RESUMEN
A patient in her early 20s presented with constant and progressive lower abdominal and back pain, mainly on the right side of the abdomen, purulent vaginal discharge and pyrexia. A radiological assessment revealed a possible tubo-ovarian abscess and the incidental diagnosis of ipsilateral renal agenesis. The patient was treated for pelvic inflammatory disease (PID); however, after antibiotic administration and since the symptoms did not resolve, an abdominal MRI was requested, which revealed uterus didelphys with two cervices, an obstructed haemivagina and evidence of haematocolpos. The diagnosis of Obstructed Hemi-Vagina with Ipsilateral Renal Agenesis (OHVIRA) syndrome was confirmed, and the patient underwent the excision of the vaginal septum, the drainage of the haematopyocolpos and the laparoscopic drainage of the tubo-ovarian abscess. She achieved a good recovery.
RESUMEN
Interventional radiology is a subspecialty of radiology that provides a range of minimally invasive diagnostic and therapeutic procedures. It continues to expand and evolve, and has had a marked impact on clinical care in many settings, in some cases averting the need for major surgery and hospital admission. While its role in the setting of trauma is relatively well established, with arterial embolisation a valuable option in the management of haemodynamically unstable patients, it is less prominent in the elective setting. This article provides an overview of emerging applications of interventional radiology in the elective treatment of orthopaedic conditions.
Asunto(s)
Procedimientos Quirúrgicos Electivos/métodos , Embolización Terapéutica/métodos , Ortopedia/métodos , Radiología Intervencionista/métodos , Lesiones del Sistema Vascular/terapia , Humanos , Lesiones del Sistema Vascular/patologíaRESUMEN
May-Thurner syndrome (MTS) is a rare condition in which patients develop iliofemoral deep venous thrombosis due to an anatomical variant in which the right common iliac artery overlies and compresses the left common iliac vein against the lumbar spine. We report a case of variant MTS, where vascular distortion secondary to spontaneous spinal arthrodesis of degenerative lumbar spondylolisthesis resulted in left common iliac vein compression and iliofemoral deep vein thrombosis. While the common complications of degenerative spondylolisthesis, such as spinal stenosis, are well described; the potential for pelvic vascular distortion secondary to anterior translation of the lumbar spine is not well recognized. The purpose in presenting this case is to describe the mechanism by which this variant of MTS occurs and highlight the need for vigilance for this unusual clinical entity.
Asunto(s)
Dolor Abdominal/etiología , Isquemia/diagnóstico por imagen , Periodo Posprandial , Tomografía Computarizada por Rayos X , Enfermedades Vasculares/diagnóstico por imagen , Anciano de 80 o más Años , Femenino , Humanos , Isquemia/complicaciones , Isquemia Mesentérica , Enfermedades Vasculares/complicacionesAsunto(s)
Aneurisma/cirugía , Aneurisma de la Aorta/cirugía , Procedimientos Endovasculares/métodos , Arteria Femoral , Esponja de Gelatina Absorbible/uso terapéutico , Arteria Ilíaca , Anciano , Anciano de 80 o más Años , Técnicas Hemostáticas/instrumentación , Humanos , Masculino , Punciones , Técnicas de Sutura , Ultrasonografía Intervencional , Procedimientos Quirúrgicos Vasculares/métodosRESUMEN
OBJECTIVES: To outline a range of minimally invasive image-guided procedures that benefit spinal cord-injured patients and may expedite clinical care. STUDY DESIGN: Pictorial review. RESULTS/CONCLUSIONS: Image-guided procedures have made a significant impact in medical management in many specialties. These techniques continue to evolve rapidly and afford opportunities to reduce patient morbidity and in-patient length of stay.
Asunto(s)
Angioplastia de Balón/instrumentación , Arteria Femoral , Técnicas Hemostáticas/instrumentación , Radiografía Intervencional/instrumentación , Adulto , Anciano , Anciano de 80 o más Años , Atención Ambulatoria , Diseño de Equipo , Femenino , Técnicas Hemostáticas/efectos adversos , Humanos , Pierna/irrigación sanguínea , Masculino , Persona de Mediana Edad , Dimensión del Dolor , Estudios Prospectivos , PuncionesRESUMEN
Interventional radiology is continuing to reshape current practice in many specialties of clinical care. It is a relatively new and innovative branch of medicine in which physicians treat diseases non-operatively through small catheters guided to the target by fluoroscopic and other imaging modalities. The aim is to provide image-guided, minimally invasive alternatives to traditional surgical and medical procedures in suitable cohorts of patients. Procedures which previously required major surgery can now be performed by interventional radiologists, sometimes on an outpatient basis, with little patient discomfort. In this review, we highlight the importance of interventional radiology in treating a comprehensive range of obstetric and gynaecological pathologies.
Asunto(s)
Procedimientos Quirúrgicos Ginecológicos/tendencias , Pautas de la Práctica en Medicina/tendencias , Radiografía Intervencional/tendencias , Radiología Intervencionista/tendencias , Femenino , HumanosRESUMEN
The AMPLATZER Vascular Plug (AVP; AGA Medical, USA) is designed to provide optimal embolization of peripheral veins and arteries through single-device occlusion. There are no reported cases of the AVP's being used to prevent bile leak. We report the successful use of the AVP within the liver to prevent intraperitoneal bile leak following inadvertent subcapsular stent deployment.
Asunto(s)
Colestasis Intrahepática/terapia , Embolización Terapéutica/instrumentación , Cuerpos Extraños/etiología , Migración de Cuerpo Extraño/prevención & control , Cuidados Paliativos/métodos , Dispositivo Oclusor Septal , Stents/efectos adversos , Anciano , Neoplasias de los Conductos Biliares/complicaciones , Neoplasias de los Conductos Biliares/terapia , Conductos Biliares Intrahepáticos , Colangiocarcinoma/complicaciones , Colangiocarcinoma/terapia , Colestasis Intrahepática/etiología , Migración de Cuerpo Extraño/etiología , Humanos , Ictericia Obstructiva/etiología , MasculinoRESUMEN
Improvements in Imaging technology have revolutionized liver imaging and allowed the recognition of abnormalities arising from various architectural components such as vessels and biliary ducts of the liver. A spectrum of various hepatic vascular disorders as demonstrated by multidetector CT (MDCT) is presented in this review article.
Asunto(s)
Hepatopatías/diagnóstico por imagen , Tomografía Computarizada por Rayos X , Enfermedades Vasculares/diagnóstico por imagen , Humanos , Hepatopatías/etiología , Hepatopatías/terapia , Valor Predictivo de las Pruebas , Enfermedades Vasculares/etiología , Enfermedades Vasculares/terapiaRESUMEN
Symptomatic obstruction of the superior vena cava is a debilitating and potentially life-threatening condition. Conventional surgery and radiation therapy have a historical role in the management of patients with malignant superior vena cava obstruction. Interventional radiologists can relieve these symptoms rapidly and safely in the vast majority of patients. The technical and clinical success rates are high and compare very favorably with currently available medical and surgical treatments. Although recurrent obstruction may occur, most patients can be treated by re-intervention.
Asunto(s)
Prótesis Vascular/tendencias , Stents/tendencias , Síndrome de la Vena Cava Superior/cirugía , HumanosAsunto(s)
Embolización Terapéutica/instrumentación , Hemorragia Gastrointestinal/etiología , Hemorragia Gastrointestinal/terapia , Arteria Ilíaca , Anciano , Anticoagulantes/administración & dosificación , Medios de Contraste , Extravasación de Materiales Terapéuticos y Diagnósticos , Femenino , Migración de Cuerpo Extraño , Humanos , Relación Normalizada Internacional , Recto , Tomografía Computarizada por Rayos XRESUMEN
The use of closure devices is widespread and becoming more common. Radiologists performing arterial access procedures should be aware of when and how to use them, as well as the advantages and disadvantages of various devices, and any complications that may occur. This review intends to provide an overview of these devices, focusing on how they work, their efficacy in achieving hemostasis, any risks associated with their use, and our view as to which should be used for particular indications. There are three main categories of vascular closure devices: collagen based, suture based, and staples and clips. Newer generation devices use the same technique of closure and there are some that utilize newer techniques. Vascular closure devices have been demonstrated to reduce time to hemostasis, facilitate ambulation, and potentially decrease length of stay. The choice of a device would depend on the availability of that particular device, operator preference, anticipation of repeat arterial access, and size of the arteriotomy hole.
Asunto(s)
Arterias/cirugía , Hemostasis Quirúrgica/instrumentación , Hemorragia Posoperatoria/prevención & control , Instrumentos Quirúrgicos , Procedimientos Quirúrgicos Vasculares/instrumentación , Materiales Biocompatibles , Colágeno , Diseño de Equipo , Humanos , SuturasRESUMEN
Chronic pelvic pain (CPP) is a common cause of gynecologic referral. Pelvic congestion syndrome, which is said to occurs due to ovarian vein incompetence, is a recognized cause of CPP. The aim of this paper is to briefly describe the clinical manifestations, and to review the role of diagnostic and interventional radiology in the management of this probably under-diagnosed condition.
Asunto(s)
Diagnóstico por Imagen , Ovario/irrigación sanguínea , Dolor Pélvico/diagnóstico , Dolor Pélvico/etiología , Pelvis/irrigación sanguínea , Várices/complicaciones , Várices/diagnóstico , Enfermedad Crónica , Embolización Terapéutica , Femenino , Humanos , Imagen por Resonancia Magnética Intervencional , Dolor Pélvico/terapia , Radiografía Intervencional , Síndrome , Ultrasonografía Intervencional , Várices/terapiaRESUMEN
OBJECTIVE: The objectives of our study were to review the appearances on diagnostic imaging and amenability to imaging-guided intervention of a novel bovine ureter graft (Syner-Graft 100 [SG 100]) for use as a conduit for hemodialysis fistulas. CONCLUSION: The SG 100 shows initial promise as a conduit for hemodialysis fistulas in patients with difficult vascular access. The SG 100 has characteristic appearances on diagnostic imaging and is prone to similar pathologic processes that affect autogenous venous and synthetic grafts. These grafts are readily amenable to imaging-guided percutaneous intervention, which plays a major role in prolonging graft function.
Asunto(s)
Derivación Arteriovenosa Quirúrgica/instrumentación , Bioprótesis , Diálisis Renal/instrumentación , Uréter/diagnóstico por imagen , Uréter/trasplante , Grado de Desobstrucción Vascular , Animales , Bovinos , Análisis de Falla de Equipo , Humanos , Diseño de Prótesis , Radiografía Intervencional/métodos , Diálisis Renal/métodosRESUMEN
Central venous access plays an important role in the management of an ever-increasing population of patients ranging from those that are critically ill to patients with difficult clinical access. Interventional radiologists are key in delivering this service and should be familiar with the wide range of techniques and catheters now available to them. A comprehensive description of these catheters with regard to indications, technical aspects of catheterization, success rates, and associated early and late complications, as well as a review of various published guidelines on central venous catheter insertion are given in this article.
Asunto(s)
Cateterismo Venoso Central , Cateterismo/clasificación , Cateterismo/instrumentación , Cateterismo/normas , Cateterismo Venoso Central/efectos adversos , Cateterismo Venoso Central/instrumentación , Cateterismo Venoso Central/tendencias , Humanos , Radiología Intervencionista/métodosRESUMEN
OBJECTIVE: Our objective was to determine the MDCT appearance of gastrointestinal stromal tumors (GISTs) after treatment with imatinib mesylate. CONCLUSION: Cystic changes within primary and metastatic GISTs seen on MDCT in patients after imatinib mesylate therapy are evidence of disease response. Calcification may also occur in lesions that respond to therapy.