Post-laparoscopic Cholecystectomy Cystic Artery Stump Pseudoaneurysm Presenting With Haemobilia and Hematochezia: a Case Report With Literature Review

Author(s):  
Dalal Sibira ◽  
Mohamed Fatihelrahman Ahmed ◽  
Loai Aker ◽  
Ali Barah ◽  
Omran Almokdad ◽  
...  

Abstract Background: Cystic artery stump pseudoaneurysm (CASP) is a potentially life-threating condition that can be related to multiple etiologies, especially the iatrogenic factor owing to the increased number of hepatobiliary procedures. Most patients present with haemobilia. Here we report a rare case of unusual presentation of CASP with recurrent haemobilia and hematochezia. Case presentation: A 38-year-old patient developed bile duct injury after laparoscopic cholecystectomy which was identified by magnetic resonance cholangiopancreatography (MRCP). Later, she developed haemobilia due to CASP which was then treated by trans-arterial embolization (TAE) followed by fresh bleeding per rectum one month later. The latter complication eventually required surgical ligation.Conclusions: CASP is a rare complication after cholecystectomy that can present as upper gastrointestinal bleeding or rarely as fresh bleeding per rectum. Level of evidence: Level 4, Case report and literature review

2012 ◽  
Vol 97 (2) ◽  
pp. 140-144 ◽  
Author(s):  
Athanasios Petrou ◽  
Nicholas Brennan ◽  
Zahir Soonawalla ◽  
Michael Anthony Silva

Abstract Hemobilia is the process of bleeding into the biliary tree and is an unusual cause of upper gastrointestinal hemorrhage. When this event results from a cystic artery pseudoaneurysm, it is a particularly rare phenomenon; fewer than 20 cases are described in the literature. Alongside the literature review, we report a case of a 34-year-old woman presenting 3 months post laparoscopic cholecystectomy with hematemesis. Computed tomography (CT) angiography revealed a cystic artery pseudoaneurysm. Following an ineffective hyperselective arterial embolization, the patient was successfully treated by surgical ligation of the right hepatic artery. Even though this complication is uncommon, all surgeons need to be aware of its presentation and of available therapeutic options.


2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Cong Jin ◽  
Minghua Xie ◽  
Wengqing Liang ◽  
Yu Qian

Abstract Background Osteoradionecrosis (ORN) is a complication that occurs after radiotherapy for head or neck malignancies. ORN of the spine is rare, with only few cases affecting the cervical spine reported to date. To our knowledge, no case of lumbar ORN has been reported. We report a rare case of ORN in the lumbar spine that occurred 2 years after radiotherapy and perform a literature review. Case presentation We present a case of lumbar ORN that occurred 2 years after radiotherapy for gallbladder carcinoma. The patient was successfully treated conservatively and followed up for > 10 years. Conclusions ORN of the spine is a rare complication of radiotherapy. Spinal ORN is clinically described as a chronic disease with a slow onset. The most common presenting symptom of spinal ORN is pain. However, as ORN progresses, spinal kyphosis and instability can lead to neurological compression and thus to induced myelopathy or radiculopathy. Treatment of spinal ORN is comprehensive, including orthosis, medication, hyperbaric oxygen therapy, surgery, and new treatment combinations of pentoxifylline and tocopherol. The surgical rate for spinal ORN is relatively high.


Author(s):  
Saleh A AlSuwaydani ◽  
Mohammed Alfehaid

Background: Xanthogranulomatous cholecystitis XGC is a rare variant of Cholecystitis characterized by extensive inflammation and Fibrosis and associated with more complicated presentation like invading other organs and fistula formation. it could mimic Underlying malignancy like Gallbladder Cancer GBC. Challenges started by difficulty of diagnosis pre operatively due to multi factors include less threshold of diagnosis, which can lead to over treatment if GBC suspected. Gallstones plays major role in pathogenesis of most variant of Cholecystitis and can be trigger for GBC. Case presentation: we report 2 cases with different pre-operative course, both cases managed with laparoscopic cholecystectomy, and Histopathology showed Xanthogranulomatous cholecystitis XGC. Discussion: recent cases reported for XCG usually occurs in 5th and 6th decades and presented with multiple presentation and could be missed diagnosis, laboratory and radiological investigations can offer a limited diagnosis if not interpreted by expertise. Management can vary from simple laparoscopic cholecystectomy -as in our cases – and can extend to major en block resection.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yi Zhang ◽  
Cheng Chen ◽  
Min Lin ◽  
Kan Deng ◽  
Huijuan Zhu ◽  
...  

Abstract Background Functional gonadotroph adenomas (FGAs) are rare adenomas that most commonly secrete FSH. However, solitary LH-secreting pituitary adenomas are unusual. Case presentation A 30-year-old woman with elevated LH and normal FSH presented with inability to conceive. An MRI revealed an enlarged sella turcica and an intrasellar mass. Treatment with transsphenoidal resection led to normalization of LH and estradiol, as well as successful pregnancy. And we reviewed 6 cases of LH-secreting pituitary adenomas from 1981 to 2020. Conclusions Our case is unique because of the LH-secreting pituitary adenoma without FSH hypersecretion. This case indicates that pituitary adenoma should be considered when other diseases causing infertility have been excluded.


2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Min Li ◽  
Gang Zhu ◽  
Hao Guo ◽  
Shun Nan Ge ◽  
Guo Dong Gao ◽  
...  

AbstractBackgroundCerebral fat embolism (CFE) syndrome at high altitude was rare complicated with paroxysmal sympathetic hyperactivity (PSH) syndrome and septic shock. It is a challenge to differential diagnosis and treatment at high altitude.Case presentationThis case presents a CFE with PSH and septic shock of a 23-year-old man occurred at high altitude of 3800 m above sea level, transferred by airplane successfully and cured in the department of neurosurgery, Xi’an Tangdu Hospital.ConclusionsIt is key that CFE with PSH can be rapid diagnosed and treatment bundles of septic shock should be initiated as soon as possible. Early neurological rehabilitation played an important role for good outcome.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Zhicheng Zhang ◽  
Xiaowei Huang ◽  
Qian Chen ◽  
Demin Li ◽  
Qi Zhou ◽  
...  

Abstract Background Small intestine duplication cysts (SIDCs) are rare congenital anatomical abnormalities of the digestive tract and a rare cause of hematochezia. Case presentation We describe an adult female presented with recurrent hematochezia. The routine gastric endoscope and colonic endoscope showed no positive findings. Abdominal CT scan indicated intussusception due to the "doughnut" sign, but the patient had no typical symptoms. Two subsequent capsule endoscopes revealed a protruding lesion with bleeding in the distal ileum. Surgical resection was performed and revealed a case of SIDC measuring 6 * 2 cm located inside the ileum cavity. The patient remained symptom-free throughout a 7-year follow-up period. Conclusion SIDCs located inside the enteric cavity can easily be misdiagnosed as intussusception by routine radiologic examinations.


BMC Surgery ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Dmitry Batiukov ◽  
V. Podgaiski ◽  
D. Mikulich ◽  
S. Kalinin

Abstract Background Breast augmentation with implants continues to be the most popular aesthetic surgical procedure performed worldwide. Fat grafting may improve the results of breast augmentation and breast reconstruction with implants. However, fat grafting to the breast with implants carries the risk of implant puncture. To our best knowledge this is the first case in which polyurethane implant puncture during fat grafting is described. Case presentation We report multiple bilateral implant punctures with the cannula during fat grafting in a patient who previously underwent breast reconstruction with polyurethane implants. Conclusions Implants that promote tissue ingrowth may be more prone to puncture with the cannula during fat grafting. Specific planning and surgical maneuvers decrease the risk of implant puncture. Level of evidence Level V, case report.


BMC Surgery ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Wen Ai ◽  
Zhihua Liang ◽  
Feng Li ◽  
Haihua Yu

Abstract Background The common complications of radical hysterectomy and pelvic lymphadenectomy usually include wound infection, hemorrhage or hematomas, lymphocele, uretheral injury, ileus and incisional hernias. However, internal hernia secondary to the orifice associated with the uncovered vessels after pelvic lymphadenectomy is very rare. Case presentation We report a case of internal hernia with intestinal perforation beneath the superior vesical artery that occurred one month after laparoscopic pelvic lymphadenectomy for cervical cancer. A partial ileum resection was performed and the right superior vesical artery was transected to prevent recurrence of the internal hernia. Conclusions Retroperitonealization after the pelvic lymphadenectomy should be considered in patients with tortuous, elongated arteries which could be causal lesions of an internal hernia.


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