ABSTRACT
Arterioenteric fistulas (AEFs) are a rare disease. They are a communication between a major artery and digestive tract. We present a patient who, after suffering a gunshot wound to the abdomen, underwent an exploratory laparotomy with damage control surgery, who later presented with hematemesis and melena. Studies were performed where an aneursyma of the right renal artery and gastrointestinal bleeding due to primary arterioenteric fistula were evidenced, which is successfully treated by angioembolization. Endovascular therapy for the treatment of AEF is a useful resource in patients with the previous abdominal surgeries that could make their management more difficult.
Las fístulas arterio-entéricas son un padecimiento infrecuente. Son una comunicación entre una arteria mayor y el tracto digestivo. Paciente masculino quien sufre una herida por arma de fuego en abdomen se le realiza una laparotomía exploradora con cirugía de control de daños, quien posteriormente presenta cuadro de hematemesis y melena. Se realizan estudios donde se evidencia un aneursima de la arteria renal derecha y sangrado de tubo digestivo por fístula arterioentérica primaria, la cual se trata por medio de angioembolización de manera exitosa. La terapia endovascular para el tratamiento de fístula arterio-enterica es un recurso útil en pacientes con cirugías abdominales previas que pudieran hacer más difícil el manejo.
Subject(s)
Endovascular Procedures , Intestinal Fistula , Wounds, Gunshot , Endovascular Procedures/adverse effects , Gastrointestinal Hemorrhage/etiology , Humans , Intestinal Fistula/etiology , Intestinal Fistula/surgery , Wounds, Gunshot/complications , Wounds, Gunshot/surgeryABSTRACT
OBJECTIVE: To assess the Occipital condyle morphology in an all-age population of Northeastern Mexico, and determine age and gender related changes for surgical viability. METHODS: A total of 175 consecutive HRCT scans were included and divided into 5 age groups. The condylar length, width, height, sagittal angle, anterior, posterior and medial intercondylar distances, and intercondylar angle of the OC were measured. RESULTS: Mean condylar length, width, and height in total population were 20.58â¯mm, 9.42â¯mm, and 9.02â¯mm, respectively. Differences were observed in most morphometric parameters when comparing age groups. Significant intergender differences in total population were observed in most parameters, when individualizing each age group the height remained significant in all. The group with the least height measurement was aged 5-9 years, this however, could allow the OC screw (≥6.5â¯mm) placement. CONCLUSION: Differences in most morphometric parameters of OC were observed between age groups and gender, particularly patients with 5-9 years. However, all groups presented a minimum height that allows the placement of a standard screw. A preoperative imaging study is always recommended due to the variability and complexity of the region.