1/11. Multiple duodeno-jejunal diverticula causing massive intestinal bleeding.A case of massive intestinal blood loss from multiple duodeno-jejunal diverticula is described. A 39-year-old man was referred to our hospital because of recurrent bloody stool and worsening anemia. Upper and lower endoscopy, selective abdominal angiography, and radionuclide scanning were performed to seek the cause of the intestinal bleeding, but none of these studies revealed the source of bleeding. Small-bowel barium follow-through examination showed numerous diverticula in the distal duodenum and proximal jejunum. Excision of the duodenal diverticulum and resection of the involved portion of the jejunum cured the patient. On histopathological examination, an ulcerative lesion with an exposed vessel suggestive of the source of bleeding was seen in the resected duodenal diverticulum. Although duodeno-jejunal diverticula are rare, the importance of a careful search for this malformation in a patient with intestinal blood loss is stressed.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
2/11. Massive bleeding from multiple jejunal diverticula associated with an angiodysplasia: report of a case.We report herein the case of a 70-year-old woman who presented with massive bleeding from multiple jejunal diverticula. She was initially admitted to our hospital with massive melena. An upper gastrointestinal endoscopic examination revealed no bleeding site. colonoscopy revealed clotted and red blood throughout the colon, and a small diverticulum in the ascending colon which was thought to be the source of bleeding. Following admission, she was treated conservatively at first, but melena continued and the anemia did not improve despite blood transfusions. A laparotomy was performed and multiple jejunal diverticula, distributed from 10 to 40 cm distal to the ligament of Treitz, were found. A segment of the jejunum containing all diverticula was resected. The most distal diverticulum contained a clot of blood, but no ulceration was observed. A histological examination revealed many dilated blood vessels in the mucosa and submucosa of this diverticulum, which were compatible with the findings of angiodysplasia. Based on these findings, we believe that angiodysplasia was the cause of bleeding from the jejunal diverticula in this case.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
3/11. Evaluation of spontaneous intracranial hypotension: assessment on ICP monitoring and radiological imaging.We describe two recent cases of spontaneous intracranial hypotension. A 38-year-old woman developed a severe postural headache. magnetic resonance imaging (MRI) showed marked dural enhancement. Histopathological findings of dural biopsy showed numerous dilated vessels in the dura, rather than hypertrophic change. Lumber CSF pressure was 5 cmH2O and RI cisternography suggested CSF leakage. A 58-year-old woman with postural headache and vertigo had bilateral subdural haematoma associated with diffuse dural enhancement on MRI. Lumber CSF monitoring confirmed persistent low pressure ranging from 0-5 cm H2O. MRI myelography revealed multiple CSF pouches along the whole spinal axis. CSF leakage was demonstrated on Radioisotope (RI) cisternography. Both cases described in this report were diagnosed as spontaneous intracranial hypotension caused by CSF leakage from spinal meningeal diverticula and were successfully treated by intravenous factor xiii administration.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
4/11. diverticulum of Kommerell: a review of a series and a report of a case with tracheal deviation compromising single lung ventilation.IMPLICATIONS: Birth defects can affect the great vessels of the aorta and its branches, compressing the upper airway and the swallowing track. Surgical repair of these defects requires manipulating the airway to improve surgical exposure. This is a report of a series of cases with compromised airway resulting from such a birth defect and methods of its management.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
5/11. A new therapeutic procedure for treatment of objective venous pulsatile tinnitus.Pulsatile tinnitus usually means a turbulent flow within the vessels. We describe a 54-year-old man with a disabling objective pulsatile tinnitus due to a diverticulum of the sigmoid sinus toward the ipsilateral mastoid. We performed a surgical intervention via the endovascular route using coils to obliterate the diverticulum and a stent to avoid coil migration. The patient had a complete and immediate remission of the pulsatile tinnitus. This procedure has been described only in arterial circulation.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
6/11. Massive upper gastrointestinal bleeding in a patient with a duodenal diverticulum: a case report and review of the literature.Diverticula of the duodenum occur in approximately 2% to 5% of individuals who have had upper gastrointestinal (GI) series; the majority of these patients are asymptomatic. These diverticula occasionally result in the obstruction of the biliary and pancreatic ducts, which leads to jaundice and pancreatitis. Other complications such as hemorrhage, perforation, sepsis, and death can occur. This article reports a case of upper GI bleeding in a patient who was found to have duodenal diverticula by upper GI series and endoscopy. Diverticulectomy was performed, and microscopic examination of the specimen showed dilated blood vessel suggestive of angiodysplasia.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
7/11. Massive gastrointestinal bleeding and perforation of a duodenal diverticulum with coexisting pancreatitis.A case of perforation and bleeding from a diverticulum of the second portion of the duodenum in a patient with recurrent pancreatitis is presented. Upper gastrointestinal roentgenogram revealed an abnormal tract and retroperitoneal air arising from the diverticulum. The fistulous tract communicated with pancreas. Bleeding was due to erosion of the wall of the pancreaticoduodenal artery. Extensive bleeding should suggest involvement of blood vessel.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
8/11. Massive arterial haemorrhage from the lower gastrointestinal tract.We have studied the clinical, radiological and pathological features of three patients with recurrent massive lower gastrointestinal arterial haemorrhage. Case 1 was an example of Dieulafoy's vascular malformation within the proximal ascending colon in a 46-year-old woman. Cases 2 and 3 were men aged 81 and 83 years with arterial erosions contained within small mucosal diverticula in the hepatic flexure and descending colon, respectively. All three patients presented with recurrent acute episodes of massive lower gastrointestinal haemorrhage. Selective mesenteric angiography was performed in cases 1 and 3 to localize the bleeding point in both patients. The features were very different to those of angiodysplasia, lacking the tuft of abnormal vessels and the early venous filling phase commonly seen in the latter condition. The patients were all successfully treated by partial colectomy. The aetiology of Dieulafoy's vascular malformation remains unclear. The ruptured arteries in cases 2 and 3 shared many histological features with the Dieulafoy lesion in case 1. The lesions in cases 1 and 2 were associated with recent oral non-steroidal anti-inflammatory therapy, suggesting coincidental mucosal ulceration as a contributory factor.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
9/11. dissection of retroesophageal aortic diverticulum and descending aorta in a patient with right aortic arch: magnetic resonance demonstration.An acute aortic dissection involved the retroesophageal aortic diverticulum (RAD) and descending thoracic aorta in a patient with right aortic arch. The RAD, which was separated into false and true lumens by an intimal flap-the classic diagnostic sign of aortic dissection-was overlooked on transesophageal echocardiography and computed tomography but was clearly depicted on magnetic resonance imaging (MRI). It was found that MRI can delineate the anatomy of a congenital arch anomaly complicated by great vessels disease.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
10/11. Urologic abnormalities in Menkes' kinky hair disease: report of three cases.Menkes' kinky hair disease is a rare congenital disorder of copper metabolism with X-linked recessive inheritance. It is well known that it is frequently associated with urologic abnormalities. The authors experienced three such cases, but each of them was different. Multiple bladder diverticula, right vesico-ureteral reflux, and right hydronephrosis were noted on the first baby boy. In the second case, hematomas in the left kidney, pelvis, ureter and the adipose capsule, which were thought to be the abnormality of vessels, were noted in the neonatal period. In the third body, multiple bladder diverticular were noted at the age of 1 year. One year, 10 months later, a spontaneous rupture at the huge diverticulum occurred.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
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