ABSTRACT
A 41-year-old woman was admitted to the emergency room with symptoms compatible with deep vein thrombosis affecting the left lower extremity and pulmonary thromboembolism. A CT scan was consistent with pulmonary emboli and thrombosis of the iliac veins extending to the inferior vena cava, which persisted even after correct systemic fibrinolytic therapy. For this reason, a venography was performed and local thrombolysis was administered. Venography revealed a compression of the left common iliac vein caused by the right common iliac artery, so that the patient was diagnosed with May-Thurner syndrome. The clinical features of this anatomical condition and sometimes lethal clinical syndrome are discussed
No disponible
Subject(s)
Humans , Female , Adult , May-Thurner Syndrome/complications , Pulmonary Embolism/etiology , Venous Thrombosis/physiopathology , Contraceptives, Oral/adverse effects , Venous Insufficiency/complications , Risk FactorsABSTRACT
We present a case of gastroesophageal junction leak after gastric bypass with serious sepsis and hemodynamic instability. Minimally invasive treatment was performed in two stages: initial sepsis control by lavage and endoscopy-assisted laparoscopic placement of an intraluminal esophageal drainage tube through the leak orifice; this was followed by definitive leak treatment with a self-expandable covered metal stent after achieving hemodynamic stability. Patient evolution was satisfactory without the need for open surgery.
Subject(s)
Esophagogastric Junction/injuries , Esophagogastric Junction/surgery , Gastric Bypass/adverse effects , Postoperative Complications/surgery , Stents , Esophageal Fistula/etiology , Esophageal Fistula/surgery , Female , Gastric Fistula/etiology , Gastric Fistula/surgery , Hemodynamics , Humans , Middle Aged , Obesity, Morbid/surgery , Sepsis/etiology , Sepsis/surgery , Treatment OutcomeABSTRACT
Intrasplenic pseudoaneurysm is a potentially lethal complication of abdominal trauma. We present the case of a 33-year-old patient with this particular complication diagnosed by CT-scan. Selective embolization was not possible due to its extraordinarily large size and finally splenectomy was performed. We review the English literature and discuss the particular role of the interventional radiologist to treat this entity. The interventional radiologist is the specialist who better estimates the success of embolization or the risk and possibility of delayed splenic rupture. Embolization of the arterial tributary to the pseudoaneurysm should be considered as the treatment of choice only when the diagnosis is made before rupture of the spleen and only in selected cases. Splenectomy always remains as an alternative treatment for high-risk pseudoaneurysms.
ABSTRACT
Localization of digestive hemorrhage is essential for the management of this entity. However, management is difficult in the small bowel, where emergency situations are rare but may require surgery without precise location of the lesion. We present a case of hemorrhage caused by jejunal diverticulum diagnosed by angiography. A highly selective microcatheter was placed in the bleeding site to achieve staining of the lesion with intraoperative methylene blue.
Subject(s)
Diverticulum/diagnosis , Gastrointestinal Hemorrhage/etiology , Jejunal Diseases/diagnosis , Aged , Diagnosis, Differential , Diverticulum/complications , Fatal Outcome , Female , Humans , Indicators and Reagents , Jejunal Diseases/complications , Methylene BlueABSTRACT
La localización de la hemorragia digestiva es fundamental para controlarla, algo que se complica en el caso del intestino delgado, donde las situaciones de emergencia son infrecuentes pero pueden requerir una laparotomía sin una clara localización de la lesión. Presentamos un caso de una hemorragia secundaria a divertículos yeyunales que se diagnosticó por angiorradiología y canulación selectiva del vaso sangrante, para conseguir el tatuaje de la lesión mediante inyección intraoperatoria de azul de metileno (AU)
Localization of digestive hemorrhage is essential for the management of this entity. However, management is difficult in the small bowel, where emergency situations are rare but may require surgery without precise location of the lesion. We present a case of hemorrhage caused by jejunal diverticulum diagnosed by angiography. A highly selective microcatheter was placed in the bleeding site to achieve staining of the lesion with intraoperative methylene blue (AU)
Subject(s)
Female , Aged , Humans , Gastrointestinal Hemorrhage/diagnosis , Methylene Blue , Diverticulum/diagnosis , Jejunal Diseases/diagnosisABSTRACT
No disponible
Subject(s)
Male , Female , Humans , Bile , Bile Ducts/surgery , Bile Ducts, Intrahepatic , Choledochostomy/instrumentation , Choledochostomy/methods , Digestive System Surgical Procedures/instrumentation , Biliary Tract Surgical Procedures/instrumentation , Gallstones/surgery , Intubation/instrumentation , Intubation/methods , Intubation, Gastrointestinal/methodsABSTRACT
An aortic neck with a nonconstant diameter represents a challenge for endovascular treatment. We report our experience in a patient with right aortic arch, aneurysmatic aberrant subclavian artery, aortic coarctation, and a precoarctation aneurysm that was treated with surgery and endoprothestic procedures in two stages.
