11/349. Three-dimensional CT imaging of aneurysm of aberrant right subclavian artery.We report a case of an aneurysm originating from an aberrant right subclavian artery, which was incidentally found as a compression deformity of the upper esophagus on a barium study in a 46-year-old man. Computed tomography (CT) clearly demonstrated the aneurysm of the aberrant right subclavian artery. In particular, reconstructed three-dimensional CT (3D-CT) was valuable in evaluating the positional relationships between the anomalous vessel with aneurysm and other structures.- - - - - - - - - - ranking = 1keywords = upper (Clic here for more details about this article) |
12/349. Successful resection of ductus arteriosus aneurysm in infancy.We report a case of thrombosed patent ductus arteriosus aneurysm in an infant. The aneurysm was detected accidentally on chest roentgenogram and presented as globular soft tissue density mass in left posterosuperior mediastinum. Resection of the aneurysm was performed without cardiopulmonary bypass. Two years after operation the patient is well and growing normally.- - - - - - - - - - ranking = 1.3678632021711keywords = chest (Clic here for more details about this article) |
13/349. A subclavian artery aneurysm associated with aortitis syndrome.We performed surgery on a 61-year-old woman who had increasingly severe right shoulder pain and paresthesia in her right upper extremity as a result of a large right subclavian artery aneurysm. She had suffered from aortitis syndrome for 10 years for which she was treated with steroids and had multiple arterial lesions, including bilateral subclavian artery aneurysms, abdominal aortic aneurysm and obstruction of bilateral superficial femoral arteries. The right subclavian artery aneurysm measured 4 cm in diameter and rupture appeared imminent, prompting surgical therapy. Via the supraclavicular incision approach and additional partial sternotomy, the aneurysm was excluded and the brachiocephalic to right axillar arterial bypass was set up using an extended polytetrafluoroethylene graft. The patient recovered without complications and a subclavian artery aneurysm demonstrated by computed tomography was thrombosed 1 month after surgery. In conclusion, we recommend the exclusion technique to treat subclavian artery aneurysms in cases in which aneurysmectomy is likely to injure adjacent veins and nerves.- - - - - - - - - - ranking = 1keywords = upper (Clic here for more details about this article) |
14/349. Gastric pseudotumor.The authors present a case report of a pseudotumor of the stomach and a brief discussion about this very unusual entity. A 75-year-old female patient was admitted with melena and a large epigastric tumor; she underwent upper gastrointestinal endoscopy, abdominal ultrasound, magnetic resonance imaging, guided needle aspiration and angiography. Preoperative diagnostic hypothesis included a partially thrombosed aneurysm of the splenic artery, pancreatic cystic neoplasm with gastric invasion and pancreatic pseudocyst complicated with hemorrhage. laparotomy revealed a gastric tumor and the patient was submitted to a radical subtotal Billroth II gastrectomy. Only the pathologic examination revealed the unexpected definitive diagnosis of an organized intramural gastric hematoma. There were no postoperative complications and she remains asymptomatic 10 months after surgery.- - - - - - - - - - ranking = 1keywords = upper (Clic here for more details about this article) |
15/349. Ruptured submucosal gastric artery microaneurysm.A patient with massive upper gastrointestinal hemorrhage from a ruptured submucosal gastric artery microaneurysm is described. Intraoperative diagnosis was made and wedge resection of the lesion resulted in survival of the patient. Forty-two cases in this entity have been reported in the literature, with nonoperative therapy being uniformly fatal; there were only four cases of successful surgical management. An increased awareness of this entity in cases of unexplained gastrointestinal hemorrhage is the key to diagnosis and successful management.- - - - - - - - - - ranking = 1keywords = upper (Clic here for more details about this article) |
16/349. Bilateral renal infarction in a black man with medial fibromuscular dysplasia.We report a case of bilateral renal infarction in a patient with medial fibrous dysplasia of both renal arteries and a thrombosed aneurysmal dilatation of the right renal artery. A previously healthy 40-year-old black man presented to the emergency department with acute onset of bilateral flank pain. Computerized tomography of the abdomen showed bilateral renal infarction, predominantly affecting the anterior distribution of both renal arteries. Estimated loss of renal mass was 50% on the right and 25% on the left. The patient was treated with intravenous heparin, oral warfarin, and antihypertensive therapy with labetolol and long-acting nifedipine. By day 3, his abdominal pain resolved; however, the serum creatinine level increased to a maximum value of 2.6 mg/dL. The serum creatinine level slowly improved and stabilized at 1.9 mg/dL, and he was subsequently discharged on the seventh hospital day. magnetic resonance angiography performed 2 months later showed "beading2 of both renal arteries consistent with medial fibromuscular dysplasia, a finding confirmed by conventional angiography. To our knowledge, bilateral renal infarction complicating medial fibrous dysplasia of the renal arteries has not been previously reported, nor has medial fibrous dysplasia been reported in blacks.- - - - - - - - - - ranking = 9.7611096261151keywords = abdominal pain (Clic here for more details about this article) |
17/349. Aneurysm of the gastroduodenal artery: an unusual cause of obstructive jaundice.Splanchnic artery aneurysms are among the most infrequent aneurysms that affect the arterial circulation. Aneurysms of the gastroduodenal artery are the rarest splanchnic artery aneurysms, comprising fewer than 10 per cent of all such lesions. The most typical presentations include abdominal pain and acute gastrointestinal bleeding. However, the diagnosis is often missed preoperatively. We report the successful surgical management of a patient with a gastroduodenal artery aneurysm who presented with isolated obstructive jaundice and review the literature on this unusual finding.- - - - - - - - - - ranking = 9.7611096261151keywords = abdominal pain (Clic here for more details about this article) |
18/349. Operative aneurysmectomy and middle lobectomy for asymptomatic bronchial artery aneurysm in young patient.A 33-year-old woman was admitted for investigation of a round right hilar shadow on chest X-ray. A bronchial arteriogram revealed it was a bronchial artery aneurysm. She had no symptoms such as bloody sputum or hemoptysis. Although bronchial arterial embolization (BAE) is a good procedure for controlling hemoptysis, sometimes hemostasis is unsuccessful or bleeding recurs after BAE. Our patient underwent an operative aneurysmectomy and middle lobectomy to eliminate aneurysmal rupture instead of BAE.- - - - - - - - - - ranking = 1.3678632021711keywords = chest (Clic here for more details about this article) |
19/349. Endovascular repair of an extracranial internal carotid artery aneurysm complicated by heparin-induced thrombocytopenia and thrombosis.PURPOSE: To report the endovascular treatment of a symptomatic extracranial internal carotid artery (ICA) aneurysm that was complicated by heparin-induced thrombocytopenia and thrombosis. methods AND RESULTS: After undergoing a coronary artery bypass graft procedure, a patient was diagnosed with a symptomatic, 3.5-cm ICA aneurysm by computed tomography and angiography. Via a semiclosed access, an Enduring vascular graft was inserted under controlled back bleeding from the ICA. The patient was recovering uneventfully when routine duplex scanning on the fifth postoperative day suggested multiple thrombi within the graft, which was confirmed by arteriography. thrombectomy and local fibrinolysis were performed; however, the graft occluded the next day without causing neurological symptoms. heparin-induced thrombocytopenia was diagnosed by enzyme-linked immunosorbent assay. CONCLUSIONS: Endovascular repair of high cervical extracranial ICA aneurysms is feasible, and protection against intracerebral embolization can be achieved using a semiclosed technique with controlled back bleeding from the ICA during endograft deployment. However, multiple thrombi or thrombotic occlusion during the postoperative period, particularly in a patient already sensitized to heparin, should direct attention toward possible heparin-induced thrombocytopenia.- - - - - - - - - - ranking = 0.29108891042133keywords = back (Clic here for more details about this article) |
20/349. Management of aberrant subclavian artery aneurysms.An aberrant subclavian artery is the most common congenital anomaly of the aortic arch. Aneurysms of these vessels are relatively rare lesions. A high clinical suspicion must be maintained in patients with an abnormal mediastinum on chest X-ray, especially in patients with dysphagia, dyspnea, or upper extremity ischemic symptoms not otherwise explained. Potentially disastrous complications, including spontaneous rupture and perforation into the esophagus may occur, and are invariably fatal. We present the case of an 1 asymptomatic 72-year-old male with an aberrant right c subclavian artery aneurysm presenting as a mediastinal mass on routine chest X-ray. Repair was by aneurysmectomy through a left thoracotomy and right common carotid artery to subclavian artery bypass via median sternotomy with resolution of his symptoms. We reviewed 74 cases in the English literature to February 1998. The pertinent anatomy is discussed and trends in surgical treatment are identified. Recent agreement on the surgical approach and choice of revascularization appears to exist, but advances in diagnostic and interventional radiologic capabilities have increased the number of asymptomatic lesions encountered and may alter the treatment of this lesion in the near future.- - - - - - - - - - ranking = 3.7357264043421keywords = chest, upper (Clic here for more details about this article) |
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