1/8. Acute biliary-vascular fistula following needle aspiration of the liver.A patient with cavernous transformation of the portal vein and a suspected hepatic mass lesion underwent an ultrasound-guided aspiration of the liver with a skinny needle. Two days later he became acutely ill. bilirubin level peaked at 1375 mumol/L (80.4 mg/dL), and alkaline phosphatase level was 2290 IU/mL. There was no evidence of biliary obstruction. A biliary-vascular fistula was diagnosed by endoscopic retrograde cholangiography, and nasobiliary drainage was placed, leading to resolution of the symptoms and jaundice. A pressure gradient between the biliary tree and a venous collateral probably led to flow of bile into a blood vessel. Nasobiliary drainage should be considered as a potential therapy for acute biliary-vascular fistula.- - - - - - - - - - ranking = 1keywords = tree (Clic here for more details about this article) |
2/8. Inferior vena cava stenosis in scimitar syndrome: a case report.The scimitar syndrome, first described by Chassinat in 1836, consists aessentially of an anomalous pulmonary vein draining whole or part of the right lung into the inferior vena cava. Associated anomalies are frequent, such as hypoplasia of the right lung, dextrocardia, malformations of the right pulmonary artery and bronchial tree, and abnormal arterial supply of the right lung (the so-called sequestration). This article describes a scimitar syndrome associated with stenosis of the inferior vena cava, whose initial diagnosis was made by two-dimensional echocardiographic Doppler color flow mapping. To our knowledge this is the first description of such an unusual association.- - - - - - - - - - ranking = 1keywords = tree (Clic here for more details about this article) |
3/8. Nosocomial pulmonary mucormycosis with fatal massive hemoptysis.We postulate that the previously healthy woman reported here developed abnormal host defense mechanisms because of acute renal failure, metabolic acidosis, hyperglycemia, and glucocorticosteroid administration. pneumonia unresponsive to antibiotics terminated in massive fatal hemoptysis that was due to mucormycosis with rupture of the pulmonary artery into the tracheobronchial tree.- - - - - - - - - - ranking = 1keywords = tree (Clic here for more details about this article) |
4/8. The development of pulmonary vascular obstructive disease after successful Mustard operation in early infancy.Pulmonary vascular obstructive disease developed postoperatively in an infant with aortopulmonary transposition and intact ventricular septum who underwent a Mustard operation in 3 months of age. Preoperative catheterization had shown normal pulmonary artery pressures. Four months after surgery, catheterization showed pulmonary artery systolic pressure above the systemic level and a tortuous, attenuated pulmonary vascular tree visualized angiographically. Early corrective surgery may not preclude the development of pulmonary vascular obstructive disease in patients with aortopulmonary transposition.- - - - - - - - - - ranking = 1keywords = tree (Clic here for more details about this article) |
5/8. Massive thrombosis as a result of triple infestation of the pulmonary arterial circulation by Ascaris, Candida, and Mucor.A 35-year-old man with a brief history of dyspnea and fever experienced rapid progressive respiratory distress and died shortly after being hospitalized. Postmortem examination revealed thrombotic occlusion of the pulmonary tree; the thrombotic material showed ascaris lumbricoides, candida albicans, and Mucor. This rare coincidence is an unexpected complication of ascariasis that has not been described previously.- - - - - - - - - - ranking = 1keywords = tree (Clic here for more details about this article) |
6/8. Pulmonary arteriopexy to relieve tracheobronchial compression by dilated pulmonary arteries.Adequate treatment of pulmonary artery compression of the tracheobronchial tree requires a high index of suspicion for the diagnosis, precise localization of the sites of airway compromise by bronchoscopy, and accurate identification of the anatomy of the obstructing vascular structures. Surgical correction of this vascular anomaly to relieve airway compression is necessary in many infants and should be performed promptly. pulmonary artery plication, arteriopexy, or aneurysmorrhaphy is well tolerated and can be dramatically successful in improving airway patency.- - - - - - - - - - ranking = 1keywords = tree (Clic here for more details about this article) |
7/8. Inadvertent intraradial arterial injection of cocaine.Injection of a chemical irritant into the radial artery at the wrist causes acute discoloration of the skin, edema, and pain in the hand. Subsequent damage due to vasospasm, endarteritis, particulate embolization, and vascular thrombosis may result in ischemic contractures, amputations, and other functional hand deficits. Injection of a street cocaine preparation into the radial artery of a 22-year-old man produced a constellation of signs and symptoms similar to that described for other irritants. Current thoughts with regard to the pathophysiology and treatment of these injuries are reviewed.- - - - - - - - - - ranking = 1keywords = tree (Clic here for more details about this article) |
8/8. Hepatobiliary scintigraphy in a patient with bilhemia.A 4-year-old child referred for acute jaundice following percutaneous needle biopsy of the liver underwent hepatobiliary scintigraphy. Although all conventional liver tests suggested preservation of hepatocyte function, the tracer uptake in the liver appeared dramatically reduced at scintigraphy and the blood pool activity did not decrease significantly until the end of the study. Visualization of the bile ducts indicated, however, that the tracer was taken up by the hepatocyte and further excreted into the biliary tree. There was no tracer pooling in the biliary tree although no bowel activity was observed, even on delayed images. The association of persistent blood pool activity, bile duct visualization without tracer pooling, and nonvisualization of the bowel was caused by a continuous recirculation of the tracer from the biliary tree into the bloodstream. The presence of a biliovenous fistula was further proven by percutaneous transhepatic cholangiography performed 24 h later. Since 1975, only 16 cases of bilhemia have been reported. To the best of our knowledge the scintigraphic pattern of this rare but life-threatening complication has not previously been reported.- - - - - - - - - - ranking = 3keywords = tree (Clic here for more details about this article) |