RESUMO
Patients with atrial fibrillation with contraindications to anticoagulation can undergo left atrial appendage closure with a device. Hours after a 73-year-old man had undergone left atrial appendage closure, he lost perfusion to his lower extremities. Imaging studies showed that the device had migrated to the infrarenal aorta. After right common femoral artery cutdown and sheath placement, the device was retrieved with a balloon embolectomy catheter, and a balloon was simultaneously deployed in the proximal left common femoral artery to prevent device embolization. To the best of our knowledge, this report represents the first documented device retrieval from the aorta using balloon embolectomy and contralateral lower extremity embolic protection.
Assuntos
Traumatismos Abdominais , Doenças da Vesícula Biliar , Traumatismos Torácicos , Ferimentos não Penetrantes , Traumatismos Abdominais/complicações , Traumatismos Abdominais/diagnóstico por imagem , Traumatismos Abdominais/cirurgia , Vesícula Biliar/diagnóstico por imagem , Vesícula Biliar/cirurgia , Humanos , Ferimentos não Penetrantes/complicações , Ferimentos não Penetrantes/diagnóstico por imagemRESUMO
Traumatic rupture of an ovarian endometrioma is extremely rare injury. We describe a case of a 63-year-old female presenting after a motor vehicle crash (MVC) with complex abdominal injuries requiring exploratory laparotomy that was complicated by delayed presentation of an ovarian endometrioma rupture on second look laparotomy. During the repeat exploration of the abdomen, multiple regions of small bowel and the pelvic floor were noted to be covered with a brown-colored material which was concerning for fecal matter from a missed enterotomy. The patient was kept open for an additional 24 h providing time for occult injuries to reveal themselves and for proper mechanical preparation of the rectum to perform rigid sigmoidoscopy, essential to definitively rule out a missed injury in this rare situation.