RESUMO
Pancreatic arteriovenous malformation is a rare vascular anomaly which may cause abdominal pain, acute pancreatitis, gastrointestinal bleeding and portal hypertension. Pancreatic arteriovenous malformation is mostly congenital; however secondary pancreatic arteriovenous malformation due to pancreatitis has been suggested by some authors. We encountered a case which can confirm this presumption. Several imaging modalities are useful for the diagnosis of pancreatic arteriovenous malformation, especially dynamic contrast-enhanced studies. Angiography is the most important diagnostic tool because of the dynamic features of this vascular lesion. Treatment is advised and consists of surgical resection and/or transarterial embolization.
RESUMO
Lumbar arterial bleedings are rare but potentially life threatening. We report a case of an isolated right lumbar arterial bleeding after radical nephrectomy for renal infarction with infected perirenal haematoma. The diagnosis was suggested by computed tomography and confirmed with angiography. Definitive treatment of this vascular injury was obtained after percutaneous transcatheter embolization of the fourth right lumbar artery. General anaesthesia, further blood loss due to difficult surgical dissection, or even failure to find and ligate the injured artery, especially in redo-operations, can be avoided by this minimal invasive procedure. Endovascular embolization of a lumbar artery injured after radical nephrectomy might be a valuable treatment alternative in patients with postoperative retroperitoneal bleeding.
Assuntos
Embolização Terapêutica/métodos , Hematoma/complicações , Hemorragia/terapia , Infarto/cirurgia , Infecções/complicações , Rim/irrigação sanguínea , Nefrectomia/efeitos adversos , Injúria Renal Aguda/diagnóstico , Injúria Renal Aguda/etiologia , Angiografia , Diagnóstico Diferencial , Drenagem , Feminino , Seguimentos , Hematoma/terapia , Hemorragia/etiologia , Humanos , Infarto/complicações , Infecções/diagnóstico , Infecções/terapia , Rim/cirurgia , Vértebras Lombares/irrigação sanguínea , Pessoa de Meia-Idade , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/terapia , Doenças Raras , Tomografia Computadorizada por Raios XRESUMO
A case is reported of a 20-year-old female presenting with confusion and progressive sensory aphasia. CT and MRI showed bilateral and symmetric acute necrosis of the basal ganglia and of the left temporal and occipital lobe, besides chronic spinocerebellar degeneration. The imaging findings suggested a mitochrondrial encephalopathy. Genetic examination confirmed a MELAS syndrome (mitochondrial myopathy, encephalopathy, lactate acidosis and stroke like episodes).
