Sessile Osteochondroma

Great example of a benign osteochondroma in a somewhat atypical location, mid diaphysis of the humerus.

 

The osteochondroma does abut the brachial neurovascular bundle with some displacement which could produce symptoms.

 

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A setup for mesenteric ischemia

ER case.  Likely unimportant in the current presentation but potentially important down the road.  2 vessel comp.png

  • Salient Points
    • Chronically occluded proximal SMA
    • >50% and probably 70% stenosis of Celiac origin
  • My recall from Sabistons book says that a single vessel can be ligated with impunity.  2 Vessels and the patient is on the threshold.  If this patient were to thrombose a collateral reconstituting the SMA or the Celiac, there could be a large territory of dead bowel.

Python 3.6 Install on DietPi

Debian repos don’t have python 3.6 ready to go at this time but thanks to the awesome dudes at HA forums, the guide to replacing your venv with 3.6 works to install also.

Step 1.

sudo apt-get install build-essential tk-dev libncurses5-dev libncursesw5-dev libreadline6-dev libdb5.3-dev libgdbm-dev libsqlite3-dev libssl-dev libbz2-dev libexpat1-dev liblzma-dev zlib1g-dev

Step2.

wget https://www.python.org/ftp/python/3.6.0/Python-3.6.0.tgz tar
xzvf Python-3.6.0.tgz cd Python-3.6.0/
./configure
make
sudo make install

Allergic Fungal Rhinosinusitis

 

 

CT
The majority of sinuses show near complete opacification. On unenhanced CT, the sinuses are typically opacified by centrally hyper-dense material with a peripheral rim of hypo-dense mucosa.

Approximately 40% of patients may have each of the following features:

  • expansion of an involved sinus
  • remodeling and thinning of the bone sinus walls
  • erosion of the sinus wall

MRI

  • Hypointensity on T1WI and T2WI is the most common finding.
  • T1: hypointense inflamed mucosal thickness. It can have multiple T1 appearances.
  • T2usually a hyperintense peripheral inflamed mucosal thickness
  • low T2 signal or signal void is due to high concentration of various metals such as iron, magnesium and manganese concentrated by fungal organisms as well as high protein and low free water content in allergic mucin
  • T1 C+ (Gd): an inflamed mucosal lining has contrast enhancement
  • no enhancement in the center or majority of the sinus contents

Classic Imaging Presentation

AFRS_CT.pngAFRS_CT.png