Cases reported "Vascular Diseases"

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1/101. Arterial imaging.

    angioscopy, magnetic resonance angiography, computed tomography, and nuclear medicine are assuming an increasingly important role in arterial imaging. This review discusses recent advances in these modalities. angioscopy has proven valuable in monitoring intraoperative surgical procedures as well as percutaneous interventions. Carotid artery magnetic resonance angiography is gaining increasing acceptance in clinical practice. magnetic resonance angiography of the peripheral arteries is limited by spatial resolution and signal loss distal to the stenosis. The role of computed tomography in limiting the number of aortograms performed in evaluating aortic laceration remains controversial; however, several recent papers indicate its usefulness in evaluating clinically stable patients with abnormal chest radiographs. Computed tomography of abdominal aortic aneurysms may obviate the need for preoperative aortography in the majority of cases. Nuclear imaging for deep venous thrombosis using 111In-labeled antifibrin monoclonal antibodies was shown highly sensitive in its initial report.
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ranking = 1
keywords = chest
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2/101. Hepatobiliary cystadenoma presenting with intermittent inferior vena caval obstruction.

    Hepatobiliary cystadenomas are rare benign tumours. They form as multilocular cysts in and around the liver. Their presentation is usually at a late stage when their size causes symptoms. We report a case of a 44-year-old woman presenting with abdominal pain, which was attributed to a multiloculate liver cyst. After intially refusing surgery she relented once intermittent inferior vena caval obstruction had developed. The cyst was found to be a hepatic cystadenoma.
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ranking = 7.388072449348
keywords = abdominal pain
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3/101. Respiratory distress due to tracheal compression by the dilated innominate artery.

    The case reported is of an 88 yr old female with hypertension and respiratory distress. A chest radiograph revealed a widening of the upper mediastinum. Computed tomographic scanning revealed tracheal compression by the innominate artery, which was elongated and curved. After intubation, she was treated with antihypertensive drugs. This resulted in the remarkable recovery of the patient from respiratory distress. To the authors' knowledge, this is the first reported case of respiratory distress owing to tracheal compression by elongation and curvature of the innominate artery.
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ranking = 1.2452421103872
keywords = chest, upper
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4/101. Giant cervical epidural veins after lumbar puncture in a case of intracranial hypotension.

    A 29-year-old woman presented with dilated epidural veins and incapacitating headache after undergoing a lumbar puncture. Two months later, the results of follow-up MR imaging were normal. These findings suggest that temporary dilation of the epidural vein may occur in association with post-lumbar puncture intracranial hypotension syndrome. In these cases, it seems useful to confirm whether the patient has recently undergone a lumbar puncture.
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ranking = 0.39532708075767
keywords = headache
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5/101. hemoperitoneum following rupture of ectopic varix along splenorenal ligament in extrahepatic portal vein obstruction.

    A 29-year-old man with extrahepatic portal vein obstruction who underwent variceal eradication by sclerotherapy six years ago, was admitted with hypotension and abdominal pain. Abdominal paracentesis yielded frank blood. laparotomy showed bleeding from a large ectopic vessel along the splenorenal ligament. The vessel was ligated and the patient recovered.
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ranking = 7.388072449348
keywords = abdominal pain
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6/101. Crushed stents in benign left brachiocephalic vein stenoses.

    Two hemodialysis patients presenting with left venous arm congestion due to benign catheter-induced stenosis of the left brachiocephalic vein were treated by angioplasty and stent placement. External compression of the stents was responsible for rapid recurrence of the symptoms. No osseous or vascular malformation could be identified. Mechanical constraints induced by respiratory chest wall motion and aortic arch flow-related pulsation are proposed to explain this observation. This potential hazard should be considered when stent placement into the left brachiocephalic vein is advocated.
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ranking = 1
keywords = chest
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7/101. Intermittent brachiocephalic vein obstruction secondary to a thymic cyst.

    Mediastinal thymic cysts are usually asymptomatic and found incidentally on a routine chest roentgenogram. Rarely, they may cause symptoms of vascular obstruction. A 55-year-old woman presented with intermittent swelling in her left neck. The swelling was positional and was worse while supine and disappeared while upright. Evaluation revealed a thymic cyst causing extrinsic compression of the left brachiocephalic vein. The cyst was resected with complete resolution of the left neck swelling.
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ranking = 1
keywords = chest
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8/101. Portal venous calcifications 20 years after portosystemic shunting: demonstration by spiral CT with CT angiography and 3D reconstructions.

    BACKGROUND: Evaluation of the value of spiral computed tomography (SCT), and postprocessing procedures in patients with extensive portal venous calcifications 20 years after portosystemic shunting was performed. methods: In two patients spiral CT (SCT) examinations of the abdomen (slice thickness 3 mm, table feed 6 mm/s) were performed prior and after application of 150 ml of contrast material administered at a flow rate of 4 ml/s. Axial images were reconstructed at 2 mm increments for postprocessing procedures and 6 mm increments for axial source images. Postprocessing was performed with a maximum intensity projection (MIP) and shaded surface display (SSD) imaging program. RESULTS: In both cases preoperative plain film radiography of the chest and abdomen showed large curvilinear calcifications located at the upper quadrant of the abdomen. The calcifications were directed along the expected axis and position of the portal vein and the portosystemic venous anastomosis. Axial CT slices and CTA showed that the calcifications were located in the vessel wall and that the portal vein lumen as well as the portosystemic venous anastomosis were patent. CONCLUSION: Long-standing portal hypertension is capable of causing portal venous calcifications due to mechanical stress to the vessel wall even years after performing portosystemic shunting. Typically, the calcifications are directed along the expected axis and position of the portal vein. SCT of the portal venous system is a reliable method to differentiate between calcifications in a thrombus or in the vessel wall, which may have therapeutic significance.
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ranking = 1.2452421103872
keywords = chest, upper
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9/101. Dramatic worsening of vascular calcifications after kidney transplantation in spite of early parathyroidectomy.

    vascular calcification is a common feature in chronic dialysis patients, but their clinical significance is debated and the role of kidney transplantation (TP) in the natural history of their development has received scanty attention. We will describe a case of dramatic worsening of vascular calcifications during TP in a young patient in spite of early and successful parathyroidectomy (PTX), and will discuss other causes which might be putatively linked to vascular damage during the time of TP. A 37-year-old man on regular dialytic treatment (RDT) for 11 years, received his first cadaveric transplantation in January 1993. He underwent PTX 6 months after TP because of the lack of decreasing in parathyroid hormone values despite normal graft function. Although PTX was effective, a dramatic worsening was evident in large as well as in medium and small-sized arteries during the following three years of TP. In February 1997, few months after starting dialysis again because of the recurrence of his primary membranoproliferative glomerulonephritis (MPGN), the patient experienced myocardial infarction followed by aorto-coronary bypass (right coronary artery and anterior descending coronary artery) and leg "claudicatio". Though a role for parathyroid hormone in vascular disease has been commonly accepted, the case here reported clearly shows that blunting parathyroid gland activity may be unable to avoid the worsening of a process of vascular disease during the time of TP. Many other factors--linked to the time of TP--may be involved in vascular diseases, such as nephrotic syndrome, dyslipidemia, hypertension and drugs. In the case of our patient, a clear cut risk factor for his progressive atherosclerosis can be designated hyperlipidema and other disturbancies secondary to a nephrotic syndrome due to relapse of MPGN, together with persistent hypertension. This is the first case report in the English literature which clearly demonstrates that TP may add fuel to the fire of vascular disease also in young people and even in the absence of parathyroid hyperactivity, perhaps on the basis of a favorable genetic background. Furthermore, the history of our patient demonstrates that vascular calcifcation heralds major cardiovascular diseases.
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ranking = 0.10482820635826
keywords = back
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10/101. Dieulafoy's lesion of the small bowel causing massive gastrointestinal bleeding: two case reports and literature review.

    Dieulafoy's lesions are an often unrecognized cause of obscure, massive GI hemorrhage. Their diagnosis may elude conventional investigations, including upper and lower endoscopy, arteriography, and even laparotomy. In this paper, we report two cases of small-bowel Dieulafoy lesions. The first, a jejunal lesion, occurred in a young patient and was discovered at laparotomy. The second was an ileal Dieulafoy's malformation in an older patient. An intraoperative endoscopy with surgical guidance may be needed for definitive localization of this lesion.
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ranking = 0.24524211038724
keywords = upper
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