Prostaglandin E1 for alleviating symptoms of ergot intoxication: a case report.

A woman was admitted after ergotamine tartrate overuse for migraine headaches and her symptoms of arterial vasospasm were treated with PGE1, the first reported use of the vasodilator for ergot intoxication. The advantages of producing local vasodilatation without systemic effect, as well as inhibiting the formation of arterial microthrombi, suggest PGE1 as the agent of choice for relief of symptoms due to peripheral vasoconstriction caused by ergot. Treatment with PGE1 may allow sufficient collateral to preserve limb function and integrity, while awaiting remission of anatomic changes after withdrawal of ergot.

Prostaglandin E1 in hand angiography.

Prostaglandin E1 (PGE1) is a rapid, potent vasodilator which, when infused into the arterial system in low doses by bolus injection, has no significant systemic effects and has a relatively long duration of action. Sixty-three hand angiograms were done on 55 patients, comparing PGE1 to tolazoline and to angiograms done with no vasodilation. There was no significant difference between PGE1 and tolazoline in digital artery opacification; however, venous opacification was very significantly better with PGE1. PGE1 should be a drug of choice in hand angiography.

Current experience with digital subtraction angiography in the community medical center.

At the community medical center, we have introduced and successfully applied digital subtraction angiography (DSA) to disease processes seen in 1,144 patients. Although there is a trade-off between increased contrast resolution and decreased spatial resolution with the DSA approach, nonetheless in many vascular beds it provides rapid, safe, and accurate disease diagnosis.

Traumatic arteriovenous fistula of the superior mesenteric vessels.

A case of traumatic arteriovenous fistula of the superior mesenteric vessels is added to a collective review of 16 previous cases. Nausea, vomiting, cramping abdominal pain, diarrhea, abdominal thrill and bruit were usually present. Arteriography was diagnostic. Four patients operated upon immediately or within 11 hours after penetrating abdominal trauma had superior mesenteric arteriovenous injuries repaired; the remainder had a mesenteric vascular injury missed at initial laparotomy. The location of the fistula determined the method of repair. Spontaneous obliteration occurred in one patient. In two of the three deaths, portal hypertension was persent and a fistula was discovered at autopsy; the other occurred 3 months after massive bowel resection. Thorough exploration of hematomas and lacerations of the mesentery will minimize or eliminate subsequent formation of an arteriovenous fistula.