1/3. Therapeutic embolisation for postoperative haemorrhage after total arthroplasty of the hip and knee.We describe three cases of postoperative haemorrhage, two after total hip and one after total knee replacement, treated by percutaneous embolisation. After diagnostic angiography, this is the preferred method for the treatment of postoperative haemorrhage due to the formation of a false aneurysm, after hip or knee arthroplasty. This procedure, carried out under local anaesthesia, has a low rate of complications and avoids the uncertainty of further surgical exploration.- - - - - - - - - - ranking = 1keywords = anaesthesia (Clic here for more details about this article) |
2/3. Traumatic aneurysm of the internal carotid artery in an infant: a surprise diagnosis.Isolated aneurysm of the extracranial section of the internal carotid artery has been reported in children but never, to our knowledge, in an infant. It can represent a major anaesthetic challenge with compromise of both airway and cerebral perfusion and the associated risks of rupture. We report on an 11-month-old infant, who had undergone an examination under anaesthesia of her nose and throat for epistaxis and gastrointestinal endoscopy due to apparent gastrointestinal bleeding shortly before presenting to us with signs of rapidly progressive upper airway obstruction. Emergency examination under anaesthesia revealed a large pulsatile mass in the posterior nasopharynx which, on subsequent radiological investigation, was revealed to be a large pseudoaneurysm of the right internal carotid artery, obstructing distal flow. An apparently minor episode of trauma had occurred around the time of the first nosebleed; she had allegedly fallen onto her face with a spoon in her mouth.- - - - - - - - - - ranking = 2keywords = anaesthesia (Clic here for more details about this article) |
3/3. Infected false aneurysm after puncture of an aneurysm of the deep femoral artery.Pseudoaneurysm of the femoral artery is a well known complication after diagnostic and therapeutic catheterisation. We report a case of voluminous postcatheterisation false aneurysm, which developed on a pre-existing deep femoral artery aneurysm. infection by staphylococcus aureus was demonstrated. After surgical exploration, rupture and external haemorrhage occurred before reconstructive surgery was possible. Due to the septic conditions only a lateral aneurysmorraphy was performed. Postoperative angiogram showed an acceptable result. An aneurysm of the deep femoral artery was also demonstrated on the contralateral side. This was scheduled for elective surgery. In conclusion, this complication could have been avoided by accurate puncture technique. Surgical exploration under local anaesthesia is ill-advised. Especially in patients with advanced vascular disease, non-invasive studies of the puncture site is recommended.- - - - - - - - - - ranking = 1keywords = anaesthesia (Clic here for more details about this article) |