RESUMO
Uterine arteriovenous malformation (UAVM) is uncommon. They are usually acquired, due to previous intra uterine trauma. We report a case of acquired UAVM in a 28-years-old patient after a medical abortion, diagnosed with ultrasonography and successfully managed with uterine artery embolization.
Assuntos
Aborto Induzido/efeitos adversos , Malformações Arteriovenosas/etiologia , Malformações Arteriovenosas/terapia , Embolização da Artéria Uterina , Artéria Uterina/anormalidades , Adulto , Malformações Arteriovenosas/diagnóstico , Feminino , Humanos , Gravidez , Resultado do Tratamento , Artéria Uterina/lesões , Artéria Uterina/patologia , Artéria Uterina/cirurgia , Hemorragia Uterina/diagnóstico , Hemorragia Uterina/etiologia , Hemorragia Uterina/terapia , Útero/irrigação sanguínea , Útero/lesões , Útero/cirurgiaRESUMO
BACKGROUND: The aim of this study was to report through 13 cases the particularities of abdominal computed tomography (CT) aspects of hepatic portal venous gas (HPVG) and its correlation with patient prognosis. METHODS: We analyzed abundance of HPVG and its association with pneumatosis intestinalis (PI) in correlation with fatal outcome using chi-square tests. RESULTS: Etiologies were mesenteric infarction (n=5), sigmoid diverticulitis (n= 1), septic shock (n=1), postoperative peritonitis (n=1), acute pancreatitis (n=1), iatrogenic cause (n=3) and idiopathic after a laparotomy (n=1). The outcome was fatal in for 6 patients. Abundance of HPV was expressed in total number of hepatic segments involved. The involvement of 3 or more segments was a sensitive sign for lethal outcome with high sensitivity (100%) but it was not specific (50%). Negative predictive value of this sign was 100% (p≤0.005). Positive predictive value of PI for death was 100% (p≤0.001). DISCUSSION: Abundance of HPVG is correlated with prognosis. The presence of PI announces poor outcome Negative predictive value of presence of HPVG in 3 or more segments is interesting. Predicting prognosis with CT can help surgeons to assess the most adequate treatment. Iatrogenic causes are increasingly described after interventional radiology procedures with favorable course. CONCLUSION: The first etiology radiologists should look for in front of HPVG involving more than 3 hepatic segments and associated with PI is intestinal necrosis which announces a poor prognosis. This study shows that outside of shock situations, HPVG involving 2 or less hepatic segments without PI predicts a good outcome.
RESUMO
Cervical pregnancy is a rare form of ectopic pregnancy. Its treatment has been described by different authors. We report our successful experience of a cervical twin pregnancy that was diagnosed by transabdominal and transvaginal ultrasound and confirmed by magnetic resonance imaging. To preserve fertility, our patient was treated by a bilateral hyperselective uterine artery embolization followed by dilatation and curettage of the cervical canal without ancillary procedures for cervical hemostasis. Arterial embolization by a resorbable agent reduces arterial circulation by providing a temporary occlusion of the vessels in order to decrease the risk of massive hemorrhage.
Assuntos
Embolia/diagnóstico por imagem , Gravidez Ectópica/diagnóstico por imagem , Aborto Espontâneo/diagnóstico por imagem , Aborto Espontâneo/prevenção & controle , Adulto , Angiografia , Embolia/cirurgia , Feminino , Humanos , Imageamento por Ressonância Magnética/métodos , Gravidez , Gravidez Ectópica/cirurgia , Resultado do Tratamento , UltrassonografiaRESUMO
We report a case of acute pancreatitis caused by a metallic foreign body located in the pancreatic head in a 38-Year-old woman. Only 15 cases of acute pancreatitis due to foreign bodies, metallic in five cases, have been published to date. In our case, diagnosis was established by the computed tomography scan. The patient declined surgery.