Acute and Chronic Complications of Aortic Intramural Hematoma on Follow-up Computed Tomography: Incidence and Predictor Analysis

2008 ◽  
Vol 2008 ◽  
pp. 203-205
Author(s):  
G.A. Gardiner
2007 ◽  
Vol 31 (3) ◽  
pp. 435-440 ◽  
Author(s):  
Young Kyung Lee ◽  
Joon Beom Seo ◽  
Yu Mi Jang ◽  
Kyung Hyun Do ◽  
Song Soo Kim ◽  
...  

Circulation ◽  
1999 ◽  
Vol 100 (suppl_2) ◽  
Author(s):  
Shuichiro Kaji ◽  
Kazuhiro Nishigami ◽  
Takashi Akasaka ◽  
Takeshi Hozumi ◽  
Tsutomu Takagi ◽  
...  

Background —It has been reported that early surgery should be required for patients with type A aortic intramural hematoma (IMH) because it tends to develop classic aortic dissection or rupture. However, the anatomic features of type A IMH that develops dissection or rupture are unknown. The purpose of this study was to investigate the predictors of progression or regression of type A IMH by computed tomography (CT). Methods and Results —Twenty-two consecutive patients with type A IMH were studied by serial CT images. Aortic diameter and aortic wall thickness of the ascending aorta were estimated in CT images at 3 levels on admission and at follow-up (mean 37 days). We defined patients who showed increased maximum aortic wall thickness in the follow-up CT (n=9) or died of rupture (n=1) as the progression group (n=10). The other 12 patients, who all showed decreased maximum wall thickness, were categorized as the regression group. In the progression group, the maximum aortic diameter in the initial CT was significantly greater than that in the regression group (55±6 vs 47±3 mm, P =0.001). A Cox regression analysis revealed that the maximum aortic diameter was the strongest predictor for progression of type A IMH. We considered the optimal cutoff value to be 50 mm for the maximum aortic diameter to predict progression (positive predictive value 83%, negative predictive value 100%). Conclusions —Maximum aortic diameter estimated by the initial CT images is predictive for progression of type A IMH.


2002 ◽  
Vol 35 (6) ◽  
pp. 1179-1183 ◽  
Author(s):  
Eijun Sueyoshi ◽  
Tatsuya Imada ◽  
Ichiro Sakamoto ◽  
Yohjiro Matsuoka ◽  
Kuniaki Hayashi

2020 ◽  

Anticoagulants, including vitamin K antagonists, are widely used for therapeutic and prophylactic purposes. Bleeding is the most important complication of anticoagulant therapy due to over-anticoagulation. Over-anticoagulation may present in unusual ways, such as spontaneous intramural hematoma of the small bowel. The classical clinical picture consists of abdominal pain, small bowel obstruction (that can present as vomiting) and hemorrhagic symptoms that can be related to the bowel or other parts of the body. Radiological examinations are essential for the diagnosis. Ultrasound can be helpful in the diagnostic process, but computed tomography is the procedure of choice. Conservative treatment is usually successful, including procedures that stop the over-anticoagulant consequences. A surgical approach is reserved for complications such as necrosis or perforation of the bowel. The diagnosis is definitively confirmed by the spontaneous resolution of the pathological findings on a follow-up computed tomography scan. We present a case of a 72-year-old woman who was diagnosed with this rare condition affecting the jejunum in the emergency department in our hospital.


Circulation ◽  
2011 ◽  
Vol 124 (11_suppl_1) ◽  
pp. S174-S178 ◽  
Author(s):  
T. Kitai ◽  
S. Kaji ◽  
A. Yamamuro ◽  
T. Tani ◽  
M. Kinoshita ◽  
...  

2010 ◽  
Vol 18 (5) ◽  
pp. 456-463 ◽  
Author(s):  
Thanongchai Siriapisith ◽  
Jitladda Wasinrat ◽  
Worawong Slisatkorn

Circulation ◽  
1999 ◽  
Vol 100 (Supplement 2) ◽  
pp. II-281-II-286 ◽  
Author(s):  
S. Kaji ◽  
K. Nishigami ◽  
T. Akasaka ◽  
T. Hozumi ◽  
T. Takagi ◽  
...  

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