A Unique Type of Dural Arteriovenous Fistula at Confluence of Sinuses Treated with Endovascular Embolization: A Case Report / 신경중재치료의학

Dural arteriovenous fistula (DAVF) is classically defined as abnormal arteriovenous connections located within the dural leaflets. Though the exact etiology is still not clear, they are generally accepted as acquired lesions. However, some DAVFs formed as the congenital disorders are called dural arteriovenous malformations and these lesions with a marked cortical venous reflux are considered to be aggressive and warrant an early intervention. The authors describe a case of 35-year-old man presented with unique type of DAVF. The fistula was located adjacent to the confluence of venous sinuses with multiple feeders. The feeders drained into a large venous pouch just anterior to the confluence which had a bilateral venous drainage. This was associated with multiple cerebellar venous ectasia along the draining cortical vein. It was managed by staged endovascular procedures and complete cure could be achieved. The pathogenesis and technique of embolization of this complex fistula/malformation are also discussed.

Post percutaneous nephrolithotripsy nephrostomy site tuberculosis: a report of six cases

With the increase in endoscopic surgery, there is a growing concern about the effectiveness of sterilizing reusable equipment by immersion in 2% glutaraldehyde. Although reports of port site tuberculosis [post laparoscopy] are there in the literature, those of nephrostomy site post percutaneous nephrolithotripsy are not available. We describe the clinical features and treatment of six patients who presented with biopsy-proven skin tuberculosis at the nephrostomy-site for non-healing wound

Bilateral spontaneous perinephric hematoma

A-55-year-old man presented with a history of generalized swelling all over the body and uremic symptoms. Physical examination revealed pallor, anasarca, and hypertension. A gradual elevation of serum creatinine level from 1.6 mg/dL to 6.49 mg/dL was documented within 3 weeks. Urinalysis did not show any abnormal sing. Ultrasonography revealed the right kidney sized 9.5 x 3 cm and the left kidney, 10 x 4.9 cm, with large bilateral perinephric collections. Doppler ultrasonography revealed a 1.3 cm midopole aneurysm in the right kidney and multiple left renal aneurysms. Computed tomography revealed heterogeneous bilateral collection with fascial thickening in the peripheral spaces suggestive of bilateral perirenal hematomas with bilateral renal artery aneurysms. He was subjected to bilateral renal angiography and coiling of the aneurysms. Perinephric collection was evacuated by flank incision. Subcapsular renal hematomas occur secondary to variable etiologies and Page Kidney phenomenon can les to kidney failure. When occurs unilaterally, it can be managed expectantly, but page kidney in a solitary unit or bilateral Page kidney can lead to acute kidney failure, necessitating intervention to avoid the irreversible kidney damage