1/18. Acute abdominal pain and urgency to defecate in the young and the old: a useful symptom-complex?In the belief that "pattern recognition" is an important first step of the diagnostic process, we report our observation of an uncommon and heretofore poorly documented symptom-complex in 10 patients, and suggest that the constellation of abdominal pain and urgency to defecate in the acutely ill surgical patient should raise the diagnostic possibility of intra-abdominal bleeding. In our experience, this is statistically likely to be associated with a ruptured abdominal aortic aneurysm in the old and a ruptured ectopic pregnancy in the young.- - - - - - - - - - ranking = 1keywords = aneurysm (Clic here for more details about this article) |
2/18. Lupus abdominal crisis owing to rupture of an ileocolic aneurysm with successful angiographic treatment.There are many causes of acute abdominal pain, or abdominal "crises," in patients with systemic lupus erythematosus (SLE), most frequently the causes are serositis or vasculitis. vasculitis generally causes small vessel abnormalities and may present with symptoms owing to mucosal damage, such as pain, diarrhea, or bleeding. We present a patient with SLE who had the acute onset of severe abdominal pain while hospitalized for a lupus flare and who was found to have a ruptured ileocolic aneurysm with intraperitoneal bleeding. She was successfully managed with angiographic embolization, without further complications. Although angiography is well established as a therapeutic intervention for mesenteric aneurysms of various etiologies, this is the first case of an SLE-related ileocolic aneurysm so managed. This entity should be considered in the differential diagnosis of abdominal pain in patients with lupus, and angiographic embolization should be considered in its management.- - - - - - - - - - ranking = 7keywords = aneurysm (Clic here for more details about this article) |
3/18. Ruptured true aneurysm of the splenic artery: an unusual cause of haemoperitoneum.True aneurysm of the splenic artery is rare. Two cases of ruptured true splenic artery aneurysms are presented. The first patient was a 62-year-old female who presented within 6 hours of the onset of symptoms. The other was a 27-year-old non-alcoholic male patient who was admitted in a state of shock after 2 days of observation in a peripheral hospital. Both patients had haemoperitoneum and were subjected to exploratory laparotomy. Aneurysmectomy was performed in both the patients in addition to left splenopancreatectomy in the first case and splenectomy in the second. However, due to the prolonged preoperative shock, the second patient succumbed on the third postoperative day.- - - - - - - - - - ranking = 6keywords = aneurysm (Clic here for more details about this article) |
4/18. Ruptured aneurysm of the visceral artery: report of two cases.We present herein two cases of a ruptured aneurysm of the visceral artery. The first case involved a 74-year-old man with abdominal pain who was admitted to our hospital with a tentative diagnosis of intra-abdominal bleeding of unknown origin. Computed tomography revealed a hematoma in the greater curvature of the stomach. At surgery, a hematoma along the right gastroepiploic artery was found and totally removed. Histological examination showed a pseudo-aneurysm of unknown etiology. The second case involved a 68-year-old man with progressive anemia who presented with spontaneous intra-abdominal bleeding. A ruptured aneurysm of the accessory middle colic artery was diagnosed by superior mesenteric angiography. The ruptured aneurysm was ligated and totally resected without a colectomy. Histological examination showed a pseudoaneurysm of unknown etiology. The postoperative courses were uneventful, and both patients were doing well at the time of writing.- - - - - - - - - - ranking = 51.475232830681keywords = pseudoaneurysm, aneurysm (Clic here for more details about this article) |
5/18. A case of a ruptured pheochromocytoma with an intratumoral aneurysm managed by coil embolization.Although the spontaneous rupture of adrenal pheochromocytoma is rare, it can be lethal because it can induce serious changes in the circulation. We describe a 32 year old man with bilateral pheochromocyroma presenting as abdominal pain. In the emergency room, an abdominal MRI showed an aneurysmal vessel in the right adrenal mass and accompanying hemorrhage around the tumor capsule. The bleeding site was found by transfemoral abdominal angiography. Coil embolization was done in the bleeding vessels, specifically branches of the right adrenal artery. The hemorrhage was successfully controlled and vital signs of the patient were restored. Following emergency care, biochemical and imaging studies showed compatible findings of a bilateral adrenal pheochromocytoma. Postoperative histologic findings confirmed these observations. A ruptured pheochromocytoma should be considered as a cause of acute abdomen in cases of a concomitant adrenal mass. Intratumoral aneurysmal bleeding may be a cause of ruptured tumor, and careful angiographic intervention will help to ensure safe control of bleeding in such an emergency situation, even in cases of bilateral tumor.- - - - - - - - - - ranking = 6keywords = aneurysm (Clic here for more details about this article) |
6/18. Abdominal apoplexy: a case study of the spontaneous rupture of the gastroepiploic artery.This is a case report of abdominal apoplexy (AA) or spontaneous rupture of a visceral vessel, without associated aneurysmal dilation of the vessel. Spontaneous rupture of the left gastroepiploic artery (LGEA) resulting in a hemoperitoneum is discussed. The clinical presentation of left lower quadrant abdominal pain, along with the histologic findings of medial degeneration of the LGEA, makes this case an unusual one. The incidence, origin, associated predisposing medical conditions, clinical presentation, and treatment of abdominal apoplexy are discussed.- - - - - - - - - - ranking = 1keywords = aneurysm (Clic here for more details about this article) |
7/18. Systemic multiple aneurysms of the extracranial internal carotid artery, intracranial vertebral artery, and visceral arteries: case report.A rare case of systemic multiple aneurysms located in the extracranial internal carotid artery, intracranial vertebral artery, and intraperitonial arteries is described. A 56-year-old woman was referred to our hospital with suspected rupture of an aneurysm of the right extracranial internal carotid artery. Digital subtraction angiography demonstrated a giant aneurysm in the right extracranial internal carotid artery and an aneurysm of fusiform type of the left intracranial vertebral artery. The extracranial carotid artery aneurysm was successfully resected, with end-to-end anastomosis of the internal carotid artery, preserving the cranial nerves. Five days later, an aneurysm of the left hepatic artery ruptured unexpectedly and was treated with emergency surgery. Other aneurysms in the liver and spleen were identified on postoperative celiac angiography. The patient subsequently underwent an operation for a left intracranial vertebral artery aneurysm by proximal clipping.- - - - - - - - - - ranking = 12keywords = aneurysm (Clic here for more details about this article) |
8/18. Successful endovascular repair of a ruptured abdominal aortic aneurysm in a patient with unfavorable anatomy.Endovascular repair of an abdominal aortic aneurysm (AAA) offers hope of improved outcomes in patients presenting with acute rupture. However, a high proportion of such patients have unfavorable proximal neck anatomy and are not suitable for treatment with conventional endografts. Fenestrated endografts overcome the problem of a short proximal neck, but at present their deployment is time consuming and therefore not easily applicable to a ruptured AAA. In this case report, the authors describe a hybrid device (a composite thoracic and infrarenal stent graft) that was able to overcome the problem of a short wide proximal neck in a patient with a ruptured AAA.- - - - - - - - - - ranking = 5keywords = aneurysm (Clic here for more details about this article) |
9/18. Unusual presentation of ruptured splenic artery aneurysms.Two cases of ruptured splenic artery aneurysms with unusual clinical presentation are reported. In one case an inflammatory abdominal process was suspected, while in the other the operation was delayed by several hours due to the unexplained coma, high blood sugar levels and lack of signs of shock until an advanced stage of the disease. As there was no active bleeding during the operation, the presence of free blood in the abdomen and clots in the omentum provided the clue for localization of the source of the bleeding.- - - - - - - - - - ranking = 5keywords = aneurysm (Clic here for more details about this article) |
10/18. Tender pulsatile abdominal mass. Abdominal aortic aneurysm or not?Twenty-nine patients had symptomatic pulsatile abdominal masses. Initially six patients underwent emergency surgical exploration without prior arteriography. An abdominal aortic aneurysm was found in only one patient. In the next 23 patients, in whom arteriography was performed, no aneurysm was detected and emergency surgery could be avoided. In patients with symptomatic pulsatile abdominal masses, in the absence of hypovolemic shock the initial diagnostic study should be abdominal angiography. It is an accurate and safe procedure, and supplies the necessary preoperative information should abdominal aortic surgery become necessary. If, however, no aneurysm is found, valuable information is still obtained with regard to the underlying disease process.- - - - - - - - - - ranking = 7keywords = aneurysm (Clic here for more details about this article) |
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