Mert

Interventional Radiology Consultant

[Mert @nephexchange]

@robshahverdyan @SocietyAccess @Vascupedia_com @VASBImedia @VASAMD @ASDINNews @Dialysis_Access Delayed recoil?

[Mert @nephexchange]

@somubetageri Really nice result. Was expecting a nasty dissection flap

[Mert @nephexchange]

@farkomd Full metal jacket and pants

[Mert @nephexchange]

@Marri_VIR Which drain did you use? Is it a nephroureterostomy drain?

[Mert @nephexchange]

@DrJayMohan Not when it is that large, stretching the skin and risk of overlying skin necrosis ?

[Mert @nephexchange]

@somubetageri This is a beautifully uniform gelfoam tract. How are you making it out of interest? How much saline to sponge?

[Mert @nephexchange]

@drkeithsiau that is called the left ventricular apex

[Mert @nephexchange]

@DrNeilGuptaIR @somubetageri @nhsuhcw Recently found this Merit drain which could be useful in this scenario of needing covering drain.

https://t.co/3G3dcLSqu9

[Neil Gupta @DrNeilGuptaIR]

Another @nhsuhcw patient saved from having a life-long cholecystostomy drain, as unfit for surgical cholecystectomy.

I've now helped 40 patients so they can live drain free by performing GUPTAS procedure, which involves putting a stent between the gall bladder & the duodenum.

[Mert @nephexchange]

@ItaniMalak Double IVC?

[Mert @nephexchange]

@Oxy_m0r0n @northwoods1980 No evidence of appendicitis on a macroscopic level but please note microscopic histological changes can’t be ruled out

[Mert @nephexchange]

@Microbedoc2 What are your thoughts on presumed bacterial liver abscess. Eg. Small <3cm liver abscess. Is there any evidence on drainage Vs 6 week antibiotics ?

[Mert @nephexchange]

@ZhiVenFongMD @Declanfj @ziadtawad @rajibaji1983 @st07tmc I think some proportion of the ‘not identified’ is probably still GDA. Can’t always find the bleeding point as can be transient. If ongoing bleeding with some sign of localisation in GDA region, Empiric GDA/stump embolisation probably still less risk than a re look?

[Mert @nephexchange]

@PMccoubrie

[Mahmoud Ali MD @mahmoudali_md]

Pudendal nerve cryoablation for 9/10 pelvic pain, non resectable vulvar cancer, Great response to diagnostic bupivicaine block. Pain is down to 3, no pain on sitting. Nerve cryoablation is effective long term solution @SIRRFS @SIRspecialists

[frank arko @farkomd]

Heavy menses, pelvic pain treated with OCPs without improvement in young woman. Pelvic varices, gonadal vein reflux, nutcracker renal vein. Left outflow actually via right gonadal vein.

[Mert @nephexchange]

@Neuromed_ Bilateral bleed, could be internal cerebral vein thrombosis?

[Mert @nephexchange]

@NephroP Don’t think this is useful to be honest. Subcutaenous edema doesn’t diagnose infection , and necrotising fasciitis is a clinical diagnosis.

[Mert @nephexchange]

@VascularArtist

[Mert @nephexchange]

@mattdbull I guess weeks to months, but 2bh the obvious diagnosis being ruled out, statistically means should look for an alternative cause?