A Neglected Case of Thoracic Aortic Aneurysm– A Case Report

A 52 year old female reported to surgery department of Bangabandhu Sheikh Mujib Medical University (BSMMU) with dysphasia and exertional chest pain. With detailed history and examination she was diagnosed as a case of epigastric mass and undergone X-ray chest. The report revealed enlarged mediastinal shadow with suspicion of thoracic aortic aneurysm. X-ray chest was followed by contrast enhanced CT scan which revealed a large partially thrombosed aneurysmal dilatation of the aortic arch with sharp kinking (bend) at distal end of aneurysm and beginning of descending aorta. Then the patient was referred to cardiac surgery for immediate management. But the patient refused to have a surgery. Then two months later the patient again presented with chest pain and admitted in DMCH. But the patient died.DOI: http://dx.doi.org/10.3329/jom.v16i1.22405 J MEDICINE 2015; 16 : 53-55

Download Full-text

Chest Pain of Uncertain Aetiology: Role of Contrast Enhanced Computed Tomography in the Emergency Department

The Open Cardiovascular Medicine Journal ◽

10.2174/1874192401610010205 ◽

2016 ◽

Vol 10 (1) ◽

pp. 205-211

Author(s):

Firas Yassin ◽

Chris Sawh ◽

Pankaj Garg

Keyword(s):

Emergency Department ◽

Chest Pain ◽

Acute Chest Pain ◽

Coronary Event ◽

Computed Tomographic ◽

Contrast Enhanced Ct ◽

Contrast Enhanced ◽

Enhanced Ct ◽

Enhanced Computed Tomography

There is increasing role of computed tomographic (CT) in the assessment of acute chest pain in the emergency department especially when the diagnosis is not clear. We report a case where non ECG gated contrast enhanced CT in the emergency department for rule-out of pulmonary embolus guided to the actual diagnosis, which was, acute coronary event, as evidenced by the presence of perfusion defect.

Download Full-text

System and Method for 3-D/3-D Registration between Non-contrast-enhanced CBCT and Contrast-Enhanced CT for Abdominal Aortic Aneurysm Stenting

Advanced Information Systems Engineering - Lecture Notes in Computer Science ◽

10.1007/978-3-642-40811-3_48 ◽

2013 ◽

pp. 380-387 ◽

Cited By ~ 3

Author(s):

Shun Miao ◽

Rui Liao ◽

Marcus Pfister ◽

Li Zhang ◽

Vincent Ordy

Keyword(s):

Abdominal Aortic Aneurysm ◽

Aortic Aneurysm ◽

Contrast Enhanced Ct ◽

Abdominal Aortic ◽

Contrast Enhanced ◽

Enhanced Ct

Download Full-text

Patterns of aortic remodelling after total arch replacement with frozen elephant trunk for acute aortic dissection

Interactive CardioVascular and Thoracic Surgery ◽

10.1093/icvts/ivz185 ◽

2019 ◽

Vol 29 (6) ◽

pp. 923-929 ◽

Cited By ~ 2

Author(s):

Yasunori Iida ◽

Susumu Fujii ◽

Hideyuki Shimizu ◽

Shigeharu Sawa

Keyword(s):

Aortic Dissection ◽

Acute Aortic Dissection ◽

Type A ◽

Total Arch Replacement ◽

Elephant Trunk ◽

Descending Aorta ◽

Type A Aortic Dissection ◽

Contrast Enhanced Ct ◽

Contrast Enhanced ◽

Enhanced Ct

Abstract OBJECTIVES We investigated the outcomes of total arch replacement with frozen elephant trunk (FET) for Stanford type A acute aortic dissection and the patterns of postoperative aortic remodelling from computed tomographic (CT) findings. METHODS From April 2015 to November 2018, we performed total arch replacement with FET for Stanford type A aortic dissection in 30 patients. Postoperative contrast-enhanced CT showed the position of the FET distal end, the number and the site of communications between the lumina and the presence or absence of aortic remodelling. RESULTS Primary entry tear was found in the ascending aorta (n = 6), proximal arch (n = 6), aortic arch (n = 11) and distal arch (n = 7). The mean diameter and length of FET were 26 ± 2 and 84 ± 18 mm, respectively. Postoperative contrast-enhanced CT was performed in 26 patients. When the number of communications between the lumina was 0, complete aortic remodelling was achieved in all cases (n = 12). In the case of the most proximal tear in the descending aorta (n = 9), aortic remodelling was not recognized in 3 cases, and additional TEVAR was performed because of diameter enlargement. In the remaining 6 patients, neither aortic remodelling nor aortic diameter enlargement was recognized. When the most proximal tear was below the diaphragm (n = 5), aortic remodelling occurred up to the most proximal tear, but not in the periphery. CONCLUSIONS We investigated the patterns of aortic remodelling after total arch replacement with FET for Stanford type A aortic dissection from postoperative CT findings. Regardless of the position of the most proximal tear in the descending aorta, aortic remodelling did not occur as long as the most proximal tear was located in the descending aorta. When the most proximal tear occurred in the descending aorta, TEVAR as a pre-emptive treatment can be effective in preventing postoperative aortic adverse events.

Download Full-text

THE ROLE OF IMAGISTIC INVESTIGATIONS IN DIAGNOSING ACUTE COMPLICATED DIVERTICULITIS

Journal of Surgical Sciences ◽

10.33695/jss.v2i3.120 ◽

2015 ◽

Vol 2 (3) ◽

pp. 124-127

Author(s):

I. Tănase ◽

S. Păun ◽

B. Stoica ◽

I. Stoica ◽

M. Beuran

Keyword(s):

Diagnostic Accuracy ◽

Ct Scan ◽

Acute Diverticulitis ◽

Abdominal Ultrasound ◽

Complicated Diverticulitis ◽

X Ray ◽

Contrast Enhanced Ct ◽

Contrast Enhanced ◽

Mean Waiting Time ◽

Enhanced Ct

Recent progress in medical imaging allowed higher accuracy in diagnosis of acute diverticulitis. Contrast enhanced Computed Tomography (CT) has a high sensitivity and specificity, reaching a diagnostic accuracy over 95%. Although abdominal X-ray and ultrasonography are still used, their utility is limited in this pathology. Retrospective study including patients admitted for acute diverticulitis in the Surgery Clinic of Bucharest Clinical Emergency Hospital between January 2012 and July 2014. From the total number of 29508 admissions, 156 patients were diagnosed with acute diverticulitis staged Hinchey I to IV. The imagistic investigations on admission were plain abdominal X-ray (128 cases), which identified 6 cases of pneumoperitoneum; abdominal ultrasound (112 cases) which identified colonic wall thickening and/or free peritoneal fluid in 29.4% cases. Contrast enhanced CT was performed in 97 cases, successfully establishing the diagnostic in 80% of cases. The mean waiting time interval until CT scan was under 24 hours for the patients with acute complicated diverticulitis. Patients with acute diverticulitis staged Hinchey II-III needed CT reevaluation both for monitoring the response to conservative treatment and identification of postoperative complications. Due to its high diagnostic accuracy and short waiting interval, in the studied cohort, contrast enhanced CT represents the investigation of choice in diagnosing acute diverticulitis. Abdominal ultrasound remains an alternative only in cases where CT scan is unavailable or contraindicated, having a lower accuracy in diagnosis and evaluation of diverticular disease complications.

Download Full-text