1/426. Detection of retroperitoneal hemorrhage by transesophageal echocardiography during cardiac surgery.PURPOSE: To present a case of massive retroperitoneal hemorrhage during cardiopulmonary bypass (CPB) which was detected using transesophageal echocardiography (TEE). CLINICAL FEATURE: A 50-yr-old man suffering from severe mitral regurgitation (MR) was admitted for mitral valvuloplasty. After the beginning of CPB, the volume in the reservoir was noticed to be gradually decreasing. Although venous cannulation had been properly performed, TEE showed an echo free space around the liver, the spleen and in front of the abdominal aorta showed intraabdominal hemorrhage. After cardiac surgery, emergency laparotomy revealed about 5,000 ml of blood in the retroperitoneal space probably as a result of femoral artery cannulation prior to CPB. hemostasis was achieved, and the patient made complete cardiac and neurological recovery. Retrospective review of the TEE imaging revealed that the kidneys were surrounded by blood bilaterally confirming the diagnosis of retroperitoneal hemorrhage. CONCLUSION: Retroperitoneal hemorrhage during CPB is rare, but may be lethal. Transesophageal echocardiography is a useful monitor not only to evaluate cardiac performance, but also to detect unexpected intraabdominal bleeding during cardiac surgery.- - - - - - - - - - ranking = 1keywords = artery (Clic here for more details about this article) |
2/426. Pseudoaneurysm of the superficial femoral artery following accidental trauma: result of treatment by percutaneous stent-graft placement.Accidental trauma frequently involves the extremities, and can extend to involve their blood supply, causing exsanguinating hemorrhage and pseudoaneurysm in the involved blood vessel. This is traditionally managed by surgical repair. We report a case in which control of life-threatening hemorrhage and exclusion of a large, post-traumatic pseudoaneurysm in the superficial femoral artery was performed by a commercially available stent-graft, without complication. This treatment method may be a safe and effective alternative to surgery in selected patients.- - - - - - - - - - ranking = 5keywords = artery (Clic here for more details about this article) |
3/426. Bleeding simulated by the distal internal pudendal artery stain.A capillary and venous phase blush in the region of the distal branches of the internal pudendal artery that simulates bleeding can sometimes be seen on arteriograms of male patients who are not bleeding. We describe five such cases. Correct identification of this pooling of contrast material is important to avoid unnecessary treatment by transcatheter embolization or by infusion of vasoactive drugs.- - - - - - - - - - ranking = 5keywords = artery (Clic here for more details about this article) |
4/426. Cervical pregnancy--a conservative stepwise approach.A case of cervical pregnancy resistant to intramuscular methotrexate therapy is presented, which was successfully treated by intra-arterial methotrexate followed by selective prophylactic hypogastric artery embolization to avoid aggravating the vaginal bleeding. It is suggested that, in cervical pregnancies in which fertility preservation is desired, a stepwise conservative approach should be applied before resorting to surgical intervention.- - - - - - - - - - ranking = 1keywords = artery (Clic here for more details about this article) |
5/426. Acute hemorrhage into the peritoneal cavity--a complication of chronic pancreatitis with pseudocyst: a case report from clinical practice.Acute hemorrhage due to a pseudocyst of the pancreas is a dangerous complication of chronic pancreatitis (CP). Without operative treatment, mortality is as high as 90%. Immediate recognition of this complication as well as urgent operative treatment allowing the survival of 70% of patients is imperative. Described is the case of a patient with CP and pseudocyst in which hyperamylasemia and unclarified anemia developed following sudden abdominal pain. The suspicion of hemorrhage into the peritoneal cavity was confirmed by selective visceral angiography showing hemorrhage from the splenic artery in the region of the hilus of the spleen. Operative treatment was successful. During the procedure, a ligature was applied to the hemorrhaging splenic artery and a splenectomy was carried out with 2500 ml of bloody contents being removed from the abdominal cavity. Acute hemorrhage into the peritoneal cavity as a complication of chronic pancreatitis with pseudocyst (CPP) requires immediate identification, confirmation by visceral angiography, and urgent operative treatment.- - - - - - - - - - ranking = 2keywords = artery (Clic here for more details about this article) |
6/426. arteriovenous fistula of the thyroid gland associated with spontaneous bleeding from a flow-induced aneurysm of the inferior thyroid artery.A case of acute, spontaneous cervical hemorrhage caused by a ruptured aneurysm of the inferior thyroid artery is described. This lesion was accompanied by an arteriovenous fistula within the thyroid gland that caused a flow-induced aneurysm. diagnosis and treatment were successfully performed by selective angiography with endovascular occlusion and embolization. Both diagnostic and therapeutic management are discussed, and the related literature is reviewed. To our knowledge, this is the first reported case of an aneurysm of a thyroid artery in conjunction with an intraparenchymatous arteriovenous fistula of the thyroid gland.- - - - - - - - - - ranking = 6keywords = artery (Clic here for more details about this article) |
7/426. An aneurysm of the petrous internal carotid artery.Internal carotid artery aneurysms are a rare cause of pulsatile tinnitus and conductive hearing loss but should be borne in mind when there is a suspected diagnosis of glomus jugulare or high-riding jugular bulb. Most cases are congenital. We present a case of otorrhagia which was initially thought to be a glomus jugulare, the diagnosis of internal carotid artery aneurysm was made at angiography and treated by balloon embolization.- - - - - - - - - - ranking = 24.002586759291keywords = carotid, carotid artery, artery (Clic here for more details about this article) |
8/426. Access to the traumatized vertebral artery: an unusual approach.Although injuries to the vertebral arteries are relatively uncommon, there are several different methods used to gain access to these vessels, and to control any bleeding arising from them. We describe a case of torrential oropharyngeal bleeding following a stab wound to the neck in which rapid access to the vertebral artery was gained using a paramedian mandibulotomy; this approach has not previously been documented. The other approaches are discussed.- - - - - - - - - - ranking = 5keywords = artery (Clic here for more details about this article) |
9/426. Renal hemorrhage in polyarteritis nodosa: diagnosis and management.We report a patient with biopsy-proven polyarteritis nodosa with massive hemorrhage from presumed interlobar artery rupture. The use of interventional radiology techniques such as embolization are discussed in the acute management of such patients. Embolization by interventional radiology should be considered a useful alternative to surgery in these patients. The utility of angiography as a diagnostic and therapeutic tool is demonstrated in this case.- - - - - - - - - - ranking = 1keywords = artery (Clic here for more details about this article) |
10/426. Superior thyroid artery lesion after US-guided chemical parathyroidectomy: angiographic diagnosis and treatment by embolization.A 71-year-old woman presented with a life-threatening thyroid hemorrhage after US-guided chemical parathyroidectomy. The diagnosis was made by angiography followed by immediate embolization of a pseudoaneurysm of the left superior thyroid artery. Embolization controlled the hemorrhage, obviating the need for surgery. The patient made a full recovery with no evidence of further hemorrhage. Pseudoaneurysm of the superior thyroid artery is a rare cause of hemorrhage and percutaneous embolization is an effective method of treatment.- - - - - - - - - - ranking = 6keywords = artery (Clic here for more details about this article) |
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