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BACKGROUND: Typhlitis, (neutropenic enterocolitis), is a necrotizing enteropathy of the right colon, and is characterized by the clinical triad of fever, abdominal pain, neutropenia and imaging findings of right-side colonic inflammation. It is seen in the setting of severe neutropenia in immune suppressed patients who undergo treatment for malignancies, in those who have organ transplant(s) or congenital or other acquired immunosuppression. We report the clinical and imaging findings of typhlitis in pediatric cancer patients who had received chemotherapy in the largest tertiary center in Addis Ababa, Ethiopia over a period of 20 months. METHODS: The medical records of hospitalized cancer patients on treatment and with suspected typhlitis and with ultrasound reports were screened (November 2018-July 2020). Retrospective analysis of the clinical and sonographic data of those with typhlitis was done. RESULTS: Typhlitis was identified in 4.2% (12/286) of the patients on chemotherapy. 11 (91.7%) had hematologic malignancies (leukemia, lymphoma), one had a solid tumor (Head and neck embryonal RMS). Most (83.3%) had abdominal pain, diarrhea and neutropenia. Fever was identified in 67.7%. All had ultrasound evidence of typhlitis. and treated with IV antibiotics. Neither complications requiring surgical intervention nor death were seen. CONCLUSION: The magnitude of disease was comparable to what had previously been reported in other studies. While the presence of clinical a triad should prompt suspicion for the diagnosis, sonography can be used for confirmation and follow up obviating radiation, with good access in a resource limited setting. [ABSTRACT FROM AUTHOR]

Background: Despite advances in non-invasive radiological techniques for the treatment of intussusception, management of the entity still remains exclusively surgical in many developing countries, including Ethiopia. Fluoroscopic units are rare or mostly dysfunctional. Ultrasound scanners are more commonly available. Ultrasound-guided hydrostatic reduction (USGHR) was recently introduced to the main referral hospital in Ethiopia, and subsequently has been adopted as the initial management option for intussusception.Purpose: The aim of this study was to evaluate our experience with USGHR in Ethiopia and measure the impact on patient care.Methods: A prospective study was conducted between July 2014 and August 2015 on all pediatric patients, with US-confirmed intussusception, at the Tikur Anbessa Specialized Teaching Hospital in Addis Ababa, Ethiopia. All patients, excluding those with signs of peritonitis, bowel ischemia, or symptoms lasting longer than 4 days, were selected to undergo USGHR.Results: A total of 53 children were diagnosed with intussusception, confirmed via ultrasound. Following exclusion criteria, USGHR was attempted in 47 of the patients. Forty-one of the 47 patients (87.2%) had successful reduction, resulting in a 77% overall rate of successful non-operative management in all patients with intussusception.Conclusion: The rate of operative reduction of intussusception decreased by 77% following the introduction of USGHR as the initial non-surgical intervention. Therefore, we believe USGHR should be fully implemented in our hospital, and recommend that this study serves as an example to other institutions in our country as well as in other developing countries facing similar challenges. [ABSTRACT FROM AUTHOR]

Objective: The objective of the present study was to validate the use of web-based tutorials to teach technical skills in pediatric ultrasound., Materials and Methods: A series of 10 video tutorials, each of which was less than 10 minutes long, was created to improve the education of radiology trainees in terms of their ultrasound technique. Pediatric radiology fellow trainees from our institution in the United States and radiology resident trainees from our partner institution in Ethiopia were invited to participate in the study. Validation of the video tutorials was performed using two learning modules that focused on the renal bladder and the right upper quadrant (RUQ). Pretest and posttest skill and confidence assessments were also conducted. After watching the tutorials, the trainees completed questionnaires that assessed the reach, appeal, and learning effectiveness of the modules., Results: Ten fellow trainees and eight resident trainees participated in the study. The fellows were invited to evaluate both the RUQ and the renal bladder learning modules, whereas the residents evaluated the RUQ module only. Before reviewing the RUQ module, the fellows had performed a median of four RUQ ultrasound examinations, whereas the residents had performed a median of 400 RUQ ultrasound examinations. After the trainees viewed the learning module, the median skills test scores of the fellows increased from 20 to 37.5 (highest possible score, 45) (p < 0.01), and those of the residents increased from 38 to 40 (highest possible score, 40) (p = 0.04). With a total possible score of 15, the median confidence score improved from 8 to 11 for fellows (p < 0.01) and from 13.5 to 14.5 for residents (p = 0.04). After the fellows viewed the renal bladder learning module, their median skills test scores increased from 20 to 37.5 (highest possible score, 40) (p < 0.01), and their median confidence score increased from 8.5 to 11 (highest possible score, 15) (p = 0.01). Trainees gave the tutorials positive ratings overall., Conclusion: Radiology fellow trainees and resident trainees with disparate backgrounds in ultrasound showed significant improvement in their technical skills in pediatric ultrasound and confidence after viewing the tutorials. The web-based design of the tutorials allows integration of international pediatric radiology training communities.

We are reporting a rare case of McKusick- Kaufman Syndrome in a ten-month old female infant from Addis Ababa with difficulty of urination often days duration. Clinical exam revealed supra-pubic mass with tenderness and had left hand postaxial polydactily. Ultrasound and CT scans showed the mass to be hydrometrocolpos posterior to the bladder. Intravenous urography revealed a lower abdomen-pelvic mass displacing and compressing the ureters with bilateral hydronephrosis. Further pelvic exam under anaesthesia revealed hydrometrocolpos with vaginal agenesis. This, to the best knowledge of the authors, is the first ever reported case of the syndrome in Ethiopia.