RESUMEN
Popliteal injuries are well known to be serious with a high rate of mortality due to damage caused to popliteal vessels. Pseudoaneurysm formation and arteriovenous fistulas are well-known complications of arterial injury, but are rarely concomitant. Diagnosis is usually done by computed tomography (CT) angiography. Treatment strategies consist of surgery or endovascular management. We report the surgical treatment of two cases of popliteal arteriovenous fistula associated with pseudoaneurysm complicating stab wounds.
Asunto(s)
Aneurisma Falso/etiología , Fístula Arteriovenosa/etiología , Arteria Poplítea/lesiones , Vena Poplítea/lesiones , Heridas Punzantes/complicaciones , Adolescente , Aneurisma Falso/cirugía , Fístula Arteriovenosa/cirugía , Humanos , Masculino , Arteria Poplítea/cirugía , Vena Poplítea/cirugía , Heridas Punzantes/cirugíaRESUMEN
We report the case for a 44-year-old patient without medical history, admitted in our department for bilateral acute limb ischemia (H6). The patient was hemodynamically stable and the physical examination shows limb sever ischemia (no femoral arterial pulses, coldness, cyanosis and paralysis). Abdominal CT angiography showed a complete occlusion of the infra renal abdominal aorta compatible with embolus. An embolectomy with Fogarty catheters was performed. Echocardiography showed a mass in the left atrium. Pathological examination of the material embolic confirmed the diagnosis of the cardiac myxoma. The clinical course was marked by the development of a sever syndrome of revascularization, death occurred the third day of hospitalization. Cardiac myxomas are the most common primary cardiac tumor. The mobility of the tumor and its gelatinous and crumbly consistency generates peripheral emboli.
Asunto(s)
Aorta Abdominal , Arteriopatías Oclusivas/etiología , Embolectomía/instrumentación , Atrios Cardíacos , Neoplasias Cardíacas/complicaciones , Pierna/irrigación sanguínea , Mixoma/complicaciones , Enfermedad Aguda , Adulto , Angiografía , Aorta Abdominal/diagnóstico por imagen , Ecocardiografía , Resultado Fatal , Atrios Cardíacos/diagnóstico por imagen , Atrios Cardíacos/patología , Neoplasias Cardíacas/diagnóstico por imagen , Humanos , Masculino , Mixoma/diagnóstico por imagen , Tomografía Computarizada por Rayos XRESUMEN
Thromboembolic events in chronic inflammatory bowel diseases are rare and predominated by venous damage. Arterial thromboembolic events are extremely uncommon. We are reporting the case of a 50-year-old male patient with an 8-year history of ulcerative colitis, who presented a recurring severe lower limb ischemia during hospital stay for exacerbation of his inflammatory bowel disease. During the first visit, the patient underwent a balloon thromboembolectomy via femoral approach, with fasciotomy of the leg. Because of recurrence of symptoms, he underwent a second and a third thromboembolectomy by a popliteal approach, with an uneventful postoperative course and was discharged home 10 days later, on warfarin therapy and oral corticosteroids. After an extensive literature review using PubMed, we found 20 reported cases in the English literature over the past 25 years; not including this present case. In the absence of major cardiovascular risk factors, inherited thrombophilia and intracardiac thrombi, we consider active ulcerative colitis to be the major trigger of the embolic lower limb ischemia in our patient. By means of this report, we seek to create awareness of the increased risk of arterial thromboembolism in inflammatory bowel diseases patients.
Asunto(s)
Colitis Ulcerosa/complicaciones , Isquemia/etiología , Extremidad Inferior/irrigación sanguínea , Tromboembolia/complicaciones , Corticoesteroides/uso terapéutico , Embolectomía con Balón , Humanos , Masculino , Persona de Mediana Edad , Tromboembolia/cirugía , Warfarina/uso terapéuticoRESUMEN
Infectious aortitis is a rare clinical entity that most often manifests itself by an aortic aneurysm. The syphilitic or tubercular forms can be subacute. When it is caused by Salmonella sp., Staphylococcus sp. or Streptococcus pneumoniae, the aortitis is acute with alarming symptoms. Germs found in most cases are Salmonella and Staphylococcus aureus. S. pneumoniae rarely causes infectious aortitis. We report the case of a 75-year-old patient seen in an emergency setting for sudden-onset abdominal pain with fever. An abdominal angio-computed tomography (CT) scan showed a sacciform infrarenal abdominal aortic aneurysm, with an inflammatory aspect and periaortic hematoma. Surgical cure was undertaken because of the impending rupture. An interposition aortic replacement graft was implanted. Blood cultures and bacteriological study of the aortic wall isolated a S. pneumoniae. The anatomical pathology study reported fibrin clot leukocyte remodeling of the aortic wall. An intravenous antibiotic regimen was started. Several organisms, including Streptococcus, can cause infectious aortitis. We found 36 cases described in the literature in addition to our patient.