Ruptured left colic arterial aneurysm treated by transcatheter arterial embolization alone and without a subsequent laparotomy: report of a case.

We herein report the case of a 49-year-old male patient with a ruptured aneurysm originating in the left colic artery, which was successfully treated by transcatheter arterial embolization (TAE) Abdominal computed tomography revealed a large hematoma with a central small aneurysm in the left upper abdomen. Celiac and superior mesenteric arteriography showed no dye extravasation. Subsequent aortography showed an aneurysm arising from the branch of the left colic artery that was successfully treated by selective TAE. Further surgery for subsequent ischemia was not performed. In cases presenting with an unclear source of intraabdominal bleeding, an aneurysm of the inferior mesenteric arterial branch should be considered. Transcatheter arterial embolization is a plausible initial treatment option as an effective therapeutic approach because it provides a curative and less invasive alternative to other therapies. Based on our experience and a review of the literature, surgery may not necessarily be imperative, even in cases of a ruptured aneurysm of a colic arterial branch after TAE.

Potential hippocampal region atrophy in diabetes mellitus type 2: a voxel-based morphometry VSRAD study.

PURPOSE: Among diabetes mellitus type 2 (DM2) patients, the frequency of cognitive dysfunction is higher and the relative risk of Alzheimer's disease (AD) is approximately twice that of nondiabetics. Cognitive impairment symptoms of AD are induced by limbic system dysfunction, and an early-stage AD brain without dementia has the potential for atrophy in the hippocampal region. In this study, we estimated potential hippocampal region atrophy in DM2 and pursued the association between DM2 and cognitive impairment/AD. MATERIALS AND METHODS: Voxel-based morphometry analysis was performed in 28 diabetics (14 men, 14 women; ages 59-79 years, mean 70.7 years) and 28 sex- and agematched (+/-1 year) nondiabetics. Severity of gray matter loss in the hippocampal region and whole brain were investigated. Group analysis was performed using twotailed unpaired t-test; significance was assumed with less than 1% (P < 0.01) of the critical rate. RESULTS: There was a significant difference between diabetics and nondiabetics regarding the severity of hippocampal region atrophy and whole-brain atrophy. Only diabetics showed a positive correlation for severity of hippocampal region atrophy and whole-brain atrophy (rs = 0.69, P < 0.0001). CONCLUSION: Aged DM2 patients have the potential for hippocampal region atrophy, and its dysfunction can be related to the expression of a cognitive impairment that resembles AD.