Abdominal angina - a rare cause of chronic abdominal pain

We report here a case of chronic postprandial abdominal pain and weight loss of more than one year duration. He was diagnosed to have abdominal angina [chronic mesenteric ischemia] on CT angiography. Open surgical revascularization procedure-right common iliac mesenteric polytetrafluoroethylene [PTFE] bypass graft achieved positive short and long-term outcome with follow-up of twenty two months

Acute limb ischemia due to ergotism

Acute ischemia of an extremity potentially threatens limb loss and occasionally the life of the patient. We are reporting two cases of extremity ischemia secondary to ergot poisoning. The first patient was a 60 years old woman, who presented with a 15 days history of ischemia of the left arm with gangrene of the fingers and pain in the resting right hand for one day. Right brachial artery catheterization showed severe spasm of the artery which was resolved by passage of the inflated balloon catheter. She underwent amputation for gangrene of the left hand. The second patient presented with bilateral symmetrical ischemia of the lower extremities which improved upon withdrawal of the ergot containing medicine. She responded to nifedipine

Cerebral embolism Distal subclavian disease as a rare etiology

Subclavian artery occlusive disease is usually secondary to persistent compression caused by thoracic outlet syndrome [TOS] and rarely due to focal atherosclerosis. Emboli from diseased vessel can flow retrograde to the vertebral or carotid arteries to produce ischemic infarct with or without neurological deficit. We are reporting two cases of distal subclavian artery disease presenting with cerebral embolization, an unusual manifestation. Such surgically correctable lesions producing cerebral emboli and stroke needs consideration while evaluating patients with unusual presentation to prevent further occurrence of stroke

Ruptured abdominal aortic aneurysm two years experience in AKUH

Abdominal aortic aneurysm [AAA] occurs in 2 per cent of the elderly population in the Western world. The incidence of this disease in Pakistan is unknown. Over a two-year period, between March 1989 to February 1991, we have operated upon three patients with ruptured abdominal aortic aneurysm [RAAA], all were male patients between 46-77 years with varied presentations. In all three cases, preoperative diagnosis was established. The operations were done by transperitoneal approach, and a Dacron graft was used for replacement of the aneurysm. There was one death in the immediate post-operative period. We stress the need for a high index of suspicion in elderly patients to aid early detection of asymptomatic cases, and elective surgery, as RAAA carries a high mortality