Pneumonia and Acute Left Iliac Vein Thrombosis after Percutaneous Vertebroplasty

Acute iliac vein obstruction can occasionally elicit a limb threatening condition. We report a patient who had pneumonia and acute left iliac vein obstruction after percutaneous vertebroplasty for spine fractures. This patient, a 53-year-old woman, was treated with right great saphenous vein, bypass surgery. She was admitted to our hospital complaining of dyspnea for 2 days after percutaneous vertebroplasty and was diagnosed with pulmonary pneumonia. On hospital day 12, the left leg edema was aggravated which elicited pain and cyanosis. Thrombotic occlusion of the common iliac and common femoral veins was found on duplex Doppler sonography. One day of full heparinization resulted in no clinical improvement and emergency surgery was performed. The left iliac vein was filled with recently formed thrombus and the iliac bifurcation region was completely obstructed. After thrombectomy, bypass surgery was performed using the right great saphenous vein as a conduit to the left common femoral vein. The patient was discharged without any complication on postoperative day 24. There was no gate disturbance at postoperative 1 month.

Preoperative CT Diagnosed Transomental Internal Hernia with Intestinal Obstruction: A case report

We report a case of an incarcerated internal hernia which was diagnosed preoperatively by using an abdominal CT scan. An-84-year-old female patient suddenly developed cramping upper abdominal pain after a meal, followed by nausea and vomiting associated with slight abdominal distension. This patient's initial abdominal plain X-ray was interpreted as indicating abdominal free gas. A dilated small bowel loop was revealed based on a late abdominal CT scan, and an internal hernia was suspected. On operation, herniation through defects in the gastrocolic omentum and gastrohepatic ligament was found and was successfully reduced. A jejunal loop internal herniation of this nature is extremely rare, and closed-loop obstructions result to incarceration or strangulation. When abnormal gas is detected at the right upper or the epigastric area in a simple abdominal X-ray. An unusual internal hernia must be a concern, and an abdominal CT scan can be useful for preoperative diagnosis.