ABSTRACT
BACKGROUND: Ruptured aneurysms secondary to the tuberculous infection of the aorta are a rare and life-threatening disease. We report a single-center experience of two patients with ruptured infrarenal tuberculous aneurysms. CASE PRESENTATION: We report 2 patients with ruptures of the tuberculous aneurysm. All patients had acute abdominal pain and were diagnosed by echography then CT scan preoperatively. The first patient (male, 50 years old) had a ruptured saccular aneurysm. The second patient (male, 43 years old) had a retroperitoneal contained rupture. All were treated by open prosthetic repair, by vascular surgeons. The two patients were well after operations. The diagnosis was confirmed by pathology examination. Antituberculous treatment was introduced after the operation. CONCLUSIONS: Ruptured tuberculous aneurysms are rare but life-threatening. The diagnosis requires a high degree of suspicion. The treatment includes early diagnosis and emergent surgical intervention, extensive excision of infected field, aortic reconstruction, and prolonged antituberculous drug therapy.
ABSTRACT
The hepatic venous anatomic variations on hepatic resection and transplantation are very important and the least understood aspect of the liver. In particular, data are lacking in the literature with reference to Vietnamese patients. The objective of this study was to examine the morphologic and biometric variations of the hepatic veins in Vietnamese cadavers. Livers from 20 Vietnamese cadavers preserved in formalin solution were used in this study. Specimens were carefully scraped by curette to expose the branches of hepatic veins. Diameters, lengths and morphologic hepatic variations were recorded. The average diameters of veins were: 34.78 mm (IVC), 20.26 mm (RHV), 14.35 mm (MHV), 14.76 mm (LHV), and 22.49 mm (common trunk). The average length of the common trunk was 6.45 mm; 35% of cases in the short group (< 10 mm), and 65% in the long group (≥ 10 mm). A common trunk was present in 90% of specimens. The morphology of the common trunk was comparable to that observed by other investigators. Only 10% of cases had accessory RHVs of Type II, with a main trunk and accessory branches to the IVC, in contrast to 90% of Type I, with a main trunk alone. The anatomical variations of the hepatic veins are very diverse. Knowledge of these variations prior to surgery is useful during both partial hepatectomy and segmental liver transplantation. Pre-operative hepatic venous imaging can allow for assessment of venous flow and morphology, and may lessen surgical complications
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