seen to lie somewhere in the middle part of the abdomen. It was a confused scenario. The family doctor advised to undergo ultrasound abdomen to correctly localize the metallic foreign body. Thus, the child presented to ARDISS IMAGING & DIAGNOSTIC CENTRE, Sector Alpha-2, Greater Noida. High resolution scan of the abdomen was conducted. The battery was localized in the pylorus of the stomach, just proximal to the first part of the duodenum. As the foreign body had not moved as expected in the alimentary canal; the parents were advised to undergo endoscopic removal to avoid any future complications. The ultrasound in expert hands saved the day for the doctors. The ultrasound image demonstrating the foreign body is as appended below.