Inusual complicación en procedimiento de cirugía ortognática / Unusual complication in an orthognathicsurgery procedure

Objetivo: presentar un caso de pseudoaneurisma de la arteria maxilar interna, complicación hemorrágica infrecuente mediata al procedimiento de osteotomía sagital mandibular. Caso clínico: El tratamiento consistió en la embolización selectiva del vaso afectado, un procedimiento menos cruento que las maniobras hemostáticas tradicionales, como la ligadura arterial a través de un abordaje cervical. Conclusión: Es posible resolver la hemorragia con un método alternativo pero seguro, que conlleva menos morbilidades asociadas a las maniobras hemostáticas clásicas.

Aim: to report a mediate rare bleeding complication tothe procedure of mandibular sagittal split osteotomy as is thepseudoaneurysm of the internal maxillary artery is.Case report: The treatment consisted of selective embolizationof the affected vessel, which turns out to be a lessinvasive procedure than traditional hemostatic maneuverssuch as arterial ligation through a cervical approach.Conclusion: It is possible to resolve the bleeding withan alternative safe method with lower morbidity than the oneassociated with classical hemostatic maneuvers.

Spontaneous Retroperitoneal Hemorrhage from Ruptured Suprarenal Artery Aneurysm

Retroperitoneal hemorrhage from a ruptured suprarenal artery aneurysm is very rare. We report on a 34-year-old man who underwent selective angiography for diagnosis and treatment of retroperitoneal hemorrhage for suprarenal artery aneurysm. The patient made a full recovery with no evidence of further hemorrhage.

Tumor miofibroblástico inflamatorio de arteria carótida interna resecado con embolización selectiva previa: reporte de caso / Inflammatory myofibroblastic tumor related to the internal carotid artery, extirpated after an arterial selective embolization

El tumor miofibroblástico inflamatorio es una lesión infrecuente, cuya importancia radica en ser diagnóstico diferencial de otras neoplasias. Se le ha relacionado con Infecciones, traumas, cirugías previas e ínmunosupresión, pero se cree que éstos sólo serían el evento ínidal que daría lugar a una serie de cascadas autoinmunes que perpetuarían al cuadro. Afecta a población infantil y adulta joven, con una edad media de aparición de 10 años, sin distinción de género. A continuación se presenta el caso de una mujer de 45 años de edad con diagnóstico de tumor miofibroblástico inflamatorio de arteria carótida interna, resecado con embolización arterial selectiva previa. Además, se revisa la literatura al respecto.

The inflammatory myofibroblastic tumor is a rare condition, and its' relevant for being a differential diagnosis of many other neoplasms. It has been related with different infections, traumas, previous surgeries and immune deficiencies, but there are studies that support the theory that these factors are only the initial event of an autoimmune reaction that perpetuates the disease. It affects childs and young adults, with an average of 10 years old at the moment of presentation, without differences between genre. In this case, we reporta 45 year old woman, with an histological diagnosis of inflammatory myofibroblastic tumor related to the internal carotid artery, extirpated after an arterial selective embolization. Besides, we review the literature.

The Clinical Outcomes of Transcatheter Microcoil Embolization in Patients with Active Lower Gastrointestinal Bleeding in the Small Bowel

OBJECTIVE: To assess the clinical outcomes of the transcatheter microcoil embolization in patients with active lower gastrointestinal (LGI) bleeding in the small bowel, as well as to compare the mortality rates between the two groups based on the visualization or non-visualization of the bleeding focus determined by an angiography. MATERIALS AND METHODS:We retrospectively evaluated all of the consecutive patients who underwent an angiography for treatment of acute LGI bleeding between January 2003 and October 2007. In total, the study included 36 patients who underwent a colonoscopy and were diagnosed to have an active bleeding in the LGI tracts. Based on the visualization or non-visualization of the bleeding focus, determined by an angiography, the patients were classified into two groups. The clinical outcomes included technical success, clinical success (no rebleeding within 30 days), delayed rebleeding (> 30 days), as well as the major and minor complication rates. RESULTS: Of the 36 patients, 17 had angiography-proven bleeding that was distal to the marginal artery. The remaining 19 patients did not have a bleeding focus based on the angiography results. The technical and clinical success rates of performing transcatheter microcoil embolizations in patients with active bleeding were 100% and 88%, respectively (15 of 17). One patient died from continued LGI bleeding and one patient received surgery to treat the continued bleeding. There was no note made on the delayed bleeding or on the major or minor complications. Of the 19 patients without active bleeding, 16 (84%) did not have recurrent bleeding. One patient died due to continuous bleeding and multi-organ failure. CONCLUSION: The superselective microcoil embolization can help successfully treat patients with active LGI bleeding in the small bowel, identified by the results of an angiography. The mortality rate is not significantly different between the patients of the visualization and non-visualization groups on angiography.