Background and Importance: Diffuse idiopathic skeletal hyperostosis (DISH) can compress the trachea and esophagus when located in the cervical spine. In this report, we investigated whether it is preferable to perform the early surgical intervention in symptomatic patients or to wait and administer supportive care and perform late surgical intervention regardless of whether symptoms progress or not. Case Presentation: We present the case of a 70-year-old patient with diffuse idiopathic skeletal hyperostosis (DISH) causing significant dysphagia and unilateral vocal cord paresis, resulting in dyspnea and stridor. Imaging diagnostics revealed large osteophytes anterior to the cervical spine from C3 to C6 compressing the cervical spine. Significant clinical improvement was observed following the anterior resection of the patient's osteophytes. Conclusion: In order to achieve higher success and less recurrence, it is preferable to perform surgical intervention earlier in the disease's progression. However, more studies are necessary to confirm this because most of the present results are from case report articles and have less evidence.

Ankylosing spinal disease (ASD) is a common clinical entity [1]. The main etiologies of ASD are diffuse idiopathic skeletal hyperostosis (DISH), ankylosing spondylitis and postoperative spinal fusion after removal of instrumentation. Because of the rigidity of the spine patients with ASD are prone to fractures even with minor trauma and unstable fracture patterns (distraction fractures and involvement of the posterior column) are common. . .

Background: Necrotizing enterocolitis is the leading cause of intestinal perforation and pneumoperitoneum in neonates. In addition, neonatal pneumoperitoneum includes several conditions requiring surgery, such as gastric and duodenal perforation, intestinal atresia, volvulus, meconium ileus, and Hirschsprung’ s disease. A type of pneumoperitoneum in which intra-abdominal free air is detected through direct X-ray; however, no cause is found clinically and radiologically during the surgery is named “ benign pneumoperitoneum” . Case report: This case report presents a 5-day-old male newborn who is presented with complaints of abdominal color change and vomiting and is diagnosed with Idiopathic Benign Pneumoperitoneum (IBP) during the operation. Neonatal pneumoperitoneum usually occurs as a result of perforation and requires emergency surgery. Rare cases of IBP should also be kept in mind. Unnecessary surgery can be prevented by establishing a differential diagnosis with clinical, laboratory, and imaging methods. Conclusion: This case demonstrated that laparotomy is not a true routine in neonates with IBP if a timely diagnosis is established.

Introduction: Zenker's diverticulum is an acquired sac-like outpouching of the mucosa and submucosa layers originating at the pharyngoesophageal junction. The predominant symptom of Zenker’, s diverticulum is dysphagia. Videofluoroscopy confirms the diagnosis. Forestier disease is a clinical entity characterized by ossification of anterolateral vertebral ligament and anterior osteophyte formation along the anterolateral spinal column. Its etiopathogenesis remains unknown and common symptoms are dysphagia, dysphonia and airway obstruction. The objective of this study is to identify a pathophysiological correlation between Forestier disease and the onset of Zenker’, s diverticulum. Materials and Methods: A retrospective observational study was conducted. The electronic database of our Radiology Unit was analyzed in order to identify patients with hypopharyngeal diverticulum and osteophytes at the cervical vertebrae level, from January 2010 to January 2021. The search was performed using precise keywords. Results: The computerized database search outlined 10 imaging exams: 5 videofluorographies and 5 computed tomography scans. In 100% of the cases, dysphagia was the main symptom that led to the diagnostic assessment,30% of patients, on the other hand, reported dyspnoea. From the data analysis, the male / female ratio is 1: 1 and the average age of the patients is 64. 8 (+/-11. 31) years. Conclusions: We assume that the anatomical abnormalities in Forestier disease may cause an increase of pharyngeal pressure and consequently support the development of the Zenker’, s diverticulum. Hence, it is always recommended to investigate the presence of Zenker’, s diverticulum in a patient with Forestier disease, especially for the lifethreatening complications of Zenker's diverticulum.

Diffuse idiopathic pulmonary neuroendocrine cell hyperplasia (DIPNECH) is a rare pulmonary disorder characterized by hyperplasia of pulmonary neuroendocrine cells. It is frequently asymptomatic and can be challenging to differentiate from other forms of reactive pulmonary neuroendocrine cell hyperplasia (NECH). Presented is a case report of DIPNECH along with a review of the diagnosis and management. A 50-year-old female patient with a history of airway disease presented to the pulmonary ward with complaints of Functional Class III dyspnea and productive cough. The HRCT revealed the presence of multiple bilateral nodules in both lungs. The histopathology report from the nodule resection confirmed the presence of a carcinoid tumor, specifically identified as DIPNECH. As many similar cases have favorable treatment responses and satisfactory prognoses due to multidisciplinary treatment methods, the necessity of evidence-based management guidelines for DIPNECH and the accuracy of the disease definition is emphasized.

Introduction: Bone metastases are the most common cause of cancer-related pain in various primary malignant tumors, most often, breast and prostate.188Re-hydroxyethylidene diphosphonate (188Re-HEDP) is a new and less expensive bone seeking radiopharmaceutical with favorable physical characteristics of the radionuclide such as short half life of 16.9h, maximal b energy of 2.1 MeV with a 15% g-component of 155 keV and easily available from an in-house 188W/188Re generator. The aim of this study is to evaluate the therapeutic efficacy and safety profile of bone palliative therapy following administration of 188Re-HEDP.Methods: Twenty patients with painful metastatic bone lesions secondary to breast, prostate, multiple myeloma, ampulla of vater and lung cancers received 1 mCi/kg of 188Re-HEDP. Four hours after treatment, post-therapy scintigraphy was performed. All patients were interviewed using a standard set of questions (visual analogue scale: VAS) concerning their pain relief before, and after therapy at weekly intervals for the first month and every 2 weeks for the following 4 months.The general condition of the patients was also evaluated by Karnofsky-index and ECOG (Eastern Cooperative Oncology Group) performance status. Hematologic profiles were recorded before treatment and every two weeks up to 8 weeks after treatment.Results: Overall pain relief was found in 68.8% of patients. Decreased from 8.37±2.12 to 5.68±2.98 at VAS was observed 4 weeks after treatment. The osteoblastic lesions (breast and prostate) showed rather similar response to the treatment. Mean platelet counts decreased in 6th week and returned to baseline level in 8th week. One patient showed grade III leukopenia without any serious complication.Conclusion: 188Re-HEDP is an effective radiopharmaceutical for metastatic bone pain palliation therapy. Side effects include mild and transient thrombocytopenia and leucopenia and no life threatening side effect is observed.