1/15. Hepatic subcapsular hematoma after extracorporeal shock wave lithotripsy (ESWL) for pancreatic stones.We present a patient with complication of huge hepatic subcapsular hematoma after extracorporeal shock wave lithotripsy (ESWL) for pancreatic lithotripsy. The hematoma measured 78-110mm. angiography showed a subcapsular hematoma, rather than a hematoma in the liver. In the arterial phase, the distal end of the small vessel showed spotty opacification similar to microaneurysma, suggesting that it was an injury caused by separation of the liver and its capsule, caused by the shock waves. The portal vein and hepatic vein were normal. After 8 weeks of conservative therapy, the hematoma was gradually absorbed and the patient was discharged. Eight months after the accident, the hematoma had decreased to 40mm in size. After 20 months, it was completely absorbed. The reported rate of renal subcapsular hematoma after ESWL for renal or ureter stones is 0.1%-0.7%. To date, however, only five cases of hepatic subcapsular hematoma after right renal stone disintegration have been reported. This is the first report of hepatic subcapsular hematoma after ESWL for pancreatic stones.- - - - - - - - - - ranking = 1keywords = aneurysm (Clic here for more details about this article) |
2/15. Repair of a saccular aortic aneurysm with superficial femoral-popliteal vein in the presence of a pancreatic abscess.When one is faced with impending rupture, repair of an aortic aneurysm cannot be delayed. In the presence of coexisting intra-abdominal sepsis, traditional therapy would call for aneurysm exclusion and axillofemoral bypass grafting. Consequences of this choice of treatment include limited long-term graft patency and recurrent prosthetic infection. Autogenous deep veins from the lower extremities have demonstrated exceptional patency and resilience to infection when used to replace infected aortic grafts. We now report a case of concomitant open drainage of a pancreatic abscess and repair of a saccular abdominal aortic aneurysm using the superficial femoral-popliteal vein as a conduit.- - - - - - - - - - ranking = 7keywords = aneurysm (Clic here for more details about this article) |
3/15. A case of pancreaticoduodenal artery aneurysm causing pancreatic pseudotumour and duodenal obstruction.This case report describes a ruptured pancreaticoduodenal artery aneurysm (PDAA) causing pancreatic pseudotumour and duodenal obstruction. A 59-year-old man was referred to our hospital with a chief complaint of frequent vomiting without abdominal pain. Because a mass lesion 10 cm in diameter was palpated in the right para-umbilical region and found in the head of the pancreas on computerized tomography (CT) and ultrasonography, malignant tumour of the pancreas or tumour-forming pancreatitis was strongly suspected, and further examination was performed.magnetic resonance imaging (MRI) results suggested subacute haematoma inside the mass. On angiography, an aneurysm 8 mm in diameter was found in the posterior superior pancreaticoduodenal artery (PSPD). Since an ultrasound-guided percutaneous needle biopsy from the solid part of the mass indicated no malignancy, the lesion was considered an inflammatory pseudotumour in the head of pancreas due to ruptured aneurysm. Bypass surgery was planned, but the tumour shrank significantly with conservative treatment. Obstruction disappeared completely without surgery 4 weeks after the first symptom.- - - - - - - - - - ranking = 7keywords = aneurysm (Clic here for more details about this article) |
4/15. Transarterial electrocoagulation therapy of a pseudoaneurysm in the head of the pancreas.Because chemical and transcatheter embolizations for control of bleeding were inappropriate, electrocoagulation through a guidewire was used for arterial occlusion. The power was alternating current. The effectiveness of the procedure was confirmed by arteriograms done immediately and 5 months later.- - - - - - - - - - ranking = 23.34510514673keywords = pseudoaneurysm, aneurysm (Clic here for more details about this article) |
5/15. Spontaneous pancreatic bleeding.A condition of massive pancreatic hemorrhage without relation to injury, inflammation, or aneurysm is described. Seven patients treated between 1972 and 2001 with spontaneous pancreatic bleeding were reviewed. Follow-up examinations were performed in 1999. At the time of presentation, all patients had abdominal pain, upper abdominal tenderness, and shock, findings that led laparotomy, where the diagnosis was made. The treatment was suture ligation in every case. The postoperative course was uncomplicated for five of the seven patients. The other two patients died. In conclusion, spontaneous pancreatic bleeding is rare and, because of shock and the need for urgent surgery, the diagnosis cannot be made preoperatively. The immediate mortality seems to be high.- - - - - - - - - - ranking = 1keywords = aneurysm (Clic here for more details about this article) |
6/15. diagnosis and treatment of hemosuccus pancreaticus during a nonbleeding episode: A case report of a patient with obscure intermittent gastrointestinal bleeding and silent chronic pancreatitis.BACKGROUND: Hemorrhage from the pancreatic duct, i.e. hemosuccus pancreaticus (HP), is a rare cause of gastrointestinal bleeding. This potentially life-threatening complication of chronic pancreatitis may pose a significant diagnostic and therapeutic dilemma, especially in patients with silent forms of the disease. methods: We report a case of a 64-year-old man with no history or symptoms but positive findings of chronic calcifying pancreatitis at computed tomography (CT) scan. RESULTS: The patient presented with repeated episodes of gastrointestinal bleeding requiring transfusion and did not, until later in the disease, develop hyperamylasemia and epigastric pain. Repeated endoscopies could not reveal the source of bleeding. The radiological diagnosis and successful transcatheter embolization of a small splenic pseudoaneurysm were performed during an interval when the patient was asymptomatic and showed no signs of bleeding. CONCLUSION: We suggest that when HP is suspected, a contrast-enhanced CT angiography with reconstruction of the arteries should be performed regardless of whether the patient shows signs of active bleeding or not.- - - - - - - - - - ranking = 5.8362762866825keywords = pseudoaneurysm, aneurysm (Clic here for more details about this article) |
7/15. Pancreatic abscess involving the aortic graft following repair of a ruptured aortic aneurysm: successful replacement with femoro-popliteal vein.Acute pancreatitis is a rare complication after aortic surgery and carries a high mortality. We report the successful management of an infected aortic graft secondary to complicated severe pancreatitis in a 77-year-old man by open drainage of the abscess and replacement of the prosthetic graft with superficial femoro-popliteal vein (SFPV). The patient remains free from infection with a patent graft 8 months later.- - - - - - - - - - ranking = 4keywords = aneurysm (Clic here for more details about this article) |
8/15. Abdominal aortic aneurysm in a neonate.This is the second reported case of abdominal aortic aneurysm in neonates to be presented in the English language literature. The first case was reported by Howorth in 1967. In addition to the presence of abdominal aortic aneurysm, this neonate has nesidioblastosis and sequestration of the lungs. The combination of these three rare anomalies in one infant is fascinating and has not been reported.- - - - - - - - - - ranking = 6keywords = aneurysm (Clic here for more details about this article) |
9/15. Hemosuccus pancreaticus and intraperitoneal bleeding secondary to spontaneous rupture of the splenic artery.Hemosuccus pancreaticus is a rare condition where bleeding occurs through the pancreatic duct, usually due to a pseudoaneurysm of the splenic artery. We describe a patient with spontaneous rupture of the splenic artery that caused hemosuccus pancreaticus and later massive hemoperitoneum. The pathological process had lasted at least 10 days before the diagnosis was established. The patient underwent an emergency operation during which splenectomy and distal pancreatectomy were successfully performed.- - - - - - - - - - ranking = 5.8362762866825keywords = pseudoaneurysm, aneurysm (Clic here for more details about this article) |
10/15. Severe hemorrhage associated with pancreatic pseudocysts: report of two cases.Severe hemorrhage from pancreatic pseudocysts is a rare condition that poses a diagnostic and therapeutic challenge. Two cases of preoperative intracystic bleeding and massive postoperative gastrointestinal hemorrhage observed during the last year form the basis of the present report. In the first patient, transcystic suture ligation of the bleeding vessel was necessary to control this life-threatening and dramatic condition--External drainage of the cyst was followed by an uneventful postoperative course. In the second patient, massive gastrointestinal bleeding occurred after cysto-gastrostomy, and neither endoscopy nor arteriography was able to identify the source. Despite aggressive medical and surgical therapy, the patient died. Massive intracystic or gastrointestinal hemorrhage caused by rupture of pseudoaneurysms into pancreatic pseudocysts still remains a rare but severe condition, difficult to treat and affected by high mortality rates. angiography should be performed routinely in the preoperative assessment of pancreatic pseudocysts, even when the other diagnostic techniques do not raise the suspicion of pseudoaneurysm formation. After internal drainage procedures early surgery is recommended whenever GI bleeding occurs in the postoperative course.- - - - - - - - - - ranking = 11.672552573365keywords = pseudoaneurysm, aneurysm (Clic here for more details about this article) |
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