Multiple Pseudoaneurysms of the Brachiocephalic Artery Following Penetrating Arrow Injury in the Neck.

Arrow injury in the neck with subsequent pseudoaneurysm formation of the brachiocephalic artery is an uncommon type of injury in our country. Initially it was a punctured wound in the neck which was simply repaired. About 13 days after the initial injury patient came back to hospital with severe respiratory distress and backache for which emergency tracheostomy was needed. This simple puncture wound subsequently developed haematoma in the neck and two pseudoaneurysms at distal brachiocephalic artery. CT angiogram was very helpful to confirm the diagnosis. Correct referral to tertiary hospital like National Institute Cardiovascular Diseases (NICVD) ,prompt diagnosis, definitive treatment of the injury and subsequent aggressive postoperative management saved the life of this young tailor.

Ghost Face on a Left Atrial Thrombus in a Young Lady of Bangladesh.

A 36 years old married female with children from a district of Bangladesh had been suffering from mitral stenosis with atrial fibrillation ( AF) with left atrial(LA) thrombus & active pulmonary tuberculosis under anti-TB drugs. She presented with shortness of breath ( SOB),blood mixed sputum &right lower limb pain for 14 days which was later diagnosed as thromboembolism with acute limb ischemia. LA clot was removed by open heart surgery. Three masses of clots were removed, one ball thrombus, another irregular mass taking the shape of LA appendage and the other is a mixture of old and fresh thrombus..Patient underwent mitral valve replacement (MVR). One side of the irregular thrombus showed the impression of a human face (? Ghost).Histopathology confirmed them as thrombi.Patient was discharged home on the 8th post operative day.

Mycotic Aneurysm of Aorta Following Mitral Valve Replacement – A Case Report.

The term mycotic aneurysm refers to aneurysm associated with infection by microorganism. Sir William Osler first coined the term mycotic aneurysm in 1885 by disclosing the relation between abnormal cardiac valves and infection with micrococci not with fungi. An 11 years old female from Feni presented with asymptomatic vascular swelling in abdomen referred by a cardiologist. CT angiogram revealed fusiform aneurysm in distal part of abdominal aorta involving ostioproximal part of both common iliac arteries and saccular aneurysm of distal part of superior mesenteric arteries suggestive of mycotic aneurysm. Patient underwent vascular operation aorto biilliac bypass by PTFE graft with excision and ligation of aneurysm of superior mesenteric arteries .Mycotic aneurysm in bacterial endocarditis is rare. It is a challenging job for the cardiologists, infectious disease specialists and vascular surgeon. Time appropriate skilled prompt surgical management can bring smile for both patients and physicians.