Endoureteral coil embolization of an ureteral arterial fistula

Vascular ◽  
2017 ◽  
Vol 25 (5) ◽  
pp. 557-560 ◽  
Author(s):  
Pavel Kibrik ◽  
Justin Eisenberg ◽  
Marc A Bjurlin ◽  
Natalie Marks ◽  
Anil Hingorani ◽  
...  
Keyword(s):  
Coil Embolization ◽  
Hemoglobin Level ◽  
Ureteral Orifice ◽  
Endovascular Stenting ◽  
Endovascular Interventions ◽  
Threatening Condition ◽  
Robotic Nephrectomy ◽  
Life Threatening ◽  
The Right

Background Ureteral arterial fistulas are rare but potentially life threatening. We present a female who developed a ureteral arterial fistula following a right robotic nephrectomy. After several endovascular interventions to control the bleeding had failed, we approached the fistula through the right ureteral stump with coil embolization. Methods Coil embolization of the right ureteral stump was performed. We utilized a 6Fr × 45 cm sheath inserted through one of the cystoscope channels to cannulate the right ureteral orifice. We then performed a retrograde ureterogram. After, we were able to visualize full length of the ureter, ahd we began placing several 10–12 mm Nester coils to pack the ureter and tamponade the fistula for hemostasis. After the ureter was packed, we injected 1 g of Vancomycin into the ureter. The sheath and cytoscope were removed and the patient did well and was sent to the recovery room. Results Postoperatively, the patient had no complaints of hematuria and her hemoglobin level remained unchanged. She was observed for a few days prior to being discharged to home. The patient’s follow-up at six months revealed resolution of her hematuria. Conclusion Ureteral arterial fistula is a potentially life-threatening condition. Endovascular stenting has provided a safe, reliable alternative to open surgery. However, when endovascular options are not satisfactory, coil embolization of the ureteral stump may serve as a safe and effective alternative treatment for these cases.

May-Thurner syndrome – Are we aware enough?

VASA ◽  
2019 ◽  
Vol 48 (5) ◽  
pp. 381-388 ◽  
Author(s):  
Katalin Mako ◽  
Attila Puskas
Keyword(s):  
Contraceptive Use ◽  
Iliac Vein ◽  
Common Iliac Vein ◽  
Vein Thrombosis ◽  
Compression Syndrome ◽  
Threatening Condition ◽  
Life Threatening ◽  
Iliac Vein Compression ◽  
Iliac Vein Compression Syndrome ◽  
The Right

Summary. Iliac vein compression syndrome (May-Thurner syndrome – MTS) is an anatomically variable clinical condition in which the left common iliac vein is compressed between the right common iliac artery and the underlying spine. This anatomic variant results in an increased incidence of left iliac or iliofemoral vein thrombosis. It predominantly affects young women in the second or third decades of life with preponderance during pregnancy or oral contraceptive use. Although MTS is rare, its true prevalence is underestimated but it can be a life-threatening condition due to development of pulmonary embolism (PE). In this case based review the authors present three cases of MTS. All patients had been previously confirmed with PE, but despite they were admitted to hospital, diagnosed and correctly treated for PE and investigated for thrombophilia, the iliac vein compression syndrome was not suspected or investigated. With this presentation the authors would like to emphasize that MTS is mostly underdiagnosed, and it needs to be ruled out in left iliofemoral vein thrombosis in young individuals.

scholarly journals Peritoneal well-differentiated papillary mesothelioma associated with infertility in a 37-year-old woman

2021 ◽  
Vol 49 (1) ◽  
pp. 030006052098668
Author(s):  
Bo Pang ◽  
Cong Hu ◽  
Qian Liu ◽  
Jinyu Yu ◽  
Zhentong Wei ◽  
...  
Keyword(s):  
Benign Tumors ◽  
Free Fluid ◽  
Adenomatoid Tumor ◽  
Cancer Antigen 125 ◽  
Immunohistochemical Markers ◽  
Serum Ca125 ◽  
Life Threatening ◽  
Well Differentiated ◽  
The Right

Well-differentiated papillary mesothelioma (WDPM) is an uncommon mesothelial tumor. The lesions may be single or multiple and usually behave in a benign or indolent fashion, sometimes persisting for many years. In the present case, a 37-year-old woman had experienced primary infertility for 12 years, and a diagnostic laparoscopy was performed. Approximately 200 mL of dark red, free fluid in the pelvis and more than 10 yellow-white nodules on the surface of the right round ligament, sacrum ligament, right fallopian tube, and both sides of the uterus were found. A lesionectomy was performed and immunohistochemical markers indicated WDPM with adenomatoid tumor. The patient was monitored by computed tomography and serum CA125 (cancer antigen 125) levels for 49 months with no recurrence. WDPM and adenomatoid tumor are both benign tumors of mesothelial origin. Because of the lack of effective radical treatment, regular follow-up is sufficient. However, the effects of estrogen and progesterone on WDPM and adenomatoid tumors during ovulation or pregnancy remains unclear. Although WDPM is not life threatening, a strategy to fulfill the fertility requirements of women with this condition is a new challenge for infertility doctors.

scholarly journals Necrotizing fasciitis with group A Streptococci and Eggerthella lenta as a complication of Varicella in a child – case presentation –

2014 ◽  
Vol 20 (1) ◽  
pp. 35-39
Author(s):  
Cambrea Simona Claudia ◽  
Ilie Maria Margareta ◽  
Carp Dalia Sorina ◽  
Ionescu C.
Keyword(s):  
Necrotizing Fasciitis ◽  
Severe Disease ◽  
The Body ◽  
Group A Streptococci ◽  
Threatening Condition ◽  
Life Threatening ◽  
Group A ◽  
The Right ◽  
Surgery Department ◽  
Short Time

ABSTRACT Necrotizing fasciitis is a life threatening condition that can be quickly spread through the flesh surrounding the muscle. The disease can be polymicrobial, or caused by group A beta hemolytic Streptococci, or by Clostridium spp. We present a case of a 7 years old girl, which was hospitalized in Children Infectious Diseases Department in a 7th day of chickenpox (hematic crusts all over the body), high fever, asthenia, vomiting, oligoanuria, and tumefaction, pain and functio lessa in the right thigh. In a very short time in the right thigh swelling, edema and congestion have increased gradually, and in the third highest middle thigh the ecchymotic areas appeared evolving towards bubbles and blisters which included the right thigh and calf. After excluding the diagnosis of thrombophlebitis was raised suspicion of necrotizing fasciitis. CT pelvic scan evidenced pelvic asymmetry by maximus and medium right gluteal muscles swelling with important inflammatory infiltrate extended laterally in the subcutaneous adipose tissue. In blood culture was isolated Eggerthella lenta, and from throat swab was isolated group A Streptococci. Treatment consists of a combination of antibiotics associated with intravenous immunoglobulin administration. Despite medical treatment evolution worsened and required transfer in a pediatric surgery department where emergent surgical debridement associated with intensive antibiotic therapy was done. After this intervention evolution was slowly favorable without major limb dysfunction. Polymicrobial necrotizing fasciitis is a severe disease, which if recognized early can have a favorable outcome.

scholarly journals Endoscopic follow-up of cyanoacrylate obliteration of gastric varices

2009 ◽  
Vol 46 (1) ◽  
pp. 81-84 ◽  
Author(s):  
Fernanda Prata Martins ◽  
Erika Pereira de Macedo ◽  
Gustavo Andrade de Paulo ◽  
Frank Shigueo Nakao ◽  
José Celso Ardengh ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Portal Hypertension ◽  
Gastric Varices ◽  
Study Endpoint ◽  
Mild Abdominal Pain ◽  
Threatening Condition ◽  
Life Threatening ◽  
Related Mortality ◽  
Overall Mortality

Bleeding from gastric varices is a life-threatening condition. We report our experience with cyanoacrylate injection. Twenty three patients with portal hypertension and gastric varices underwent intra-variceal injection of a cyanoacrylate/lipiodol solution (1:1). Study endpoint was variceal obliteration. Mean follow-up was 25.3 months. Variceal obliteration was achieved in 87% of patients. Recurrence occurred in one patient (4.3%) and rebleeding in another case (4.3%). Mild abdominal pain was described in 13% of patients. Overall mortality was 21.7% and rebleeding related mortality rate was 4.3%. Our results confirm that cyanoacrylate injection is effective and safe to eradicate gastric varices.

scholarly journals Stridor in infant caused by subglottic hemangiome: case report

2020 ◽  
Vol 10 (3) ◽  
Author(s):  
Raquel Lot ◽  
Caroline Rosa ◽  
Camila Freitas ◽  
Gracinda Adnet ◽  
Luisa Costa ◽  
...  
Keyword(s):  
Beta Agonist ◽  
First Year ◽  
Vascular Neoplasms ◽  
Threatening Condition ◽  
Life Threatening ◽  
Diagnostic Hypothesis ◽  
Therapeutic Measures ◽  
The Right ◽  
First Year Of Life ◽  
Age Range

Subglottic hemagioma is a rare cause of stridor, but it is one of the most common vascular neoplasms of the airways in childhood. If the treatment is not promptly instituted, it becomes a life-threatening condition. The diagnosis should be suspected when infants outside the age range for acute laryngitis present with stridor associated with severe respiratory effort, without viral prodromes, with a condition that is not responsive to initial therapeutic measures considering the main diagnostic hypothesis. Infantile hemangiomas begin to proliferate during the first year of life (between the 1st and 2nd month of life). Involution usually occurs between 6 months and 12 months of life (most involution until 4 years). The case is a 5-month-old female infant, with sudden stridor associated with respiratory distress without viral prodromes or fever, with little response to inhaled short-acting beta-agonist, inhaled adrenaline, as well as corticosteroids inhalation/parenteral. Bronchoscopy showed a bulging of the submucosa to the right of the subglottis with slight vascularization, suggestive of subglottic hemangioma. Treatment with propranolol was initiated orally with the aim of regressing the hemangioma and after clinical stability, the infant was discharged with outpatient follow-up.

scholarly journals Successful treatment of pulmonary mucormycosis caused by Rhizopus microsporus with posaconazole

2021 ◽  
Vol 26 (1) ◽  
Author(s):  
F. Yuan ◽  
J. Chen ◽  
F. Liu ◽  
Y. C. Dang ◽  
Q. T. Kong ◽  
...  
Keyword(s):  
Fungal Culture ◽  
Rhizopus Microsporus ◽  
Pulmonary Tissue ◽  
Case Presentation ◽  
Common Cause ◽  
Pulmonary Mucormycosis ◽  
Threatening Condition ◽  
Life Threatening ◽  
One Year

Abstract Background Mucormycosis is a rare fungal infection occurring chiefly in the lung or the rhino-orbital-cerebral compartment, particularly in patients with immunodeficiency or diabetes mellitus. Among Mucorales fungi, Rhizopus spp. are the most common cause of mucormycosis. Case presentation We report a case of pulmonary mucormycosis caused by Rhizopus microsporus in a young patient with diabetes but no other apparent risk factors. The diagnosis mainly relied on clinical manifestation, positive pulmonary tissue biopsy, and fungal culture. The patient was successfully treated with posaconazole oral suspension and remains asymptomatic at one-year follow-up. Conclusions Pulmonary mucormycosis is a life-threatening condition and posaconazole is an effective treatment for pulmonary mucormycosis caused by Rhizopus microspores.

Abstract P147: Association Of Rosuvastatin Use With Risk Of Rhabdomyolysis Across Chronic Kidney Disease Status

Circulation ◽  
2021 ◽  
Vol 143 (Suppl_1) ◽  
Author(s):  
Jung-Im Shin ◽  
Yao Qiao ◽  
Aditya Surapaneni ◽  
Lesley Inker ◽  
Derek Fine ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Proportional Hazards ◽  
Disease Status ◽  
Cox Proportional Hazards ◽  
Lower Egfr ◽  
Threatening Condition ◽  
Life Threatening ◽  
End Stage

Introduction: Statin-induced rhabdomyolysis is a rare, but potentially life-threatening condition. It is unknown whether specific statins carry a greater risk of rhabdomyolysis and whether the risk differs between patients with and without chronic kidney disease (CKD). The objective of this study was to investigate the association of rosuvastatin use vs. atorvastatin use with the risk of rhabdomyolysis across CKD status. Hypothesis: Rosuvastatin use is associated with a higher risk of rhabdomyolysis as compared to atorvastatin use and the risk is greater among those with CKD than those without CKD. Methods: We identified adult patients who initiated rosuvastatin or atorvastatin between January 1, 2004 and December 31, 2018 and were free of end-stage kidney disease at the time of prescription in the Geisinger Health System. The association between rosuvastatin use and rhabdomyolysis was assessed using Cox proportional hazards regression models with an interaction between rosuvastatin use and CKD (i.e., estimated glomerular filtration rate <60 ml/min/1.73 m 2 ) in an inverse probability of treatment weighted (IPTW) sample. Results: Of 8,748 rosuvastatin users (mean [SD] age, 59.7 [12.6] years; 49.8% female; 11.8% CKD) and 31,770 atorvastatin users (mean [SD] age, 59.1 [12.6] years; 48.2% female; 11.9% CKD), 0.7% and 0.4% patients developed rhabdomyolysis, respectively, during a median follow-up of 5.1 years. Rosuvastatin use was associated with a higher risk of rhabdomyolysis in patients with CKD (hazard ratio [HR], 3.29; 95% CI, 1.53-7.09), but not in those without CKD (HR, 1.29; 95% CI, 0.82-2.03; p-interaction=0.04). A higher risk of rhabdomyolysis associated with rosuvastatin use in lower eGFR was also observed in the analysis with continuous eGFR ( Figure ). Conclusions: The findings suggest that rosuvastatin use in patients with CKD may be associated with excess risk of rhabdomyolysis as compared to atorvastatin.

scholarly journals Giant Intrahepatic Subcapsular Haematoma: A Rare Complication following Laparoscopic Cholecystectomy—A Case Report and Literature Review

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Eltaib Saad ◽  
Lauren O’Connell ◽  
Anne M. Browne ◽  
W. Khan ◽  
R. Waldron ◽  
...  
Keyword(s):  
Rare Complication ◽  
Rare Event ◽  
Decisive Role ◽  
Postoperative Monitoring ◽  
Refractory Hypotension ◽  
Life Threatening ◽  
The Right ◽  
Tomography Scan

We report on a 59-year-old female with symptomatic cholelithiasis on a background of morbid obesity who underwent an elective LC with an uncomplicated intraoperative course; however, she experienced a refractory hypotension within one hour postoperatively with an acute haemoglobin drop requiring fluid resuscitation and blood transfusion. A triphasic computed tomography scan revealed a large intrahepatic subcapsular haematoma (ISH) measuring 21   cm × 3.1   cm × 17   cm surrounding the lateral surface of the right hepatic lobe without active bleeding. She was managed conservatively with serial monitoring of haemoglobin and haematoma size. A follow-up ultrasound scan after eight weeks confirmed complete resolution of the haematoma. Giant ISH is a fairly rare, but life-threatening complication following LC which merits special attention. This case demonstrates the necessity of close postoperative monitoring of patients undergoing LC and considering the possibility of ISH, although being rare event, in those who experience a refractory postoperative hypotension. It also highlights the decisive role of diagnostic imaging in securing a timely and accurate diagnosis of post LC-ISH.

Intracranial aneurysm following radiation therapy for medulloblastoma

1997 ◽  
Vol 38 (1) ◽  
pp. 37-42 ◽  
Author(s):  
F. K. Jensen ◽  
A. Wagner
Keyword(s):  
Radiation Therapy ◽  
Intracranial Aneurysm ◽  
Intracranial Aneurysms ◽  
Distal Part ◽  
Anterior Cerebral Artery ◽  
Craniospinal Radiation ◽  
Threatening Condition ◽  
Life Threatening ◽  
Radiation Induced ◽  
The Right

Radiation-induced intracranial aneurysm formation is a rare but life-threatening condition with a high mortality rate secondary to rupture of the aneurysm. Further-more, this condition can mimic tumour recurrence. Only 10 months after craniospinal radiation therapy for medulloblastoma, a 9-year-old boy developed a subarachnoid haemorrhage secondary to a ruptured saccular aneurysm arising from the distal part of the right anterior cerebral artery. The development of intracranial aneurysms and rupture following radiation damage of the arteries has been reported previously, but in no case as soon as 10 months after radiation therapy. It is important to diagnose these aneurysms as they can be successfully treated.

scholarly journals Tracheal development after left pulmonary artery reimplantation: an individual study

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Xiaoyang Hong ◽  
Ruijie Li ◽  
Zhe Zhao ◽  
Jiangheng Guan ◽  
Hui Wang ◽  
...  
Keyword(s):  
Pulmonary Artery ◽  
Pulmonary Arteries ◽  
Left Pulmonary Artery ◽  
Weaning Failure ◽  
Threatening Condition ◽  
Ventilation Weaning ◽  
Life Threatening ◽  
The Mean ◽  
Tracheal Carina

Abstract Pulmonary artery sling (PA sling) often presents as a life-threatening condition requiring urgent surgical correction. We reported 32 cases of PA sling in children who were followed up postoperatively in the past 6 years. All patients with PA slings who were admitted to the hospital from January 2012 to December 2017 and underwent surgery were retrospectively analyzed. The mean age of the 32 patients at repair was 16.97 months (range, 15 days to 128 months). Six patients required ventilator assistance for respiratory failure. All children underwent left pulmonary artery (LPA) reimplantation (n = 32), and 3 patients needed reimplantation slide tracheoplasty (n = 3) due to ventilation weaning failure. Four patients died, 27 patients survived until discharge, and 18 patients were followed up. Pulmonary computed tomography imaging and echocardiography were performed in 18 patients who were followed up. After LPA reimplantation, the tracheal carina area was significantly enlarged compared to that preoperation (p = 0.0002). In this follow-up cohort study, 75% of the patients who underwent LPA reimplantation survived until discharge. The survivors had subsequently well-developed pulmonary arteries and tracheas.

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