1/37. Pseudoaneurysm of the left ventricle progressing from a subepicardial aneurysm.A 56-year-old man presented with an inferior myocardial infarction and a huge pseudoaneurysm below the inferior surface of the left ventricle, which had progressed from a small subepicardial aneurysm over a 6-month period. Transthoracic echocardiography, doppler color flow images, radionuclide angiocardiography, magnetic resonance imaging and contrast ventriculography all revealed an abrupt disruption of the myocardium at the neck of the pseudoaneurysm, where the diameter of the orifice was smaller than the aneurysm itself, and abnormal blood flows from the left ventricle to the cavity through the orifice with an expansion of the cavity in systole and from the cavity to the left ventricle with the deflation of the cavity in diastole. coronary angiography revealed 99% stenosis at the atrioventricular nodal branch of the right coronary artery. At surgery the pericardium was adherent to the aneurysmal wall and a 1.5-cm orifice between the aneurysm and the left ventricle was seen. Pathological examination revealed no myocardial elements in the aneurysmal wall. The orifice was closed and the postoperative course was uneventful. Over-intense physical activity as a construction worker was considered to be the cause of the large pseudoaneurysm developing from the subepicardial aneurysm. These findings indicate that a subepicardial aneurysm may progress to a larger pseudoaneurysm, which has a propensity to rupture, however, it can be surgically repaired.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
2/37. aorta-cutaneous fistula as a rare complication of localized chronic mediastinitis.A 35-year-old man was admitted 5 years after congenital heart surgery complicated by staphylococcus aureus and a cutaneous fistula located at the left fourth intercostal space. He was febrile (40 degrees C), suffering from sternal pain and suppuration from the old fistula. During examination arterial blood suddenly discharged from the fistula, so that surgery was immediately instituted. An infected Dacron tube implanting on the ascending aorta for a central aorto-pulmonary shunt was at the origin of a false aneurysm: this had led to the repeat formation of an aorta-cutaneous fistula and outbreak of external bleeding.- - - - - - - - - - ranking = 0.74895944515172keywords = suffering (Clic here for more details about this article) |
3/37. Iatrogenic pseudoaneurysm in the upper arm: treatment by transcatheter embolization.A 32-year-old woman presented with a pulsatile, painful mass in her left upper arm, originating several days after removal of an Ilizarov external fixation. The diagnosis of a pseudoaneurysm was made by medical history and by physical and ultrasonographic examination of the mass. Angiography confirmed the presence of the pseudoaneurysm, originating from a branch of the arteria profunda brachii, and definitive treatment was performed by transcatheter embolization. Clinical follow-up showed absence of pulsation and pain in the upper arm and a gradual volume decrease of the mass lesion.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
4/37. Traumatic pseudoaneurysm of the brachial artery.Detection and treatment of vascular injuries in extremity and pelvic trauma can be challenging. Angiography, while no longer routinely used in asymptomatic patients, is still a primary means of diagnosis. Appropriate patient selection based on physical examination, along with other less invasive imaging modalities, can decrease the need for angiography while still detecting the vast majority of clinically significant injuries. Angiography also plays a definitive therapeutic role in most cases of significant hemorrhage in the pelvis through precise identification and selective embolization of bleeding vessels.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
5/37. Traumatic pseudoaneurysm of the superficial temporal artery: two cases.Pseudoaneurysms of the superficial temporal artery are a rare and potentially critical cause of facial masses. Most pseudoaneurysms form as a result of blunt trauma and present as painless, pulsatile tumors that may be associated with neuropathic findings and enlarged size. Without careful evaluation in the primary care setting, pseudoaneurysms can be easily misdiagnosed and improperly managed. They can, however, be accurately diagnosed through physical examination alone and subsequently treated with surgical ligation. The authors present two cases of traumatic pseudoaneurysms of the superficial temporal artery caused by blunt injury and discuss pertinent diagnosis and treatment options, as well as provide a brief review of the anatomy and histopathology of pseudoaneurysms.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
6/37. Pseudoaneurysm of the gastroduodenal artery as a cause of obstructive jaundice.A 35-year-old man presented to our emergency room with asymptomatic jaundice. A physical exam revealed a palpable mass with audible bruit in the epigastrium. Total serum bilirubin was 21.7 mg%. A real time sonography/Doppler examination showed widening of the biliary tree (common bile duct diameter of 13 mm) and a mass in the pancreatic head with turbulent flow. Arteriography of the celiac axis revealed a pseudoaneurysm of the gastroduodenal artery. A ligation of the gastroduodenal artery was performed surgically, and the aneurysmal cavity was explored and emptied. An intraoperative cholangiography showed slight stenosis of the common bile duct distally, and so a choledochojejunostomy was performed. The patient's recovery was uneventful. A follow-up angiogram revealed the short stump of the gastroduodenal artery and no aneurysm or extravasation of dye. A follow-up ultrasound showed the common bile duct measuring 5.5 mm. The bilirubin level dropped to normal values. The patient was discharged on 12 days after surgery. Ten months following surgery he was doing well. The pathology, diagnosis, and treatment of such cases are briefly discussed.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
7/37. Aortic root replacement and coronary interposition using a cryopreserved allograft and its branch.This communication describes a modified aortic root replacement technique using a cryopreserved allograft consisting of the aortic conduit and its branch. This method was applied in a patient suffering from infective pseudoaneurysm which had developed after aortic root replacement using an artificial graft with a mechanical aortic valve. A piece of the innominate artery obtained from the aortic allograft was used for interposition between the fragile left coronary artery root and the main conduit of the allograft.- - - - - - - - - - ranking = 0.74895944515172keywords = suffering (Clic here for more details about this article) |
8/37. Spontaneous false aneurysm of left internal mammary artery.A 15-year-old female patient presented with a history of a mass just medial to the left breast and fever. Her physical examination revealed upper extremity hypertension, delayed and diminished pulsations in the femoral arteries and a midsystolic murmur over the back. On catheterization of the aorta a 45 mmHg systolic pressure gradient was obtained across the coarctation segment. The selective left internal mammary artery angiography showed the relationship of distal portion with false aneurysm. A magnetic resonance scan showed a left parasternal mass extending anteriorly.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
9/37. hepatic artery pseudoaneurysm after liver transplantation. A result of transhepatic biliary drainage for primary sclerosing cholangitis.hepatic artery pseudoaneurysm (HAP) is a rare but often life-threatening complication of liver transplantation. Treatment is usually ligation, revascularization, or retransplantation. We report a patient suffering from primary sclerosing cholangitis who required transhepatic percutaneous biliary drainage. Following orthotopic liver transplantion (OLT), he developed HAP, which was successfully embolized angiographically. We discuss the association between transhepatic biliary drainage and the development of HAP after OLT, and the possibilities for angiographic intervention in these cases.- - - - - - - - - - ranking = 0.74895944515172keywords = suffering (Clic here for more details about this article) |
10/37. Massive intraperitoneal hemorrhage from traumatic intrasplenic pseudoaneurysms: treatment using superselective embolotherapy.The importance of splenic preservation in the setting of penetrating and blunt trauma has led to the development of more sophisticated and noninvasive methods for controlling splenic hemorrhage. Although controversy exists, transcatheter embolotherapy has challenged the use of splenectomy in patients suffering from persistent bleeding after splenic trauma. We describe a case of a 41-year-old man with hepatitis c, ethanol-induced liver disease, and portal hypertension who presented with splenic rupture secondary to blunt trauma. Continued intra-abdominal hemorrhage was successfully controlled by superselective embolotherapy using microcoils and gelatin sponge pledgets.- - - - - - - - - - ranking = 0.74895944515172keywords = suffering (Clic here for more details about this article) |
| | Next -> |