RESUMO
The value of visceral arteriography is discussed in relation to four hepatoblastomas, two vascular hamartomas of the liver, one inactive islet cell tumour of the pancreas and two malignant intraperitoneal tumours. Although non-invasive methods, such as computer tomography, sonography and scintigraphy are valuable, angiography is an important part of the pre-operative diagnosis of visceral tumours during childhood.
Assuntos
Neoplasias Hepáticas/diagnóstico por imagem , Neoplasias Pancreáticas/diagnóstico por imagem , Neoplasias Peritoneais/diagnóstico por imagem , Adenoma de Células das Ilhotas Pancreáticas/irrigação sanguínea , Adenoma de Células das Ilhotas Pancreáticas/diagnóstico por imagem , Angiografia , Carcinoma Hepatocelular/irrigação sanguínea , Carcinoma Hepatocelular/diagnóstico por imagem , Criança , Hamartoma/irrigação sanguínea , Hamartoma/diagnóstico por imagem , Humanos , Neoplasias Hepáticas/irrigação sanguínea , Neoplasias Pancreáticas/irrigação sanguínea , Neoplasias Peritoneais/irrigação sanguíneaRESUMO
Varicosities of the renal veins and of the veins of the upper urinary tract may occur with or without haematuria. The urogram may be negative. Frequently, however, there are single or multiple impressions on the ureters as a result of the venous varicosities. Arteriography, which should always be carried out in the presence of undiagnosed haematuria, is unable to demonstrate the venous abnormalities. Since the symptoms are also not characteristic, it is necessary to carry out renal vein pharmaco-phlebography. The clinical features, radiological appearances and aetiology of this rare condition are illustrated by three cases.
Assuntos
Pelve Renal/irrigação sanguínea , Veias Renais/diagnóstico por imagem , Ureter/irrigação sanguínea , Varizes/diagnóstico por imagem , Adulto , Feminino , Humanos , Masculino , Urografia , Varizes/etiologiaRESUMO
A combination of two rare malformations of the lung was observed in a four-year-old asymptomatic boy. He had typical scimitar syndrome (dextrocardia, hypoplastic right lung and right-sided anomalous pulmonary venous drainage into the v. cava inferior) together with horseshoe lung. Diagnosis was established by angiocardiography and computerized tomography. In the absence of recurrent pulmonary infections operative intervention is not necessary with normal pulmonary arterial pressure and resistance. To the best of our knowledge this case with both malformations seems to be the fourth which is reported in the literature.
Assuntos
Pulmão/anormalidades , Artéria Pulmonar/anormalidades , Veias Pulmonares/anormalidades , Angiocardiografia , Pré-Escolar , Humanos , Pulmão/diagnóstico por imagem , Masculino , Artéria Pulmonar/diagnóstico por imagem , Veias Pulmonares/diagnóstico por imagem , Síndrome , Tomografia Computadorizada por Raios XRESUMO
Percutaneous nephropyelostomy has been performed on 24 patients. The method is simple, has few complications and can be performed rapidly; it can be recommended for both temporary and permanent supravesical urinary drainage. It represents an improvement in urologic techniques.
Assuntos
Obstrução Ureteral/terapia , Derivação Urinária/métodos , Idoso , Hematoma/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Fibrose Retroperitoneal/terapia , Cálculos Urinários/terapia , Derivação Urinária/efeitos adversosRESUMO
A strong tendency to symmetrical development of the organ systems manifests itself in the syndrome of Polysplenia. These symmetrical organs show the anatomy of leftsided structures. For this reason the syndrome is also referred to as the "syndrome of bilateral leftsidedness". It encompasses complex abnormalities of situs, typical cardiac and vascular deformities as well as extracardiac malformations. Polysplenia is the leading symptom. Diagnosis is rarely made intra vitam. Certain typical deformities can give hints to this diagnosis, which is finally proved by szintigraphic and arteriographic visualization of multiple spleens. A typical case is reported and subsequently discussed according to the picture of this syndrome in the literature.
Assuntos
Baço/anormalidades , Anormalidades Múltiplas/diagnóstico por imagem , Malformações Arteriovenosas/complicações , Malformações Arteriovenosas/diagnóstico por imagem , Veia Ázigos/anormalidades , Pré-Escolar , Feminino , Cardiopatias Congênitas/complicações , Veias Hepáticas/anormalidades , Humanos , Artéria Pulmonar/anormalidades , Radiografia , Síndrome , Veias Cavas/anormalidadesRESUMO
It is reported on the occlusion of the renal artery with Spongostan in 25 cases of malignant renal tumours. The embolisation takes place immediately after the angiographic diagnosis of the renal tumour, in which case on account of the simplicity of the method every radiologist working in the field of angiography is able to perform the occlusion of the renal artery. It is not difficult to get embolisation material and it is available in nearly every surgical department. In 15 cases the later on performed extracapsular nephrectomy was, compared with the non-embolised kidneys, was facilitated by an edematous marginal zone and diminution and lacking filling of the tumour veins and on account of the smaller loss of blood led to a reduced operation stress of the patient. Apart from this on account of the missing blood supply of the kidney the ligature of the renal vein could be performed at an earlier moment of the operation and thus an intraoperatively haematogenic metastasation could be prevented. In 10 inoperable cases the embolisation was performed for the exclusion of haematuria and in order to stop and to decrease the further growth of the tumour. On account of the simplicity if the method, connected with the advantages resulting from this, the authors would like no more to miss this approach in future.
Assuntos
Embolização Terapêutica/métodos , Neoplasias Renais/terapia , Humanos , Neoplasias Renais/irrigação sanguínea , Metástase Neoplásica , Artéria Renal , Fatores de Tempo , Cateterismo Urinário/métodosRESUMO
In the initial descriptions of the elfin-facies-syndrome by Williams and Beuren, supravalvular aortic stenosis was considered to be a constant feature of the syndrome, combined with retardation of mental and physical development, dentition anomalies and the peculiar face. According to newer findings, the missing of this deformity is no proof against the existence of the above-mentioned syndrome. Usually an elevation of the calcium-level is not found in the serum of these children, although there seems to be some relation to the calcium-metabolism. The characteristic picture of this deformity is demonstrated by two, very typical cases.
Assuntos
Anormalidades Múltiplas/diagnóstico , Cardiopatias Congênitas/diagnóstico , Anormalidades Dentárias , Distúrbios do Metabolismo do Cálcio/diagnóstico , Cardiomiopatia Hipertrófica/diagnóstico , Pré-Escolar , Expressão Facial , Humanos , Deficiência Intelectual/diagnóstico , Masculino , Síndrome , Anormalidades Dentárias/diagnósticoRESUMO
A newborn baby is admitted in the second week of life with osteomyelitis and septicemia due to Staph. aureus infection. In his tenth week of life--the osteomyelitis nearly overcome--the infant shows signs of heart failure with a murmur and cyanosis. Cardiac catheterization reveals tricuspid insufficiency and thrombosis of the right pulmonary artery. Postmortem examination shows isolated polypous endocarditis of the tricuspid valve together with thrombosis of the right and recent embolus of the left pulmonary artery. A similar case has to the best of our knowledge not been described.
Assuntos
Endocardite/etiologia , Infecções Estafilocócicas/complicações , Valva Tricúspide , Humanos , Recém-Nascido , Doenças do Recém-Nascido , Masculino , Osteomielite/microbiologia , Artéria Pulmonar , Sepse/microbiologia , Staphylococcus aureus/isolamento & purificação , Trombose/etiologiaRESUMO
Transposition of the great arteries with horizontal interventricular septum is characterized by a superior-inferior relationship of the ventricular chambers in the presence of ventriculo-arterial discordance. Embryologically this very peculiar anatomy can be explained by a rotation of the bulboventricular loop around a sagittal axis. A typical case is reported. The most important anatomical features are described and the embryologic mechanisms leading to this ventricular arrangement are discussed. The significance of this deformity to nomenclature of congenital heart disease is emphasized.
Assuntos
Defeitos dos Septos Cardíacos , Transposição dos Grandes Vasos/complicações , Angiocardiografia , Cateterismo Cardíaco , Cardiopatias Congênitas/complicações , Cardiopatias Congênitas/diagnóstico , Humanos , Lactente , MasculinoRESUMO
Case report on a 5 years old boy suffering from a congenital arteriovenous fistula of the left internal thoracic artery. At the age of 9 months hypertrophy of the left arm combined with dilated veins in this area developed. Diagnosis was made by clinical examination together with a density in the left upper chest on x-ray and was confirmed by phlebography and thoracic aortography. A dilatation of the left heart, which was marked at the age of 9 months vanished in childhood without any therapy. The child was operated successfully.
Assuntos
Malformações Arteriovenosas/complicações , Artérias Torácicas , Braço , Fístula Arteriovenosa/cirurgia , Cardiomegalia/complicações , Pré-Escolar , Humanos , Hipertrofia/etiologia , Lactente , Masculino , Telangiectasia/etiologiaRESUMO
A case of arteriovenous aneurysm of the great vein of Galen with congestive heart failure in a newborn infant is presented. Efficiancy of medical management and stop of growth of the head circumference point towards a good prognosis. Patients with this malformation have been divided into four clinical groups presenting with different symptoms in different ages. Anatomy, hemodynamics, clinical picture and diagnosis are considered.
Assuntos
Insuficiência Cardíaca/complicações , Malformações Arteriovenosas Intracranianas/diagnóstico , Humanos , Recém-Nascido , Malformações Arteriovenosas Intracranianas/classificação , Malformações Arteriovenosas Intracranianas/complicações , PrognósticoRESUMO
Pulmonary sequestration is a relatively rare condition in which a part of lung tissue has no or only a secondary connection with the tracheobronchial tree. Blood supply comes from the aorta in anomalous branches. Sequestrations may be intra- or extralobar. Gerle et al. include both types in the general term congenital bronchopulmonary foregut malformation. Two surgically confirmed observations of bilateral intralobar pulmonary sequestrations are reported. The clinical features are recurrent respiratory infections with cough, fever and purulent sputum. X-rays only show nonspecific alterations. Chronic changes in the lower lobes should draw attention to pulmonary sequestration. Thoracic aortography is the procedure of choice in establishing the diagnosis and should always be carried out preoperatively. Segmental resection or lobectomy is the indicated treatment.
Assuntos
Sequestro Broncopulmonar/diagnóstico por imagem , Adolescente , Angiografia , Sequestro Broncopulmonar/cirurgia , Criança , Feminino , Hemorragia/complicações , Humanos , Artéria Pulmonar/diagnóstico por imagem , Artéria Pulmonar/cirurgia , Procedimentos Cirúrgicos Vasculares/efeitos adversosRESUMO
Myocardial blood flow in 16 patients before and after coronary bypass surgery in conjunction with coronary angiography, left ventricular function measurement, and graded exercise test. Radioactive 133-Xe was injected into the coronary artery or bypass graft and the washout was recorded by an Anger camera. Myocardial blood flow increased in 11 out of 14 patients and decreased in three patients. The average flow was 55 (plus or minus 6) preoperatively and 96 (plus or minus 10) ml 100 g/min postoperatively. Increase of blood flow occurred in both the bypassed left anterior descending coronary artery (LAD) region and the nonbypassed left circumflex coronary artery (LCIR) region. The postoperative flow increase and the absolute postoperative flow values are higher with saphenous vein than with mammary artery grafts. Statistically significant correlation is not found between myocardial blood flow changes and exerice tolerance. The volume measurements (end diastolic volume, stroke volume, ejection fraction) remained unchanged.