scholarly journals Giant descending aortic pseudo-aneurysm in an adult man with uncorrected aortic coarctation

2021 ◽  
Vol 73 (1) ◽  
Author(s):  
Zahra Jabbary ◽  
Mehrnoush Toufan
Keyword(s):  
Aortic Coarctation ◽  
Heart Diseases ◽  
Rare Complication ◽  
Aortic Aneurysms ◽  
Heart Team ◽  
Case Presentation ◽  
Perimembranous Ventricular Septal Defect ◽  
Contrast Enhanced ◽  
Pseudo Aneurysm ◽  
Enhanced Computed Tomography

Abstract Background Aortic coarctation (CoAo) accounts for 6 to 8% of all congenital heart diseases and occurs two to five times more often in males. The uncorrected aortic coarctation is complicated by hypertension, ascending and descending aortic aneurysms, endarteritis, and heart failure. The aortic pseudo-aneurysm (APD) usually occurs in patients with endarteritis. We report an adult man with bicuspid aortic valve, perimembranous ventricular septal defect, and uncorrected aortic coarctation complicated by descending aortic pseudo-aneurysm without aortic endarteritis. Case presentation A 40-year-old man was referred to our division for hemoptysis and severe aortic coarctation. Echocardiography confirmed the aortic coarctation diagnosis and showed a large aortic pseudo-aneurysm at the coarctation site with intra-cavity mural thrombus. Subsequently, the patient underwent contrast-enhanced computed tomography angiography, and diagnosis of coarctation and APD was confirmed. Due to various malformations and considering that the patient had become unstable due to hemoptysis, it was discussed in the heart team, and it was decided that the patient would undergo staged surgery. Conclusions The aortic pseudo-aneurysm is a rare complication in patients with untreated coarctation that requires prompt surgery, and this complication should be considered in patients with untreated aortic coarctation who present with hemoptysis.

scholarly journals Severe Gastroparesis following Radiofrequency Catheter Ablation for Atrial Fibrillation: Suggestion for Diagnosis, Treatment, and Device for Gastroparesis after RFCA

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Dong Seok Lee ◽  
Sang Jin Lee
Keyword(s):  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Radiofrequency Catheter Ablation ◽  
English Literature ◽  
Rare Complication ◽  
Food Material ◽  
Gastrointestinal Series ◽  
Contrast Enhanced ◽  
Enhanced Computed Tomography ◽  
Contrast Enhanced Computed Tomography

Gastroparesis following radiofrequency catheter ablation (RFCA) is a very rare complication, as only two cases have been reported in the English literature. A 42-year-old man underwent RFCA due to recurrent drug-resistant symptomatic atrial fibrillation. The patient complained of indigestion and early satiety 2 days after the procedure. Contrast-enhanced computed tomography and an upper gastrointestinal series of the abdomen showed a large amount of material remaining in the stomach area. All food material was removed by endoscopy, and the patient received medical treatment. We suggest a flow chart for diagnosis and treatment of AFGS based on the present case and previous cases. Endoscopic medical patent was designed on the basis of this case.

scholarly journals An uncommon cause of hemoptysis: aortobronchial fistula

2018 ◽  
Vol 13 ◽  
Author(s):  
Roberto Tonelli ◽  
Matteo Fontana ◽  
Filippo Gozzi ◽  
Ivana Castaniere ◽  
Alessandro Marchioni ◽  
...  
Keyword(s):  
Respiratory Diseases ◽  
Aortic Surgery ◽  
Aneurysmal Dilatation ◽  
Case Presentation ◽  
Aortobronchial Fistula ◽  
Contrast Enhanced ◽  
History Of ◽  
Clinical Awareness ◽  
Enhanced Computed Tomography ◽  
Contrast Enhanced Computed Tomography

Background: Hemoptysis is a frequent sign of respiratory and non-respiratory diseases. While in most cases the underlying cause is rapidly identified, sometimes the real etiology might be misdiagnosed with dramatic delay in treatment. Case presentation: A 46-year-old man with hiatal hernia and a history of aortic surgery for aortic coarctation presented with dramatic episodes of hemoptysis and subsequent severe anemia (6,9 g/dl). Digestive and respiratory endoscopy resulted not exhaustive, thus he underwent a contrast-enhanced computed tomography (CT) scan of the chest that showed an aneurysmal dilatation of the descending thoracic aorta with suspected aortobronchial fistula. He underwent cardiac surgery that confirmed the diagnosis and successfully treated the fistula. Conclusion: We briefly review the literature to raise clinical awareness on this uncommon cause of hemoptysis.

scholarly journals Mixed cortico-medullary adrenal carcinoma in children: looks are deceptive!!

2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Arti Khatri ◽  
Nidhi Mahajan ◽  
Niyaz Ahmed Khan ◽  
Natasha Gupta
Keyword(s):  
Past History ◽  
Case Reports ◽  
Final Diagnosis ◽  
Adrenal Carcinoma ◽  
Case Presentation ◽  
First Case ◽  
Contrast Enhanced ◽  
Paediatric Age ◽  
History Of ◽  
Enhanced Computed Tomography

Abstract Background Mixed cortico-medullary adrenal carcinoma (MCMAC) is an extremely rare entity with scarce literature on its cytomorphology. Case presentation A 2-year-old girl presented with abdominal pain for 3 days and a past history of fever with significant weight loss. On examination, a non-tender left hypochondrial firm mass and an enlarged left supraclavicular node were found. Twenty-four-hour urinary levels of VMA were marginally high. Contrast-enhanced computed tomography of the abdomen showed a suprarenal heterogeneous mass encasing major vessels. Aspiration cytology of both mass and node showed similar features comprising a predominant population of singly scattered large cells with moderate cytoplasm, eccentric nucleus and prominent nucleolus in a necrotic background. Tumour cells expressed Synaptophysin and Melan-A. In view of increasing respiratory distress, debulking surgery was performed, and histopathology of the specimen revealed the presence of both malignant medullary and cortical components supported by immunohistochemistry making a final diagnosis of MCMAC. The patient succumbed to death in the postoperative period. The cytology slides were reviewed and were seen to show a dual cell population. Conclusion Coexistent malignant cortical and medullary tumour of the adrenal gland is the first case reported in the paediatric age group in the literature with only three previous case reports in adults.

Endoleak as a Complication of Endoluminal Grafting of Abdominal Aortic Aneurysms: Classification, Incidence, Diagnosis, and Management

1997 ◽  
Vol 4 (2) ◽  
pp. 152-168 ◽  
Author(s):  
Geoffrey H. White ◽  
Weiyun Yu ◽  
James May ◽  
Xavier Chaufour ◽  
Michael S. Stephen
Keyword(s):  
Management Strategies ◽  
Clinical Trial Data ◽  
Diagnostic Techniques ◽  
Aneurysm Rupture ◽  
Aortic Aneurysms ◽  
Collateral Arteries ◽  
Abdominal Aortic ◽  
Contrast Enhanced ◽  
Imaging Surveillance ◽  
Enhanced Computed Tomography

The inability to obtain or maintain a secure seal between a vessel wall and a transluminally implanted intra-aneurysmal graft is a complication unique to the evolving technique of endovascular aneurysm exclusion. Because the term “leak” has long been associated with aneurysm rupture, the term “endoleak” is proposed as a more definitive description of this phenomenon. Embracing both persistent blood flow into the aneurysmal sac from within or around the graft (graft related) and from patent collateral arteries (nongraft related), endoleak can be classified as primary or secondary depending on the time of occurrence (within 30 days of implantation or following apparent initial seal, respectively). Diagnostic techniques to detect endoleak include arteriography, intraprocedural pressure monitoring, contrast-enhanced computed tomography, abdominal X ray, and duplex scanning. Management strategies for endoleak range from observation with periodic imaging surveillance to correction by additional endoluminal or surgical procedures. Standardization of the terminology describing this important sequela to endovascular aneurysm exclusion should facilitate uniform reporting of clinical trial data vital to the evaluation of this emerging technique.

scholarly journals Mildly symptomatic liraglutide-induced acute pancreatitis in a patient with type 2 diabetes mellitus: a case report

2020 ◽  
Vol 32 (1) ◽  
Author(s):  
Mohammed Ali Gameil ◽  
Ahmed Hassan Elsebaie
Keyword(s):  
Acute Pancreatitis ◽  
Diabetic Patients ◽  
Abdominal Ultrasonography ◽  
Serum Lipase ◽  
Case Presentation ◽  
Clinical Challenge ◽  
Contrast Enhanced ◽  
Glucagon Like Peptide 1 ◽  
Enhanced Computed Tomography

Abstract Background Acute pancreatitis (AP) represents a serious clinical challenge as it can threaten the patient’s life if it is missed or improperly managed. Liraglutide is one of the glucagon-like peptide 1 receptor agonists (GLP1-RA) which represent a novel class of antidiabetic medications in the Egyptian market. Hereby, we report a case of liraglutide-induced acute pancreatitis with atypical presentation. Case presentation A 53-year-old Egyptian male patient with diabetes presented to the emergency department with abdominal discomfort and vomiting without significant abdominal pain. Serum lipase and amylase were elevated more than three folds the upper normal limit (NUL 300 and 110 U/L respectively); abdominal ultrasonography was inconclusive, but contrast-enhanced computed tomography was diagnostic. A diagnosis of liraglutide-induced AP was built after exclusion of other causes. After admission, his medications were modified and improved clinically after 1 week. Conclusion Mildly symptomatic AP in diabetic patients is a clinical challenge as it can be missed. Therefore, in certain clinical situations, AP should be suspected in patients administrating liraglutide particularly for those with autonomic neuropathy.

scholarly journals A rare cause of chronic dysphagia: pulmonary inflammatory myofibroblastic tumor with distal esophagus invasion

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Yi-Min Gu ◽  
Long-Qi Chen
Keyword(s):  
Inflammatory Myofibroblastic Tumor ◽  
Distal Esophagus ◽  
Case Presentation ◽  
Contrast Enhanced ◽  
Rare Lesion ◽  
Children And Young Adults ◽  
Enhanced Computed Tomography ◽  
Contrast Enhanced Computed Tomography ◽  
Pulmonary Inflammatory Myofibroblastic Tumor

Abstract Background Inflammatory myofibroblastic tumor (IMT) is rare intermediate tumor, which happens mostly in children and young adults. Case presentation Reported is the successful treatment of a 29-year-old man presented with progressively dysphagia and weight loss. No other abnormal symptoms were observed. The contrast enhanced computed tomography (CT) revealed a dumbbell-shaped lesion between lung and esophagus. Finally, it was pathologically diagnosed as pulmonary IMT invading to the distal esophagus after operation. The patient underwent partial esophagectomy and left lower lobectomy, and was discharged on 10th postoperative day. Conclusions IMT is a rare lesion that usually occurs in the lung, but pulmonary IMT with distal esophagus invasion has not been described previously. Discriminating untypical symptom, completed resection, pathological expertise and closed follow-up will reach the successful diagnosis and treatment.

scholarly journals Vaginal Bleeding As The Presenting Manifestation of Post-Hepatectomy/-Splenectomy Portal-Mesenteric Venous Thrombosis

2021 ◽  
Author(s):  
Che-Ming Yeh ◽  
Jen-Tang Sun ◽  
Chieh-Min Fan ◽  
Kuang-Chau Tsai ◽  
Chih-Jung Chang
Keyword(s):  
Venous Thrombosis ◽  
Menopausal Woman ◽  
Mesenteric Venous Thrombosis ◽  
Case Presentation ◽  
Delayed Treatment ◽  
Abdominal Symptoms ◽  
Contrast Enhanced ◽  
History Of ◽  
Enhanced Computed Tomography ◽  
Specific Symptoms

Abstract Background: Portal-mesenteric venous thrombosis is not uncommon after hepatectomy or splenectomy but is under-recognized because of non-specific symptoms and lack of awareness of the clinicians. However, misdiagnosis or delayed treatment may have fatal consequences. Case Presentation: A 57-year-old menopausal woman with the medical history of hepatocellular carcinoma, stage I, underwent laparoscopic partial hepatectomy (S4) and splenectomy 2 months before the presentation of progressive vaginal spotting and vague abdominal pain. Dysfunctional uterine bleeding was suspected initially, but subsequent contrast-enhanced computed tomography due to concern for post-procedure complications revealed thrombosis in the portal vein and superior mesenteric vein. The patient received anticoagulant therapy, and her symptoms gradually resolved. Conclusions: To the best of our knowledge, vaginal variceal bleeding secondary to portal-mesenteric venous thrombosis has never been reported, but it can be the presenting manifestation for this condition. It should be considered in the differential diagnosis of patients who present with vague abdominal symptoms after hepatectomy or splenectomy.

scholarly journals Emergent laparoscopic dome resection and omental suturing to the splenic parenchymal edge for a spontaneously ruptured non-parasitic large splenic cyst in a pediatric patient: a case report

2019 ◽  
Vol 5 (1) ◽  
Author(s):  
Kumiko Shono ◽  
Yoshiko Hashimoto ◽  
Takeshi Shono
Keyword(s):  
Pediatric Patient ◽  
Splenic Cyst ◽  
Greater Omentum ◽  
Case Presentation ◽  
First Case ◽  
Splenic Parenchyma ◽  
Contrast Enhanced ◽  
Cyst Recurrence ◽  
Enhanced Computed Tomography ◽  
Emergent Case

Abstract Background Spontaneously ruptured large splenic cyst is a rare in children, and traditionally total or partial splenectomy has been performed for treating an emergent case. We herein present a first case with spontaneously ruptured pediatric splenic cyst treated with emergent laparoscopic dome resection with omental suturing to the parenchymal edge of the spleen. Case presentation A 12-year-old girl with a spontaneously ruptured large non-parasitic splenic cyst (SC) was successfully treated by emergent laparoscopic dome resection with omental suturing to the edge of the splenic parenchyma. The patient presented with acute abdominal pain and was diagnosed with a ruptured non-parasitic SC and peritonitis by contrast-enhanced computed tomography (CT). Emergent laparoscopic dome resection of the SC and omental suturing to the splenic parenchymal edge were then performed. The protruding part of the cyst wall was completely resected using an ultrasonically activated device (USAD), and the greater omentum was then sutured to the anterior edge of the splenic parenchyma under a laparoscopic view. No complications were observed during the operation. A histological examination revealed a congenital splenic cyst lined by epithelial cells. The postoperative course was uneventful, and an ultrasound scan showed no evidence of cyst recurrence at 3 years after the operation. Conclusions This minimally invasive laparoscopic procedure was feasible and effective for treating a ruptured large splenic cyst in an emergent pediatric patient.

scholarly journals Renal Endometriosis Mimicking Cystic Renal Tumor: Case Report and Literature Review

2021 ◽  
Vol 8 ◽  
Author(s):  
Ye Yang ◽  
Xinxin Zhao ◽  
Ying Huang
Keyword(s):  
Renal Mass ◽  
Clinical Symptoms ◽  
Renal Tumor ◽  
Cystic Mass ◽  
Case Presentation ◽  
Contrast Enhanced ◽  
The Right ◽  
Enhanced Computed Tomography ◽  
Contrast Enhanced Computed Tomography

Background: Endometriosis mainly affects female pelvic tissues and organs, and the presence of endometriosis in the kidney is extremely rare.Case Presentation: We report a case of a 48-year-old woman who presented with intermittent hematuria. She was found to have a cystic mass on renal ultrasonography, and contrast-enhanced computed tomography (CT) showed slight enhancement of the cystic wall and septa. These findings were indicative of cystic renal tumor. The patient subsequently underwent partial right nephrectomy. Histopathology revealed endometriosis of the right renal parenchyma. The patient recovered well and had no evidence of a recurrent renal mass at the 3 months' follow up.Conclusion: The possibility of renal endometriosis should be considered in a female patient with a cystic renal mass and clinical symptoms related to the menstrual cycle.

scholarly journals Is Expanding Heart Always Serious?

2018 ◽  
pp. 11-12
Author(s):  
Jamilah Al Rahimi ◽  
Amin Mulji ◽  
Omid Salehian
Keyword(s):  
High Risk ◽  
Clinical Presentation ◽  
Rare Complication ◽  
Left Ventricular ◽  
Management Decision ◽  
Diagnostic Modality ◽  
Case Presentation ◽  
Risk Of Death ◽  
High Clinical Suspicion ◽  
Pseudo Aneurysm

Left Ventricular Pseudo Aneurysm (LVPA) is a rare complication occurs in population that carries the risk. Clinical presentation of a large LVPA can be variable which make the diagnosis challenging. Given the high risk of death in such cases, high clinical suspicion in addition to the use of proper diagnostic modality may reduce the mortality rate & guide the management decision. Echocardiogram is considered the proper investigation tool to screen, diagnose the presence of LVPA & identify the high-risk feature of rupture. In this review will present catastrophic echocardiographic features in unusual clinical case presentation of a patient with large LV pseudo aneurysm presented with ischemic stroke & background of diabetes & hypertension.

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