ABSTRACT
BACKGROUND: To assess the effectiveness and prospects of transcatheter gastroduodenal artery embolization in the control of massive duodenal bleeding and to relate our experience. METHODS OF STUDY: The study is based on the retrospective analysis of 165 patients with endoscopically detected bleeding duodenal ulcer who presented between 1991-1998. 28 patients were considered eligible for endovascular treatment either at initial presentation or following hemorrhage recurrence after endoscopic therapy. RESULTS: Technical failure was noted in 3 cases, thereafter treated by surgery. In the other 25 patients, embolization was performed: bleeding recurrence occurred in 7 cases. Four were treated only endoscopically. One was reembolized and the last two were treated by surgery. In 6 cases, a coaxial technique was used (guiding catheter in 2 and 3F microcatheter in 4). No complication related to the catheterization was observed. CONCLUSION: Transcatheter embolization of the gastroduodenal artery appears to be an efficient procedure even in the absence of active bleeding at the time of the procedure. Failure and recurrence rates can be reduced by using a coaxial technique in the uneasy cases. Embolization seems to have a low recurrence rate and a very low complication rate.
Subject(s)
Duodenal Ulcer/complications , Embolization, Therapeutic , Peptic Ulcer Hemorrhage/therapy , Aged , Female , Hemostasis, Endoscopic , Humans , Male , Recurrence , Treatment OutcomeABSTRACT
We report the case of a woman with atypical anterior basithoracic pain as only initial symptom of pustulotic arthro-osteitis. Early diagnosis was made only after development inferior lumbar pain, some months later. At that time, the radiological investigations revealed the osteoarticular counterpart of pustulotic arthro-osteitis.
Subject(s)
Arthritis/diagnosis , Hyperostosis/diagnosis , Osteitis/diagnosis , Ribs , Adult , Arthritis/complications , Chest Pain/etiology , Female , Humans , Hyperostosis/complications , Osteitis/complicationsABSTRACT
Suprarenal masses shown on CT scan should be diagnosed with caution. In fact normal structures, anatomic variations, and lesions of adjacent organs may mimic actual adrenal tumors. A gastric diverticulum simulating an adrenal metastasis is reported.
