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1/169. takayasu arteritis--a case report of aortic aneurysm.

    Aortic pseudo-aneurysm is a rare manifestation of takayasu arteritis. We present a 16-year-old girl who first complained of multiple arthritis, recurrent abdominal pain and malaise at the age of 15 years. The initial working diagnosis was juvenile rheumatoid arthritis. Follow-up abdominal ultrasonography for her hepatomegaly incidentally revealed an aortic aneurysm. Total aortography showed diffuse aortic narrowing and an infra-renal aortic pseudo-aneurysm. Vascular reconstruction with an interposition Dacron graft was performed with uneventful recovery. Early non-specific presentation of takayasu arteritis often results in delay of diagnosis. The presence of a vascular bruit in a young female with non-specific symptoms should point to a differential diagnosis of takayasu arteritis. We review the role of surgery in the management of this condition.
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keywords = abdominal pain
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2/169. Percutaneous fenestration of the aortic dissection membrane in malperfusion syndrome.

    We present two cases of malperfusion syndrome due to aortic dissection type-B. A supra-renal blind sac phenomenon resulted in renal failure and absent femoral pulses in both patients. Additionally, one patient suffered from spinal cord ischemia, the other from severe abdominal pain. By interventional techniques, catheter perforation of the blind sac was achieved. The resulting re-entries were enlarged with a balloon catheter. Distal perfusion without pressure gradients was restored by this technique in both patients and resulted in complete relief of symptoms. Percutaneous fenestration of the aortic dissection membrane may be an alternative to operative treatment in malperfusion syndrome.
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keywords = abdominal pain
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3/169. Subacute ischaemic proctitis: a rare condition requiring extensive rectal surgery.

    Subacute ischaemic proctitis is a rare condition. We describe the case of a 60-year-old male patient who developed, after aortic aneurysm repair, a transient ischaemic colitis that totally healed without sequelae. He eventually developed symptoms of severe proctitis. Investigations identified a stenosis of the mid rectum, while the upper rectum was inflammatory. On angiogram, there was a poor blood flow through the Riolan's arcade and a stenosis of the proximal aorto-graft anastomosis. diagnosis of subacute ischaemic proctitis due to poor blood supply through the internal iliac arteries was made. Anti-inflammatory drugs and dilations were inefficient. A subtotal proctectomy with low colorectal anastomosis was required. On pathological specimen, the lesions were strongly suggestive of an ischaemic process. The patient had an excellent recovery and was asymptomatic 8 months after the operation.
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ranking = 0.0075831597261967
keywords = upper
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4/169. Small ruptured abdominal aneurysm diagnosed by emergency physician ultrasound.

    Ruptured abdominal aortic aneurysms currently have a high rate of both mortality and misdiagnosis. Aneurysms smaller than 4 cm are not commonly considered for surgical repair. This report describes the case of a ruptured abdominal aneurysm measuring less than 4 cm diagnosed by the emergency physician utilizing bedside ultrasound. Within 30 minutes of arrival at the emergency department the patient's abdominal pain resolved spontaneously after defecation. If the bedside ultrasound had not been performed it is possible the patient would have been discharged from the hospital without surgical intervention. Bedside ultrasound by emergency physicians may improve the diagnosis of ruptured aortic aneurysms, particularly if the presentation is atypical.
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ranking = 1
keywords = abdominal pain
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5/169. Acute abdominal pain and urgency to defecate in the young and the old: a useful symptom-complex?

    In the belief that "pattern recognition" is an important first step of the diagnostic process, we report our observation of an uncommon and heretofore poorly documented symptom-complex in 10 patients, and suggest that the constellation of abdominal pain and urgency to defecate in the acutely ill surgical patient should raise the diagnostic possibility of intra-abdominal bleeding. In our experience, this is statistically likely to be associated with a ruptured abdominal aortic aneurysm in the old and a ruptured ectopic pregnancy in the young.
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keywords = abdominal pain
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6/169. Abdominal aortic aneurysm rupture in systemic lupus erythematosus.

    Many cardiovascular complications have been described in systemic lupus erythematosus (SLE), however, aortic involvement is very rare. We are reporting abdominal aortic aneurysm rupture in a 47-year old woman with SLE. The patient was admitted to our hospital with severe abdominal pain. Emergency computed tomography of the abdomen demonstrated ruptured abdominal aortic aneurysm. The restoration of aortic flow with vascular prosthesis was performed in emergency. Postoperative course was uneventful.
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ranking = 1
keywords = abdominal pain
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7/169. Type B aortic dissection and thoracoabdominal aneurysm formation after endoluminal stent repair of abdominal aortic aneurysm.

    Endoluminal stent graft repair of abdominal and thoracic aortic aneurysms is being performed in increasing numbers. The long-term benefits of this technology remain to be seen. Reports have begun to appear regarding complications of stent graft application, such as renal failure, intestinal infarction, distal embolization, and rupture. Many of these complications have been associated with a fatal outcome. We describe a case of acute, retrograde, type B aortic dissection after application of an endoluminal stent graft for an asymptomatic infrarenal abdominal aortic aneurysm. An extent I thoracoabdominal aortic aneurysm subsequently developed and was successfully repaired. Aggressive evaluation of new back pain after such a procedure is warranted. Further analysis of the short-term complications and long-term outcome of this new technology is indicated before universal application can be recommended.
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ranking = 2.7765399369899
keywords = back pain, back
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8/169. Two-step approach for the operation of male breast cancer: report of a case at high risk for surgery.

    We report herein the rare case of a 61-year-old man with a history of dissecting aortic aneurysm as well as right breast cancer. He complained of abdominal pain due to a progress of aortic dissection in preparation for the radical operation for breast cancer. blood pressure was initially controlled and he was administered a simple mastectomy under local anesthesia. One month after the first operation, a radical operation for breast cancer was successfully performed. The tumor was in stage II, and two years after the operation, the patient remained free of recurrent disease. This two-step approach for the operation of male breast cancer may be used as a treatment of breast cancer if a patient is too frail for normal surgery.
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ranking = 1
keywords = abdominal pain
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9/169. saphenous vein graft ectasia: an unusual late complication of coronary artery bypass surgery. A case report.

    Aneurysms and ectasias of saphenous vein grafts are infrequent complications of coronary artery bypass surgery. They usually present as an expanding asymptomatic mediastinal mass on chest x-ray film or computed tomography scan. Though rare, they must be excluded from the differential diagnosis of mediastinal masses to avoid potentially dangerous needle biopsy. The authors describe ectasia of a saphenous vein graft in a 62-year-old man 14 years after coronary artery bypass surgery. The relevant literature is also discussed.
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ranking = 0.00398891966759
keywords = chest
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10/169. Aortocaval fistula complicating abdominal aortic aneurysm: diagnosis with gadolinium-enhanced three-dimensional MR angiography.

    With approximately 150 reported cases, fistulas between the abdominal aorta and inferior vena cava are rare. Preoperative clinical diagnosis of aortocaval fistula is difficult because the classical triad of abdominal pain, pulsatile abdominal mass, and abdominal machinery-like bruit may be absent in up to 50 % of patients. We report a case of aortocaval fistula complicating abdominal aortic aneurysm which was diagnosed preoperatively using breath-hold gadolinium-enhanced three-dimensional MR angiography.
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ranking = 1
keywords = abdominal pain
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