Alana Y Stubbs

Interests

No activities entered.

Courses

No activities entered.

Scholarly Contributions

Journals/Publications

• Ateeli, H., Kovoor, A., Desai, H., Stubbs, A. Y., & Nguyen, T. N. (2015). Medical image of the week: bilateral atrial appendange thrombi. Southwest Journal of Pulmonary and Critical Care. doi:10.13175/swjpcc006-15
• Graham, A. R., Holden, D. A., Hunter, T. B., Rogers, L. F., Stubbs, A. Y., Taljanovic, M. S., & Turecki, M. B. (2010). Imaging of musculoskeletal soft tissue infections.. Skeletal radiology, 39(10), 957-71. doi:10.1007/s00256-009-0780-0
  More info

  Prompt and appropriate imaging work-up of the various musculoskeletal soft tissue infections aids early diagnosis and treatment and decreases the risk of complications resulting from misdiagnosis or delayed diagnosis. The signs and symptoms of musculoskeletal soft tissue infections can be nonspecific, making it clinically difficult to distinguish between disease processes and the extent of disease. Magnetic resonance imaging (MRI) is the imaging modality of choice in the evaluation of soft tissue infections. Computed tomography (CT), ultrasound, radiography and nuclear medicine studies are considered ancillary. This manuscript illustrates representative images of superficial and deep soft tissue infections such as infectious cellulitis, superficial and deep fasciitis, including the necrotizing fasciitis, pyomyositis/soft tissue abscess, septic bursitis and tenosynovitis on different imaging modalities, with emphasis on MRI. Typical histopathologic findings of soft tissue infections are also presented. The imaging approach described in the manuscript is based on relevant literature and authors' personal experience and everyday practice.
• Singh, B., & Stubbs, A. Y. (2010). A Rare Case of Hemorrhagic Pancreatic Pseudocyst Secondary to Arc of Riolan Pseudoaneurysm. American Journal of Gastroenterology, 105, S193-194. doi:10.14309/00000434-201010001-00532
  More info

  Purpose: Hemorrhagic complications of chronic pancreatitis can become quickly life-threatening. While uncommon, ruptured pseudoaneurysms are the most rapidly fatal, and typically involve the splenic artery, gastroduodenal artery or pancreaticoduodenal artery. We report a rare case of arc of Riolan pseudoaneurysm rupture resulting in hemorrhagic conversion of a chronic pancreatic pseudocyst with concomitant GI bleed. A 59 year old male with a past medical history of alcoholic chronic pancreatitis, chronic pancreatic pseudocysts, and coronary artery disease presented to our hospital with one day duration of hematemesis and hematochezia. His initial hemoglobin was 12.2 gm/dl, which subsequently dropped to 9.2 gm/dl over 24 hours. An upper endoscopy showed a greater gastric curvature crater oozing dark red blood. Aggressive irrigation of the area showed no obvious source amenable to endoscopic treatment. Given the patient's history of chronic pancreatic pseudocyst, a post-endoscopy contrast-enhanced CT scan revealed active hemorrhage into a known chronic pancreatic tail pseudocyst eroding into the adjacent stomach, secondary to an arc of Riolan pseudoaneurysm. The patient subsequently underwent angiographic evaluation and transcatheter embolization of the arc of Riolan pseudoaneurysm, utilizing metallic coils and Gelfoam. Post-embolization angiography showed pseudoaneurysm exclusion and lack of active contrast extravasation. The patient remained hemodynamically stable for 48 hours after the intervention but on day 3 experienced a sentinel bleed, went into cardiopulmonary arrest and died. Conclusion: One should suspect hemorrhage into a known pancreatic pseudocyst if there is a sudden increase in pseudocyst size, an overlying bruit is detected or there is evidence of GI bleeding without obvious source seen on EGD. Common approaches to treatment of hemorrhagic pseudocyst include surgical resection of the cyst and pseudoaneurysm, surgical ligation of the artery proximal and distal to the pseudoaneurysm and internal or external pseudocyst drainage, or angiographic embolotherapy. Due to the high mortality associated with pancreatic pseudocyst-related arterial hemorrhage and pseudoaneurym rupture, early identification of the source of hemorrhage and rapid intervention are necessary.Figure: Pseudoaneurysm (white arrow).
• Schwartz, S. A., Smyth, S. H., Stubbs, A. Y., & Taljanovic, M. S. (2008).

  Pancreatitis-associated splenic vein thrombosis with intrasplenic venous thrombosis: a case report.

  . Emergency radiology, 15(6), 433-6. doi:10.1007/s10140-007-0693-y
  More info

  Splenic vein thrombosis most often results from pancreatic disease and can result in gastrointestinal bleeding due to gastric varices. The diagnosis is becoming more frequent with the increasing utilization of imaging. This case report will review the imaging findings of splenic vein thrombosis with an illustration of the involvement of intrasplenic segmental venous branches.
• Stubbs, A., Taljanovic, M., Massey, B., Graham, A., Friend, C., & Walsh, J. (2008). Myonecrosis of Behcet's disease. Skeletal Radiology, 37(4). doi:10.1007/s00256-007-0432-1
  More info

  Behcet's disease is an inflammatory disease of unknown cause characterized by intermittent episodes of acute inflammation manifested by oral aphthous ulcers, genital ulcers, uveitis, and skin lesions. We report a rare case of myonecrosis associated with Behcet's disease. Myonecrosis of Behcet's disease can mimic soft tissue abscess and therefore awareness of this entity in the appropriate clinical setting is important for initiation of appropriate and timely treatment. © 2007 ISS.
• Hunter, T., Taljanovic, M., Krupinski, E., Ovitt, T., & Stubbs, A. (2007). Academic Radiologists' On-Call and Late-Evening Duties. Journal of the American College of Radiology, 4(10). doi:10.1016/j.jacr.2007.06.012
  More info

  On-call and late-evening duties have increased dramatically for radiologists, be they in private practice, at academic medical centers, or at state or federal government health care facilities. Most busy medical centers in North America require around-the-clock radiology interpretations for emergent or urgent patients, particularly if they are level 1 trauma centers. Coverage by attending radiologists around the clock is expensive and difficult to implement. In this study, an e-mail questionnaire was sent to 83 members of the Society of Chairmen of Academic Radiology Departments concerning general radiologists' on-call and after-hours duties. Detailed replies were received from 29 academic medical centers, all of which were university owned or affiliated. There was complex variation on how academic radiology departments approached their after-hours commitments, but only 10% of academic institutions (3 of 29) answering the survey had 24-hour in-house coverage by general radiologists. Coverage by attending radiologists around the clock at academic medical centers is not the current standard of practice at most academic medical centers. © 2007 American College of Radiology.