Background: Pneumonia is a ubiquitous health condition with severe outcomes. The advancement of ultrasonography techniques allows its application in evaluating pulmonary diseases, providing safer and accessible bedside therapeutic decisions compared to chest X-ray and chest computed tomography (CT) scan. Because of its aforementioned benefits, we aimed to confirm the diagnostic accuracy of lung ultrasound (LUS) for pneumonia in adults. Methods: A systematic literature search was performed of Medline, Cochrane and Crossref, independently by two authors. The selection of studies proceeded based on specific inclusion and exclusion criteria without restrictions to particular study designs, language or publication dates and was followed by data extraction. The gold standard reference in the included studies was chest X-ray/CT scan or both. Results: Twenty-nine (29) studies containing 6702 participants were included in our meta-analysis. Pooled sensitivity, specificity and PPV were 92% (95% CI: 91–93%), 94% (95% CI: 94 to 95%) and 93% (95% CI: 89 to 96%), respectively. Pooled positive and negative likelihood ratios were 16 (95% CI: 14 to 19) and 0.08 (95% CI: 0.07 to 0.09). The area under the ROC curve of LUS was 0. 9712. Conclusions: LUS has high diagnostic accuracy in adult pneumonia. Its contribution could form an optimistic clue in future updates considering this condition.

The involvement of the aortic arch in thoracic aortic aneurysms (TAA), or acute aortic dissections (AAD), represents a challenging clinical entity, mandating a meticulous surgical plan, tailored to each individual case. The advent of endovascular techniques and the introduction of modern arch protheses have led to the implementation of the frozen elephant trunk (FET) technique. This one-step hybrid operation consists of a total aortic arch replacement combined with an antegrade delivery of a stent–graft for the descending aorta, which acts as a proximal landing zone facilitating a potential distal endovascular reintervention. In this manner, this technique addresses acute and chronic arch disease with an acceptable morbidity and mortality. Several FET prosthetic devices are available on the global market and have exhibited favourable outcomes, although with some disadvantages in complex cases; similarly, the hybrid procedure described in this review has also been associated with complications, such as coagulopathy and neurological and graft-related events. The purpose of this review is to thus provide key insights into successful hybrid aortic arch replacements and to discuss useful tips and relevant considerations regarding its use.

Background: Aneurysms of the middle colic artery (MCAA) and its branches are exceedingly rare accounting for 4 cm. Method: We describe the successful open repair with ligation of a 4.2 cm asymptomatic MCAA in a female patient through the gastrohepatic ligament taking meticulous caution to avoid injury of the pancreas. The postoperative period was uneventful and the patient was discharged from the hospital on the fifth postoperative day. At 1 month follow-up the postoperative computed tomographic angiography documented complete exclusion of the MCAA and absence of contrast agent in the sac both in the arterial and the venous phase. Conclusion: While the endovascular treatment is the first-line option for visceral aneurysms, the open approach is still reserved for certain cases of hostile anatomy, challenging location and large size. Our case highlights the irreplaceable role of open surgery and underlines the collaboration between surgical specialties.

Chest trauma is a critical medical condition that encompasses a range of injuries and can result from various causes. Prompt and accurate diagnosis is crucial in managing chest trauma patients and radiology plays a pivotal role in this aspect. Imaging modalities in chest trauma aid in precise diagnosis and treatment planning. Especially, X-rays remain the initial imaging modality of choice due to their accessibility, speed, and ability to detect acute life-threatening conditions. Computed Tomography (CT) Scan offers detailed cross-sectional images allowing for comprehensive evaluation of chest trauma and surgical planning when necessary. Ultrasound (US) is increasingly valuable tool due to its portability and real-time imaging capabilities, aiding in rapid assessment at the bedside. Magnetic Resonance Imaging (MRI) is less commonly used due to time constraints and limited availability. Radiological imaging serves various purposes in the diagnosis and management of chest trauma such as early detection and triage, characterization and severity assessment, surgical planning, follow-up and monitoring of chest trauma. Reduction of radiation exposure, advancements in imaging technology (dual-energy CT, contrast-enhanced imaging) and Artificial Intelligence (AI) algorithms are crucial challenges and deserve attention. A multidisciplinary approach integrating radiological expertise remains fundamental in ensuring optimal outcomes for patients with chest trauma.

Background: Solid pancreatic lesions are crucial to identify because of their high incidence rate and their poor survival rate. Surgical biopsy, ultrasonography, computed tomography, MRI, and PET-CT are examples of diagnostic tools. Although common, endoscopic ultrasonography guided biopsy carries a risk of needle track seeding. A more effective and affordable method for determining the differential diagnosis of solid pancreatic lesions is contrast-enhanced ultrasonography (CEUS). CEUS is a less nephrotoxic method that uses a contrast chemical to distinguish between teratomas, benign tumors, and neuroendocrine tumors. The goal of this meta-analysis is to evaluate how well CEUS can identify solid pancreatic lesions for use in clinical diagnostic procedures. Methodology: Medical literature comprehensively searched and reviewed without restrictions to particular study designs, or publication dates using PubMed, Cochrane Library and Google Scholar databases for all relevant literature. The extraction of necessary data proceeded after specific inclusion and exclusion criteria were applied. Meta Analysis included 27 RCTs and 3061 patients, and analyzed using the QualSyst yool. The risk of bias was evaluated by using QUADAS-2 analysis. The statistical software packages MetaDiSc 1.4, RevMan (Review Manager, version 5.3), SPSS (Statistical Package for the Social Sciences, version 20) and Excel in Stata 14 were used to perform the statistical analyses. Result: According to the findings of four studies, CEUS demonstrates high sensitivity, with values equal to or above 95%, and one study indicates specificity above 95%. True Positive (TP) and True Negative (TN) values are reported as 2080 and 621, respectively, while False Positive (FP) and False Negative (FN) values are noted as 124 and 236. With a 95% confidence interval, CEUS sensitivity is calculated as 0.90 (range: 0.89 to 0.91) and specificity as 0.83 (range: 0.80 to 0.86). The positive predictive value (PPV) of CEUS is estimated at approximately 94.3%. These results highlight CEUS as a promising tool for diagnosing pancreatic lesions. Conclusion: The study concluded that CEUS (Contrast-Enhanced Ultrasound) is an important diagnostic test for pancreatic lesions. This is due to their high sensitivity and specificity, along with other aspects like enhanced visualization, real-time imaging, and safety benefits. Additionally, CEUS is cost-effective, making it a practical choice in healthcare settings with budget constraints. Thus, CEUS remains a valuable asset for healthcare professionals in their efforts to accurately diagnose pancreatic lesions.

Background Necrotizing soft tissue infection (NSTI) is a potentially fatal skin and soft tissue infection, characterized by fulminant tissue damage, systemic signs of toxicity, and high mortality with case fatality rates ranging from 14% to 41% over the last two decades. It can be challenging to diagnose NF in its initial phases as it frequently presents symptoms that are similar to those of other non-necrotic SSTIs, such as cellulitis. It is unclear how the different diagnostic imaging modalities should be used to evaluate patients who have a suspected NSTI and there are concerns about their accuracy and potential delays in surgical intervention. Therefore, we aimed to gather data on the sensitivity and specificity of physical findings of fever, hypotension as well as imaging techniques such as ultrasound (USG) and computed tomography (CT) scans, and the LRINEC score, in detecting Necrotizing Soft Tissue Infections (NSTI) in patients. Methods Medical literature was comprehensively searched and reviewed without restrictions to particular study designs, or publication dates using PubMed, Cochrane Library, and Google Scholar databases for all relevant literature. The extraction of necessary data proceeded after specific inclusion and exclusion criteria were applied. In this Meta-Analysis, a total of 49 RCTs with an aggregate of 11,520 cases were handpicked. wherein two writers independently assessed the caliber of each study as well as the use of the Cochrane tool for bias risk apprehension. The statistical software packages RevMan (Review Manager, version 5.3), SPSS (Statistical Package for the Social Sciences, version 20), and Excel in Stata 14 were used to perform the statistical analyses. Results We calculated the sensitivity and specificity for each of the parameters. Here, USG has a sensitivity of 0.556 and specificity of 0.879, CT has a sensitivity of 0.932 and specificity of 0.849, and LRINEC Score >= 6 has a sensitivity of 0.59 and specificity of 0.849. we also calculated the same for physical signs like fever and hypotension. Conclusion we conclude that physical signs like fever and hypotension and LRINEC Score >= 6 are not advisable indicators, however, CT shows significant superior modality but it is not a cost-effective solution. USG is relatively reliable and cost-effective for the early diagnosis of NSTI.