Traumatic pseudo-aneurysm and concurrent dissection of the aortic arch treated with endovascular stenting

The pseudo-aneurysms of thoracic aorta are rare and a life-threatening complication of aortic surgery and blunt chest trauma. This article demonstrates a case report of a traumatic aortic arch dissection and formation of a false aneurysm after blunt chest trauma in Iran. A 23-year-old man was referred complaining of chest pain and exertional cough. He had a history of chest and abdominal trauma five months ago after a car accident, resulting in acceleration-deceleration injury. The trauma resulted in an extensive injury on the left side of the chest and abdomen associated with multiple rib fractures, hemopneumothorax and splenic rupture. Splenectomy and left chest tube drainage was performed. The patient was admitted for 15 days. Finally, he recovered to normal and was discharged in satisfactory condition. However, his chest pain and cough restarted and its severity gradually increased. In chest x-ray, a left upper mediastinal mass was detected, which was later confirmed by 64 multi-slice chest CT scan as a false aortic arch aneurysm and aortic dissection. It seems endovascular stent-graft technique for the treatment of thoracic aorta aneurysm may present a good treatment choice with a low risk and less invasive approach

Endoscopic resection of lower ureter in upper urinary tract tumors

To evaluate the efficacy and safety of endoscopic resection of lower ureter in upper urinary tract tumor cases. Five patients with transitional cell carcinoma [TCC] of the upper urinary tract were enrolled in this study. Nephrectomy was carried out through a flank incision and distal ureter with a cuff of bladder, which was removed using endoscopic approach. Complications and recurrence rate were evaluated. A total of 5 patients with upper urinary tract tumor underwent the endoscopic resection of lower ureter. All the patients had grade I transitional cell tumor. Two patients had suffered from bladder TCC treated previously. During the follow-up two cases developed bladder tumor: one, 18 months and another, one year postoperatively, both in the base of bladder, which was managed successfully by transurethral resection [TUR]. Endoscopic resection of lower ureter in selected patients with upper urinary tract tumors can lead to lower morbidity, shorter operation time, and higher patient's satisfaction. Despite the minority of cases in this study, it seems that this method is applicable in selected cases