scholarly journals Curious case of a true aneurysm of the lateral femoral circumflex artery: a rare but important differential in the diagnosis of a painless groin mass

2019 ◽  
Vol 12 (3) ◽  
pp. e228312
Author(s):  
Joe Hwong Pang ◽  
Ahmed Elbasty ◽  
Felicity J Meyer
Keyword(s):  
Femoral Nerve ◽  
Uneventful Recovery ◽  
True Aneurysm ◽  
Circumflex Artery ◽  
Left Groin ◽  
History Of ◽  
Lateral Femoral Circumflex Artery ◽  
Us Scan ◽  
Firm Mass

A 60-year-old man, presented with a 3-month history of a painless, non-pulsatile firm mass in the left groin. He was referred to sarcoma clinic for a biopsy following MRI and B mode ultrasound (US). This was abandoned when colour flow US imaging revealed the mass more in keeping with a pseudoaneurysm rather than malignancy. He was then referred to the vascular team for further investigation, where CT angiography revealed a large and thrombosed true aneurysm of his left femoral circumflex artery. This was treated with open surgical repair. Technical challenges included an adherent femoral nerve, which was carefully dissected off the aneurysm before the aneurysm was ligated and resected. An uneventful recovery followed with discharge within 48 hours. Follow-up duplex US scan revealed patent arteries with no further abnormalities.

scholarly journals A case report: delayed right ventricular pericardial fistula and aneurysm following penetrating traumatic injury—a controversial aetiology

2020 ◽  
Vol 4 (4) ◽  
pp. 1-5
Author(s):  
Martina Steinmaurer ◽  
Blanche Cupido ◽  
Matthew Hannington ◽  
Rodgers Manganyi
Keyword(s):  
Pericardial Effusion ◽  
Right Ventricular ◽  
Cardiac Tamponade ◽  
Traumatic Injury ◽  
Clinical Signs ◽  
The Body ◽  
Delayed Presentation ◽  
True Aneurysm ◽  
History Of

Abstract Background Right ventricular aneurysms (RVAs) are rare. We present a case with a combined RVA and right ventricular pericardial fistula resulting in a pericardial effusion and cardiac tamponade. The RVA was detected 47 days after the patient suffered a gunshot wound. This report adds to the body of scarce literature on RVA aetiology, diagnoses, and treatment. Case summary A 30-year-old male patient presented with worsening respiratory distress over a 7-day period with clinical signs of cardiac tamponade following a history of a gunshot (with associated liver laceration, pulmonary embolism, right nephrectomy, and sepsis) 47 days prior. Transthoracic echocardiography showed a large circumferential pericardial effusion and an RVA. The patient was emergently taken for surgical repair of the RVA. Discussion Our case presents a delayed presentation of a gunshot heart and an aetiology with indications of and against a true aneurysm. It brings attention to possible complications of penetrating precordial injuries, with the need for consideration and possible evaluation at follow-up. The literature on the operative excision of RVA is reviewed and various aetiological factors and consequences are discussed.

scholarly journals Pantaloon Hernia in a Female: A Rare Finding

2021 ◽  
Vol 3 (2) ◽  
pp. 1-2
Author(s):  
Onyeyirichi Otuu ◽  
Uche Emmanuel Eni ◽  
Callistus Ugochukwu Ndunaka ◽  
Nwanneka Louisa Kwentoh
Keyword(s):  
Inguinal Hernia ◽  
Correct Diagnosis ◽  
Posterior Wall ◽  
Uneventful Recovery ◽  
Indirect Inguinal Hernia ◽  
Left Groin ◽  
Epigastric Artery ◽  
Appropriate Treatment ◽  
Groin Swelling

The incidence of inguinal hernia in females is less compared to the males. Pantaloon hernia in females is even rarer and may be first diagnosed during surgery. We report a rare case of pantaloon hernia in a 60 year old female patient. She presented with reducible left groin swelling of 3 years duration and a clinical diagnosis of an indirect inguinal hernia made. A direct sac and an indirect sac were discovered at operation on both sides of the inferior epigastric artery. The posterior wall was repaired by Lichtenstein method. Patient made an uneventful recovery and there was no recurrence after 12 months of follow up. Though pantaloon hernia is rare in females, proper dissection, and identification of structure in the inguinal canal is necessary to make the correct diagnosis and to offer the appropriate treatment.

scholarly journals Successful Ultrasound-Guided Femoral Nerve Blockade and Catheterization in a Patient with Von Willebrand Disease

2015 ◽  
Vol 2015 ◽  
pp. 1-4
Author(s):  
Youmna E. DiStefano ◽  
Michael D. Lazar
Keyword(s):  
Femoral Nerve ◽  
Opioid Therapy ◽  
Von Willebrand Disease ◽  
Nerve Blockade ◽  
Perioperative Analgesia ◽  
Peripheral Nerve Blockade ◽  
History Of ◽  
Total Knee ◽  
Von Willebrand

Peripheral nerve blockade (PNB) is superior to neuraxial anesthesia and/or opioid therapy for perioperative analgesia in total knee replacement (TKR). Evidence on the safety of PNB in patients with coagulopathy is lacking. We describe the first documented account of continuous femoral PNB for perioperative analgesia in a patient with Von Willebrand Disease (vWD). Given her history of opioid tolerance and after an informative discussion, a continuous femoral PNB was planned for in this 34-year-old female undergoing TKR. A Humate-P intravenous infusion was started and the patient was positioned supinely. Using sterile technique with ultrasound guidance, a Contiplex 18 Gauge Tuohy needle was advanced in plane through the fascia iliaca towards the femoral nerve. A nerve catheter was threaded through the needle and secured without complications. Postoperatively, a levobupivacaine femoral catheter infusion was maintained, and twice daily Humate-P intravenous infusions were administered for 48 hours; enoxaparin thromboprophylaxis was initiated thereafter. The patient was discharged uneventfully on postoperative day 4. Given documentation of delayed, unheralded bleeding from PNB in coagulopathic patients, we recommend individualized PNB in vWD patients. Multidisciplinary team involvement is required to guide factor supplementation and thromboprophylaxis, as is close follow-up to elicit signs of bleeding throughout the delayed postoperative period.

scholarly journals Preliminary Experience of Autologous Free Dermal Graft Combined With Free Myocutaneous Flap in the Treatment of Refractory Bronchopleural Fistula With Empyema

2021 ◽  
Author(s):  
Lei Wang ◽  
Zhongliang He ◽  
Guoxing Chen ◽  
Shunxin Xin ◽  
Chun Zhang
Keyword(s):  
Myocutaneous Flap ◽  
Bronchopleural Fistula ◽  
Disease Recurrence ◽  
Clinical Effects ◽  
Circumflex Artery ◽  
Dermal Graft ◽  
Chronic Empyema ◽  
Residual Cavity ◽  
Lateral Femoral Circumflex Artery

Abstract Background: To explore the effects of autologous free dermal graft combined with free myocutaneous flap on bronchopleural fistula with empyema. Methods: Two patients with refractory empyema and bronchopleural fistula were treated with autologous free dermal graft combined with free myocutaneous flap. The free dermal graft was harvested from the skin around the incision and the fistula was sutured intermittently. The lateral femoral myocutaneous flap was selected as the free flap. Using microsurgery techniques, the descending branch of the lateral femoral circumflex artery and the thoracodorsal blood vessel were anastomosed intermittently to maintain the blood supply of the myocutaneous flap. After surgery, the empyema, air leakage, and the survival of the myocutaneous flap were observed. Results: No necrosis of the myocutaneous flap was observed after surgery. There was no disease recurrence after follow-up for seven and six months, respectively. Re-examination of the chest computed tomography or magnetic resonance imaging indicated that the empyema residual cavity had disappeared. Conclusion: Autologous free dermal graft combined with free lateral femoral myocutaneous flap transplantation is effective in the treatment of patients with bronchopleural fistula with refractory chronic empyema, with satisfactory clinical effects.

scholarly journals Hemangioblastoma of the lateral ventricle

2018 ◽  
Vol 22 (1) ◽  
pp. 94-96
Author(s):  
Carlos Augusto Ferreira Lobão ◽  
Albedy Moreira Bastos ◽  
Leonidas Braga Dias Junior
Keyword(s):  
Lateral Ventricle ◽  
English Literature ◽  
Tumor Resection ◽  
Uneventful Recovery ◽  
Von Hippel Lindau ◽  
Left Lateral Ventricle ◽  
Pubmed Search ◽  
History Of ◽  
Brain Ct Scan

Introduction: Hemangioblastomas are capillary-rich benigntumors mainly found in the infratentorial compartment. When at the supratentorial space, they are rarely located at the lateral ventricle. We report on a case of a 25 years-old female patient treated at our institution. Case report: The patient came to our service with a three months history of progressive headache, bilateral visual loss, and right hemiparesis. Brain CT-scan and MRI showed a heterogeneous intraventricular contrast-enhancing lesion at the left lateral ventricle. Von Hippel-Lindau was investigated but she had neither family history of the disease nor any signs of it. She was submitted to microsurgical tumor resection with a parieto-occipital craniotomy via the intraparietal sulcus, with an uneventful recovery. Hystological examination confirmed the diagnosis of hemangioblastoma. The patient is in outpatient clinic follow-up completely integrated to her familiar and professional life. Discussion: According to a PubMed search, this is the seventh case of lateral ventricle hemangioblastoma reported on English literature. It has a cystic characteristic that differs from other cases, and a bigger volume compared to the previous ones. 

Use of a stent graft in tumor erosion of the common femoral artery with life-threatening bleeding

VASA ◽  
2017 ◽  
Vol 46 (5) ◽  
pp. 400-402
Author(s):  
Hong H. Keo ◽  
Nicolas Diehm ◽  
Daniel Staub ◽  
Frederic Baumann
Keyword(s):  
Femoral Artery ◽  
Common Femoral Artery ◽  
Stent Grafts ◽  
Left Groin ◽  
Limited Life ◽  
Alternative Treatment Option ◽  
Oncologic Patients ◽  
Life Threatening ◽  
History Of

Abstract. We report a case of a 56-year-old male patient with a life-threatening left common femoral artery bleeding due to tumor erosion. The patient had a history of advanced high-grade pleomorphic leiomyosarcoma of the left groin with pulmonary metastasis. Clinical examination revealed a massive tumor bulking at the left groin with necrosis and phleb- and lymphedema. Given the circumstances, open surgery was not possible. Thus, it was decided to treat the patient with an endovascular procedure. The postprocedural course was uneventful, the patient received blood product and was hemodynamically stable. He was discharged at day six with ambulatory follow-up. Endovascular therapy using stent grafts to exclude a life-threatening bleeding is a valuable alternative treatment option in oncologic patients with limited life expectancy, which are unsuitable for surgery

Abstract 141: A Case of Kawasaki Disease with Re-dilatation of a Coronary Artery Aneurysm after Regression

Circulation ◽  
2015 ◽  
Vol 131 (suppl_2) ◽  
Author(s):  
Kensuke Oka ◽  
Takaomi Minami ◽  
Tatsuya Anzai ◽  
Sadahiro Furui ◽  
Akiko Yokomizo ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Kawasaki Disease ◽  
Coronary Angiography ◽  
Artery Aneurysm ◽  
Circumflex Artery ◽  
Left Circumflex Artery ◽  
Coronary Ct ◽  
History Of ◽  
The Right

Background: In patients with Kawasaki disease (KD), re-dilatation of coronary artery lesions (CAL) after regression is very rare. Here we report a case of KD with CAL re-dilatation after regression. Case report: A 15-year-old boy was diagnosed with KD at 1 year of age and was treated with intravenous immunoglobulin (IVIG, 400 mg/kg х 5 days). On day 14, echocardiography revealed CAL on the right coronary artery (RCA) and left coronary artery (LCA). Coronary arteriographic findings were as follows: segment 1, 3 mm in diameter; segment 6, 5 mm in diameter. He was prescribed aspirin, ticlopidine, and warfarin for 3 years. When he was 3 years old, coronary angiography showed complete CAL regression. His medications were discontinued and he underwent routine follow-up by echocardiography on which the CAL were not seen. At 14 years of age, coronary CT revealed re-dilatation of the LCA. Coronary angiography showed the same findings: 7 mm in diameter at the bifurcation between the LAD and the left circumflex artery, while the other regions were intact. He restarted aspirin and warfarin. The mechanism of CAL re-dilatation remains unclear; however, it is very important to follow patients carefully and routinely using echocardiography and/or coronary computed tomography, especially in cases with a history of CAL.

scholarly journals Agenesis of the corpus callosum with interhemispheric cyst: clinical implications and outcome

2018 ◽  
Vol 11 (1) ◽  
pp. bcr-2018-227366 ◽  
Author(s):  
Krishna Gopagondanahalli Revanna ◽  
Victor Samuel Rajadurai ◽  
Suresh Chandran
Keyword(s):  
Corpus Callosum ◽  
Head Circumference ◽  
Infantile Spasm ◽  
Male Infant ◽  
Fetal Ultrasound ◽  
Neurodevelopmental Delay ◽  
History Of ◽  
Us Scan ◽  
Interhemispheric Cyst

We describe two cases of agenesis of the corpus callosum (ACC) with interhemispheric cyst (IHC). Case 1: a male infant was born at 36 weeks gestation with a history of second trimester fetal ultrasound (US) scan and MRI showing ACC with IHC. His head circumference at birth and 5 months was at 90th centile. He developed infantile spasm and electroencephalogram showed hypsarrhythmia at 5 months of age. Seizures were controlled. He is under evaluation for surgical treatment. Case 2: ACC with a midline cyst was reported in the midtrimester US scan of a male infant. Subsequent fetal scans showed increasing size of the cyst. At birth, he had macrocephaly with a head circumference above 97th centile. MRI of the brain confirmed ACC with IHC. The parents refused a cystoperitoneal shunt offered. The child displayed gross neurodevelopmental delay with progressive hydrocephalus on follow-up and succumbed to aspiration pneumonia at 22 months of age.

Bilateral aneurysm formation developing from junctional dilatation (infundibulum) of the posterior communicating arteries

1983 ◽  
Vol 58 (1) ◽  
pp. 117-119 ◽  
Author(s):  
Toru Itakura ◽  
Fuminori Ozaki ◽  
Ekini Nakai ◽  
Toru Fujii ◽  
Seiji Hayashi ◽  
...  
Keyword(s):  
Young Women ◽  
True Aneurysm ◽  
Content Type ◽  
Aneurysmal Rupture ◽  
Follow Up Study ◽  
Aneurysm Formation ◽  
History Of ◽  
Fine Print

✓ The authors report a case in which bilateral aneurysms developed from junctional dilatations of the posterior communicating arteries. A 7-year follow-up study of this case strongly suggested that an infundibulum can develop into a true aneurysm. After reviewing seven cases in the literature, the authors conclude that junctional dilatations, especially in young women with a history of aneurysmal rupture, should be carefully followed by angiography.

scholarly journals How Point-of-Care Ultrasound led to a diagnosis of May-Thurner Syndrome

POCUS Journal ◽  
2021 ◽  
Vol 6 (2) ◽  
pp. 76-79
Author(s):  
Daniel Belkin ◽  
Mitchell Belkin ◽  
Maedeh Ashrafi ◽  
Charan Vegivinti ◽  
Yung-Hsien Wang ◽  
...  
Keyword(s):  
Groin Pain ◽  
Point Of Care ◽  
Lumbar Vertebrae ◽  
Point Of Care Ultrasound ◽  
Left Groin ◽  
Vein Thrombosis ◽  
Left Limb ◽  
History Of ◽  
Deep Vein

A 65-year-old man with a history of a left-sided inguinal hernia presented with three days of left-sided groin pain worsened with exertion and fatigue. The patient was afebrile but tachycardic, and physical examination revealed a tender, erythematous immobile bulge in his left groin. Laboratory studies revealed leukocytosis. Lymphadenopathy secondary to infectious or inflammatory etiology was suspected. However, point-of-care ultrasound (POCUS) identified extensive deep vein thrombosis (DVT) of the lower left limb. Follow-up imaging revealed this to be secondary to May-Thurner syndrome, a mechanical compression of an iliocaval vein against the lumbar vertebrae by a common iliac artery. This report demonstrates how POCUS can be used to identify lower extremity DVT, thereby expediting diagnosis and treatment and potentially preventing complications.

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