1/12. Spontaneous rupture of the kidney with perirenal hematoma.Spontaneous rupture of the kidney involves either the collecting system or parenchyma, the latter being associated with a subcapsular or perirenal hematoma. A review was made of 78 cases of spontaneous parenchymal rupture with perirenal hematoma, including 4 of our own. One of these cases is the first description of spontaneous rupture of the kidney secondary to renal vein thrombosis. The patients are usually in the fourth decade of life and present with an acute onset of flank pain, a tender mass and commonly symptoms and signs of shock. hematuria is often present and generally urography reveals a mass, distorted collecting system and/or non-visualization of the kidney. Tumors are the most common cause followed by vascular diseases, infection, nephritis and blood dyscrasias. nephrectomy when possible should be performed expeditiously since conservative therapy is uniformly unsuccessful.- - - - - - - - - - ranking = 1keywords = vascular disease (Clic here for more details about this article) |
2/12. Unusual pregnancy-related vascular emergency.Although rare, aneurysms are well-known pregnancy-related vascular diseases. They are influenced by hormonal, mechanical, and genetic factors and may be associated with high incidence of maternal and fetal mortality. We present a case of a pregnancy-related common iliac aneurysm, ruptured 5 days after delivery. The source of bleeding was recognized during the second emergency laparotomy for hemoperitoneum and retroperitoneal hematoma. The treatment consisted of excision and substitution of the common iliac artery (totally involved) by an autologous saphenous vein graft. The outcome for the patient was good. We underline that the only way to avoid a fatal event is to know and to think about this rare but very important complication that may occur during pregnancy or shortly after delivery.- - - - - - - - - - ranking = 1keywords = vascular disease (Clic here for more details about this article) |
3/12. Spontaneous rupture of a left gastroepiploic artery aneurysm in a patient with autosomal-dominant polycystic kidney disease.Autosomal-dominant polycystic kidney disease (ADPKD) has been known to be associated with a variety of vascular diseases. We present a hemodialysis patient with ADPKD who died of a massive intraperitoneal hemorrhage caused by the spontaneous rupture of a left gastroepiploic artery aneurysm. A 64-year-old male was admitted to our hospital with acute upper abdominal pain and hemorrhagic shock. An abdominal angiography showed three aneurysms and the source of hemorrhage was assumed to be the left gastroepiploic artery aneurysm. The patient died of severe metabolic acidosis and disseminated intravascular coagulation (DIC) on the second hospital day. At autopsy, there was massive bleeding into the abdominal cavity, and pathological examination of the left gastroepiploic artery aneurysm revealed a dissecting aneurysm. This is the first case describing a rupture of a gastroepiploic aneurysm in a patient with ADPKD.- - - - - - - - - - ranking = 1keywords = vascular disease (Clic here for more details about this article) |
4/12. Antiplatelet therapy and spontaneous perirenal hematoma.This case report clarifies an adverse reaction of antiplatelet therapy which has been a standard prophylactic method for patients harboring significant risks of thromboembolic events. A 71-year-old Japanese man who had been taking aspirin tablets (81 mg) for a year presented with sudden colic pain in the left flank region. An abdominal computed tomography scan revealed a significant perirenal hematoma of the left kidney. There were no pathological kidney conditions, such as renal tumors, calculi or vascular diseases, found by magnetic resonance imaging examination. After cessation of aspirin administration followed by conservative management, the hematoma completely disappeared 6 months later. This is the first documented case of spontaneous perirenal hematoma secondary to low-dose aspirin treatment. While such unpleasant events occur extraordinarily, this should be noted as a severe risk of antiplatelet therapy.- - - - - - - - - - ranking = 1keywords = vascular disease (Clic here for more details about this article) |
5/12. Scleral melting in a patient with carotid artery obstruction.PURPOSE: To report a case of severe scleral melting in a patient with carotid artery obstruction. methods: This is an observational case report. We reviewed the patient's chart and the available literature on ocular melting and ocular ischemia. RESULTS: A 71-year-old man with a history of carotid vascular disease and a blind left eye due to a previous vascular accident developed scleral melting of the right eye. Despite frequent lubricants, systemic immunosuppressives, and repeated conjunctiva transplants, the thinning progressed and his visual acuity deteriorated. Intensive screening for possible underlying diseases revealed no infectious or collagen vascular disease. Magnetic resonance angiography, however, showed a subtotal obstruction of the right internal carotid artery. Further investigations revealed coronary artery obstruction. Carotid surgery combined with coronary artery bypass grafting was performed, and a stable ocular situation was achieved. CONCLUSIONS: Although a causal factor cannot always be determined, corneoscleral melting should be regarded as a manifestation of underlying systemic or ocular disorders. In the absence of more common causes of corneoscleral melting, a thorough workup is warranted and might reveal life-threatening disorders.- - - - - - - - - - ranking = 2keywords = vascular disease (Clic here for more details about this article) |
6/12. hemobilia from ruptured hepatic artery aneurysm. Report of a case and review of the literature.hepatic artery aneurysm is a rare vascular disease associated with high mortality caused by massive hemorrhage or by complications following surgical treatment. Over the past twenty-five years it has been managed surgically with increasing success. Eighty reported cases of hepatic artery aneurysms ruptured into the biliary tree were reviewed and the etiology, clinical signs, diagnosis, and treatment of such an aneurysm are discussed. A personal case with an aneurysm of the right hepatic artery ruptured into the common hepatic duct is reported. The diagnosis was made before surgery by arteriography and the aneurysm was successfully managed by ligation of the right hepatic artery both proximal and distal to the aneurysm, closure of the communication between the common hepatic duct and the aneurysm, and choledochal drainage. hemobilia secondary to hepatic artery aneurysm must be considered in thedifferential diagnosis of unexplained gastrointestinal hemorrhage.- - - - - - - - - - ranking = 1keywords = vascular disease (Clic here for more details about this article) |
7/12. Fatal dissection of the pulmonary trunk. An obscure consequence of chronic pulmonary hypertension.Spontaneous (nontraumatic, noninfectious) rupture and/or dissection of the pulmonary trunk or secondary pulmonary arteries in the setting of pulmonary hypertension is rarely considered as a cause of sudden death. Systemic-to-pulmonary vascular shunts and rheumatic mitral stenosis have been the most common predisposing factors, occurrence in association with recurrent thromboembolic hypertension rarely having been documented. Recently, we had the opportunity to study a 52-year-old white woman with catheterization-proved "primary" pulmonary hypertension who died suddenly with cardiac tamponade from rupture/dissection of the pulmonary trunk, and who had morphological evidence of extensive thromboembolic pulmonary vascular disease.- - - - - - - - - - ranking = 1keywords = vascular disease (Clic here for more details about this article) |
8/12. Spontaneous bladder rupture owing to atherosclerotic emboli: a case report.We report a case of spontaneous intraperitoneal rupture of the bladder in an elderly man with severe atherosclerotic vascular disease who had widespread systemic evidence of an arterial embolic phenomenon after elective abdominal aortic aneurysm repair. Atherosclerotic plaques were identified in the vesical arteries and were believed to be the primary event responsible for spontaneous vesical perforation. The clinical presentation, diagnosis and principles of management of vesical rupture are discussed.- - - - - - - - - - ranking = 1keywords = vascular disease (Clic here for more details about this article) |
9/12. Ruptured cerebral aneurysms associated with arterial occlusion.Seven cases of ruptured cerebral aneurysm associated with an occlusion of a large cerebral artery are reported. All seven patients had never suffered from ischemic cerebrovascular disease before the aneurysmal rupture. All nine aneurysms, including the two unruptured ones, arose on the artery serving as an important collateral pathway, and eight of the nine were found in locations where saccular aneurysms are known to occur infrequently. The role of hemodynamic factors in the pathogenesis of these aneurysms is stressed.- - - - - - - - - - ranking = 1keywords = vascular disease (Clic here for more details about this article) |
10/12. Intracranial hemorrhage due to rupture of an arteriovenous malformation in a full-term neonate.A case of neonatal intracerebral hemorrhage (ICH) secondary to rupture of an arteriovenous malformation (AVM) is reported. The baby began to vomit frequently 9 h after birth. Computed tomographic scan revealed the presence of an ICH. Intravenous digital subtraction angiography (IVDSA) demonstrated an AVM, which was successfully excised on the 2nd day after birth. It is stressed that IVDSA is safe and noninvasive in comparison with conventional angiography and is useful for diagnosis of cerebral vascular disease in neonates.- - - - - - - - - - ranking = 1keywords = vascular disease (Clic here for more details about this article) |
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