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https://www.readbyqxmd.com/read/29046081/splenic-artery-pseudoaneurysm-causing-delayed-gastrointestinal-bleeding-after-gastrocolonic-fistula-following-sleeve-gastrectomy
#1
J F Ball, L Sreedharan, S Reddy, Bhl Tan, V Sujendran
Delayed gastrointestinal bleeding in the context of a gastric fistula is a very rare complication of longitudinal sleeve gastrectomy. We report the case of a patient who presented with massive gastrointestinal bleeding from a pseudoaneurysm arising from the splenic artery following complications after a longitudinal sleeve gastrectomy several months previously. The case was successfully managed with angiographic embolisation and we present our experience with recommendations for managing this rare but life-threatening complication...
October 19, 2017: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/29039623/the-challenge-of-takotsubo-syndrome-heterogeneity-of-clinical-features
#2
Susanne Anna Schlossbauer, Jelena-Rima Ghadri, Frank Scherff, Christian Templin
Takotsubo syndrome (TTS) was first described in 1991 as a rare, spontaneous and completely reversible left ventricular regional systolic dysfunction. Today the incidence of TTS is estimated at 2% in patients with an initial diagnosis of acute coronary syndrome (ACS). Notably, the incidence can be as high as 5.9 to 7.5% in female patients. TTS occurs predominantly in postmenopausal women, but both sexes may be affected, at any age. Acute chest pain or dyspnoea is a characteristic symptom of TTS, but initial presentation can also include more severe disease manifestation such as acute heart failure with pulmonary oedema or haemodynamic instability, especially in an in-hospital setting...
October 17, 2017: Swiss Medical Weekly
https://www.readbyqxmd.com/read/29034283/endovenous-laser-ablation-of-spermatic-vein-for-the-treatment-of-varicocele
#3
Antonio Basile, Alessandro Motta, Giovanni Failla, Giuseppe Caltabiano, Marco Pizzarelli, Cecilia Gozzo, Davide Castiglione, Stefano Palmucci
INTRODUCTION: Varicocele is a relatively complex pathology of the scrotum veins', known to be one of the easiest to treat. Modern treatment involves both surgical (open, laparoscopic and microsurgery) and interventional approach (either with coils and/or sclerosant injection). Our aim is to demonstrate the feasibility and the reliability of endovenous laser ablation (EVLA) of the spermatic vein for the treatment of varicocele. MATERIALS AND METHODS: We consecutively and prospectively treated 11 patients (age range 24-45 years old, mean 31y) with left varicocele, phlebografically classified as Bahren type I and with indication for percutaneous treatment...
2017: European Journal of Radiology Open
https://www.readbyqxmd.com/read/29025963/sacral-dural-arteriovenous-fistulas-a-diagnostic-and-therapeutic-challenge-single-centre-experience-of-13-cases-and-review-of-the-literature
#4
Andrea Gioppo, Giuseppe Faragò, Caterina Giannitto, Luigi Caputi, Andrea Saladino, Francesco Acerbi, Elisa Ciceri
BACKGROUND: Sacral dural arteriovenous fistulas (DAVFs) are rare vascular abnormalities of the spine characterised by slowly progressive symptoms that can mimic different myelopathy disorders. OBJECT: To report our single Institution experience with sacral DAVFs. METHODS: We retrospectively reviewed the clinical records of patients admitted from 1 January 2006 to 31 December 2016 with a diagnosis of sacral DAVFs, treated by endovascular embolisation or surgical clipping...
October 12, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29018013/stroke-resulting-from-an-isolated-pulmonary-arteriovenous-malformation
#5
Jakob Saidman, Hossam Abdou, Sridhar Sampath Kumar
Isolated pulmonary arteriovenous malformations (PAVM) are rare, but can be responsible for paradoxical embolic events. It is important to recognise these situations early and intervene quickly to attain the best outcome. We describe the case of a 45-year-old woman with a long-standing history of migraines with aura who presented to the emergency department with left-sided weakness and slurred speech. Work-up was unclear and she was diagnosed with cryptogenic stroke. Follow-up transoesophageal echocardiogram was suggestive of an atrial septal defect, though no clear defect was evident...
October 10, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28993867/efficacy-of-pelvic-artery-embolisation-for-severe-postpartum-hemorrhage
#6
Annette Spreu, F Abgottspon, M U Baumann, J Kettenbach, D Surbek
PURPOSE: The purpose of our study was to evaluate the outcome of selective pelvic arterial embolisation (PAE) in women with severe postpartum hemorrhage (PPH). METHODS: We performed a retrospective, controlled, single-center cohort study. A total of 16 consecutive women with PPH who underwent therapeutic PAE were included. As historical control group, we included 22 women with similar severity of PPH who were managed without PAE. Outcome measures included necessity of surgical interventions such as postpartum hysterectomy and laparotomy after vaginal delivery, the amount of red blood cell transfusions, and hematologic findings after the procedure...
October 9, 2017: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/28992753/pelvic-vein-embolisation-of-gonadal-and-internal-iliac-veins-can-be-performed-safely-and-with-good-technical-results-in-an-ambulatory-vein-clinic-under-local-anaesthetic-alone-results-from-two-years-experience
#7
Mark S Whiteley, Chiyinde Lewis-Shiell, Sophia I Bishop, Eluned L Davis, Tim J Fernandez-Hart, Previn Diwakar, David Beckett
Objectives Pelvic vein embolisation is increasing in venous practice for the treatment of conditions associated with pelvic venous reflux. In July 2014, we introduced a local anaesthetic "walk-in walk-out" pelvic vein embolisation service situated in a vein clinic, remote from a hospital. Methods Prospective audit of all patients undergoing pelvic vein embolisation for pelvic venous reflux. All patients had serum urea and electrolytes tested before procedure. Embolisation coils used were interlock embolisation coils (Boston Scientific, USA) as they can be repositioned after deployment and before release...
January 1, 2017: Phlebology
https://www.readbyqxmd.com/read/28987770/prognostic-scores-for-sorafenib-treated-hepatocellular-carcinoma-patients-a-new-application-for-the-hepatoma-arterial-embolisation-prognostic-score
#8
J Edeline, J-F Blanc, B Campillo-Gimenez, Y-T Ma, J King, O Faluyi, J Mathurin, S Ghazi, D H Palmer, T Meyer
BACKGROUND: No prognostic classification is currently used for patients treated with systemic therapies for Hepatocellular Carcinoma (HCC). METHODS: We retrospectively analysed data from patients treated with sorafenib for HCC from five centres in France and in the United Kingdom (UK). The training set comprised data from two centres and the validation set from three. Variables independently associated with Overall Survival (OS) in the training set were used to build the SAP (Sorafenib Advanced HCC Prognosis) score...
October 4, 2017: European Journal of Cancer
https://www.readbyqxmd.com/read/28981490/ten-year-experience-of-splenic-trauma-in-new-zealand-the-rise-of-non-operative-management
#9
Yassar Alamri, Dana Moon, Damien Ah Yen, Chris Wakeman, Tim Eglinton, Frank Frizelle
AIM: The aim of this study was to describe the demographics, mechanisms of injury, management and outcomes in patients who suffered splenic trauma in Christchurch, New Zealand. METHODS: A retrospective study included all splenic injury patients admitted to Christchurch Public Hospital between January 2005 and August 2015. RESULTS: A total of 238 patients were included, with a median age of 26 years (4-88.7). Of these, 235 patients had blunt injuries...
October 6, 2017: New Zealand Medical Journal
https://www.readbyqxmd.com/read/28980900/one-year-in-review-2017-beh%C3%A3-et-s-syndrome
#10
REVIEW
Gulen Hatemi, Emire Seyahi, Izzet Fresko, Rosaria Talarico, Vedat Hamuryudan
A meta-analysis showed that methodological differences in prevalence studies such as a sample survey design or census design may be responsible for some of the variance in BS prevalence reported across countries, in addition to a true geographic variation. Efforts towards developing a data driven core set of outcome measures for clinical trials is continuing. Multimodal imaging using color fundus photography, fluorescein angiography, and optical coherence tomography is essential in visualising diagnostic features, detecting structural changes, and monitoring disease activity and response to treatment in Behçet's uveitis...
September 29, 2017: Clinical and Experimental Rheumatology
https://www.readbyqxmd.com/read/28963389/typical-carcinoid-involving-the-main-carina-managed-with-arterial-embolisation-endobronchial-resection-and-ablation-ultimately-followed-by-carinal-resection
#11
Michael W Y Tan, Paul Leong, Phillip Antippa, Barton R Jennings
Bronchial carcinoids are uncommon pulmonary tumours, and the gold standard management is surgical resection. Their management is often complicated by their proximal location and propensity to bleed when manipulated. A 22-year-old man was found to have typical carcinoid tumour involving the carina and surgical resection was considered not feasible. We report our experience with a multimodality approach involving arterial embolisation, with subsequent endobronchial resection and ablation. Residual disease was found and managed with definitive carinal resection...
September 28, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28959490/abcd-2-risk-score-does-not-predict-the-presence-of-cerebral-microemboli-in-patients-with-hyper-acute-symptomatic-critical-carotid-artery-stenosis
#12
Mahmud Saedon, Charles E Hutchinson, Christopher H E Imray, Donald R J Singer
INTRODUCTION: ABCD(2) risk score and cerebral microemboli detected by transcranial Doppler (TCD) have been separately shown to the predict risk of recurrent acute stroke. We studied whether ABCD(2) risk score predicts cerebral microemboli in patients with hyper-acute symptomatic carotid artery stenosis. PARTICIPANTS AND METHODS: We studied 206 patients presenting within 2 weeks of transient ischaemic attack or minor stroke and found to have critical carotid artery stenosis (≥50%)...
June 2017: Stroke and Vascular Neurology
https://www.readbyqxmd.com/read/28951647/endovascular-management-of-traumatic-pseudoaneurysm-short-long-term-outcomes
#13
Bishav Mohan, Shekhar Singal, Akshdeep Singh Bawa, Pankaj Mahindra, Mohammad Yamin
BACKGROUND: Pseudoaneurysms as result of orthopaedic injuries are a known clinical entity. But with increase in operative interventions and use of implants, its incidence is bound to increase. It is important to detect this complication at the earliest to avoid any limb or life threatening problems. Selective angiography is a minimally invasive technique to pin point the diagnosis and at the same time allow for therapeutic embolization/stenting of the pseudo aneurysm. METHODS: A retrospective review of inpatients from January 2007 to January 2013 requiring transarterial embolization/stenting for pseudoaneurysm in the limbs...
July 2017: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/28951427/an-unexpected-complication-following-uterine-artery-embolisation
#14
Sarah Peters, Michelle Wise, Brendan Buckley
A 35-year-old nulliparous woman underwent uterine artery embolisation (UAE) for heavy menstrual bleeding and anaemia due to fibroids, refractive to medical and surgical treatment.Bilateral UAE was performed after cephazolin prophylaxis and analgesia. Postoperatively, pain and abdominal bloating were prominent. Symptoms were initially treated as postembolisation syndrome, and analgesia was escalated. By the third day, pain was worsening and the woman developed marked tachypnoea and tachycardia, with raised inflammatory markers and lactate...
September 26, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28947428/fat-attacks-a-case-of-fat-embolisation-syndrome-postliposuction
#15
Adam Ali, George Theobald, Mohammed Asif Arshad
Liposuction is a procedure commonly performed in the UK usually with a low incidence of serious sequelae; however with larger patients and increased volumes of lipoaspirate, complications have been reported more frequently. One of the rare but very serious complications postliposuction is fat embolism syndrome (FES), a life-threatening condition difficult to diagnose and limited in treatment.The authors present the case of a 45-year-old woman who was admitted to the intensive care unit postelective liposuction for bilateral leg lipoedema...
September 25, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28929055/the-four-port-bradoo-technique-an-alternative-to-the-modified-endoscopic-denker-s-approach-for-giant-jna
#16
Renuka Bradoo, Anagha Joshi, Kshtij Shah, Tejal Patel, Tanvi Lohiya
The aim of this study is to emphasise the importance of preserving the anterior facial skeleton in angiofibroma surgery and to introduce a new approach by which tumors with far lateral extensions can be operated upon successfully without disruption of the anterior facial skeleton. This is a prospective study conducted at a tertiary referral academic centre. Two patients with extensive juvenile nasopharyngeal angiofibroma with far lateral extensions were recruited and they underwent surgery between July and August 2016...
September 2017: Indian Journal of Otolaryngology and Head and Neck Surgery
https://www.readbyqxmd.com/read/28910356/recent-trends-in-30-day-mortality-in-patients-with-blunt-splenic-injury-a-nationwide-trauma-database-study-in-japan
#17
Chie Tanaka, Takashi Tagami, Hisashi Matsumoto, Kiyoshi Matsuda, Shiei Kim, Yuta Moroe, Reo Fukuda, Kyoko Unemoto, Hiroyuki Yokota
BACKGROUND: Splenic injury frequently occurs after blunt abdominal trauma; however, limited epidemiological data regarding mortality are available. We aimed to investigate mortality rate trends after blunt splenic injury in Japan. METHODS: We retrospectively identified 1,721 adults with blunt splenic injury (American Association for the Surgery of Trauma splenic injury scale grades III-V) from the 2004-2014 Japan Trauma Data Bank. We grouped the records of these patients into 3 time phases: phase I (2004-2008), phase II (2009-2012), and phase III (2013-2014)...
2017: PloS One
https://www.readbyqxmd.com/read/28890122/lumbar-segmental-artery-pseudoaneurysm-after-l5-pedicle-screw-placement-a-rare-vascular-complication
#18
M Álvarez Postigo, J Pizones Arce, E Izquierdo Núñez
Posterior lumbar screw fixation is a common surgical procedure nowadays. However, it can sometimes produce complications that can be devastating. One of the less common causes of major complication is the misplacement of a pedicle screw. This highlights the importance of being methodical when placing pedicle screws, and checking that the pathway has been created correctly and their placement. We present a case of a massive bleed after a pedicular screw placement during lumbar canal stenosis surgery. Screw malposition led to intraoperative haemodynamic instability after failed attempts to control bleeding in the surgical site...
September 7, 2017: Revista Española de Cirugía Ortopédica y Traumatología
https://www.readbyqxmd.com/read/28881497/therapies-for-advanced-stage-hepatocellular-carcinoma-with-macrovascular-invasion-or-metastatic-disease-a-systematic-review-and-meta-analysis
#19
REVIEW
Richard S Finn, Andrew X Zhu, Farah Wigdan, Jehad Almasri, Feras Zaiem, Larry J Prokop, Mohammad Hassan Murad, Khaled Mohammed
Hepatocellular carcinoma (HCC) is a complex disease most commonly arising in the background of chronic liver disease. In the past two decades there has been a significant increase in our understanding of both the clinical and molecular heterogeneity of HCC. There has been a robust increase in clinical trial activity in patients with poor prognostic factors such as macrovascular invasion and extrahepatic spread. We aimed to synthesize the evidence for the treatment of patients with advanced HCC based on these baseline characteristics including patients with both Child-Pugh scores of A and B...
September 7, 2017: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/28876573/hemosuccus-pancreaticus-from-ruptured-splenic-vein-pseudoaneurysm-secondary-to-necrotizing-pancreatitis-a-case-report
#20
M L Medina, C Saroca
Hemosuccus pancreaticus is a rare cause of gastrointestinal bleeding in which haemorrhage occurs from the ampulla of vater via the pancreatic duct, mostly from ruptured pseudoaneurysms. Our patient is a 25-year-old Filipino male who presented with intermittent epigastric pain associated with melena and decreasing haemoglobin despite multiple blood transfusions. EGD showed erythematous gastric and duodenal mucosa with no evidence of active bleeding. Whole abdominal CT scan with IV contrast showed diffusely prominent pancreas with areas of non-enhancement suggestive necrosis...
September 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
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