scholarly journals A rare case of a giant arterio-venous fistula (AVF) following metastatic choriocarcinoma conditioning pulmonary embolism: multimodal transcatheter embolization using a simultaneous transarterial and transvenous approach

2018 ◽  
Vol 1 (1) ◽  
Author(s):  
Massimo Venturini ◽  
Alice Bergamini ◽  
Anna Colarieti ◽  
Micaela Petrone ◽  
Paolo Marra ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Rare Case ◽  
Transarterial Embolization ◽  
Vena Cava ◽  
Transcatheter Embolization ◽  
Good Prognosis ◽  
Gonadal Vein ◽  
Venous Fistula ◽  
The Right ◽  
Transvenous Approach

Abstract Background Choriocarcinoma is a highly malignant tumor but with a good prognosis due to the valid response to systemic chemotherapy. We present a case of a young woman affected by a giant pelvic arterio-venous fistula following a metastatic gestational choriocarcinoma, conditioning metrorrhagia and pulmonary embolism, successfully treated by multimodal transcatheter embolization, using a simultaneous transarterial and transvenous approach. Case presentation In a young patient affected by choriocarcinoma and metrorrhagia, a computed tomography showed a giant arterio-venous fistula, pulmonary metastases and embolism. A transfemoral diagnostic arteriography showed a giant arterio-venous fistula sustained by right and left hypogastric arteries with early opacification of the right gonadal vein and of the inferior vena cava. A transarterial embolization of the distal branches of hypogastric arteries with poly-vinyl-alcohol particles, coils and Squid was performed. A transfemoral phlebography of the right gonadal vein showed multiple thrombi, responsible of the pulmonary embolism. An Amplatzer plug via trans-jugular was finally placed at the confluence of the gonadal vein in the vena cava, to reduce arterio-venous fistula out-flow and to occlude the vein, preventing further episodes of pulmonary embolism. Metrorrhagia progressively disappeared. A second transarterial embolization combined with a complete response to systemic chemotherapy determined arterio-venous fistula resolution. Conclusions This was a very rare case of a giant pelvic arterio-venous fistula following choriocarcinoma in a patient symptomatic for metrorrhagia with an accidental finding of pulmonary embolism at computed tomography. A transcatheter embolization was successfully performed with different embolic materials, using a simultaneous transarterial and transvenous approach: the goal was not only to obtain metrorrhagia resolution but also to avoid a massive pulmonary embolism, a potential life threatening condition, in a young woman affected by a highly malignant tumor but with a good prognosis.

scholarly journals An incidental finding of testicular seminoma in the context of acute pulmonary embolism: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Kaitlin J. Mayne ◽  
Emma Lewis ◽  
Lewis Vickers
Keyword(s):  
Pulmonary Embolism ◽  
Venous Thromboembolism ◽  
Clinical Guidelines ◽  
Acute Pulmonary Embolism ◽  
Incidental Finding ◽  
White Male ◽  
Vena Cava ◽  
Testicular Seminoma ◽  
Computed Tomography Scanning ◽  
The Right

Abstract Background Clinical guidelines do not recommend further investigation for occult malignancy in the scenario of unprovoked venous thromboembolism in the absence of additional clinical features suggestive of malignancy. We present the case of a young gentleman with pulmonary embolism who was diagnosed with testicular seminoma despite lack of symptoms or signs suggestive of malignancy. This is a unique case describing a scenario not well documented in existing literature where contravention of clinical guidelines had a potentially advantageous outcome for the patient. Case presentation A 37-year-old white male presented with seemingly unprovoked acute pulmonary embolism with right heart strain. He did not have any predisposing factors for venous thromboembolism and did not have any symptoms or signs suggestive of malignancy. Clinical guidelines do not recommend further investigation to screen for malignancy in this scenario. Despite this, our young, otherwise healthy patient proceeded to computed tomography scanning, resulting in the diagnosis of localized testicular seminoma. Testicular ultrasound described normal-sized testes (despite a discrete lesion in the right testis), suggesting this was not detectable by the patient or clinician on routine examination. The patient was anticoagulated and had an inferior vena cava filter inserted to facilitate orchidectomy followed by adjuvant radiotherapy. Conclusions This case highlights the importance of considering malignancy in seemingly unprovoked venous thromboembolism and the availability of guidelines to direct further investigation. Our patient’s treatment was not in line with clinical guidelines and was considered a “lucky find.”

scholarly journals A Rare Case of Clavicle Osteomyelitis in a Child and Literature Review

2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Author(s):  
Elisavet-Anna Chrysochoou ◽  
Charalampos Antachopoulos ◽  
Konstantinos Badekas ◽  
Emmanuel Roilides
Keyword(s):  
Staphylococcus Aureus ◽  
Literature Review ◽  
Antimicrobial Susceptibility ◽  
Rare Case ◽  
English Literature ◽  
Good Prognosis ◽  
Periosteal Reaction ◽  
Older Children ◽  
Abnormal Signal ◽  
The Right

Acute clavicle osteomyelitis in children is rare representing <3% of osteomyelitis cases. We treated a 12-year-old boy who presented with acute pain in the right clavicle and high fever for 4 days. MRI showed abnormal signal in the right clavicle with periosteal reaction.Staphylococcus aureusisolated from blood was susceptible to methicillin, clindamycin, and macrolides. Clindamycin was given intravenously for 3 wks and orally for another 3 wks with no recurrence. We reviewed clavicle osteomyelitis cases in children searching PubMed English literature. From a total of 89 studies retrieved, only 6 fulfilled the criteria and were analyzed. Sixteen patients (56% female) were included with a median age of 9 yrs (range 2 wks–16 yrs). Osteomyelitis was hematogenous in most cases, withS. aureusbeing the most frequent cause, isolated from either blood or tissue. Symptoms included fever, swelling, and localized bone tenderness. Antimicrobial therapy lasted for 4–12 weeks (median 7.5). Three patients required drainage or curettage. Recurrence occurred in 1/16 cases (6.2%) and persistence of symptoms occurred to 2/16 cases (12.5%) reported before 90s with unknown antimicrobial susceptibility of the pathogen. Acute clavicle osteomyelitis mainly affects older children and has generally good prognosis.Staphylococcus aureusis most commonly implicated and surgery may be needed.

scholarly journals Catheter-induced infectious endocarditis complicated by pulmonary embolism: successful surgical treatment

2020 ◽  
Vol 179 (3) ◽  
pp. 85-90
Author(s):  
A. P. Medvedev ◽  
S. A. Fedorov ◽  
V. V. Pichugin ◽  
A. L. Maksimov ◽  
M. B. Sukhova ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Pulmonary Artery ◽  
Rare Case ◽  
Superior Vena ◽  
Vena Cava ◽  
Left Pulmonary Artery ◽  
Infectious Endocarditis ◽  
Left Main ◽  
Right Heart ◽  
The Right

A rare case of catheter-induced infectious endocarditis of the right heart chambers complicated by embolism of the left pulmonary artery and its successful surgical treatment is presented. We performed the operation to remove a foreign body and vegetations from the superior vena cava and the right atrium, embolectomy from the left main branch of the pulmonary artery, chemical sanitation of the right chambers of the heart and pulmonary artery under extracorporeal circulation.

scholarly journals Anatomical study of the renal veins observed during 342 living-donor nephrectomies

1997 ◽  
Vol 115 (3) ◽  
pp. 1456-1459 ◽  
Author(s):  
José Carlos Costa Baptista-Silva ◽  
Marcos José Veríssimo ◽  
Marcos Joaquim Castro ◽  
André Luiz Guimarães Câmara ◽  
José Osmar Medina Pestana
Keyword(s):  
Renal Vein ◽  
Living Donor ◽  
Inferior Vena ◽  
Left Renal Vein ◽  
Vena Cava ◽  
Anatomical Study ◽  
Anatomical Variations ◽  
Renal Veins ◽  
Gonadal Vein ◽  
The Right

The anatomical variations of renal veins observed during 342 nephrectomies in living donors are described, 311 cases on the left side and 31 on the right. The following anatomy of the renocava veins was observed: 1. On the left side the renal vein was always unique (311/311) and had two tributaries (suprarenal and gonadal veins) in 100 per cent and one or more renolumbar veins in 65.27 per cent, encircling the aorta in 1.07 per cent, was retroaortic in 1.4 per cent; and the inferior vena cava was double in 0.64 per cent; B- on the right side the renal vein was double in 29 per cent (9/31) and had only one tributary (gonadal vein) in one case, for 3.22 per cent (1/ 31); three or more renal veins in 9.7 per cent (3/31). We concluded that the left renal vein is always unique, presenting variations principally in its tributaries and trajectory. On the right side, the renal vein was double or triple in 38.79 per cent

scholarly journals Double Inferior Vena Cava Associated with Double Suprarenal and Testicular Venous Anomalies: A Rare Case Report

2018 ◽  
Vol 35 (04) ◽  
pp. 221-224
Author(s):  
Kimaporn Khamanarong ◽  
Jarupon Mahiphot ◽  
Sitthichai Iamsaard
Keyword(s):  
Interventional Radiology ◽  
Inferior Vena Cava ◽  
Rare Case ◽  
Inferior Vena ◽  
Left Renal Vein ◽  
Vena Cava ◽  
Gross Anatomy ◽  
Male Cadaver ◽  
Double Inferior Vena Cava ◽  
The Right

Introduction The variant courses of blood vessels are very important in considerations for retroperitoneal surgeries or interventional radiology. The present study attempted to describe a very rare case of double inferior vena cava (IVC) associated with double left suprarenal veins (LSRVs) and double right testicular veins (RTVs) in a Thai male embalmed cadaver. Material and Methods A 70-year-old Thai male cadaver was systemically dissected and observed for the vascular distributions during gross anatomy teaching for medical students at the anatomy department of the faculty of medicine of the Khon Kaen University. Results We found that the double IVCs were connected with the transverse interiliac vein. While the upper LSRV is a tributary of the IVC, the lower LSRV is a tributary of the left renal vein. The RTV bifurcates at about the height of the iliac cristae to form the medial and lateral RTVs, which drain into the right IVC at different heights. Conclusion All these duplications and associated anomalies are assumed to occur during the embryological development. These anomalies are rare, but the knowledge about the possibilities of these anomalies is of great importance during retroperitoneal surgeries, and during interventional radiology.

Scimitar vein descending from the right inferior lobe to the inferior vena cava beneath the diaphragm: a rare case

2014 ◽  
Vol 90 (2) ◽  
pp. 123-125
Author(s):  
Shogo Hayashi ◽  
Shuichi Hirai ◽  
Munekazu Naito ◽  
Shinichi Kawata ◽  
Ning Qu ◽  
...  
Keyword(s):  
Inferior Vena Cava ◽  
Rare Case ◽  
Inferior Vena ◽  
Vena Cava ◽  
Inferior Lobe ◽  
The Right
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