RESUMO
Infection with severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2/Covid-19) has been correlated with micro and macrovascular thrombosis. Reports have discussed localized thrombosis leading to ischemia, we report a case of diffuse systemic thromboembolism resulting in limb ischemia and organ damage from Covid-19 despite prompt anticoagulation. A 60-year-old unvaccinated male with a history of asthma, diabetes mellitus and coronary artery disease, presented with shortness of breath and right lower extremity pain. The patient was found to be Covid-19 Delta variant positive. CTA and transthoracic echocardiogram showed diffuse thromboembolic disease affecting the left ventricle, right kidney and bilateral lower extremities.
RESUMO
A common origin of the celiac trunk and superior mesenteric artery is exceedingly rare, and aneurysms of this common trunk are even rarer. According to our literature search, there are no reported cases of nutcracker syndrome or phenomenon involving this rare aneurysmal anomaly. Repair of such anomalies is standardly via open surgical approach with few reported cases of endovascular repair. We describe a patient with an aneurysm of the celiomesenteric trunk resulting in nutcracker phenomenon of the left renal vein. The celiomesenteric trunk aneurysm was repaired endovascularly, resulting in decreased surrounding inflammation and improvement of the left renal vein compression.
Assuntos
Aneurisma/complicações , Artéria Celíaca/anormalidades , Artéria Mesentérica Superior/anormalidades , Síndrome do Quebra-Nozes/etiologia , Aneurisma/diagnóstico por imagem , Aneurisma/cirurgia , Artéria Celíaca/diagnóstico por imagem , Artéria Celíaca/cirurgia , Procedimentos Endovasculares/instrumentação , Feminino , Humanos , Artéria Mesentérica Superior/diagnóstico por imagem , Artéria Mesentérica Superior/cirurgia , Pessoa de Meia-Idade , Síndrome do Quebra-Nozes/diagnóstico por imagem , Stents , Resultado do TratamentoRESUMO
We describe a case of nutcracker syndrome in a 35 year-old male that was treated with a left renal vein transposition via an open retroperitoneal approach. Our case highlights some of the advantages of the retroperitoneal approach, which may decrease the risk of postoperative complications when compared to the traditional midline abdominal transperitoneal approach. The patient agreed to publish the case details and images included below.