Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 5.215
Filtrar
6.
Medicina (Kaunas) ; 58(5)2022 Apr 21.
Artigo em Inglês | MEDLINE | ID: mdl-35629985

RESUMO

Pseudoaneurysm is a rare complication of laparoscopic cholecystectomy (LC). In most cases, the patient presents with gastrointestinal bleeding or hemoperitoneum. Here, we present a case with a post-cholecystectomy right hepatic artery pseudoaneurysm (PSA) induced by a generalized seizure. A 39-year-old male was sent to the emergency room with a generalized seizure and a loss of consciousness for approximately 5 min. Diffuse abdominal pain was complained of after consciousness returned. The surgical history of LC 13 days prior was mentioned. Abdominal computer tomography (CT) revealed a lobulated fluid accumulation in the gallbladder fossa with prominent fatty stranding and suspected biloma formation. After admission for one week, sharp abdominal pain was observed. Abdominal CT angiography revealed a right hepatic artery pseudoaneurysm. Transcatheter arterial embolization was performed with a total of seven platinum coils. In conclusion, it is important for doctors to take pseudoaneurysm into consideration in the patient who presents with seizure attack after receiving LC. Late discovery of PSA when it is ruptured can lead to fatal conditions, such as severe hemoperitoneum.


Assuntos
Falso Aneurisma , Hemobilia , Dor Abdominal , Adulto , Falso Aneurisma/etiologia , Colecistectomia , Hemobilia/complicações , Hemoperitônio/complicações , Artéria Hepática , Humanos , Masculino , Convulsões/etiologia
7.
Acta Biomed ; 93(S1): e2022080, 2022 04 14.
Artigo em Inglês | MEDLINE | ID: mdl-35420596

RESUMO

True and false aneurysms (FA) of the subclavian artery are at high risk of rupture due to their localization and proximity/closeness to the articular bone structures of the upper thoracic outlet and shoulders. Surgical and endovascular treatments are good options to avoid complications such as aneurysms rupture, thrombosis and distal embolism alone or in combination. Self-expandable (SE) covered stents are the most used devices for the treatment of subclavian artery aneurysms. We report on a case of post traumatic left intra-thoracic subclavian artery FA treated using endovascular technique, highlighting the usefulness of the new covered Gore Viabahn VBX-BE stent-graft that combines the advantages of a high radial strength of a BE stent with the deliverability and conformability of a SE stent.


Assuntos
Falso Aneurisma , Aneurisma , Implante de Prótese Vascular , Procedimentos Endovasculares , Aneurisma/diagnóstico por imagem , Aneurisma/etiologia , Aneurisma/cirurgia , Falso Aneurisma/diagnóstico por imagem , Falso Aneurisma/etiologia , Falso Aneurisma/cirurgia , Prótese Vascular , Humanos , Desenho de Prótese , Stents , Artéria Subclávia/diagnóstico por imagem , Artéria Subclávia/cirurgia , Resultado do Tratamento
8.
Toxins (Basel) ; 14(4)2022 04 06.
Artigo em Inglês | MEDLINE | ID: mdl-35448869

RESUMO

Russell's viper (Daboia russelii), one of the 'Big Four' venomous snakes in India, is responsible for the majority of snakebite-induced deaths and permanent disabilities. Russell's viper bites are known to induce bleeding/clotting abnormalities, as well as myotoxic, nephrotoxic, cytotoxic and neurotoxic envenomation effects. In addition, they have been reported to induce rare envenomation effects such as priapism, sialolithiasis and splenic rupture. However, Russell's viper bite-induced pseudoaneurysm (PA) has not been previously reported. PA or false aneurysm is a rare phenomenon that occurs in arteries following traumatic injuries including some animal bites, and it can become a life-threatening condition if not treated promptly. Here, we document two clinical cases of Russell's viper bites where PA has developed, despite antivenom treatment. Notably, a non-surgical procedure, ultrasound-guided compression (USGC), either alone, or in combination with thrombin was effectively used in both the cases to treat the PA. Following this procedure and additional measures, the patients made complete recoveries without the recurrence of PA which were confirmed by subsequent examination and ultrasound scans. These data demonstrate the development of PA as a rare complication following Russell's viper bites and the effective use of a simple, non-surgical procedure, USGC for the successful treatment of PA. These results will create awareness among healthcare professionals on the development of PA and the use of USGC in snakebite victims following bites from Russell's vipers, as well as other viper bites.


Assuntos
Falso Aneurisma , Síndromes Neurotóxicas , Víbora de Russell , Mordeduras de Serpentes , Falso Aneurisma/diagnóstico por imagem , Falso Aneurisma/etiologia , Falso Aneurisma/terapia , Animais , Antivenenos/uso terapêutico , Humanos , Masculino , Síndromes Neurotóxicas/tratamento farmacológico , Mordeduras de Serpentes/complicações , Mordeduras de Serpentes/diagnóstico , Mordeduras de Serpentes/terapia , Ultrassonografia de Intervenção , Venenos de Víboras/uso terapêutico
9.
J Card Surg ; 37(7): 2138-2141, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-35397124

RESUMO

BACKGROUND: Abscess of the mitral-aortic intervalvular fibrosa (MAIVF) is a rare occurrence, with its most frequently described causative associations being active or prior endocarditis, prosthetic valves, or native valves with anomalies. We report a case of infective endocarditis (IE) complicated by an abscess of the MAIVF without valvular involvement. This case highlights the importance of this rare clinical entity and of the multimodality imaging approach in reaching an accurate diagnosis and differential diagnosis. METHODS AND RESULTS: A 35-year-old male presented with fatigue and intermittent high-grade fever for a 2-week duration. IE was suspected based on a clinical exam. Transthoracic echocardiography (TTE) demonstrated heterogeneous mass with a size of about 2.9 cm × 2.3 cm coming from the MAIVF, mimicking an intracardiac mass. Color Doppler flow Imaging showed the mass without communication with the surrounding cardiovascular cavities. Cardiac computed tomography angiography (CCTA) revealed a large low-density mass without any enhancement, which was situated adjacent to the left ventricular tract with a severely compressed left atrial chamber. The patient underwent cardiac mass removal under extracorporeal circulation. During the procedure, a large abscess was found to be located in MAIVF. The postoperative course was uneventful. DISCUSSION: The abscess of MAIVF is a rare entity with a high risk of developing the pseudoaneurysm of MAIVF (p-MAIVF). The periaortic spread of the abscess is a dynamic process in which the inflammation of the deep tissue causes, in the first stage, a MAIVF thickening, which eventually progresses with the formation of an abscess, and subsequently, a pseudoaneurysm. Complications of p-MAIVF include rupture into the left atrium, aorta, or pericardial space leading to hemopericardium, tamponade, and death. The major differential diagnosis for abscess of MAIVF includes p-MAIVF an intracardiac mass. TTE plays a key role in the diagnosis and differential diagnosis of abscesses of MAIVF. CCTA can be a useful adjunct to further characterize abscess spread, three-dimensional spatial relationships with other cardiac structures for preoperative planning, as well as in the evaluation of potential complications such as coronary artery compromise and communication with the aorta, left atrium, or pericardial space. Surgical management is recommended in complicated, symptomatic patients to prevent further expansion of abscesses or pseudoaneurysms. CONCLUSION: The abscess of MAIVF is a rare complication of endocarditis and surgical trauma in the MAIVF area, TTE remains a first-line imaging modality for clinically suspected periaortic abscess or other IE complications. CCTA has a complementary role to echocardiography in identification, characterization, and preoperative planning.


Assuntos
Falso Aneurisma , Endocardite Bacteriana , Endocardite , Abscesso/diagnóstico por imagem , Adulto , Falso Aneurisma/diagnóstico por imagem , Falso Aneurisma/etiologia , Aorta , Valva Aórtica/diagnóstico por imagem , Valva Aórtica/cirurgia , Endocardite/complicações , Endocardite/diagnóstico por imagem , Endocardite Bacteriana/complicações , Humanos , Masculino , Valva Mitral/diagnóstico por imagem , Valva Mitral/cirurgia
11.
J Card Surg ; 37(7): 2155-2158, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-35485714

RESUMO

BACKGROUND: Left ventricular outflow tract pseudoaneurysm is a rare but potentially fatal complication of aortic valve replacement, infective endocarditis (IE), and suture dehiscence. Left ventricular-aortic discontinuity is a severe and uncommon manifestation of IE. For patients who have a long-standing history of endocarditis, periannular lesions in the aortic valve may rupture, leading to the rare occurrence of complete, or total, left ventricular-aortic discontinuity. METHODS: We present a case of complete postoperative left ventricular-aortic discontinuity and massive circumferential left ventricular outflow tract pseudoaneurysm discovered during a 3-month follow-up visit. Appropriate consent was obtained from all parties before submission of this case report. RESULTS: Postoperative cardiac computed tomography of a patient demonstrated dehiscence of a recently placed surgical aortic valve from the left ventricular outflow tract, with massive circumferential pseudoaneurysm formation. Only a small remnant of the membranous interventricular septum connected the aortic root to the heart, informing the diagnosis of complete left ventricular-aortic discontinuity. CONCLUSION: The clinical presentation of a left ventricular outflow tract pseudoaneurysm with concomitant left ventricular-aortic discontinuity is commonly nonspecific or clinically silent; thus, it requires a high index of suspicion and use of multimodality imaging for diagnosis and management.


Assuntos
Falso Aneurisma , Endocardite Bacteriana , Endocardite , Implante de Prótese de Valva Cardíaca , Próteses Valvulares Cardíacas , Falso Aneurisma/diagnóstico por imagem , Falso Aneurisma/etiologia , Falso Aneurisma/cirurgia , Valva Aórtica/diagnóstico por imagem , Valva Aórtica/cirurgia , Endocardite/cirurgia , Endocardite Bacteriana/cirurgia , Próteses Valvulares Cardíacas/efeitos adversos , Implante de Prótese de Valva Cardíaca/efeitos adversos , Humanos
12.
J Cardiothorac Surg ; 17(1): 87, 2022 Apr 27.
Artigo em Inglês | MEDLINE | ID: mdl-35477517

RESUMO

BACKGROUND: Percutaneous vascular interventions are performed for the treatment of haemoptysis and involve embolization of bronchial arteries, pulmonary arteries and pulmonary arteriovenous malformations. There are isolated reports of embolization of pseudoaneurysms forming in the pulmonary vasculature. The migration of components of the coils used in the embolization of vascular pulmonary pathologies is rare. CASE PRESENTATION: A 46-year-old man presented to the emergency department with cough, haemoptysis, and expectoration of lengths of metal wire. He had an episode of coughing out a wire about a year prior to his admission to our hospital, which he attributed to be present in the can of coke he had consumed at that time and did not report it to the doctors. His past medical history was significant for stab injury to the right chest 17 years ago, for which he underwent right thoracotomy and exploration for bleeding. Injury to the lung parenchyma was noted and repair was performed by suturing the defect. Post operatively the CT scan demonstrated development of pulmonary artery pseudoaneurysm. We report a case of a patient expectorating coils 17 years after embolization of this traumatic pulmonary artery pseudoaneurysm. Radiological imaging demonstrated coils in the perihilar area of the lung parenchyma and in the tracheobronchial lumen. Operative intervention was used to remove the coils. CONCLUSIONS: Although percutaneous catheter based vascular interventions have emerged as safe and effective procedures, the long-term complications such as coil migration, recanalization and need for further embolization ought to be considered and patients need to be counselled and followed-up accordingly. To the best of our knowledge, this is the first case of migrated coil post embolization of post-traumatic pulmonary artery pseudoaneurysm. Ultimately, the management of endobronchial coil migration post embolization, be it surgical or bronchoscopic, should be decided on a case-by-case basis, considering the patient's symptoms and the risk fatal complications.


Assuntos
Falso Aneurisma , Embolização Terapêutica , Falso Aneurisma/diagnóstico por imagem , Falso Aneurisma/etiologia , Falso Aneurisma/terapia , Embolização Terapêutica/métodos , Hemoptise/etiologia , Humanos , Pulmão , Masculino , Pessoa de Meia-Idade , Artéria Pulmonar/anormalidades , Artéria Pulmonar/diagnóstico por imagem , Artéria Pulmonar/cirurgia
13.
J Cardiothorac Surg ; 17(1): 83, 2022 Apr 27.
Artigo em Inglês | MEDLINE | ID: mdl-35477534

RESUMO

BACKGROUND: Pseudoaneurysm with a shunt to the right ventricle after aortic repair for acute aortic dissection is an extremely rare and life-threatening condition. Surgical treatment is unavoidable, but surgery is complicated, and there are some pitfalls. This study describes the reoperation performed in a patient at a high surgical risk by clarifying the shunt site using multimodality imaging before surgery. CASE PRESENTATION: A 69-year-old woman with a history of systemic lupus erythematosus (SLE) and Sjogren's syndrome presented with a pseudoaneurysm 1 year after emergency surgery for acute type A aortic dissection. Eight years after the first surgery, she experienced sudden chest pain and presented to the emergency department. Her dyspnea worsened; therefore, echocardiography and three-dimensional computed tomography (3DCT) were performed, and a pseudoaneurysm and shunt to the right ventricle were identified. The medical team attempted to close the shunt with a percutaneous catheter but was unsuccessful, and she was referred to our department for surgical treatment. The pseudoaneurysm originating from the proximal side of the aorta was large (diameter = 55 mm), and echocardiography-gated 3DCT identified the shunt from the pseudoaneurysm to the right ventricle. First, extracorporeal circulation was initiated, and resternotomy was performed. We could not insert the left ventricular venting tube from the right side because of the pseudoaneurysm size. Instead, the tube was inserted from the left atrial appendage. We found a half-circumferential disengaged anastomosis around the proximal anastomosis, which formed the large pseudoaneurysm leading to a fistula in the right ventricle. We closed the fistula and performed a Bentall operation. The patient had a good postoperative course and was discharged on postoperative day 21. She continued treatment for SLE and Sjogren's syndrome, and her inflammatory reaction improved. CONCLUSIONS: We performed a Bentall operation and fistula closure with resternotomy in a patient with type A aortic dissection with SLE and Sjogren's syndrome. Multimodal imaging is essential in defining the pseudoaneurysm and the fistula surrounding the anatomy while ensuring their resolution and guiding the approach for operation.


Assuntos
Aneurisma Dissecante , Falso Aneurisma , Fístula , Lúpus Eritematoso Sistêmico , Síndrome de Sjogren , Idoso , Aneurisma Dissecante/complicações , Aneurisma Dissecante/cirurgia , Falso Aneurisma/diagnóstico por imagem , Falso Aneurisma/etiologia , Falso Aneurisma/cirurgia , Feminino , Fístula/complicações , Ventrículos do Coração/cirurgia , Humanos , Lúpus Eritematoso Sistêmico/complicações , Síndrome de Sjogren/complicações
14.
Heart Surg Forum ; 25(2): E297-E299, 2022 Apr 22.
Artigo em Inglês | MEDLINE | ID: mdl-35486052

RESUMO

Coronary artery pseudoaneurysms are extremely rare and most often occur after trauma or endovascular procedures [Aoki 2008; Kar 2017]. Delay in diagnosis or treatment may lead to coronary thrombosis with resultant ischemia or hemorrhage subsequent tamponade. Here, we present the case of a 66-year-old female who developed a coronary artery pseudoaneurysm of a non-grafted vessel three weeks after coronary artery bypass grafting. To avoid re-sternotomy, the pseudoaneurysm was successfully managed with a covered coronary stent and mini-left anterior thoracotomy to evacuate the hemopericardium and relieve tamponade.


Assuntos
Falso Aneurisma , Vasos Coronários , Idoso , Falso Aneurisma/diagnóstico , Falso Aneurisma/etiologia , Falso Aneurisma/cirurgia , Ponte de Artéria Coronária/efeitos adversos , Ponte de Artéria Coronária/métodos , Vasos Coronários/diagnóstico por imagem , Vasos Coronários/cirurgia , Feminino , Humanos , Stents , Esternotomia
15.
Cir Pediatr ; 35(2): 80-84, 2022 Apr 01.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-35485756

RESUMO

INTRODUCTION: Splenic and hepatic pseudoaneurysm (PA) is a rare arteriovenous injury that may occur following abdominal trauma. The most frequent complication of PA is late rupture, which can lead to hemodynamic instability. The objective of this study was to describe our experience in the management of visceral PA. MATERIAL AND METHODS: A retrospective study of patients under 15 years of age with blunt abdominal trauma associated with splenic and/or hepatic injury treated from 2012 to 2020 was carried out. PA formation and management were analyzed. All patients underwent CT-scan, which allowed trauma grade to be established, and also control contrast-enhanced ultrasonography (CEUS) in the first week following trauma. If PA was confirmed, angiography ± percutaneous embolization were performed. RESULTS: A total of 32 patients with blunt trauma were included. Mean age was 8.7 ± 3.2 years (2-15 years). 68.7% (n = 22) of patients were male. Median trauma grade was grade III (grades II-IV). 33.3% (n = 5/15) of patients developed splenic PA, and 5.8% (n = 1/17) of patients developed hepatic PA, with mean diagnostic time being 3.7 ± 3 (3-8) days. PA formation was associated with higher severity scores, with a mean difference of 15.6 ± 5.3 (95% CI: 4.37:26.14 p < 0.008). All PA cases - except for one, which required urgent splenectomy - were treated with embolization (85.7%) (n = 5/6). CONCLUSION: Visceral PA is underdiagnosed, with an incidence higher than reported. Imaging studies (CEUS) are required prior to discharge in the presence of severe trauma. Treatment remains controversial, but we recommend percutaneous embolization, with splenectomy being reserved for unstable patients.


INTRODUCCION: Los pseudoaneurismas (PA) esplénicos y hepáticos son lesiones arteriovenosas raras que se pueden desarrollar tras un traumatismo abdominal. La rotura tardía es su complicación más frecuente que puede conducir a inestabilidad hemodinámica. El objetivo del presente es presentar nuestra experiencia en el manejo de los PA viscerales. METODOLOGIA: Estudio retrospectivo en pacientes menores de 15 años con traumatismo abdominal cerrado con lesión esplénica y/o hepática, entre 2012-2020. Se analizó el desarrollo de PA y el manejo realizado. En todos los pacientes se realizó tomografía computarizada estableciendo el grado del traumatismo, y estudio control en la primera semana postratumatismo mediante ecografía con contraste (CEUS). Si se confirmaba un PA se procedió a angiograma ± embolización percutánea. RESULTADOS: Un total de 32 pacientes con traumatismo cerrado, edad media 8,7 ± 3,2 años (2-15 años), 68,7% (n = 22) hombres y mediana de grado de traumatismo grado III (grado II-IV), 33,3% (n = 5/15) desarrollaron un PA esplénico y 5,8% (n = 1/17) desarrollaron un PA hepático con tiempo diagnóstico medio de 3,7 ± 3 (3-8) días. El desarrollo de PA se asoció a mayor puntuación en el índice de severidad con una diferencia de medias de 15,6 ± 5,3 (CI 95% 4,37:26,14 p < 0,008). Todos los PA se trataron mediante embolización un 85,7% (n = 5/6) excepto una esplenectomía urgente. CONCLUSION: Los PA viscerales están infradiagnosticados, con una incidencia mayor a la reportada. Consideramos que un estudio de imagen (CEUS) debe ser realizado previo al alta en los traumatismos severos. El tratamiento sigue siendo controversial: sin embargo, recomendamos la embolización percutánea reservando la esplenectomía para paciente inestables.


Assuntos
Traumatismos Abdominais , Falso Aneurisma , Ferimentos não Penetrantes , Traumatismos Abdominais/complicações , Traumatismos Abdominais/diagnóstico por imagem , Traumatismos Abdominais/terapia , Falso Aneurisma/diagnóstico por imagem , Falso Aneurisma/etiologia , Falso Aneurisma/terapia , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Estudos Retrospectivos , Baço/diagnóstico por imagem , Baço/lesões , Ferimentos não Penetrantes/complicações , Ferimentos não Penetrantes/diagnóstico por imagem , Ferimentos não Penetrantes/terapia
17.
Rev Med Liege ; 77(4): 199-201, 2022 Apr.
Artigo em Francês | MEDLINE | ID: mdl-35389001

RESUMO

Arterial aneurysms of visceral branches are rare, even more if they occur on the superior mesenteric artery and its branches (among which ileal branches). Rupture is its major complication, thus rapid treatment is mandatory. CT angiography is the gold standard for diagnosis and therapeutic planification. Usual treatment is surgical, even though percutaneous embolization can be safely and precisely performed. Use of coils with sandwich technique is preferred.


Les anévrysmes artériels viscéraux sont rares, d'autant plus s'ils se situent au niveau du réseau artériel mésentérique supérieur et de ses branches (dont les artères iléales). Le risque principal est leur rupture, raison pour laquelle une prise en charge rapide est nécessaire. L'angioscanner abdomino-pelvien constitue le gold standard, permettant diagnostic et planification thérapeutique. Le traitement habituel est chirurgical, cependant, la technique percutanée endovasculaire peut être réalisée de façon sûre et efficace. L'utilisation de coils avec embolisation en «sandwich¼ de l'anévrysme est préférée.


Assuntos
Falso Aneurisma , Aneurisma , Embolização Terapêutica , Aneurisma/diagnóstico , Falso Aneurisma/diagnóstico por imagem , Falso Aneurisma/etiologia , Embolização Terapêutica/métodos , Humanos , Artéria Mesentérica Superior/diagnóstico por imagem , Artéria Mesentérica Superior/cirurgia , Resultado do Tratamento
19.
Am J Otolaryngol ; 43(3): 103444, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35428534

RESUMO

Tonsillectomy is one of the most common procedures performed by Otolaryngologists. Hemorrhage is the most common complication. Iatrogenic hemorrhage resulting from pseudoaneurysm of the facial artery is rare. In this video, a case of a 30-year-old male who presented with recurrent hemorrhage from an iatrogenic pseudoaneurysm arising from the left facial artery 22 days after undergoing tonsillectomy is described. Treatment options and warning sign of iatrogenic pseudoaneurysms are discussed.


Assuntos
Falso Aneurisma , Embolização Terapêutica , Adulto , Falso Aneurisma/diagnóstico por imagem , Falso Aneurisma/etiologia , Falso Aneurisma/cirurgia , Artérias , Embolização Terapêutica/métodos , Hemorragia/terapia , Humanos , Doença Iatrogênica , Masculino
20.
Neurol India ; 70(1): 345-347, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35263910

RESUMO

Traumatic Pseudoaneurysm of Superficial temporal artery (STA) is an uncommon entity. Surgical management is the treatment of choice, and endovascular management is also equally feasible particularly for the proximal STA aneurysm. The manual compression for the treatment of STA aneurysm is also described, but it has a high chance of failure. We report a case of traumatic pseudoaneurysm of STA in a pregnant female, successfully treated with a modified manual compression technique.


Assuntos
Falso Aneurisma , Artérias Temporais , Falso Aneurisma/diagnóstico por imagem , Falso Aneurisma/etiologia , Falso Aneurisma/cirurgia , Feminino , Humanos , Artérias Temporais/cirurgia
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...