ABSTRACT
Truly reversible pulmonary hypertension is rare. Acquired systemic arteriovenous (A-V) fistulas following spinal surgery (laminectomy) are a less recognized cause of secondary pulmonary hypertension. We describe a patient who presented with symptoms and clinical evidence of pulmonary hypertension and underwent endovascular correction of an acquired A-V fistula, which led to improvement according to clinical and noninvasive hemodynamic criteria.
Subject(s)
Arteriovenous Fistula/complications , Hypertension, Pulmonary/etiology , Iliac Artery , Iliac Vein , Laminectomy/adverse effects , Arteriovenous Fistula/etiology , Arteriovenous Fistula/therapy , Cardiac Output , Female , Humans , Hypertension, Pulmonary/diagnosis , Iliac Artery/diagnostic imaging , Iliac Vein/diagnostic imaging , Middle Aged , Ultrasonography, DopplerABSTRACT
Pulmonary vein varix is a rare benign abnormality, either congenital or acquired, usually presented without symptoms. It is most frequently discovered by chance on a chest radiograph, whereas computed tomography defines the special characteristics of the lesion. Angiography is considered the method of choice for final diagnosis. The authors present the first case of a patient with pulmonary vein varix accompanied by interatrial communication.
Subject(s)
Pulmonary Veins , Tomography, X-Ray Computed , Varicose Veins/diagnostic imaging , Angiography , Female , Humans , Middle Aged , Pulmonary Veins/diagnostic imagingABSTRACT
The purpose of the study was to determine the reliability of ultrasonography in assessing plaque pathology and to relate it to clinical symptoms. Ten symptom-free patients and 26 with symptomatic carotid plaques with a stenosis > 70%, as detected by arteriography, were assessed by duplex. The findings were compared with the clinical presentation and plaque pathology. Pathological specimens of the plaque that had < 60% fibrous tissue were associated with an increased incidence of past stroke (P = 0.002). Plaque ulceration, haemorrhage and calcium were all unrelated to the clinical presentation. Using the pathological specimen as the 'gold standard', ultrasonography was unable to detect plaque ulceration or haemorrhage. Plaque regularity, irregularity, homogeneity and heterogeneity were not consistent with plaque pathology or the clinical presentation. The fibrous tissue was significantly greater (73%) in plaques with an echogenic character compared with those with an echolucent morphology (63%; P = 0.04). Moreover, echolucent plaques were most common in symptomatic patients and echogenic plaques in symptom-free patients (P = 0.002).
Subject(s)
Arteriosclerosis/diagnostic imaging , Brain Ischemia/diagnostic imaging , Carotid Stenosis/diagnostic imaging , Ultrasonography, Doppler, Color , Aged , Aged, 80 and over , Arteriosclerosis/pathology , Arteriosclerosis/surgery , Brain Ischemia/pathology , Brain Ischemia/surgery , Carotid Arteries/diagnostic imaging , Carotid Arteries/pathology , Carotid Stenosis/pathology , Carotid Stenosis/surgery , Endarterectomy, Carotid , Female , Humans , Male , Middle Aged , Sensitivity and SpecificityABSTRACT
Malignant peritoneal mesothelioma is virtually unknown to feature as a solitary lesion. A patient presented with abdominal pain, weight loss, and melena and underwent enteroclysis, computed tomography, and superior mesenteric arteriography. Sharp angulation, narrowing, and mucosal destruction in a jejunal segment, caused by an encapsulating infiltrative mesenteric mass, were shown. The diagnosis of a malignant peritoneal mesothelioma, localized to the small intestine, was made at histology.
