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1.
Tidsskr Nor Laegeforen ; 144(7)2024 Jun 04.
Artigo em Inglês, Norueguês | MEDLINE | ID: mdl-38832610

RESUMO

Background: While most cases of venous thromboembolism follow a benign course, occasionally the condition may manifest a complex clinical presentation and need a comprehensive diagnostic workup to identify the underlying cause and provide the patient with appropriate treatment. Case presentation: A woman in her late thirties presented to the emergency department with a five-day history of dyspnoea. She had recently undergone liposuction surgery after pregnancy. Upon admission, initial investigations revealed a pulmonary embolism with right heart strain, and she was treated with anticoagulants. The following day, she complained of acute-onset right flank pain without fever or other accompanying symptoms. A CT scan of the abdomen confirmed a right-side renal infarction. Further investigations revealed patent foramen ovale between the right and left atria of the heart, believed to be the source of a right-to-left shunt of arterial emboli. Although the patient had not suffered a clinical stroke, it was decided to close this defect using percutaneous technique. Interpretation: Patent foramen ovale is a common condition in adults, but in most cases it remains asymptomatic. However, patients with patent foramen ovale have an elevated risk of arterial emboli affecting multiple organs. The diagnosis depends on thorough assessment to prevent potentially fatal outcomes.


Assuntos
Abdominoplastia , Dispneia , Forame Oval Patente , Embolia Pulmonar , Humanos , Feminino , Adulto , Forame Oval Patente/complicações , Forame Oval Patente/cirurgia , Forame Oval Patente/diagnóstico por imagem , Dispneia/etiologia , Abdominoplastia/efeitos adversos , Embolia Pulmonar/etiologia , Embolia Pulmonar/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Infarto/etiologia , Infarto/diagnóstico por imagem , Infarto/diagnóstico , Infarto/cirurgia , Complicações Pós-Operatórias
5.
Commun Biol ; 7(1): 490, 2024 Apr 23.
Artigo em Inglês | MEDLINE | ID: mdl-38654111

RESUMO

Bile infarct is a pivotal characteristic of obstructive biliary disease, but its evolution during the disease progression remains unclear. Our objective, therefore, is to explore morphological alterations of the bile infarct in the disease course by means of multiscale X-ray phase-contrast CT. Bile duct ligation is performed in mice to mimic the obstructive biliary disease. Intact liver lobes of the mice are scanned by phase-contrast CT at various resolution scales. Phase-contrast CT clearly presents three-dimensional (3D) images of the bile infarcts down to the submicron level with good correlation with histological images. The CT data illustrates that the infarct first appears on day 1 post-BDL, while a microchannel between the infarct and hepatic sinusoids is identified, the number of which increases with the disease progression. A 3D model of hepatic acinus is proposed, in which the infarct starts around the portal veins (zone I) and gradually progresses towards the central veins (zone III) during the disease process. Multiscale phase-contrast CT offers the comprehensive analysis of the evolutionary features of the bile infarct in obstructive biliary disease. During the course of the disease, the bile infarcts develop infarct-sinusoidal microchannels and gradually occupy the whole liver, promoting the disease progression.


Assuntos
Tomografia Computadorizada por Raios X , Animais , Camundongos , Colestase/diagnóstico por imagem , Colestase/patologia , Ductos Biliares/diagnóstico por imagem , Ductos Biliares/patologia , Progressão da Doença , Masculino , Fígado/diagnóstico por imagem , Fígado/patologia , Modelos Animais de Doenças , Camundongos Endogâmicos C57BL , Imageamento Tridimensional/métodos , Infarto/diagnóstico por imagem , Infarto/patologia
6.
Zhongguo Yi Xue Ke Xue Yuan Xue Bao ; 46(2): 297-300, 2024 Apr.
Artigo em Chinês | MEDLINE | ID: mdl-38686729

RESUMO

Bone infarction has a low incidence in clinical practice and mostly occurs in the metaphysis and diaphysis.Few studies report the advanced imaging technique for bone infarction.Here we reported the fast field echo resembling a CT using restricted echo-spacing and calcium-suppressed spectral CT imaging for a case of multifocal bone infarcts in both lower extremities,aiming to provide diagnostic experience for clinical practice.


Assuntos
Infarto , Imageamento por Ressonância Magnética , Tomografia Computadorizada por Raios X , Humanos , Masculino , Cálcio , Infarto/diagnóstico por imagem , Extremidade Inferior/diagnóstico por imagem , Extremidade Inferior/irrigação sanguínea , Imageamento por Ressonância Magnética/métodos , Tomografia Computadorizada por Raios X/métodos , Adulto
8.
J Vasc Interv Radiol ; 35(7): 979-988.e1, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38537737

RESUMO

PURPOSE: To assess the different adjunctive catheter techniques required to achieve complete occlusion of renal arteriovenous malformations (rAVMs) of different angioarchitectural types. MATERIALS AND METHODS: Overall, data on 18 patients with rAVM (Type 1, n = 7; Type 2, n = 2; Type 3, n = 9; mean age, 53.8 years) who underwent 25 procedures between 2011 and 2022 were reviewed. The clinical presentations, endovascular techniques, arteriovenous malformation (AVM) occlusion rate, adverse events (including the incidence of renal infarction), and clinical symptoms and outcomes (including recurrence/increase of AVM) were analyzed according to the Cho-Do angioarchitectural classification. Posttreatment renal infarction was classified as no infarction, small infarction (<12.5%), medium infarction (12.5%-25%), and large infarction (>25%) using contrast-enhanced computed tomography or magnetic resonance imaging. RESULTS: Hematuria and heart failure were presenting symptoms in 10 and 2 patients, respectively. The embolic materials used were as follows: Type 1 rAVM, coils alone or with n-butyl-2-cyanoacrylate (nBCA); Type 2 rAVM, nBCA alone or with coils; and Type 3 rAVMs, nBCA alone. Fourteen patients underwent adjunctive catheter techniques, including flow control with a balloon catheter and multiple microcatheter placement, alone or in combination. Immediate postprocedural angiography revealed complete occlusion in 15 patients (83%) and marked regression of rAVM in 3 (17%). Small asymptomatic renal infarctions were observed in 6 patients with Type 3 rAVMs without any decrease in renal function. No major adverse events were observed. All symptomatic patients experienced symptom resolution. Recurrence/increase of rAVM was not observed during the mean 32-month follow-up period (range, 2-120 months). CONCLUSIONS: Transarterial embolization using adjunctive catheter techniques according to angioarchitectural types can be an effective treatment for rAVMs.


Assuntos
Malformações Arteriovenosas , Embolização Terapêutica , Artéria Renal , Veias Renais , Humanos , Pessoa de Meia-Idade , Feminino , Masculino , Embolização Terapêutica/efeitos adversos , Malformações Arteriovenosas/terapia , Malformações Arteriovenosas/diagnóstico por imagem , Resultado do Tratamento , Adulto , Estudos Retrospectivos , Idoso , Artéria Renal/diagnóstico por imagem , Artéria Renal/anormalidades , Veias Renais/diagnóstico por imagem , Veias Renais/anormalidades , Angiografia por Tomografia Computadorizada , Valor Preditivo dos Testes , Recidiva , Fatores de Tempo , Adulto Jovem , Fatores de Risco , Embucrilato/administração & dosagem , Infarto/diagnóstico por imagem , Infarto/etiologia , Infarto/terapia , Angiografia por Ressonância Magnética
9.
Rinsho Shinkeigaku ; 64(2): 105-108, 2024 Feb 23.
Artigo em Inglês | MEDLINE | ID: mdl-38246605

RESUMO

A 75-year-old man developed sudden-onset tetraparesis preceded by chest pain. MRI of the cervical spine on the day of onset showed no abnormalities. Although his motor symptoms improved gradually, the weakness of the muscles innervated by the C5 nerve root persisted. Sensory and autonomic deficits were detected on an additional neurological examination, and follow-up MRI eight days after onset revealed spinal cord infarction at the right anterior horn at C3-C4. This case suggests that motor symptoms mimicking a radiculopathy could be present during the course of spinal cord infarction.


Assuntos
Traumatismos da Medula Espinal , Isquemia do Cordão Espinal , Masculino , Humanos , Idoso , Quadriplegia , Imageamento por Ressonância Magnética , Isquemia do Cordão Espinal/diagnóstico por imagem , Isquemia do Cordão Espinal/etiologia , Vértebras Cervicais/diagnóstico por imagem , Medula Espinal/diagnóstico por imagem , Infarto/diagnóstico por imagem , Infarto/etiologia
10.
Neuroradiology ; 66(3): 431-435, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38231252

RESUMO

We report a unique case of cervical anterior spinal artery (ASA) infarction in a 49-year-old male with hypercholesterolemia and sleep apnea. The patient experienced sudden cervical pain, quadriparesis, areflexia, and urinary incontinence after swallowing a large food bolus. Imaging revealed an infarction at the C3-C5 levels and an anomalous right vertebral artery (VA) originating from the thoracic aorta, tightly enclosed between the aorta and a vertebral column with an anterior osteophyte. This aberrant VA was the primary vascular supply to the ASA, with no contribution from the left VA or supreme intercostal arteries. We propose that transient injury to the right VA, induced by compression between the aortic arch, the food bolus, and the osteophyte, led to temporary hypoperfusion of the ASA, causing a watershed ischemic injury in the mid cervical cord's anterior gray matter. The article also provides an in-depth discussion of the developmental and clinical characteristics associated with this rare vascular anomaly.


Assuntos
Osteófito , Malformações Vasculares , Masculino , Humanos , Pessoa de Meia-Idade , Artéria Vertebral/diagnóstico por imagem , Artéria Vertebral/anormalidades , Pescoço , Vértebras Cervicais/diagnóstico por imagem , Infarto/diagnóstico por imagem , Infarto/etiologia
11.
Intern Med ; 63(3): 419-423, 2024 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-37344430

RESUMO

Bilateral adrenal infarction is an extremely rare disease, and it has been reported that some coagulation abnormalities, including essential thrombocythemia (ET), exist in the background. We herein report a 76-year-old patient in whom the platelet count had been in the normal range at the onset of adrenal infarction but subsequently increased to 102×104/µL at 7 months later, leading to the diagnosis of JAK2V617F-positive ET. As the presence of the JAK2V617F mutation increases the risk of thrombosis, Janus kinase 2 (JAK2) genetic testing should be considered in some cases of nonspecific unknown thrombosis, even if there are no obvious hematological findings, such as clonal hematopoiesis of indeterminate potential (CHIP).


Assuntos
Doenças das Glândulas Suprarrenais , Trombocitemia Essencial , Trombose , Humanos , Idoso , Trombocitemia Essencial/complicações , Trombocitemia Essencial/diagnóstico , Trombocitemia Essencial/genética , Trombose/genética , Contagem de Plaquetas , Mutação , Infarto/diagnóstico por imagem , Infarto/etiologia , Janus Quinase 2/genética
13.
BMJ Case Rep ; 16(11)2023 Nov 09.
Artigo em Inglês | MEDLINE | ID: mdl-37945275

RESUMO

A previously healthy but overweight (body mass index (BMI) of 24.4) adolescent boy presented with fever and significant right-sided abdominal pain. An abdominal ultrasound scan revealed an omental infarction (OI), which was treated conservatively. OI has been described in overweight teenage children with abdominal trauma but can be missed if not considered. A missed diagnosis could result in an unnecessary laparotomy or laparoscopic surgery. Although CT is the gold standard for diagnosis, ultrasonography is an effective approach to identifying OI in children. The benefits of early diagnosis of OI by abdominal ultrasound include a shorter hospital stay and a reduction in unnecessary investigations and surgery.


Assuntos
Traumatismos Abdominais , Doenças Peritoneais , Masculino , Adolescente , Humanos , Criança , Sobrepeso , Tratamento Conservador , Infarto/diagnóstico por imagem , Infarto/etiologia , Infarto/terapia , Omento/diagnóstico por imagem , Omento/cirurgia , Traumatismos Abdominais/complicações , Traumatismos Abdominais/diagnóstico por imagem , Traumatismos Abdominais/terapia
17.
Gynecol Endocrinol ; 39(1): 2234492, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-37486308

RESUMO

Unilateral non-hemorrhagic adrenal infarction (NHAI) is a very uncommon cause of acute abdomen in pregnancy. Diagnosis is highly challenging due to its rarity, heterogeneity of clinical presentation, and inconclusiveness of the initial workup. Timely recognition is pivotal to ensuring optimal outcomes. Here we describe a case of spontaneous unilateral NHAI diagnosed in a singleton pregnant woman at 32 weeks' gestation at our centre and provide the findings of an extensive literature review on the topic. We identified 22 articles describing 31 NHAI cases in 30 obstetric patients: NHAI occurs more frequently on the right side and in the third trimester, and diagnosis is formulated more than 24 h after clinical presentation in 50% of cases; second-level imaging is always necessary to reach a definitive diagnosis and start appropriate treatment. A high degree of clinical suspicion is needed to promptly recognize NHAI in pregnancy, thus allowing appropriate multidisciplinary management and timely treatment initiation. Promotion of knowledge and awareness of NHAI as a potential cause of acute abdomen in pregnancy is mandatory to improve clinical practice and, ultimately, perinatal outcomes.


Assuntos
Abdome Agudo , Doenças das Glândulas Suprarrenais , Gravidez , Feminino , Humanos , Abdome Agudo/diagnóstico , Abdome Agudo/etiologia , Doenças das Glândulas Suprarrenais/diagnóstico , Terceiro Trimestre da Gravidez , Infarto/diagnóstico por imagem , Infarto/etiologia
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