1/49. Pseudoaneurysm in gall bladder fossa following laparoscopic cholecystectomy.A 32-year-old lady presented with severe hematemesis and melena after laparoscopic cholecystectomy. Initial ultrasonography and spiral CT suggested a vascular lesion in the gall bladder fossa. Selective hepatic angiography confirmed the presence of a pseudoaneurysm close to the surgical clip and filling through the right hepatic artery. This was treated with coil embolization, resulting in cessation of hematemesis and amelioration of symptoms.- - - - - - - - - - ranking = 1keywords = artery (Clic here for more details about this article) |
2/49. Hemorrhage from the gastroesophageal junction. A cryptic angiographic diagnosis.The angiographic localization of gastroesophageal-junction hemorrage emanating from the left inferior phrenic artery (which originated from the abdominal aorta) is described. The diagnosis was established after conventional selective celiac and left gastric arteriography failed to demonstrate extravasation. The arteriographic evaluation of upper gastrointestinal hemorrhage requires consideration of the variable arterial distribution to the gastroesophageal junction and an awareness of the variable causes of dense opacification (including superimposed adrenal glands) that may mimic extravasation.- - - - - - - - - - ranking = 1keywords = artery (Clic here for more details about this article) |
3/49. Successful management of secondary aortoesophageal fistula with graft infection.A 60-year-old woman was transferred to our institution after massive hematemesis and the diagnosis of secondary aortoesophageal fistula was made. Five months previously, she had undergone graft replacement from the origin of the left subclavian artery to midthoracic aorta for chonic type B dissection. After an extraanatomic bypass was performed through a sternotomy, the infected thoracic aortic graft was resected through a left thoracotomy. She remained well without evidence of infection.- - - - - - - - - - ranking = 1keywords = artery (Clic here for more details about this article) |
4/49. Case report: right subclavian artery pseudoaneurysm due to perforation of esophageal cancer.A 51-year-old man presented with massive hematemesis. Perforation of upper esophageal cancer, which had already occurred at least six days earlier, progressed to upper mediastinitis. The mediastinitis contiguous to the right subclavian artery was considered to have caused a pseudoaneurysm. rupture of the pseudoaneurysm into the esophagus resulted in massive hematemesis. Both enhanced computed tomography and angiography were diagnostic for the pseudoaneurysm. Transluminal endovascular stent-grafts placement was successful in preventing subsequent hemorrhage.- - - - - - - - - - ranking = 5keywords = artery (Clic here for more details about this article) |
5/49. Pseudoaneurysm of the proximal facial artery presenting as oropharyngeal hemorrhage.BACKGROUND: Penetrating trauma to the neck traversing zones II and III may cause considerable damage to soft tissues and neurovascular structures. Delayed sequelae of vascular injuries, such as pseudoaneurysm (PA), may present weeks to months after the initial injury. methods: We report an unusual case of a traumatic PA of the proximal facial artery that ruptured into the oropharynx. RESULTS: A 30-year-old man presented with oropharyngeal hemorrhage one month after a gunshot wound to the neck. angiography revealed a PA of the proximal facial artery, which was treated with embolization. The arterial injury leading to the pseudoaneurysm had not been detected by arteriography at the time. CONCLUSIONS: PAs are rare complications of penetrating neck trauma. To our knowledge, this is only the second report of PA involving the proximal facial artery, and the first of a facial PA rupture into the pharynx.- - - - - - - - - - ranking = 7keywords = artery (Clic here for more details about this article) |
6/49. Bouveret's syndrome presenting as upper gastrointestinal hemorrhage without hematemesis.A 74-year-old woman with a recent diagnosis of peptic ulcer disease diagnosed by endoscopy after presentation with an episode of upper gastrointestinal bleeding returned 6 1/2 weeks later with a 5-day history of nausea and vomiting without associated symptoms. An ultrasound was nondiagnostic except for a large gallstone and a poorly visualized gallbladder. Repeat endoscopy revealed a hard mass that was presumed to have formed secondarily to an ulcer-induced stricture, and a 6-cm filling defect just proximal to the duodenal bulb was seen on a preoperative upper gastrointestinal series. At laparotomy the mass was actually a large gallstone and two smaller stones, which had eroded into and become impacted in the duodenal bulb creating a gastric outlet obstruction. The stones were extracted via a duodenotomy, and the remaining portion of the gallbladder was removed with repair of the cholecystoduodenal fistula. The patient was discharged home after an uncomplicated postoperative course. gastric outlet obstruction by a duodenal gallstone is a condition known as Bouveret's syndrome, which is a rare complication of gallstone disease. Upper gastrointestinal hemorrhage is an especially rare form of presentation.- - - - - - - - - - ranking = 0.58204268933219keywords = obstruction (Clic here for more details about this article) |
7/49. Haematemesis resulting from ischaemic strangulating intestinal obstruction.Although bleeding into the intestinal lumen may occur in strangulating intestinal obstruction, haematemesis is infrequently encountered. We report on a patient who presented with haematemesis and who had, in addition, clinical and radiological features of small bowel obstruction. Upper gastrointestinal endoscopy did not locate the source of bleeding. At laparotomy, which was performed because of clinical deterioration, gangrenous strangulated small bowel secondary to adhesive obstruction was found. In a patient with non-resolving intestinal obstruction, a deterioration in the condition is a clear indication for exploration. Haematemesis occurring concurrently may be a marker of intestinal strangulation, adds strength to the indication and highlights the urgency of the need for exploration.- - - - - - - - - - ranking = 2.3281707573288keywords = obstruction (Clic here for more details about this article) |
8/49. Dieulafoy's lesion of esophagus.Dieulafoy's lesion is a rare arterial malformation that can cause massive gastrointestinal hemorrhage. The lesion occurs most commonly in the proximal stomach. The esophagus is not a common location for this lesion. We present the case of a 25-year-old woman who was admitted to our emergency unit with the findings of hematemesis and melena. Early upper gastrointestinal endoscopic examination revealed a Dieulafoy's lesion, which was located in the distal esophagus. Endoscopic band ligation stopped the bleeding successfully. The patient was discharged 3 days after the band ligation without any complications. Dieulafoy's lesion may cause severe, life-threatening bleeding. Endoscopic diagnosis can be difficult because of the small size and obscure location of the lesion. An abnormally dilated artery that penetrates through the mucosa constitutes the etiology. endoscopy plays an important role in the diagnosis and treatment of this pathology. Despite widespread awareness of this entity, it may present a real challenge for the endoscopist due to the small size and hidden location of the lesion. The endoscopic approach to occult gastrointestinal bleeding for the diagnosis of vascular malformations is accepted as a quick and safe diagnostic method.- - - - - - - - - - ranking = 1keywords = artery (Clic here for more details about this article) |
9/49. Idiopathic hepatic arterio-portal fistula: report of one case.Hepatic arterio-portal fistula is a rare cause of portal hypertension in children; it is an abnormal communication of hepatic artery and portal venous system, the most common causes being trauma or malignancy. There were only 11 cases reported in English literature and were not ever reported in taiwan. We report a 9-year old boy with idiopathic hepatic arterio-portal fistula presented as intractable hematemesis due to esophageal and gastric varices. He had received sclerotherapy twice, and Sugiura operation (resection of the lower part of esophagus, devasculization of the stomach and splenectomy). Idiopathic hepatic arterio-portal fistula was found in angiography examination and the esophageal and gastric varices disappeared after transarterial embolization (TAE). We conclude that angiography is the golden diagnostic method for portal hypertension when the etiology is hepatic arterio-portal fistula and TAE will provide immediately therapy.- - - - - - - - - - ranking = 1keywords = artery (Clic here for more details about this article) |
10/49. Primary splenic lymphoma complicated by hematemesis and gastric erosion.Gastrosplenic fistula resulting from erosion of a primary splenic lymphoma is a rare cause of massive upper gastrointestinal hemorrhage associated with benign peptic ulcer disease, gastric Crohn's disease, gastric adenocarcinoma, and primary gastric and splenic lymphomas. Upper intestinal hemorrhage can be successfully treated with splenic artery embolization, followed by splenectory and gastric resection.- - - - - - - - - - ranking = 1keywords = artery (Clic here for more details about this article) |
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