scholarly journals Recurrent Midgut Bleeding due to Jejunal Angioleiomyoma

2016 ◽  
Vol 2016 ◽  
pp. 1-4
Author(s):  
Mahir Gachabayov ◽  
Petr Mityushin
Keyword(s):  
Smooth Muscle ◽  
Small Bowel ◽  
Gastrointestinal Bleeding ◽  
Male Patient ◽  
Bowel Resection ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced ◽  
Enhanced Ct ◽  
Life Threatening ◽  
Bowel Neoplasm

Angioleiomyoma being a type of true smooth muscle gastrointestinal tumors can lead to serious life-threatening gastrointestinal bleeding. We report a case of 21-year-old male patient with recurrent midgut bleeding. Contrast-enhanced CT revealed highly vascular small bowel neoplasm. The patient underwent laparotomy with bowel resection and recovered uneventfully. Histopathology revealed jejunal angioleiomyoma.

scholarly journals Case Report: Seaweed Bezoar Masquerading as a Malignant Obstruction

2018 ◽  
Vol 2018 ◽  
pp. 1-3
Author(s):  
E. C. Abboud ◽  
B. Babic
Keyword(s):  
Small Bowel ◽  
High Sensitivity ◽  
Bowel Loop ◽  
Asian Woman ◽  
Malignant Obstruction ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced ◽  
Enhanced Ct ◽  
Risk Patients ◽  
High Index Of Suspicion

Bezoars represent a rare cause of small bowel obstruction (SBO). Nonoperative management of bezoars includes use of endoscopy with mechanical or chemical dissolution methods. When obstruction persists, surgical intervention becomes necessary. Here, we present the case of an Asian woman with a SBO secondary to a phytobezoar masquerading as a malignancy. She presented with two days of acute-on-chronic abdominal pain that started after eating seaweed. Initial computed tomography (CT) scan showed a SBO with a jejunal transition point and ill-defined liver lesions, worrisome for a malignant obstruction with liver metastases. Further imaging, however, showed the resolution of these artifacts. Subsequent laparotomy revealed a small bowel loop with copious obstructing seaweed. A distal stricture was palpated, and the involved segment was resected. Intraoperative liver ultrasound was negative, and final pathology revealed benign small intestine with a mild stricture. Given the rarity of bezoar-related obstructions, the diagnosis is often delayed particularly when confounding factors exist such as our patient’s concomitant hepatic findings. Contrast-enhanced CT has a high sensitivity but a lower specificity in identifying bezoars. A high index of suspicion is therefore necessary especially when managing higher risk patients.

scholarly journals Ruptured aneurysm of the hepatic artery: a mismatching diagnosis

2013 ◽  
pp. 175-178
Author(s):  
Vincenzo Bua ◽  
Lorenzo Marsigli ◽  
Roberto Nardi ◽  
Anna Maria Trivella ◽  
Salvatore Isceri ◽  
...  
Keyword(s):  
Hepatic Artery ◽  
Ct Scanning ◽  
Gelatin Sponge ◽  
Contrast Enhanced Ct ◽  
Life Saving ◽  
Contrast Enhanced ◽  
Enhanced Ct ◽  
Threatening Condition ◽  
Life Threatening ◽  
Intraabdominal Hemorrhage

Background: Hepatic aneurysms are extremely rare with very few cases reported, and most have been source of misdiagnosis and clinical pitfalls in emergency medicine. Presentation with intraabdominal hemorrhage is associated with a high mortality rate. Case report: We report the case of an adult male, referred for a severe acute pain in the left lower chest-upper quadrant abdomen pain. We present multislice contrast-enhanced CT-scanning and angiographic findings, and a life-saving emergency trancatheter embolization, using fragments of absorbable gelatin sponge. Emergency doctors should consider ruptured hepatic artery aneurysms in the differential diagnosis of acute abdominal pain and promptly cooperate with endovascular specialists to treat this life-threatening condition.

P3382Vascular calcium Index: an imaging tool to predict vascular complications and major bleeding in TF-TAVI

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
A Felix-Oliveira ◽  
R Campante Teles ◽  
A Ferreira ◽  
J Brito ◽  
P A Goncalves ◽  
...  
Keyword(s):  
Major Bleeding ◽  
Odds Ratio ◽  
Vascular Complications ◽  
Calcium Score ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced ◽  
Enhanced Ct ◽  
Quantitative Score ◽  
Life Threatening ◽  
Major Vascular Injury

Abstract Introduction Vascular calcification has been associated with worse outcomes in transfemoral TAVI (TF-TAVI). However, there is currently no simple method to assess it and identify different patterns of calcification in an objective and quantitative manner. The purpose of this study was to develop a quantitative score of aortic (Ao) and ileofemural (IF) calcification and to assess its ability to predict life-threatening bleeding (LTB) and major vascular complications during TF-TAVI. Methods Case-control single center retrospective study of patients undergoing TF-TAVI between Nov2015 and Aug2018 including 183 consecutive patients (99 women, mean age 83±3 years, mean Euroscore II - ESII - 6.0±4.1). The Vascular Calcium Score was calculated for the entire Ao and IF vessels using a modified Agatston score derived from contrast-enhanced CT images, with calcium threshold locally adjusted for luminal attenuation (mean attenuation + 5x SD). A luminal attenuation threshold >600UH impaired vascular calcium evaluation and patients were excluded. LTB and major vascular complications were adjudicated according to the VARC-2 classification and identified by chart review by and independent team. Results Thirty patients (16%) suffered major bleeding and 13 (7%) experienced LTB. Major vascular injury occurred in 11 patients (6%). The median total vascular calcium score (TCS) was 11752 AU (IQR: 6388–19844) and median IF score (IFS) was 2210AU (IQR: 865–4170). TCS indexed for body surface area (TCSi) was predictor of LTB (AUC: 0.78±0.07, p<0.05) and of major vascular complications (AUC: 0.85±0.05, p<0.05). After multivariate analysis, iTCS and glomerular filtration rate (GFR) remained as predictors of LTB with an HR of 1.11 for each increase in 1000UA/m2 of TCSi (95% CI: 1.03–1.18) and 0.94 (95% CI: 0.88–0.985) respectively, independently of the ESII. iTCS and GFR were also independently associated with major vascular complications (p<0.05). Patients with an iTCS above 9750AU/m2 have an odds ratio of 7.7 (95% CI: 2.0 - 29.2) for LTB. This cut-off has a sensitivity of 77% and a specificity of 70% for LTB. Similarly, patients with an iTCS above 9750AU/m2 have an odds ratio of 10.3 (95% CI: 22 - 49.3) for major vascular injury. Conclusions A quantitative score for vascular calcification in contrast-enhanced CT images was developed. iTCS was independently associated with life-threatening bleeding and major vascular complications.

Unusual cause of acute upper airway obstruction: spontaneous pharyngeal haematoma

2021 ◽  
Vol 14 (3) ◽  
pp. e242061
Author(s):  
Kohei Okada ◽  
Yuji Okazaki ◽  
Toshihisa Ichiba ◽  
Yusuke Higashi
Keyword(s):  
Airway Obstruction ◽  
Sore Throat ◽  
Upper Airway ◽  
Upper Airway Obstruction ◽  
Airway Protection ◽  
Emergency Airway ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced ◽  
Enhanced Ct ◽  
Life Threatening

Spontaneous pharyngeal haematoma is a rare but life-threatening cause of acute upper airway obstruction, and the clinical manifestation may mimic haemoptysis. A 65-year-old man presented to our emergency department with symptoms of sore throat and haemoptysis. He had no medical history. At arrival, O2 saturation was 95% on 5 L/min of oxygen with a mask. Results of a blood examination including a coagulation test were normal. Laryngoscopy showed enlargement of the left pharynx and a narrowed airway. Contrast-enhanced CT showed extravascular leakage of contrast medium inside the left pharyngeal haematoma. Fortunately, the haematoma did not lead to airway obstruction, and it decreased spontaneously. We finally diagnosed this case as spontaneous pharyngeal haematoma. When we examine a patient with a symptom of haemoptysis accompanied by sore throat, it is necessary to consider pharyngeal haematoma and to prepare emergency airway protection for acute upper airway obstruction.

scholarly journals Rasmussen’s aneurysm masquerading as mass lesion

2020 ◽  
Vol 13 (2) ◽  
pp. e232669
Author(s):  
Satyajeet Sahoo ◽  
Manoj Kumar Panigrahi ◽  
Suprava Naik ◽  
Prasanta Raghab Mohapatra
Keyword(s):  
Mass Lesion ◽  
Male Smoker ◽  
Adequate Treatment ◽  
Artery Pseudoaneurysm ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced ◽  
Enhanced Ct ◽  
Pulmonary Disorder ◽  
Life Threatening ◽  
Pulmonary Artery Pseudoaneurysm

Haemoptysis is an often encountered respiratory symptom. The amount of haemoptysis varies from mild to life-threatening severity and may indicate the underlying pulmonary disorder. Herein, we report a 50-year-old male smoker who presented with occasional streaky to mild haemoptysis for last 1 year. He had pulmonary tuberculosis 10 years ago and had received adequate treatment. Chest radiograph was suspicious of a mass lesion in left upper lung. Contrast-enhanced CT scan of thorax revealed pulmonary artery pseudoaneurysm suggestive of Rasmussen’s aneurysm. Unlike this case, Rasmussen’s aneurysm usually manifests as life-threatening haemoptysis and portends a high mortality.

Ileal cavernous haemangioma in an adult presenting as a rare cause of small bowel obstruction

2021 ◽  
Vol 14 (3) ◽  
pp. e239115
Author(s):  
Hitali Vasant Majethia ◽  
Vijay Waman Dhakre ◽  
Husain Gheewala ◽  
Prajesh Bhuta
Keyword(s):  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Neuroendocrine Tumour ◽  
Histopathological Analysis ◽  
Cavernous Haemangioma ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced ◽  
Enhanced Ct ◽  
Laparoscopic Assisted

Haemangiomas of the small bowel are a very rare entity and rarely considered as an aetiology for an intestinal obstruction. Contrast-enhanced CT is the investigation of choice but the lesion can be confused with malignancy or rarely a neuroendocrine tumour. Commonly it presents as abdominal pain with anaemia and/or melaena. With patients presenting without obstruction or acute gastrointestinal bleed, capsule endoscopy has shown to be a useful diagnostic tool.We present here our experience of managing a case of a patient with ileal haemangioma who presented with a subacute small bowel obstruction and underwent a laparoscopic-assisted ileal segmental resection with side-to-side anastomosis. The lesion was a cavernous haemangioma on histopathological analysis.

scholarly journals The role of MDCT in the diagnosis of small bowel obstruction secondary to multiple adhesion bands: A case report

2019 ◽  
pp. 4407-4410
Author(s):  
Farideh Gharekhanloo ◽  
Masoud Esnaashari
Keyword(s):  
Small Bowel ◽  
Ct Scan ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Multidetector Ct ◽  
Contrast Enhanced Ct ◽  
Technological Advances ◽  
Contrast Enhanced ◽  
Enhanced Ct ◽  
History Of

Adhesion band is a major cause of small bowel obstruction. Traditionally, the obtained results of computed tomography (CT) scan were indicative of adhesion band as an etiology for small bowel obstruction. However, adhesion is easily diagnosed today due to technological advances in radiology and high-quality multidetector CT. It is important to avoid the possible complications of bowel obstruction in the early and appropriate surgical intervention. This article is a report of a 45-year-old woman with abdominal pain and history of previous abdominal surgery. A contrast-enhanced CT scan showed multiple adhesion bands ensued the abrupt narrowing of bowel diameter and closed small-bowel loops obstruction. Furthermore, multiple bands were clearly observed and adhesiolysis was performed in the surgery.

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