ABSTRACT
INTRODUCTION: Inferior epigastric artery (IEA) pseudoaneurysms are recognised complications of abdominal wall procedures, and a variety of approaches including surgical excision and ligation, percutaneous procedures and conservative management have been employed in treating this rare complication. METHODS: We describe a case of an IEA pseudoaneurysm diagnosed on computed tomography (CT) angiography, 14 days following a laparoscopic assisted low anterior resection, which was managed successfully with surgical excision and ligation. A review of the literature identified 32 reports of this complication since 1973 with 69% of cases occurring since 2000. FINDINGS: The main aetiology of IEA pseudoaneurysm was abdominal surgery (n=20); 65% of cases were attributable to abdominal wound closure or laparoscopic surgery. Two-thirds (66%) of patients presented between 11 and 63 days, and all except 1 case presented with discomfort, abdominal mass or haemodynamic instability. Colour Doppler ultrasonography was the imaging modality of choice (n=18), either alone or in combination with computed tomography and/or angiography. Surgical ligation and excision and percutaneous coil embolisation formed the mainstay of attempted treatments (69%), particularly following treatment failure using an alternative technique. CONCLUSIONS: The incidence of iatrogenic IEA pseudoaneurysms appears to be increasing. Awareness of this rare complication is of clinical importance to avoid excessive morbidity for affected individuals.
Subject(s)
Aneurysm, False , Epigastric Arteries , Laparoscopy/adverse effects , Postoperative Complications , Aneurysm, False/diagnostic imaging , Aneurysm, False/pathology , Aneurysm, False/surgery , Epigastric Arteries/diagnostic imaging , Epigastric Arteries/pathology , Epigastric Arteries/surgery , Humans , Postoperative Complications/diagnostic imaging , Postoperative Complications/pathology , Postoperative Complications/surgery , Tomography, X-Ray ComputedABSTRACT
Gliomatosis peritonei is a rare complication of ovarian teratomas characterized by peritoneal implants of glial tissue. Glial tissue in such cases is usually low grade although there have been cases of malignant evolution described. There is no clear guidance as to how often and for how long these patients should be followed up. There are clear dose implications when performing multiple CT scans. We present a case of immature ovarian teratoma complicated by the development of low grade gliomatosis peritonei. The MRI appearances are presented and described, and we discuss the potential role of MRI in the follow up of such cases.
Subject(s)
Neuroglia , Ovarian Neoplasms/pathology , Peritoneal Diseases/pathology , Teratoma/pathology , Adult , Female , Humans , Magnetic Resonance Imaging/methods , Ovarian Neoplasms/complications , Ovary/pathology , Peritoneal Diseases/etiology , Peritoneum/pathology , Teratoma/complicationsABSTRACT
Malignant and benign causes of inferior vena cava (IVC) occlusion and compression are recognized. Cases of benign IVC compression with associated distal thrombus formation have not however been frequently described. We present two cases of benign external IVC compression associated with distal thrombus formation; one resulting from a giant, benign, hepatic cyst, and another due to pelviureteric junction obstruction, resulting in massive hydronephrosis.
