Assuntos
Fístula Arteriovenosa/diagnóstico por imagem , Artérias Mesentéricas/diagnóstico por imagem , Embolização Terapêutica , Feminino , Humanos , Hipertensão/complicações , Cirrose Hepática/classificação , Cirrose Hepática/diagnóstico por imagem , Pessoa de Meia-Idade , Tomografia Computadorizada MultidetectoresAssuntos
Neoplasias Hepáticas/diagnóstico por imagem , Neoplasias Hepáticas/patologia , Fígado/diagnóstico por imagem , Fígado/patologia , Neoplasias Pulmonares/diagnóstico por imagem , Neoplasias Pulmonares/patologia , Mesotelioma/diagnóstico por imagem , Mesotelioma/patologia , Idoso de 80 Anos ou mais , Biópsia com Agulha de Grande Calibre , Humanos , Biópsia Guiada por Imagem , Masculino , Mesotelioma Maligno , Tomografia Computadorizada Multidetectores , UltrassonografiaRESUMO
A 16-year-old boy had a past medical history of primary hypogonadism, due to bilateral anorchia. He presented with gallstones located in the gallbladder and a mild dilatation of the intrahepatic biliary tree. The histology study reported cholesterol gallstones. The patient had been treated with testosterone replacement therapy since infancy. We suggest a possible correlation between testosterone replacement therapy and the presence of cholesterol gallstones.
Assuntos
Cálculos Biliares/induzido quimicamente , Terapia de Reposição Hormonal/efeitos adversos , Hipogonadismo/tratamento farmacológico , Testosterona/efeitos adversos , Idoso de 80 Anos ou mais , Feminino , Cálculos Biliares/diagnóstico por imagem , Humanos , Testosterona/uso terapêutico , Tomografia Computadorizada por Raios XAssuntos
Doenças dos Ductos Biliares/etiologia , Doenças dos Ductos Biliares/radioterapia , Neoplasias dos Ductos Biliares/radioterapia , Colangiocarcinoma/radioterapia , Tratamento por Radiofrequência Pulsada/métodos , Idoso de 80 Anos ou mais , Doenças dos Ductos Biliares/diagnóstico por imagem , Humanos , Doença Iatrogênica , Masculino , Cuidados Paliativos , UltrassonografiaRESUMO
PURPOSE: We evaluated technical success, safety and effectiveness of percutaneous radiological gastrostomy (PRG) with a modified technique: single puncture and double anchor. MATERIALS AND METHODS: From January 2008 to June 2011, 163 patients underwent PRG with a single-puncture double-anchor technique. The stomach was punctured with a 17-gauge Chiba needle, and gastropexy was performed by placing two anchors in the gastric lumen. Finally, a 12-F Wills-Oglesby percutaneous gastrostomy catheter was inserted. Technical success and complications at 30 days were evaluated on the basis of imaging and patients' medical records. RESULTS: PRG was successfully completed in all 163 patients. Only a single puncture was required in all patients. The average PRG procedure time was 9 min. Three patients had major complications: haemorrhage (n=2) and pneumoperitoneum (n=1). Ten patients had minor complications: tube malfunction/breakage (n=9), and leakage through the insertion site (n=1). Two patients died 30 days after the procedure. CONCLUSIONS: Single-puncture double-anchor PRG is a fast, safe and effective technique.
Assuntos
Gastrostomia/métodos , Radiografia Intervencionista , Técnicas de Sutura , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias , Punções , Resultado do TratamentoRESUMO
PURPOSE: The purpose of this study was to evaluate prevalence, morphological characteristics and evolution of aortic branch artery pseudoaneurysms associated with type B aortic intramural haematoma (IMH) using multidetector computed tomography (MDCT). MATERIALS AND METHODS: We enrolled 14 patients (nine men; mean age 64.6±9.6; range 42-75 years) with a diagnosis in the acute phase of type B IMH without evidence of intimal tear. All patients underwent clinical and MDCT follow-up. RESULTS: Twenty-two pseudoaneurysms in six patients (6/14, 43%) were observed at MDCT. In the majority of patients (5/6, 83%) the pseudoaneurysms were multiple and involved the branches of the descending thoracic aorta (14/22, 64%), mainly the intercostal arteries (11/22, 50%). At a mean follow-up of 10.6±8.7 months, 21 pseudoaneurysms showed resolution, reduction or dimensional stability (95%), whereas only one increased in size (5%). CONCLUSIONS: Aortic branch artery pseudoaneurysms associated with IMH may be considered a benign disease, as the majority of cases resolved or did not change in size, with haematoma resorption. However, because a dynamic change in pseudoaneurysms in the acute and subacute phases was frequently observed, close clinical and imaging follow-up is mandatory.
Assuntos
Falso Aneurisma/diagnóstico por imagem , Aneurisma Aórtico/diagnóstico por imagem , Doenças da Aorta/diagnóstico por imagem , Dissecção Aórtica/diagnóstico por imagem , Hematoma/diagnóstico por imagem , Tomografia Computadorizada Multidetectores/métodos , Adulto , Idoso , Meios de Contraste , Feminino , Humanos , Iopamidol/análogos & derivados , Masculino , Pessoa de Meia-Idade , Interpretação de Imagem Radiográfica Assistida por ComputadorRESUMO
Kidney-pancreas transplantation is a valid therapeutic option for patients with insulin-dependent diabetes mellitus. However, vascular complications associated with pancreas transplantation are not uncommon. Herein we have reported a 32-year-old woman with a history of insulin-dependent diabetes mellitus and celiac disease. She underwent liver transplantation for acute hepatitis. After 7 years, the patient developed end-stage kidney disease beginning hemodialysis and being listed for a kidney-pancreas transplantation, which was successfully performed when she was 29 years old with enteric diversion (Roux intestinal loop reconstruction). Five years after kidney-pancreas transplantation, she was admitted to our hospital with serious intestinal bleeding and poor liver function. The ultrasound showed a pattern like a arteriovenous fistula near the head of the pancreas. Computed Tomography was not diagnostic; an arteriogram showed the presence of a mesenteric varix and a mesenteric-caval shunt through the duodenum of the pancreatic graft. The liver biopsy and portal pressure gradient showed portal hypertension and liver cirrhosis. To obtain time a waiting a new liver, the patient underwent percutaneous embolization of the mesenteric varix through jugular access. The procedure was uneventful. The patient was successfully transplanted 2 months later. Pancreas function was always satisfactory.
Assuntos
Diabetes Mellitus Tipo 1/cirurgia , Hipertensão Portal/complicações , Falência Renal Crônica/cirurgia , Transplante de Rim/métodos , Transplante de Pâncreas/métodos , Adulto , Doença Celíaca/complicações , Doença Celíaca/cirurgia , Diabetes Mellitus Tipo 1/complicações , Feminino , Humanos , Hipertensão Portal/cirurgia , Falência Renal Crônica/etiologia , Transplante de Rim/efeitos adversos , Transplante de Fígado/métodos , Transplante de Pâncreas/efeitos adversos , Tomografia Computadorizada por Raios X , Resultado do Tratamento , Varizes/diagnóstico por imagem , Varizes/etiologiaRESUMO
PURPOSE: The aim of this study was to evaluate the effectiveness of the new Amplatzer vascular plug (AVP) for the occlusion of vascular abnormalities and peripheral vessels, especially those with a large diameter. MATERIALS AND METHODS: The new device was used for the occlusion of five internal iliac arteries to prevent retrograde endoleak following endograft repair, three left subclavian arteries for the treatment of type II endoleaks after positioning thoracic aorta stent-grafts, one pulmonary arteriovenous malformation, one haemodialysis fistula in a patient with forearm oedema and one large gastric varix in a patient who had undergone transjugular intrahepatic portosystemic shunt (TIPS) for haemorrhage. RESULTS: The five internal iliac arteries and the three left subclavian arteries were successfully occluded within 8 and 5 min, respectively. The pulmonary arteriovenous fistula was closed within 3 min and percutaneous oxygen saturation rose from 73% to 93%. The haemodialysis fistula was closed with one device within 4 min. The gastric varix was embolised with two AVPs and two coils within 12 min. CONCLUSIONS: The AVP is an effective device for occluding large diameter vascular abnormalities and peripheral vessels. It is inexpensive and enables safe and low-risk embolisation, with saving of time and requiring only low X-ray dose.
Assuntos
Fístula Arteriovenosa/terapia , Embolização Terapêutica/instrumentação , Artéria Ilíaca , Artéria Subclávia , Aneurisma da Aorta Abdominal/diagnóstico por imagem , Aneurisma da Aorta Abdominal/terapia , Aortografia , Prótese Vascular , Humanos , Artéria Ilíaca/diagnóstico por imagem , Artéria Pulmonar/anormalidades , Artéria Subclávia/diagnóstico por imagem , Tomografia Computadorizada por Raios X/métodos , Doenças Vasculares/terapiaRESUMO
Chronic lung disease (CLD) in children represents a heterogeneous group of many distinct clinicopathological entities. The prevalence of CLD has increased in the past decade because of the more advanced and intensive respiratory support provided for compromised children and additionally the overall improved survival of preterm babies. The disorders which constitute CLD generally have a slow tempo of progression over many months or even years. The most common causes of CLD in children are cystic fibrosis (CF), and other causes of bronchiectasis (such as immunodeficiency, and in the third world, post-infective bronchiectasis, for example, measles), bronchopulmonary dysplasia (BPD) (or lung disease of prematurity), asthma, chronic gastro-oesophageal reflux/aspiration pneumonitis, and constrictive obliterative bronchiolitis.