1/6. Hepatic subcapsular hematoma after extracorporeal shock wave lithotripsy (ESWL) for pancreatic stones.We present a patient with complication of huge hepatic subcapsular hematoma after extracorporeal shock wave lithotripsy (ESWL) for pancreatic lithotripsy. The hematoma measured 78-110mm. Angiography showed a subcapsular hematoma, rather than a hematoma in the liver. In the arterial phase, the distal end of the small vessel showed spotty opacification similar to microaneurysma, suggesting that it was an injury caused by separation of the liver and its capsule, caused by the shock waves. The portal vein and hepatic vein were normal. After 8 weeks of conservative therapy, the hematoma was gradually absorbed and the patient was discharged. Eight months after the accident, the hematoma had decreased to 40mm in size. After 20 months, it was completely absorbed. The reported rate of renal subcapsular hematoma after ESWL for renal or ureter stones is 0.1%-0.7%. To date, however, only five cases of hepatic subcapsular hematoma after right renal stone disintegration have been reported. This is the first report of hepatic subcapsular hematoma after ESWL for pancreatic stones.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
2/6. Broncholithiasis: a neglected bronchial disease in this country. Illustration of three cases.A broncholith is a calcified lymph node which partially or completely erodes into the bronchial lumen. Its manifestations are non-specific and may result in life-threatening complications. In taiwan, pulmonary tuberculosis, one of the most common etiologies of broncholithiasis, is common. To our knowledge, no report on broncholithiasis can be found in literature in this country. We herein present three cases of broncholithiasis experienced in the past 11 years in Chang Gung Memorial Hospital. The presenting manifestations are obstructive pneumonia in two cases, and hemoptysis in the other one. In two of them, the broncholiths were located in the right side. Fiberoptic bronchoscopy was performed, and the stones were visible in all of them. Bronchoscopic removal of stone was successful in two cases, and the other coughed up stones spontaneously after bronchoscopies. In the absence of significant symptoms or complications, only observation is necessary. For the symptomatic borncholiths, we advocate that bronchoscopic removal is worth trying to eliminate the necessity of thoracotomy unless complications are present, which indicate surgical intervention such as massive hemoptysis, fistula formation between tracheobronchial trees and esophagus or vessels, recurrent pulmonary infection or suspicion of malignancy.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
3/6. Hepatolithiasis associated with anomalous biliary anatomy and a vascular compression. Hepatolithiasis and anomalous anatomy.biliary tract abnormalities occur in about one of every three people, usually being minor and of no clinical significance. Major abnormalities, however, may present in an unusual manner and provide a major hazard to the unsuspecting surgeon. A patient presenting with cholangitis without jaundice or abnormal liver function tests is reported. Endoscopic retrograde cholangiography failed to demonstrate any bile ducts in the right postero-lateral segments of the liver, the "naked segment sign". A percutaneous transhepatic cholangiogram demonstrated a stricture obstructing the right posterior segmental hepatic duct with hepatolithiasis above the stricture. At operation an anomalous vessel was found at the site of the stricture. This case highlights the unusual way in which biliary tract anomalies may present and the importance of adequate pre-operative investigation.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
4/6. Two case reports of macrovascular complications in fibrocalculous pancreatic diabetes.Fibrocalculous pancreatic diabetes (FCPD) is a form of diabetes secondary to chronic, non-alcoholic pancreatitis in tropical countries. Being a secondary form of diabetes, vascular complications are believed to be rare. In this paper we present two case reports of macrovascular complications (myocardial infarction and gangrene). This shows that large vessel disease does occur in FCPD.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
5/6. Pancreatic lithiasis: a rare cause of gastrointestinal hemorrhage.The rare instance of a gastrointestinal hemorrhage caused by a lithiasis of the duct of Wirsung is described. The world literature records only 13 other cases. Pancreatic calculi cause hemorrhage by either migrating through the pancreatic parenchyma to perforate the duodenum, ulcerating the vessels of the periductal parenchyma, or rupturing the pancreas. The usual sign of this complication of chronic calcifying pancreatitis, difficult to diagnose, is repeated gastrointestinal hemorrhages and sometimes pain, as in epigastric colitis. The immediate therapy is control of the hemorrhage. With transcatheter occlusive techniques, radical surgery can be postponed until it is more tolerable.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
6/6. Buccal hemangioma with phleboliths. Report of two cases.Two cases of buccal hemangioma with phleboliths were reported. Angiography, angioxerography, and computerized tomography were carried out before the procedures were planned. One patient was treated by means of surgical excision of the tumor after ligation of the left external carotid artery. The second patient was treated by means of surgical excision alone. Histologic examinations suggested that the thrombi in the blood vessels of hemangiomas might become the core of the phleboliths. Analysis of the phleboliths by means of x-ray diffraction and infrared spectrometry confirmed calcium phosphate and calcium carbonate as the main components of the phleboliths.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |