A Case of Gastro-Duodenal Artery Aneurism: Treatment and Complications.

We present the case of a 75-year-old patient with asymptomatic gastro-duodenal artery aneurism (GAA) that was coiled through the left femoral artery. The gastro-duodenal artery (GDA) was then embolized. Following the intervention, the patient'™s left foot became cold. A sub-acute ischemia caused by a stenotic effect in the left external iliac artery and by lower limb embolic phenomena caused by the introductor, was diagnosed. A thromboembolectomy of the popliteal, anterior and posterior tibial and peroneal arteries was performed with a Fogarty catheter with good results. Aneurisms of the GDA are rare. Rupture is a severe and unpredictable complication that complicates management and darkens prognosis. Though endovascular treatment for splanchnic aneurisms are used more and more often and offers numerous advantages compared to surgery, it is not without risk. A multidisciplinary approach with careful collaboration between the surgeon and the radiologist is recommended. Abbreviattions: GAA: gastro-duodenal artery aneurism, GDA: gastro-duodenal artery.

[Imaging of Lemierre in children and young adults]. / Imagerie du syndrome de Lemierre chez l'enfant et l'adolescent.

PURPOSE: The aim of this study is to describe the role of imaging in the medical care of Lemierre Syndrome and to describe its US, CT and MRI features. PATIENTS AND METHODS: Files of patients diagnosed with Lemierre Syndrome between 2005 and 2011 at CHUV hospital have been analysed retrospectively to define its imaging semiology. RESULTS: IJV thrombosis was demonstrated by US, CT and MRI. Septic pulmonary emboli were detected by CT. Complications of the Lemierre Syndrome were depicted by MR and CT. CONCLUSION: US, CT or MR evidence of IJV thrombosis and chest CT suggestive of septic emboli, should lead the physician to diagnose Lemierre Syndrome, which in case of insufficient therapy can lead to death.

But: Déterminer le rôle de l'imagerie dans la prise en charge du Syndrome de Lemierre, de décrire les caractéristiques radiologiques de cette maladie rare mais potentiellement mortelle. Patients et méthode: Analyse rétrospective des dossiers de patients diagnostiqués au CHUV avec un Syndrome de Lemierre entre 2005 et 2011 pour en définir une sémiologie spécifique. Résultats: Démonstration d'une thrombose de la VJI par l'US, le CT et l'IRM. Mise en évidence d'emboles septiques au CT. Description des complications du Syndrome de Lemierre par CT et IRM. Conclusion: La mise en évidence à l'US, au CT ou à l'IRM d'une thrombose de la VJI et la présence d'emboles septiques pulmonaires au CT devrait mener au diagnostic de Syndrome de Lemierre et permettre de traiter agressivement cette infection qui peut mener au décès du patient.