scholarly journals Embolization of Giant Post-Traumatic Arteriovenous Renal Fistula using the Penumbra Occlusion Device

2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Pierluca Torcia ◽  
Giampaolo Carraffiello
Keyword(s):  
Renal Artery ◽  
Color Doppler ◽  
Rare Condition ◽  
Renal Perfusion ◽  
High Flow ◽  
New Materials ◽  
Occlusion Device ◽  
Complete Exclusion ◽  
Post Traumatic

Purpose: Giant post-traumatic artero-venous renal fistula is a very rare condition, and the exclusion of renal perfusion is the principal risk of embolization. Aim of our presentation is to evaluate new materials and devices derivated by neuro-angio experience to treat the vascular arterio-venous renal fistula. Material and Methods: From march 2017t to december 2020 we have treated 3 post traumatic hight-flow artero-venous renal fistulas. In one case an aneurysmatic dilatation of renal artery was associated. All patients were previously and during follow-up evaluated by MDCTA and US-color-Doppler. POD Penumbra System plus, POD packing coil were used to treat arterio-venous renal fistula. Results: In all cases (3/3) complete arterio-venous renal fistula occlusion was obtained. Pod System and Pod packing coil were delivered with microcatheter directly in the arterial side of the arterio-venous renal fistula. The renal fuction and complete parenchymal preservation were obtained Conclusions: In our preliminary experience Penumbra System revealed to be a secure device for a complete exclusion of high-flow arterio-venous renal fistula and preserving renal perfusion.

scholarly journals Pseudoaneurysm with arteriovenous fistula of the prostate after pelvic trauma: Ultrasound imaging

2016 ◽  
Vol 88 (4) ◽  
pp. 317 ◽  
Author(s):  
Andrea B. Galosi ◽  
Camilla Capretti ◽  
Luca Leone ◽  
Marco Tiroli ◽  
Daniele Cantoro ◽  
...  
Keyword(s):  
Arteriovenous Fistula ◽  
Color Doppler ◽  
Pelvic Trauma ◽  
Selective Embolization ◽  
Distal Branch ◽  
Anechoic Area ◽  
Post Traumatic ◽  
Anterior Prostate ◽  
Recurrent Hematuria

Pseudoaneurysm (PA) associated with an arteriovenous fistula (AVF) of the internal pudendal artery branches are very uncommon. We report a case of post-traumatic PA with AVF connected to Santorini plexus. Diagnosis was made with trans-rectal ultrasound (TRUS) after recurrent hematuria. TRUS reported a 1.7 × 1.4 × 1.5 cm anechoic area, on anterior prostate apex close to Santorini plexus. The use of color Doppler in this area revealed high flow velocity that was indicative for AVF. The feeding artery was a distal branch of the left pudenda artery. After selective embolization was observed complete occlusion of the feeding branches and disappearance of PA with AVF. Prostate PA with concomitant symptomatic AVF detected with TRUS has not yet described in literature after pelvic trauma and represents complex diagnostic challenges. This case report suggests that the use of TURS and color Doppler can provide an important diagnostic and follow-up to address the clinical suspicion of occult vascular injuries using a noninvasive approach.

Role of color-Doppler sonography in the follow-up of renal artery stenting

2008 ◽  
Vol 113 (2) ◽  
pp. 242-248 ◽  
Author(s):  
G. C. Parenti ◽  
D. Palmarini ◽  
M. Bilzoni ◽  
P. Campioni ◽  
P. Mannella ◽  
...  
Keyword(s):  
Renal Artery ◽  
Doppler Sonography ◽  
Color Doppler ◽  
Color Doppler Sonography ◽  
Renal Artery Stenting

scholarly journals Use of Magnetic Resonance Angiography in Diagnosis and Decision Making of Post-Traumatic, High-Flow Priapism

2008 ◽  
Vol 8 ◽  
pp. 176-181 ◽  
Author(s):  
Ahmed El-Assmy ◽  
Ihab A. Hekal ◽  
Mohamed E. Abou-El-Ghar
Keyword(s):  
Decision Making ◽  
Magnetic Resonance ◽  
Magnetic Resonance Angiography ◽  
Imaging Modality ◽  
Color Doppler ◽  
Vascular Lesion ◽  
High Flow ◽  
Successful Outcome ◽  
Artery Pseudoaneurysm ◽  
Post Traumatic

The ideal imaging modality should demonstrate the presence or absence of a clinically significant, causative vascular lesion that, in high-flow arterial priapism, may need intervention. We report a 22-year-old male with post-traumatic arterial priapism. Color Doppler ultrasound could not reliably identify a significant vascular lesion. Magnetic resonance angiography (MRA) demonstrated the presence of a cavernous artery pseudoaneurysm. Based on this finding, embolization was decided, with a successful outcome. Contrast-enhanced MRA appears to be a useful, noninvasive diagnostic tool for decision making in cases of high-flow priapism.

Therapeutic embolization of high-flow priapism 1 year follow up with color Doppler sonography

2013 ◽  
Vol 82 (12) ◽  
pp. e769-e774 ◽  
Author(s):  
Song Zhao ◽  
Jun Zhou ◽  
Yi-Fan Zhang ◽  
Xiao-Long Zhang ◽  
Qing-Yun Long
Keyword(s):  
Doppler Sonography ◽  
Color Doppler ◽  
Therapeutic Embolization ◽  
High Flow ◽  
Color Doppler Sonography

Use of Doppler ultrasound and 3-dimensional contrast-enhanced MR angiography in the diagnosis and follow-up of post-traumatic high-flow priapism in a child

2000 ◽  
Vol 30 (4) ◽  
pp. 265-267 ◽  
Author(s):  
E. Eracleous ◽  
M. Kondou ◽  
K. Aristidou ◽  
S. Eliades ◽  
M. Pantziaris ◽  
...  
Keyword(s):  
Doppler Ultrasound ◽  
Mr Angiography ◽  
High Flow ◽  
3 Dimensional ◽  
Contrast Enhanced ◽  
Post Traumatic

scholarly journals Bilateral Testicular Torsion: A Case Report

2021 ◽  
Author(s):  
Behzad Lotfi
Keyword(s):  
Case Report ◽  
Conservative Management ◽  
Treatment Modality ◽  
Testicular Torsion ◽  
Color Doppler ◽  
Rare Condition ◽  
Vascular Flow

Bilateral testicular torsion is a rare condition. We report a case of a male newborn with bilateral enlarged and firm testes. Color-Doppler revealed no evidence of vascular flow in both testes. Although intraoperative findings were in favor of bilateral infarcted and gangrenous testes, the patient underwent bilateral orchiopexy after conferring with his parents. At sixmonth follow-up, both testicles were atrophic. Management of bilateral neonatal testicular torsion is controversial and includes conservative management, orchiopexy, and orchiectomy. The possibility of salvaging testis in neonatal testicular torsion is very low in each treatment modality.

Autoimmune Pancreatitis – Diagnosis, Management and Longterm Follow-up

2014 ◽  
Vol 23 (2) ◽  
pp. 179-185 ◽  
Author(s):  
Suvadip Chatterjee ◽  
Kofi W. Oppong ◽  
John S. Scott ◽  
Dave E. Jones ◽  
Richard M. Charnley ◽  
...  
Keyword(s):  
Autoimmune Pancreatitis ◽  
Rare Condition ◽  
Team Approach ◽  
Diagnostic Challenge ◽  
Multisystem Disorder ◽  
North East ◽  
The North ◽  
Work Up ◽  
Igg4 Level

Background & Aims: Autoimmune pancreatitis (AIP) is a fibroinflammatory condition affecting the pancreas and could present as a multisystem disorder. Diagnosis and management can pose a diagnostic challenge in certain groups of patients. We report our experience of managing this condition in a tertiary pancreaticobiliary centre in the North East of England.Methods: Patients were identified from a prospectively maintained database of patients diagnosed with AIP between 2005 and 2013. Diagnosis of definite/probable AIP was based on the revised HISORt criteria. When indicated, patients were treated with steroids and relapses were treated with azathioprine. All patients have been followed up to date.Results: Twenty-two patients were diagnosed with AIP during this period. All patients had pancreatic protocol CT performed while some patients had either MR or EUS as part of the work up. Fourteen out of 22 (64%) had an elevated IgG4 level (mean: 10.9 g/L; range 3.4 - 31 g/L). Four (18%) patients underwent surgery. Extrapancreatic involvement was seen in 15 (68%) patients, with biliary involvement being the commonest. Nineteen (86%) were treated with steroids and five (23%) required further immunosuppression for treatment of relapses. The mean follow up period was 36.94 months (range 7 - 94).Conclusion: Autoimmune pancreatitis is being increasingly recognized in the British population. Extrapancreatic involvement, particularly extrahepatic biliary involvement seems to be a frequent feature.Diagnosis should be based on accepted criteria as this significantly reduces the chances of overlooking malignancy. Awareness of this relatively rare condition and a multi-disciplinary team approach will help us to diagnose and treat this condition more efiectively thereby reducing unnecessary interventions.

scholarly journals Surgical Treatment of Diffuse Idiopathic Skeletal Hyperostosis (DISH) Involving the Cervical Spine: Technical Nuances and Outcome of a Multicenter Experience

2021 ◽  
pp. 219256822098827
Author(s):  
Giorgio Lofrese ◽  
Alba Scerrati ◽  
Massimo Balsano ◽  
Roberto Bassani ◽  
Michele Cappuccio ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Clinical Outcome ◽  
Waiting Times ◽  
Diffuse Idiopathic Skeletal Hyperostosis ◽  
Surgical Techniques ◽  
Rare Condition ◽  
Surgical Strategies ◽  
Bone Removal ◽  
Mild Dysphagia

Study Design: Retrospective multicenter. Objectives: diffuse idiopathic skeletal hyperostosis (DISH) involving the cervical spine is a rare condition determining disabling aero-digestive symptoms. We analyzed impact of preoperative settings and intraoperative techniques on outcome of patients undergoing surgery for DISH. Methods: Patients with DISH needing for anterior cervical osteophytectomy were collected. Swallow studies and endoscopy supported imaging in targeting bone decompression. Patients characteristics, clinico-radiological presentation, outcome and surgical strategies were recorded. Impact on clinical outcome of duration and time to surgery and different surgical techniques was evaluated through ANOVA. Results: 24 patients underwent surgery. No correlation was noted between specific spinal levels affected by DISH and severity of pre-operative dysphagia. A trend toward a full clinical improvement was noted preferring the chisel ( P = 0.12) to the burr ( P = 0.65), and whenever C2-C3 was decompressed, whether hyperostosis included that level ( P = 0.15). Use of curved chisel reduced the surgical times ( P = 0.02) and, together with the nasogastric tube, the risk of complications, while bone removal involving 3 levels or more ( P = 0.04) and shorter waiting times for surgery ( P < 0.001) positively influenced a complete swallowing recovery. Early decompressions were preferred, resulting in 66.6% of patients reporting disappearance of symptoms within 7 days. One and two recurrences respectively at clinical and radiological follow-up were registered 18-30 months after surgery. Conclusion: The “age of DISH” counts more than patients’ age with timeliness of decompression being crucial in determining clinical outcome even with a preoperative mild dysphagia. Targeted bone resections could be reasonable in elderly patients, while in younger ones more extended decompressions should be preferred.

scholarly journals Rare Etiology of Odynophagia in a Female Adolescent

2021 ◽  
pp. 352-358
Author(s):  
Anastasios Koutsoumourakis ◽  
Asterios Gagalis ◽  
Maria Fotoulaki ◽  
Maria Stafylidou
Keyword(s):  
Antiviral Treatment ◽  
Healing Process ◽  
Rare Condition ◽  
Female Adolescent ◽  
Mucosal Barrier ◽  
Esophageal Mucosa ◽  
Intact Immune System ◽  
History Of ◽  
Orolabial Herpes

Herpes esophagitis (HE) is a rare condition in immunocompetent adolescents. However, it commonly occurs as a primary infection in younger individuals. Herein, we report a 16-year-old female patient who had a history of fever for 5 days, odynophagia, and orolabial herpes infection for 7 days. Clusters of painful vesicles on an erythematous base on the lips, gingiva, and palate were observed on physical examination. Further, esophagogastroduodenoscopy revealed diffuse linear ulcerations in the distal esophagus. The patient then received the following treatment: intravenous (I.V.) acyclovir 5 mg/kg three times a day, I.V. omeprazole 40 mg two times a day, and acyclovir 5% cream four times a day. After 8 days of admission, the patient was discharged. A follow-up esophagogastroduodenoscopy was performed 7 weeks after discharge, and the results revealed that the esophageal mucosa had a normal appearance. The effect of antiviral treatment against HE remains unknown in these patients. Nevertheless, it is believed to accelerate the healing process in individuals with esophageal mucosal barrier damage. To the best of our knowledge, this case of a female adolescent with an intact immune system is the sixth case of herpes simplex esophagitis to be reported in the literature.

scholarly journals Acute otitis media in an infant complicated with osteoarthritis of temporomandibular joint and sub-periosteal abscess of the clavicle

2021 ◽  
Vol 37 (1) ◽  
Author(s):  
Kaoutar Cherrabi ◽  
Hind Cherrabi
Keyword(s):  
Septic Arthritis ◽  
Temporomandibular Joint ◽  
Nutritional Assessment ◽  
Acute Otitis Media ◽  
Clinical Signs ◽  
Rare Condition ◽  
Pediatric Emergency ◽  
Ear Infections ◽  
The Right

Abstract Background Otomastoiditis is a very frequent affection and a current complication of mal-treated benign ear infections in children. However, this a very rare case of the association of two rare complications of otomastoiditis in a newborn. On the one hand, septic arthritis of the temporomandibular joint which is a very rare condition that is difficult to diagnose, and when unrecognized or not treated accordingly, it can resolve in serious infectious complication and or definitive injury to the temporomandibular joint. On the other hand, osteomyelitis of the clavicle is also very rare, and only a few cases have been cited in the literature concerning infants. Case presentation This 46-day-old infant was brought to pediatric emergency consultation for 2 swelling inflammatory bulges, one in the right mastoid and pre-auricular regions, and another in the right basi-cervical area. The infant was hypertrophic febrile, hypotonic, and pale. He had preserved archaic reflexes. Besides, blood test showed an inflammatory syndrome, inflammatory anemia, and no other abnormalities. Upon supplementary computed tomodensitometry exam, the diagnosis of a combination of septic arthritis of the right temporomandibular joint and sub-periosteal abscess of the ipsilateral clavicle in a context of hypotrophy and malnutrition was suspected. A pus sample was obtained for bacteriological evaluation, after which the infant had a course of intravenous associated antibiotics, along with nutritional assessment and management. Surgical drainage of both collections was performed. The 6-month follow-up was satisfactory, without clinical signs of functional impact on temporomandibular joint, or acromioclavicular joint. Conclusion This work stresses the necessity of thorough clinical examination of infants even in cases of benign ear infections, as well as the importance of adapted treatment and follow-up, which could allow early diagnosis, appropriate treatment, or even prevention of severe complications that can be associated with such benign conditions.

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