ABSTRACT
Endovascular treatment options for visceral artery pseudoaneurysms depend on lesion location and size. Exclusion methods fall into two categories, embolization and stent placement, and these procedures aim to exclude the pseudoaneurysm from the circulation and if possible to maintain distal blood flow. Embolization of the afferent artery can be used in pseudoaneurysms that arise from a donor artery without collateral supply such as a visceral branch, whereas in the case of visceral arteries with well-established collateral supply, the embolization of both proximal and distal branches to the pseudoaneurysm is mandatory in preventing backflow from the collateral circulation. A direct embolization delivering coils or glue into the sac can also be performed if the aneurismal neck is narrow. Stent-graft placement represents another option to exclude the pseudoaneurysm, in the case of wide neck, reduced arterial tortuosity and large-diameter arteries. We present a case of common hepatic artery pseudoaneurysm involving the gastroduodenal artery origin treated by a combination of techniques. An hepatic stent-graft implantation plus retrograde embolization of the gastroduodenal artery through the pancreaticoduodenal anastomosis from the superior mesenteric artery was performed.
Subject(s)
Aneurysm, False/diagnosis , Aneurysm, False/therapy , Blood Vessel Prosthesis , Embolization, Therapeutic/instrumentation , Hepatic Artery/surgery , Stents , Adult , Combined Modality Therapy , Embolization, Therapeutic/methods , Hepatic Artery/diagnostic imaging , Humans , Male , Radiography , Treatment Outcome , UltrasonographySubject(s)
Carcinoma, Neuroendocrine/diagnostic imaging , Carcinoma, Neuroendocrine/surgery , Gallbladder Neoplasms/diagnostic imaging , Gallbladder Neoplasms/surgery , Abdominal Pain/diagnosis , Abdominal Pain/etiology , Aged, 80 and over , Biopsy, Needle , Carcinoma, Neuroendocrine/pathology , Cholecystectomy, Laparoscopic/methods , Female , Follow-Up Studies , Gallbladder Neoplasms/pathology , Humans , Immunohistochemistry , Postprandial Period , Risk Assessment , Treatment Outcome , UltrasonographyABSTRACT
Paracolostomy hernia is a common occurrence, representing a late complication of stoma surgery. Different surgical techniques have been proposed to repair the wall defect, but the lowest recurrence rates are associated with the use of mesh. We present the case report of a patient in which laparoscopic paracolostomy hernia mesh repair has been successfully performed.
