RESUMO
Background: Coarctation of the aorta (CoA) can either present alone as an isolated condition or in association with other aortic arch or cardiac anomalies. One percent of patients with CoA have concomitant an aberrant right subclavian artery (ARSA). Purpose: We report the case of a 35-year-old woman with uncontrolled hypertension who was found to have CoA and ARSA. Results: The patient was treated successfully using a hybrid procedure comprising ARSA ligation and subclavian to carotid transposition, followed by thoracic endovascular aortic repair. Conclusions: Patients with CoA should be carefully studied, considering the possible coexistence of other congenital aortic arch defects, such as ARSA. Hybrid repair is a safe and effective approach for this condition.
Assuntos
Coartação Aórtica , Implante de Prótese Vascular , Anormalidades Cardiovasculares , Procedimentos Endovasculares , Adulto , Aorta Torácica/diagnóstico por imagem , Aorta Torácica/cirurgia , Coartação Aórtica/complicações , Coartação Aórtica/diagnóstico por imagem , Coartação Aórtica/cirurgia , Anormalidades Cardiovasculares/complicações , Anormalidades Cardiovasculares/diagnóstico por imagem , Anormalidades Cardiovasculares/cirurgia , Feminino , Humanos , Artéria Subclávia/anormalidades , Artéria Subclávia/diagnóstico por imagem , Artéria Subclávia/cirurgia , Resultado do TratamentoRESUMO
Compression of the esophagus by a retroesophageal aberrant right subclavian artery (ARSA) is a rare cause of dysphagia. We present the case of a 47-year-old female with symptoms of progressive dysphagia diagnosed with dysphagia lusoria using barium swallow and contrast computed tomography and successfully treated with a hybrid procedure: right carotid to subclavian bypass and endovascular insertion of an Amplatzer II Vascular Plug through the right superficial femoral artery. We consider this approach safer, less invasive and more complete to avoid recurrent dysphagia.
Assuntos
Artérias Carótidas/cirurgia , Transtornos de Deglutição/terapia , Procedimentos Endovasculares/métodos , Aneurisma , Angiografia Digital , Anormalidades Cardiovasculares , Artérias Carótidas/diagnóstico por imagem , Transtornos de Deglutição/etiologia , Transtornos de Deglutição/cirurgia , Doenças do Esôfago/diagnóstico por imagem , Doenças do Esôfago/etiologia , Doenças do Esôfago/cirurgia , Feminino , Humanos , Pessoa de Meia-Idade , Artéria Subclávia/anormalidades , Tomografia Computadorizada por Raios XRESUMO
Los paragangliomas de comportamiento maligno son poco frecuentes, pero pueden ocurrir especialmente en pacientes con presentación familiar de la enfermedad. Presentamos el caso de una mujer de 23 años con diagnóstico de glomus carotídeo bilateral con metástasis ganglionares locales y a distancia, asociado a historia familiar de paraganglioma y presentamos una revisión de la literatura
Malignant paragangliomas are rare, but may occur especially in patients with familial forms of the disease. We present the case of a 23 year old woman diagnosed with bilateral carotid paraganglioma with distant and local metastases, associated to a family history of paraganglioma and we present a literature review
Assuntos
Feminino , Humanos , Adulto Jovem , Paraganglioma/patologia , Tumor do Glomo Jugular/patologia , Tumor do Corpo Carotídeo/patologia , Metástase Linfática/patologia , Predisposição Genética para DoençaRESUMO
Malignant paragangliomas are rare, but may occur especially in patients with familial forms of the disease. We present the case of a 23 year old woman diagnosed with bilateral carotid paraganglioma with distant and local metastases, associated to a family history of paraganglioma and we present a literature review.
Assuntos
Paraganglioma , Tumor do Corpo Carotídeo/diagnóstico , Feminino , Humanos , Paraganglioma/diagnósticoRESUMO
BACKGROUND: Intra-abdominal pressure rises in some circumstances and can cause abdominal compartment syndrome. Severe acute pancreatitis frequently causes abdominal compartment syndrome. OBJECTIVE: Our objective was to identify the relationship between severity of pancreatitis and abdominal pressure. MATERIAL AND METHODS: From September 2001 to September 2002, all patients with acute severe pancreatitis were included in the study; exclusion was effected with history of abdominal surgery for pancreatitis or ventral hernias. In all patients, we carried out laboratory tests to establish ranson criteria, Apache II score, and indirect measurement of abdominal pressure. Lineal regression and chi-square test were done. RESULTS: A total of 25 patients was included, 10 men and 15 women, average age 49.4 years, 11 with mild pancreatitis and 14 with severe acute pancreatitis. Abdominal pressure was 2 to 19 cm H2O. On statistic analysis, there was strong positive correlation between Apache II score and IAP and 0.781 of correlation coefficient and 99.5% confidence interval.
