Endovascular repair of a ruptured, extremely tortuous, descending thoracic aorta aneurysm with aortic coarctation.

We have presented a case of a ruptured descending aortic aneurysm that was accompanied by extreme tortuosity and a pseudocoarctation at the level of the ligamentum arteriosum. We performed successful endovascular repair, covering the left subclavian artery, using a transapical-to-femoral artery (through-and-through) guidewire technique to overcome the tortuosity, with the option to perform balloon angioplasty in the case of an increased gradient over the coarctation. In the present case report, we have underlined the role of close collaborations with aortic expertise centers.

[Acute pancreatitis after propofol administration]. / Acute pancreatitis na het toedienen van propofol.

BACKGROUND: Propofol is a widely used and safe hypnotic agent. Complications include pain on injection, dose-dependent hypotension, allergic reactions and hypertriglyceridemia; after long-term administration, propofol infusion syndrome can occur. A less common but serious complication is acute pancreatitis. CASE DESCRIPTION: In this report, a 72-year-old male is described who underwent total hip replacement and subsequent revision one year later. On both occasions propofol was administered. Both procedures were complicated by acute pancreatitis. Various known causes for pancreatitis were systematically excluded except for propofol which seemed to have caused both incidents of pancreatitis. However, a multifactorial cause could not be completely ruled out. CONCLUSION: Pancreatitis after propofol administration is a rare complication. This rare complication, however, is likely to become more frequent with increasing demand for propofol use and its administration by different care professionals. In patients who experience abdominal symptoms after propofol administration, pancreatitis should be considered as a possible cause and appropriate diagnostic testing performed.