[Complicated visceral artery aneurysms in chronic pancreatitis]. / Oslozhnennye anevrizmy vistseral'nykh arterii pri khronicheskom pankreatite.

Visceral artery aneurysms are rare and occur only in 0.01-0.2% of people. According to various authors, incidence of aneurysm rupture is 10-20% with mortality rate of 20-70% depending on localization and dimensions. One of the causes of visceral artery aneurysms, in particular common hepatic artery aneurysm, is chronic pancreatitis. Incidence of this complication is 2-10%. The first clinical manifestation is often hemorrhagic shock following false aneurysm rupture and bleeding into abdominal cavity, gastrointestinal tract or retroperitoneal space. Common hepatic artery aneurysm is complicated by bleeding in 35% of cases, and mortality may be up to 75%. Treatment of visceral artery aneurysm following chronic pancreatitis and post-necrotic parapancreatic cyst includes several stages. Endovascular methods are the first stage of treatment. The second stage is elimination of the cause of visceral artery false aneurysm (surgery for chronic pancreatitis). We present 3 patients with visceral artery aneurysms and chronic pancreatitis.

[Aneurysm of the gastroduodenal artery in a female patient with the postcholecystectomy syndrome (a clinical case report)]. / Anevrizma gastroduodenal'noi arterii u patsientki s postkholetsistéktomicheskim sindromom.

Aneurysms of visceral arteries appear to belong to rare and potentially lethal vascular diseases. The most important role in the aetiology of aneurysms of the gastroduodenal artery is plaid by either acute or chronic pancreatitis. The article deals with a clinical case report concerning a saccular partially thrombosed aneurysm having developed in a 77-year-old woman presenting with the postcholecystectomic syndrome and detected on ultrasonographic examination of the abdominal-cavity vessels. Timely radiodiagnosis (SCT angiography of abdominal cavity vessels), adequate and timely performed endovascular occlusion of the cavity of the aneurysm with metal spirals performed in a timely manner made it possible to attain a favourable outcome. Little is known regarding the understanding of the aetiology and lack of full clarity in therapeutic approaches to aneurysms of visceral arteries predetermine the necessity to continue collecting clinical case reports concerning this rarely encountered vascular pathology in order to generalize and work out an appropriate therapeutic-and-diagnostic algorithm.

[Roentgeno-endovascular occlusion and surgical correction of patent ductus arteriosus]. / Rengenoéndovaskuliarnaia okkliuziia i khirurgichskoe lechenie otkrytogo arterial'nogo protoka (sravnitel'nye aspekty).

To establish the indications to classical surgical correction and roentgenoendovascular occlusion (REO) of patent ductus arteriosus (PDA) results of treatment of patients with PDA were compared. Immediate results of treatment of 209 patients with PDA were analyzed. 110 patients underwent classical surgical operations which were performed successfully in 109 (99%) patients. Complications in early postoperative period were the following: incomplete expanding of the left lung in 1 (0.9%) patient, reactive exudation into left pleural cavity--in 1 (0.9%), and chylothorax--in 1 (0.9%). REO of PDA was performed in 99 patients. Gianturco coils (COOK, Denmark) and Saveliev--Prokubovsky occluders were used. REO was successful in 93 (93.9%) patients. It failed in 6 (6%) cases including 3 cases with coils and 3--with Saveliev--Prokubovsky occluders. According to the results, PDA with diameter less than 4 mm in the narrowest part can be closed by REO with Gianturco coils. In PDA with diameter 4-10 mm Saveliev--Prokubovsky occluders are recommended. In case of PDA with diameter more than 10 mm, aortopulmonary defect or septic botallitis it is necessary to perform thoracotomy and surgical correction.