1/29. A giant intramural gastric hematoma successfully treated by transcatheter arterial embolization.We describe a case of intramural gastric hematoma with hemorrhagic shock caused by the formation of a large hematoma. Computed tomographic and angiographic examinations confirmed the presence of active bleeding into the hematoma. Transcatheter arterial embolization (TAE) was performed for hemostasis. To our knowledge, although 21 cases of intramural gastric hematoma have been reported in the literature, this is apparently the first case treated by TAE. We conclude that TAE is a safe and effective treatment option for intramural gastric hematoma confirmed to be associated with active bleeding into the hematoma.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
2/29. A giant parietal wall hematoma: unusual complication of laparoscopic appendectomy.Laparoscopic appendectomy is an established procedure in the treatment of appendicitis. Complications of the procedure are related to the Veress needle and trocar insertions or pertain to actual operative procedures. Trocar-elated major bleeding is rare, and, if it occurs, is detected on the table or during the immediate postoperative period. Delay in recognition may lead to significant morbidity and mortality. We report a case of giant parietal wall hematoma in a 34-year-old female, presenting one week after discharge from the hospital. The hematoma was completely evacuated by exploration through paramedian incision, followed by an uneventful recovery.- - - - - - - - - - ranking = 1.25keywords = giant (Clic here for more details about this article) |
3/29. Giant cephalhaematoma in a 17-year-old boy with ehlers-danlos syndrome.We report a case of giant cephalhaematoma in a 17-year-old boy with ehlers-danlos syndrome. This haematoma occurred after a minor head injury. It increased in size, immediately after needle aspiration and was responsible for considerable blood loss. Possible physiopathological mechanisms and treatment modalities are discussed.- - - - - - - - - - ranking = 0.25keywords = giant (Clic here for more details about this article) |
4/29. Evolution of incidentally-discovered fusiform aneurysms of the vertebrobasilar arterial system: neuroimaging features suggesting progressive aneurysm growth.This study investigated the natural history and biological behavior of incidental fusiform aneurysms in four patients with incidental fusiform aneurysms of the vertebrobasilar arterial system who had been followed up for more than 3 years (mean 3.5 years). Two lesions remained the same size, and two lesions gradually grew. Angiography showed the non-growing fusiform aneurysms as a circumferentially or unilaterally fusiform dilatation of a short segment of the vertebral artery with smooth walls and a steep slope of the dilatation, and the growing fusiform aneurysms as unilaterally fusiform involving a long segment of the vertebral artery or basilar artery with irregular walls and a gentle slope of dilatation. Magnetic resonance (MR) imaging demonstrated the non-growing fusiform aneurysms as a signal-void area, and the growing fusiform aneurysms as high and intermediate signals in addition to the normal flow void. The heterogeneous MR intensities probably correspond to turbulent flow, laminar flow, thrombosis, or intramural hematoma. Differentiation of growing and non-growing fusiform aneurysms is very difficult at the initial diagnosis. However, enlargement of the fusiform aneurysms is consistent with hemorrhage into the aneurysmal wall, which is confirmed by MR imaging. Fusiform aneurysms with the characteristics of the growing aneurysms cannot be overlooked because of the potential to develop into giant fusiform aneurysms which are very difficult to manage therapeutically.- - - - - - - - - - ranking = 0.25keywords = giant (Clic here for more details about this article) |
5/29. Giant bleeding renal angiomyolipoma: diagnosis and management.A case of a giant bleeding renal angiomyolipoma is presented. The patient was a 40-year-old Egyptian male with no clinical or radiological evidence of tuberous sclerosis. The radiological features and management, including the role of angiography are briefly discussed and the medical reviews on this subject are briefly considered.- - - - - - - - - - ranking = 0.25keywords = giant (Clic here for more details about this article) |
6/29. Endovascular repair of thoracic aortic aneurysm and intramural hematoma in giant cell arteritis.An 80-year-old woman with established giant cell arteritis presented at the authors' institution with a 6.5-cm false aneurysm of the descending thoracic aorta complicated by focal dissection and intramural hematoma after a 1-week history of acute-onset chest pain. The patient underwent uncomplicated endovascular aortic repair with a 32-mm x 15-cm TagExcluder stent-graft. After the procedure, the intramural hematoma resolved and the patient's corticosteroid and immunosuppressive therapy was repeatedly adjusted. However, the giant cell arteritis activity relapsed after 8 months with development of a similar 1.5-cm false aneurysm below the thoracic stent-graft, complicated by focal intramural hematoma. Repeat uncomplicated thoracic stent-graft implantation was performed and CT follow-up displayed resorption of the intramural hematomas with no evidence of endoleak or any new aortic pathology. This report discusses the difficult management of patients with relapsing active aortic giant cell arteritis and the potential role for endovascular thoracic aortic repair.- - - - - - - - - - ranking = 1.75keywords = giant (Clic here for more details about this article) |
7/29. Spontaneous retropharyngeal hematoma of a parathyroid cyst: report of a case.A 41-year-old woman presented with severe and sudden anterior neck swelling, pain, and dysphagia. Computed tomography (CT) scan and ultrasound of the neck showed a giant mass in the retropharyngeal space, displacing the trachea and esophagus anteriorly. Aspiration cytology was done, following which extensive cervical and chest ecchymosis occurred and her symptoms immediately improved. A repeat CT scan demonstrated that the cervical giant mass had vanished, but there was a residual mass in the left paratracheal space. Exploratory surgery of the neck revealed a parathyroid cyst with severe adhesion to the surrounding tissues. We considered that a ruptured parathyroid cyst had induced massive hemorrhage into the cervical tissues and mediastinum, but that the hemorrhage had been absorbed. Extracapsular hemorrhage from a parathyroid adenoma or cyst is rare, especially from a parathyroid cyst. In fact, to our knowledge, this represents only the third case of symptomatic spontaneous bleeding of a parathyroid cyst. Nevertheless, this entity should still be considered in the differential diagnosis of all rapidly progressing retropharyngeal masses.- - - - - - - - - - ranking = 0.5keywords = giant (Clic here for more details about this article) |
8/29. A case of giant expanding cephalhematoma: does the administration of blood coagulation factor XIII reverse symptoms?BACKGROUND: The mechanism of continuous massive hemorrhage into the subperiosteal space in children without coagulation defects is unknown. We report a case of giant expanding cephalhematoma reversed by the administration of blood coagulation factor XIII concentrate. METHOD: The patient was an 8-year-old boy with a history of minor head trauma who developed a giant expanding cephalhematoma with intraorbital extension. The laboratory data showed severe anemia, but a routine blood coagulation test showed no abnormalities except for a low factor XIII level. RESULT: The administration of factor XIII concentrate completely reversed the symptoms in 2 weeks. CONCLUSION: We speculate that one of the possible mechanisms of cephalhematoma expansion without blood coagulation defects might be acquired factor xiii deficiency from severe hemorrhage in a hematoma.- - - - - - - - - - ranking = 1.5keywords = giant (Clic here for more details about this article) |
9/29. thrombosis and recanalization of symptomatic nongiant saccular aneurysm.Complete thrombosis followed by recanalization of giant aneurysms is an infrequent process that has been exceptionally mentioned in relation to nongiant saccular aneurysms. A 25-year-old male presented with a right temporal hematoma and associated subarachnoid hemorrhage. cerebral angiography revealed a small blister-like dilatation at the right middle cerebral artery bifurcation. The cerebral hematoma was surgically removed and a large thrombosed aneurysm was discovered and was wrapped. Follow-up angiography revealed complete recanalization of the aneurysm with preservation of all the arterial branches and the aneurysm was then completely occluded with detachable coils. This case provides insight into the well-known but poorly understood dynamic process of thrombosis and recanalization of cerebral aneurysms. The possible role of a cerebral hematoma in the pathogenesis of this process is discussed.- - - - - - - - - - ranking = 1.5keywords = giant (Clic here for more details about this article) |
10/29. life threatening chronic expanding hematoma of the thorax.A 73-year-old man presented with severe respiratory distress and systemic edema. diagnosis of chronic expanding hematoma (CEH) was made through examination of past and present radiographic studies. A giant mass lesion with surrounding calcification occupying the left hemi-thorax on the chest was demonstrated via computed tomography on admission, and a chest X-ray from 8 years previously revealed evidence of tubercular pleurisy. The patient's condition deteriorated rapidly after admission, necessitating urgent operative resection of the mass. The mass consisted of fresh and organized blood and demonstrated a calcified fibrous capsule, findings that are consistent with the diagnosis of CEH. Although the patient's condition improved following operative removal of the mass, he was ultimately diagnosed with postoperative empyema secondary to bronchopleural fistula, necessitating additional surgery.- - - - - - - - - - ranking = 0.25keywords = giant (Clic here for more details about this article) |
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