scholarly journals Aortoenteric Fistulae: Present-Day Management

2011 ◽  
Vol 96 (3) ◽  
pp. 266-273 ◽  
Author(s):  
Konstantinos Xiromeritis ◽  
Ilias Dalainas ◽  
Michalis Stamatakos ◽  
Konstantinos Filis
Keyword(s):  
Computed Tomography ◽  
Endovascular Repair ◽  
Surgical Techniques ◽  
Aortoenteric Fistula ◽  
Computed Tomography Scan ◽  
Intravenous Contrast ◽  
Safe Method ◽  
Life Threatening ◽  
Diagnostic Modalities ◽  
Tomography Scan

Abstract An aortoenteric fistula (AEF) is a communication between the aorta and an adjacent loop of the bowel. The three most useful diagnostic modalities for detecting AEF are abdominal computed tomography scan with intravenous contrast, esophagogastroduodenoscopy, and arteriography. The treatment of AEFs has improved in recent years, but despite the multiple surgical techniques reported, many of the patients do not survive or are left debilitated after treatment. Endovascular repair is an efficient and safe method to stabilize patients with life-threatening AEFs. The aim of this study is to provide a comprehensive and synthetic review of the latest advantages on the diagnosis and management of primary and secondary AEF.

scholarly journals A rare interesting case of fatal air embolism after intravenous contrast during computed tomography

2021 ◽  
Vol 17 (4) ◽  
pp. 93-96
Author(s):  
Naved Y. Hasan ◽  
Asiah Salem Rugaan
Keyword(s):  
Computed Tomography ◽  
Fatal Case ◽  
Pulseless Electrical Activity ◽  
Air Embolism ◽  
Sudden Onset ◽  
Radiology Department ◽  
Computed Tomography Scan ◽  
Intravenous Contrast ◽  
Shock State ◽  
Tomography Scan

We are reporting a fatal case of air embolism. Although minor cases of air embolism may go unnoticed, this is a case of fatal air embolism after intravenous entry of air, which presented with sudden onset of pulseless electrical activity during a computed tomography scan in the radiology department, requiring cardiopulmonary resuscitation for 15 min. Subsequently, after admission to the intensive care unit, we achieved return of spontaneous circulation. The patient was intubated and ventilated in a shock state. He remained in refractory shock despite of supportive care. Cardiaс arrest was registered again in the catheterization lab and the patient could not be revived after 4 h from the initial cardiac arrest. А computed tomography scan was reported to reveal a significant amount of intra-cardiac air, which was the likely cause patient’s death. The case is a rare condition, which highlights the importance of early diagnosis and delivers a message to the medical staff to have a high index of suspicion in patients who have risk factors, and who develop sudden shock with hypoxemia, in order to treat this potentially life-threatening condition effectively in a timely manner.

scholarly journals The first experience of partial spleen embolization for the correction of thrombocytopenia in patients with liver cirrhosis

2021 ◽  
Vol 26 (3) ◽  
pp. 97-103
Author(s):  
A. V. Shabunin ◽  
V. V. Bedin ◽  
P. A. Drozdov ◽  
O. N. Levina ◽  
V. A. Tsurkan ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Liver Cirrhosis ◽  
Postoperative Period ◽  
Primary Liver Cancer ◽  
Abdominal Cavity ◽  
Early Postoperative Period ◽  
Computed Tomography Scan ◽  
Intravenous Contrast ◽  
Viral Hepatitis C ◽  
Tomography Scan

Aim. To assess the efficacy and safety of interventional endovascular partial spleen embolization for the correction of thrombocytopenia in patients with liver cirrhosis.Material and methods. From September 2019 to March 2020, 5 partial spleen embolizations were performed at the surgical clinic of the Botkin Hospital. The indication was the impossibility of conducting courses of regional chemotherapy for primary liver cancer in 2 patients with cirrhosis, portal hypertension, hypersplenism, thrombocytopenia, in 3 patients – the impossibility of conducting adequate antiviral therapy with cirrhosis as a result of chronic viral hepatitis C. The platelet count was < 25 thousand/μl (19.34 ± 1.34 thousand/μl) in all patients at the time of the procedure. The median spleen volume was 1967.54 ± 476.13 (1324.34–2163.54) cm3 . We used Progreat® Terumo 2.8 Fr microcatheter 130 cm for catheterization branches of the splenic artery. Endovascular embolization was performed with microspheres 600 ± 75 nm – 2 ml before occlusion. Computed tomography scan of abdominal cavity with intravenous contrast enhancement and laboratory test of platelet levels were performed. Follow up of patients was carried out at 1, 3 and 6 months after this intervention.Results. The postoperative period in all patients was uncomplicated. Postembolization syndrome (pain, hyperthermia) developed in the early postoperative period in all patients on the next day after the procedure. Computed tomography scan of the abdominal cavity revealed areas of an irregular shape of low density that did not accumulate a contrast agent. The duration of hospitalization was 7.63 ± 3.32 (5–11) days. There were not in-hospital and 30-day mortality in our study.Conclusion. The first experience of endovascular partial spleen embolization showed its safety and efficacy in the correction of thrombocytopenia in patients with liver cirrhosis.

scholarly journals Biomechanics and Clinical Application of Translaminar Screws Fixation in Spine: A Review of the Literature

2018 ◽  
Vol 9 (2) ◽  
pp. 210-218
Author(s):  
Jimmy J. Chan ◽  
Nicholas Shepard ◽  
Woojin Cho
Keyword(s):  
Computed Tomography ◽  
Clinical Application ◽  
Pediatric Population ◽  
Thoracolumbar Spine ◽  
Surgical Techniques ◽  
Computed Tomography Scan ◽  
Translaminar Screw ◽  
Computed Tomography Scans ◽  
Translaminar Screws ◽  
Tomography Scan

Study Design: Broad narrative review. Objectives: Translaminar screw (TLS) fixation was first described as a salvage technique for fixation of the axial spine. Better understanding of the spine anatomy allows for advancement in surgical techniques and expansion of TLS indications. The goal of this review is to discuss the anatomic feasibility of the TLS fixation in different region of the spine. Methods: A review of the current literatures on the principles, biomechanics, and clinical application of the translaminar screw technique in the axial, subaxial, and thoracolumbar spine. Results: Anatomic feasibility and biomechanical studies have demonstrated that TLS is a safe and strong fixation methods for fusion beyond just the axial spine. However, not all spine segments have wide enough lamina to accept TLS. Preoperative computed tomography scan can help ensure the feasibility and safety of TLS insertion. Recent clinical reports have validated the application of TLS in subaxial spine, thoracic spine, hangman’s fracture, and pediatric population. Conclusions: TLS can be used beyond axial spine; however, TLS insertion is only warranted when the lamina is thick enough to avoid further complications such as breakage. Preoperative computed tomography scans can be used to determine feasibility of such fixation construct.

scholarly journals Rapidly Growing Pancreatic Adenocarcinoma Presenting as an Irreducible Umbilical Hernia

2018 ◽  
Vol 2018 ◽  
pp. 1-4
Author(s):  
Deepti M. Reddi ◽  
Kathryn P. Scherpelz ◽  
Angelica Lerma ◽  
Jabi Shriki ◽  
Jeffrey Virgin
Keyword(s):  
Computed Tomography ◽  
Pancreatic Adenocarcinoma ◽  
Umbilical Hernia ◽  
Clinical Laboratory ◽  
Computed Tomography Scan ◽  
Intravenous Contrast ◽  
Hernia Sac ◽  
Occult Malignancy ◽  
Noncontrast Computed Tomography ◽  
Tomography Scan

Hernia sacs are a common anatomic pathology specimen, which rarely contain malignancy. We present a case of rapidly growing pancreatic adenocarcinoma, which initially presented as metastasis to an umbilical hernia sac. The patient was a 55-year-old male with a two-year history of umbilical hernia. Two months prior to herniorrhaphy, the hernia became painful and the patient experienced nausea and weight loss. The gross examination did not reveal distinct lesions. Microscopically, the hernia sac was diffusely infiltrated by moderately differentiated adenocarcinoma, which was positive for CK7 and pancytokeratin and negative for TTF-1, CK20, PSA, and CDX2. Clinical laboratory tests found elevated levels of CA 19-9 and CEA. Computed tomography scan with intravenous contrast showed a 5 cm ill-defined and hypoattenuating mass involving the pancreatic tail and body, as well as numerous ill-defined lesions in the liver and peritoneal carcinomatosis. The patient had an earlier noncontrast computed tomography scan four months prior to the surgery, which did not detect any lesions in the abdomen. This case highlights the importance of intravenous contrast with computed tomography for the evaluation of pancreatic lesions and also emphasizes the importance of thorough histologic evaluation of hernia sacs for the detection of occult malignancy.

scholarly journals Findings in an Elderly Patient after a Fall

2017 ◽  
Vol 24 (3) ◽  
pp. 51-54
Author(s):  
Qasem M. Aljabr
Keyword(s):  
Computed Tomography ◽  
Neck Pain ◽  
Treatment Options ◽  
Limited Range ◽  
Computed Tomography Scan ◽  
Limited Range Of Motion ◽  
Initial Work ◽  
Life Threatening ◽  
Work Up ◽  
Tomography Scan

A 76-year-old male presented with neck pain beginning a month earlier, when he tripped over a ledge while exiting his truck. The patient landed on his face and lost consciousness. In the emergency room, the initial work up, including a head computed tomography scan, came back negative, but the fall work-up was incomplete. He was discharged with a physical therapy appointment to manage his neck pain but did not go. The patient’s pain continued for another four weeks before he went to the clinic. The pain was located at the midline of his posterior cervical spine with limited range of motion. He was otherwise asymptomatic. A more comprehensive fall assessment and work-up was completed. An immediate neck computed tomography scan was ordered and revealed subacute Stage 2 odontoid fractures. The patient was placed in a neck collar. An urgent appointment with the neurosurgery clinic was requested. The neurosurgeon reviewed the neck computed tomography scan; a follow up by magnetic resonance imaging confirmed the findings. After discussing treatment options, the patient agreed to proceed with fusion surgery. This case demonstrates the importance of performing a complete fall assessment and workup to ensure early detection and prevention of serious or life-threatening injuries.

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