ABSTRACT
Acute dissection of the aorta, although not common, has early and highly lethal complications. The type A dissection is treated with surgery. Patients with type B dissections are treated with surgery if they have complications like rupture, growth or visceral ischemia. Surgery, however, has complications such as spinal cord ischemia. Endovascular grafts have less mortality and complications. We report a 59 years old male patient with a type B dissection complicated with rupture. He was treated successfully with the placement of an endoluminal graft. He was discharged five days after the procedure in good conditions. After one year of follow up, the patient remains asymptomatic.
Subject(s)
Humans , Male , Middle Aged , Aortic Dissection/surgery , Aortic Aneurysm, Thoracic/surgery , Aortic Rupture/surgery , Blood Vessel Prosthesis Implantation , Stents , Aortic Dissection/complications , Aortic Aneurysm, Thoracic/complications , Aortic Rupture/complications , Tomography, X-Ray ComputedABSTRACT
Pulmonary Embolism (PE) has a wide clinical spectrum. It is imperative to detect patients with a high risk to develop right ventricular failure, because this is the main cause of death in patients with massive PE. In this group of patients, invasive therapies to relieve pulmonary obstruction and right ventricle overload should be used as soon as possible. We report a 85 years old male with massive PE treated with pharmacological thrombolysis and mechanical fragmentation with an angioplasty balloon. Pulmonary perfusion improved significantly. Afterwards, systemic anticoagulation was started and an inferior vena cava filter was installed percutaneously. The patient was discharged in good conditions, five days after admission.
Subject(s)
Aged, 80 and over , Humans , Male , Pulmonary Embolism/therapy , Thrombolytic Therapy/methods , Combined Modality Therapy , Fibrinolytic Agents/therapeutic use , Pulmonary Artery , Pulmonary Embolism/drug therapy , Pulmonary Embolism , Vena Cava FiltersABSTRACT
Splenic artery aneurysms are rare and occur predominantly in women. Most of them are asymptomatic until rupture. We report a previously healthy 73 year-old woman who presented with non specific symptoms: dyspepsia and constipation. Laboratory tests were normal. Subsequent examinations (ultrasound and CT) showed a large aneurysm of the splenic artery without any sign of rupture. Endovascular treatment remained successfully performed using coil embolization. During a 12-months follow-up period, the patient was asymptomatic and no evidences of complications or splenic infarction were observed on CT scans.
Subject(s)
Aged , Female , Humans , Aneurysm/diagnosis , Embolization, Therapeutic , Splenic Artery , Aneurysm/therapy , Follow-Up Studies , Treatment OutcomeABSTRACT
Background: Congenital hepatic fibrosis (CHF) is an autosomic dominant disease that has been associated with polycystic kidney disease. Aim: To describe the medical management of 5 children with CHF and to evaluate the presence and extension of the associated renal disease. Patients and methods: Retrospective review of the medical charts of 5 children with CHF, aged 2 to 14 years. Results: Three children presented autosomic recessive polycystic kidney disease, which was diagnosed before the appearance of liver disease manifestations. They presented a more severe liver damage, with a more aggressive clinical course requiring use of transjugular intrahepatic porto-systemic shunts (TIPS) or surgical porto-systemic shunts to control portal hypertension. The other two children, in whom the diagnosed was based on asymptomatic hepatomegaly, had normal renal function and structure with a more benign clinical course. Conclusions: The diagnosis of CHF should be suspected not only in children with polycystic kidney disease but in those children with persistent, hard consistency, left lobe predominance hepatomegaly (Rev Méd Chile 2004; 132: 733-41).
Subject(s)
Humans , Male , Adolescent , Female , Child, Preschool , Child , Liver Cirrhosis/complications , Liver Cirrhosis/congenital , Liver Cirrhosis/pathology , Liver/pathology , Hypertension, Portal/surgery , Hypertension, Portal/etiologySubject(s)
Child , Adolescent , Adult , Middle Aged , Humans , Male , Female , Biopsy, Needle , Tomography, X-Ray Computed/methods , Neoplasms/pathologySubject(s)
Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Adult , Middle Aged , Humans , Contrast Media/adverse effects , Drug Hypersensitivity/mortality , Aged, 80 and over , Risk Factors , Contrast Media/administration & dosage , Dose-Response Relationship, Drug , Injections, Intravenous/adverse effectsABSTRACT
Con el objeto de crear una tabla de referencia de los diámetros aórticos e ilíacos normales en individuos de diversas edades y evaluar la influencia del calibre arterial preexistente sobre el tipo de patología degenerativa susceptibles de presentarse en esta área, se estudian 334 angiografías convencionales correlativas que cubren ambos sexos desde los 2 hasta los 96 años de edad, incluyendo individuos sanos y con patología local. Las mediciones se realizaron en forma seriada, cubriendo los diversos segmentos de la aorta abdominal y ambas ilíacas primitivas, permitiendo obtener una tabla de referencia con los valores obtenidos para ambos sexos. Es posible comprobar que el diámetro aórtico e ilíaco es significativamente mayor en los hombres en los diversos niveles estudiados a partir de los 20 años de edad, sin demostrarse correlación con la edad de los sujetos. Cuando se analizan estos diámetros en función de la normalidad o tipo de patología existente se constata una significativa diferencia en el diámetro aórtico entre los pacientes portadores de aneurismas y los individuos normales, mientras los pacientes ocluidos, en lugar de poseer aortas menores presentan paradojalmente diámetros levemente superiores a los normales
Subject(s)
Child, Preschool , Child , Adolescent , Adult , Middle Aged , Humans , Male , Female , Aorta, Abdominal/physiology , Angiography , Aorta, Abdominal/physiopathology , Retrospective StudiesABSTRACT
Se presenta el caso de un paciente varón de 70 años, sin antecedentes broncopulmonares, que a partir de agosto de 1982 es ingresado en varias oportunidades al Servicio de Medicina del Hospital Militar, en relación a cuadros caracterizados por: tos, dolor torácico y disnea de inicio brusco. Aunque el diagnóstico de tromboembolismo pulmonar (TEP) se planteó en la segunda hospitalización, la enfermedad sólo se confirmó mediante angiografía por sustracción digital en el siguiente episodio, iniciándose tratamiento anticoagulante (TAC) con Heparina y posteriormente con Neosintrón. Nuevos episodios tromboembólicos, pese a un TAC presumiblemente correcto, llevaron a colocar un clip en la vena cava inferior, medida terapéutica que asociada a Neosintrón, permitió al paciente hacer una vida razonablemente activa sin requerir nuevas hospitalizaciones. Aunque TEP es una entidad frecuente en nuestro quehacer, a menudo nos plantea dificultades en su diagnóstico y en su terapia, como claramente lo demostró este caso. En el comentario se destaca la particular evolución radiológica del paciente y algunos aspectos de la angiografía por sustracción digital
Subject(s)
Aged , Humans , Male , Pulmonary EmbolismABSTRACT
Se analiza la experiencia con Nefrolitotomía percutánea en el Hospital Clínico de la Universidad Católica de Chile en 13 casos entre diciembre de 1983 y noviembre de 1984. Se describe la técnica de Nefrostomía percutánea y de Nefrolitotomía ultrasónica. Se obtiene éxito en 82% de los casos abordados. Se describen las indicaciones y contraindicaciones del procedimiento. La Nefrolitotomía percutánea es un procedimiento nuevo con el cual el urólogo deberá familiarizarse dadas las múltiples ventajas que representa para el paciente