RESUMEN
Left ventricular free wall rupture, ventricular pseudoaneurysm, papillary muscle rupture and ventricular septal rupture are life-threatening mechanical complications of acute myocardial infarction. Despite significant improvements over the last decades in overall mortality for patients with myocardial infarction, the outcome of subjects who develop post-infarction mechanical complications remains poor. Surgical treatment is considered the standard of care. However, percutaneous approaches (such as pericardial fibrin-glue injection for left ventricular free wall rupture, transcatheter edge-to-edge mitral repair for papillary muscle rupture and device closure for ventricular pseudoaneurysm or septal rupture) have been proposed in selected high-risk or inoperable patients, or in subjects with ideal characteristics for feasibility, as therapeutic alternatives to open surgery. The aim of the present review is to provide a comprehensive overview of the percutaneous strategies for the management of post-acute myocardial infarction mechanical complications.
Asunto(s)
Rotura Cardíaca Posinfarto , Infarto del Miocardio , Humanos , Infarto del Miocardio/terapia , Infarto del Miocardio/complicaciones , Rotura Cardíaca Posinfarto/terapia , Rotura Cardíaca Posinfarto/etiología , Aneurisma Falso/terapia , Aneurisma Falso/etiología , Rotura Septal Ventricular/etiología , Rotura Septal Ventricular/terapia , Músculos PapilaresRESUMEN
Bone marrow biopsy (BMB) is a routinely performed procedure, with the preferred site being the posterior superior iliac crest. Uncommonly, it may be complicated by haemorrhagic complications, especially in patients with coagulopathy. Here, we present a case of pelvic haematoma following a BMB due to the injury of the right internal iliac artery. Endovascular embolisation was performed on an urgent basis to manage this complication. The bleeding stopped following the embolisation.
Asunto(s)
Aneurisma Falso , Embolización Terapéutica , Hematoma , Enfermedad Iatrogénica , Arteria Ilíaca , Humanos , Aneurisma Falso/etiología , Aneurisma Falso/terapia , Aneurisma Falso/diagnóstico por imagen , Embolización Terapéutica/efectos adversos , Hematoma/etiología , Arteria Ilíaca/lesiones , Arteria Ilíaca/diagnóstico por imagen , Biopsia/efectos adversos , Femenino , Procedimientos Endovasculares , Masculino , Médula Ósea/patología , Persona de Mediana EdadRESUMEN
OBJECTIVE: Our aim is to demonstrate a rare cause of hemoperitoneum without vaginal bleeding resulting from the rupture of a uterine artery pseudoaneurysm after uncomplicated vaginal delivery. CASE REPORT: A 39-year-old woman who had experienced a normal vaginal delivery 8 days previously to being seen in our hospital, was presented to the emergency room with hypovolemic shock. Computed tomography angiography (CTA) showed massive internal bleeding and a ruptured pseudoaneurysm arising from the left uterine artery. The patient was successfully treated through transcatheter arterial embolization (TAE). CONCLUSION: A pseudoaneurysm is a rare disease which can occur during an uncomplicated vaginal delivery. The clinical presentation can vary from asymptomatic, vaginal bleeding or hemoperitoneum. The diagnosis can be made by using Doppler sonography, CTA or Magnetic Resonance Imaging. The use of TAE is now the most common treatment option and possesses a high success rate.
Asunto(s)
Aneurisma Falso , Hemoperitoneo , Arteria Uterina , Humanos , Femenino , Hemoperitoneo/etiología , Hemoperitoneo/terapia , Adulto , Aneurisma Falso/terapia , Aneurisma Falso/etiología , Aneurisma Falso/diagnóstico por imagen , Arteria Uterina/diagnóstico por imagen , Parto Obstétrico/efectos adversos , Angiografía por Tomografía Computarizada , Aneurisma Roto/terapia , Aneurisma Roto/complicaciones , Aneurisma Roto/diagnóstico por imagen , Embarazo , Embolización de la Arteria Uterina , Embolización Terapéutica/métodos , Hemorragia Posparto/etiología , Hemorragia Posparto/terapiaRESUMEN
BACKGROUND Ortner syndrome, or cardiovocal syndrome, is a left recurrent laryngeal nerve palsy secondary to cardiovascular causes. Aortic pseudoaneurysm is a rare life-threatening condition resulting from weakening of the aortic wall. Clinical presentation of aortic pseudoaneurysm is highly variable. Hoarseness is often caused by benign conditions; however, it can be the first symptom of an underlying serious condition requiring immediate diagnosis and management. CASE REPORT We report a series of 2 patients with sudden hoarseness as the first symptom of an aortic arch pseudoaneurysm. Two men, with ages of 76 and 60 years, had sudden hoarseness a few weeks before. Laryngoscopy showed a left vocal cord palsy in both cases. A computed tomography (CT) scan showed a thoracic aortic pseudoaneurysm located at the aortic arch compressing the left recurrent laryngeal nerve. Both patients were treated with endovascular aortic repair. The first patient underwent a carotid-subclavian artery bypass, and the left subclavian artery was closed with a vascular plug device. He was discharged a week later, with persistent hoarseness. In the second case, subclavian artery occlusion and pseudoaneurysm embolization with coils were performed. Control CT scan confirmed the procedure's success. However, after an initial favorable evolution, the patient had severe non-vascular complications and finally died. CONCLUSIONS Considering these 2 cases and those reported in the literature, aortic origin should be considered in the differential diagnosis of hoarseness, particularly when it appears suddenly. Thoracic endovascular aortic repair is a feasible option for those patients with penetrating aortic ulcer or pseudoaneurysm located in the aortic arch.
Asunto(s)
Aneurisma Falso , Ronquera , Parálisis de los Pliegues Vocales , Humanos , Masculino , Ronquera/etiología , Aneurisma Falso/terapia , Aneurisma Falso/complicaciones , Aneurisma Falso/diagnóstico por imagen , Parálisis de los Pliegues Vocales/etiología , Parálisis de los Pliegues Vocales/diagnóstico , Anciano , Persona de Mediana Edad , Aneurisma de la Aorta Torácica/complicaciones , Aneurisma de la Aorta Torácica/diagnóstico , Tomografía Computarizada por Rayos X , Aorta Torácica/diagnóstico por imagenRESUMEN
Mycotic aneurysm in a visceral artery due to tuberculosis (TB) is a rare occurrence. Imaging plays a critical role in its diagnosis. Over the last few years, minimally invasive interventional radiological treatment has replaced more invasive surgical procedures. Here, we report a case presenting with abdominal pain, diagnosed with jejunal artery mycotic pseudoaneurysm (PSA) secondary to TB, managed by endovascular coiling. Coil embolisation of the superior mesenteric artery branch was done using three coils, closing both the front door, back door and sac of the mycotic aneurysm. Visceral PSA following TB infection is rare and can be fatal if left untreated. Coil embolisation is a minimally invasive procedure with a high success rate and comparatively fewer complications.
Asunto(s)
Aneurisma Falso , Aneurisma Infectado , Embolización Terapéutica , Humanos , Aneurisma Falso/terapia , Aneurisma Falso/diagnóstico por imagen , Embolización Terapéutica/métodos , Aneurisma Infectado/terapia , Aneurisma Infectado/diagnóstico por imagen , Masculino , Yeyuno/irrigación sanguínea , Aortitis/terapia , Aortitis/microbiología , Procedimientos Endovasculares/métodos , Persona de Mediana Edad , Tuberculosis Cardiovascular/terapiaRESUMEN
Pseudoaneurysm of the lateral perforating branch of the peroneal artery is exceedingly rare. To our knowledge, eight cases are described in the current literature, with five occurring as a result of trauma and the remainder being iatrogenic. We present a pseudoaneurysm of the lateral perforating peroneal artery in a professional athlete following an inversion-plantarflexion injury of the ankle. He described persistent pain and fluctuant swelling to the lateral aspect of the right ankle with sudden onset of increased pain and swelling 10 days after the initial injury. Arterial duplex identified a pseudoaneurysm of the right lateral perforating peroneal artery. Endovascular coil embolisation of the aneurysm resulted in almost immediate improvement in symptoms. The patient has since regained full function of the affected ankle. This case report highlights the necessity for clinicians to maintain a high index of suspicion in order to promptly investigate and appropriately manage this pathology.
Asunto(s)
Aneurisma Falso , Traumatismos del Tobillo , Embolización Terapéutica , Humanos , Aneurisma Falso/terapia , Aneurisma Falso/etiología , Aneurisma Falso/diagnóstico por imagen , Embolización Terapéutica/métodos , Masculino , Traumatismos del Tobillo/complicaciones , Traumatismos del Tobillo/terapia , Adulto , Procedimientos Endovasculares/métodosRESUMEN
Bullet embolization is a rare and potentially life-threatening complication of gunshot wounds, particularly in lowpowered and small-caliber bullets. When these small bullets enter a large elastic vessel, they have the potential to leave a small entrance hole that can form a traumatic pseudoaneurysm. These pseudoaneurysms, which may be life-protecting at first, may rupture and lead to exsanguination if not found. We report an interesting case of an 18-year-old male gunshot victim where a bullet formed an aortic pseudoaneurysm and subsequently embolized and present a review of the literature regarding bullet embolization and traumatic pseudoaneurysms.
Asunto(s)
Aneurisma Falso , Arteria Femoral , Heridas por Arma de Fuego , Humanos , Aneurisma Falso/etiología , Aneurisma Falso/terapia , Aneurisma Falso/diagnóstico por imagen , Masculino , Heridas por Arma de Fuego/complicaciones , Adolescente , Arteria Femoral/lesiones , Arteria Femoral/diagnóstico por imagen , Embolia/etiologíaRESUMEN
We present a compelling case of an elderly male with a complex medical history who presented with sepsis secondary to a urinary tract infection. During admission, changes in his abdominal exam prompted imaging studies, which revealed a grade IV splenic laceration with a giant splenic artery pseudoaneurysm containing a suspected arteriovenous fistula component. Multidisciplinary discussion was had regarding patient management which resulted in the decision to perform an emergent splenectomy. Learning points from this case underscore the crucial role of interdisciplinary collaboration in the treatment of this pathology. Additionally, we discuss the decision-making process to support surgical intervention in the absence of clear guidelines in this exceedingly rare condition.
Asunto(s)
Aneurisma Falso , Fístula Arteriovenosa , Esplenectomía , Arteria Esplénica , Humanos , Aneurisma Falso/diagnóstico por imagen , Aneurisma Falso/terapia , Aneurisma Falso/etiología , Aneurisma Falso/diagnóstico , Aneurisma Falso/cirugía , Masculino , Arteria Esplénica/diagnóstico por imagen , Fístula Arteriovenosa/diagnóstico por imagen , Fístula Arteriovenosa/diagnóstico , Fístula Arteriovenosa/complicaciones , Fístula Arteriovenosa/cirugía , Fístula Arteriovenosa/terapia , Fístula Arteriovenosa/etiología , Bazo/irrigación sanguínea , Bazo/diagnóstico por imagen , Bazo/lesiones , Anciano , Tomografía Computarizada por Rayos XRESUMEN
BACKGROUND: Innominate artery aneurysms (IAAs) are rare and may result in rupture, distal arterial embolization, or local compression without timely treatment. Rupture is the most dangerous of these complications. This article reports a case of innominate artery bifurcation pseudoaneurysm. CASE PRESENTATION: The patient was a 45-year-old man who was admitted to the emergency department due to chest discomfort. The computed tomographic angiography (CTA) imaging indicated the presence of a 3.6*2.4 cm saccular aneurysm in the bifurcation of the innominate artery, involving both the right proximal subclavian and common carotid arteries. The patient's vital signs were normal, there was equal blood pressure in the upper arms and no neurological dysfunction was observed. Gadolinium-enhanced magnetic resonance angiography indicated that the circle of Willis was intact. The treatment involved open surgery combined with endovascular therapy. The external carotid artery was first transposed to the right subclavian artery (RSA) and an 8-mm woven Dacron graft was inserted in the middle. The covered stent graft was then placed in the proximal part of the innominate artery to close the entrance of the aneurysm. Lastly, an occluder was implanted at the origin of the RSA. There were no perioperative or postoperative complications. At 1-year follow-up, no aneurysm was observed on CTA and the right vertebral artery was patent. CONCLUSIONS: This study indicated that the combined use of endovascular therapy and open repair surgery is an effective strategy to treat innominate artery bifurcation pseudoaneurysm.
Asunto(s)
Aneurisma Falso , Implantación de Prótesis Vascular , Tronco Braquiocefálico , Procedimientos Endovasculares , Stents , Humanos , Masculino , Persona de Mediana Edad , Aneurisma Falso/diagnóstico por imagen , Aneurisma Falso/cirugía , Aneurisma Falso/etiología , Aneurisma Falso/terapia , Tronco Braquiocefálico/diagnóstico por imagen , Tronco Braquiocefálico/cirugía , Procedimientos Endovasculares/instrumentación , Resultado del Tratamiento , Implantación de Prótesis Vascular/instrumentación , Prótesis Vascular , Angiografía por Tomografía Computarizada , Angiografía por Resonancia MagnéticaAsunto(s)
Aneurisma Falso , Hemorragia Gastrointestinal , Humanos , Aneurisma Falso/terapia , Aneurisma Falso/diagnóstico por imagen , Aneurisma Falso/complicaciones , Hemorragia Gastrointestinal/etiología , Hemorragia Gastrointestinal/terapia , Masculino , Glándula Tiroides/irrigación sanguínea , Femenino , Persona de Mediana EdadRESUMEN
BACKGROUND When people in their 60s experiences abdominal pain, vomiting, and unexplained weight loss without a history of abdominal surgery, the usual diagnosis is obstruction caused by a neoplastic mass. Nevertheless, in exceptionally rare cases, these symptoms arise from complications linked to a visceral artery aneurysm. CASE REPORT We present a case of a 60-year-old man with immunodeficiency and Sneddon-Wilkinson disease (a rare subcorneal pustular dermatosis), who developed a pancreaticoduodenal aneurysm of uncertain origin, associated with pancreatic mass, retroperitoneal hematoma, and duodenal obstruction. The treatment approach included transcatheter arterial coil embolization with supportive measures such as parenteral nutrition, a nasogastric tube, octreotide administration, and antiemetics. Despite these interventions, persistence gastrointestinal symptoms prompted an endoscopic ultrasound fine-needle aspiration to rule out malignancy. The biopsy confirmed localized fibro-inflammation. Although he was initially considered for a gastro-jejunal bypass, conservative management effectively improved the pancreatic lesion and duodenal obstruction, leading to discontinuation of parenteral nutrition. The patient was able to resume a regular diet 4 weeks after embolization. CONCLUSIONS Pancreaticoduodenal artery aneurysm is a rare visceral aneurysm with multiple etiologies and potentially fatal consequences. We report an unusual case of a pancreaticoduodenal artery aneurysm associated with pancreatic mass and duodenal obstruction. This diagnosis warrants consideration when an immunodeficient patient presents symptoms of abdominal pain and vomiting. Early endovascular embolization, combined with conservative approaches, effectively alleviated the symptoms in our patient.
Asunto(s)
Aneurisma Falso , Obstrucción Duodenal , Duodeno , Páncreas , Humanos , Masculino , Persona de Mediana Edad , Aneurisma Falso/terapia , Aneurisma Falso/etiología , Aneurisma Falso/diagnóstico , Páncreas/irrigación sanguínea , Obstrucción Duodenal/etiología , Duodeno/irrigación sanguínea , Embolización TerapéuticaRESUMEN
This case report and review describes a 31-year-old man with a history of chronic pancreatitis who presented to the hospital with shortness of breath and left-sided chest pain. Three days prior, he underwent mid-splenic artery embolization due to hematemesis attributed to a splenic artery pseudoaneurysm associated with a peripancreatic pseudocyst. Upon this presentation, the patient reported increasing shortness of breath, left-sided pleuritic chest pain, and epigastric and left upper quadrant abdominal pain. Imaging revealed left pleural effusion, splenic infarcts, and adjacent fluid collections. Thoracentesis confirmed an exudative effusion. The pleural effusion was attributed to recent splenic artery embolization, and the patient was discharged on appropriate medications in stable condition on the sixth day of hospitalization. This case underscores the importance of considering embolization-related complications in the differential diagnosis of pleural effusions following such procedures. The etiology, diagnosis, and management of splenic artery aneurysms are discussed in this review.
Asunto(s)
Aneurisma Falso , Embolización Terapéutica , Derrame Pleural , Arteria Esplénica , Humanos , Masculino , Arteria Esplénica/diagnóstico por imagen , Adulto , Embolización Terapéutica/métodos , Derrame Pleural/terapia , Derrame Pleural/diagnóstico por imagen , Derrame Pleural/etiología , Aneurisma Falso/terapia , Aneurisma Falso/diagnóstico por imagen , Aneurisma Falso/complicaciones , Pancreatitis Crónica/complicaciones , Pancreatitis Crónica/terapiaRESUMEN
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Asunto(s)
Aneurisma Falso , Embolización Terapéutica , Trombina , Ultrasonografía Intervencional , Humanos , Aneurisma Falso/diagnóstico por imagen , Aneurisma Falso/terapia , Trombina/administración & dosificación , Embolización Terapéutica/métodos , Ultrasonografía Intervencional/métodos , Hemostáticos/administración & dosificación , Hemostáticos/uso terapéutico , Masculino , Terapia Combinada , Resultado del Tratamiento , FemeninoRESUMEN
PURPOSE: To describe the management of uterine artery (pseudo)aneurysm, ruptured or unruptured, during pregnancy. METHODS: After reporting a case about this rare pathology, a review of the literature was performed. The search was applied to PubMed databases. RESULTS: A total of eighteen articles met the inclusion criteria. Eighteen patients were reported. Eight (44.4 %) patients didn't have prior medical or surgical history. Fifteen (83.3 %) beneficed interventional radiology method during pregnancy including two cases (13.3 %) with repeated embolization because of recanalization of the (pseudo)aneurysm. Nine patients (50 %) beneficed a planned cesarean between 34 and 39 weeks of gestation. One (15.8 %) patient was diagnosed with fetal death before treatment of the uterine artery (pseudo)aneurysm. CONCLUSION: The decision to proceed to the treatment of the (pseudo)aneurysm must consider several factors, associated or not with a good fetal vitality and a hemodynamically stable patient. Embolization appears to be the method of choice. Mode of delivery and term remain not clear and contraindication of expulsive efforts in case of a uterine artery (pseudo)aneurysm merit further investigations.
Asunto(s)
Aneurisma Falso , Embolización de la Arteria Uterina , Arteria Uterina , Femenino , Humanos , Embarazo , Aneurisma Falso/terapia , Aneurisma Falso/diagnóstico por imagen , Complicaciones Cardiovasculares del Embarazo/terapia , Arteria Uterina/diagnóstico por imagen , Embolización de la Arteria Uterina/métodosRESUMEN
BACKGROUND: The aim of this systematic review was to assess the estimated incidence of pseudoaneurysm (PSA) with follow-up computed tomography (CT) for adult splenic injury with nonoperative management (NOM). METHODS: A systematic literature search was conducted in MEDLINE, Central, CINAHL, Clinical Trials, and ICTRP databases between January 1, 2010, and December 31, 2023. Quality assessment was performed using the Risk of Bias in Non-randomized Studies of Exposures (ROBINS-E) tool. Adult splenic injury patients who were initially managed with NOM and followed-up by protocolized CT were included. The primary outcome was the incidence of delayed PSA. Secondary outcome measures were delayed angiography and delayed splenectomy. Subgroup analyses were performed between NOM patients without initial splenic angioembolization (SAE) and NOM patients with initial SAE. RESULTS: Twelve studies were enrolled, including 11 retrospective studies and one prospective study, with 1746 patients in total. The follow-up CT rate in the included patients was 94.9%. The estimated incidence of PSA was 14% (95% confidence interval (CI), 8%-21%). The estimated delayed angiography and delayed splenectomy incidence rates were 7% (95% CI, 4%-12%) and 2% (95% CI, 1%-6%), respectively. Subgroup analyses showed that the estimated PSA incidence was 12% in NOM patients without initial SAE (95% CI, 7%-20%) and was also 12% in NOM patients with SAE (95% CI, 5%-24%). CONCLUSIONS: The estimated incidence of delayed PSA after follow-up CT for adult splenic injury with NOM was 14%. The estimated incidence of PSA in NOM with initial SAE was similar to that in NOM without initial SAE.
Asunto(s)
Aneurisma Falso , Bazo , Tomografía Computarizada por Rayos X , Humanos , Aneurisma Falso/terapia , Aneurisma Falso/diagnóstico por imagen , Aneurisma Falso/etiología , Aneurisma Falso/epidemiología , Incidencia , Bazo/lesiones , Bazo/diagnóstico por imagen , Tomografía Computarizada por Rayos X/métodos , Esplenectomía , Embolización Terapéutica/métodos , Estudios de SeguimientoRESUMEN
We aimed to analyze the feasibility of endovascular treatment for brucellosis-related aorta-iliac artery pseudoaneurysm. We did a statistical analysis that among the 11 cases, the thoracic aorta was involved in 3 cases, the abdominal aorta was involved in 6 cases, and the iliac artery was involved in 2 cases. Five patients had a history of contact with cattle and sheep, 3 had a history of drinking raw milk, 10 patients had a fever before the operation, and 11 patients had positive serum agglutination test. Blood culture was positive in 2 patients. All patients were given anti-brucellosis treatment immediately after diagnosis. One died of aortic rupture 5 days after emergency endovascular gastrointestinal bleeding. Endovascular-covered stent implantation and active anti-brucellosis therapy were used to treat 10 patients. The follow-up period was 8 years without aortic complications or death for all patients. We think early diagnosis and a combination of anti-brucellosis drugs and endovascular therapy may be the first choice for treating the pseudoaneurysm caused by Brucella.
Asunto(s)
Aneurisma Falso , Brucelosis , Procedimientos Endovasculares , Humanos , Aneurisma Falso/terapia , Aneurisma Falso/microbiología , Aneurisma Falso/etiología , Aneurisma Falso/diagnóstico , Brucelosis/complicaciones , Brucelosis/diagnóstico , Masculino , Procedimientos Endovasculares/métodos , Femenino , Persona de Mediana Edad , Adulto , Stents , Anciano , Aneurisma Infectado/microbiología , Aneurisma Infectado/diagnóstico , Aneurisma Infectado/terapia , Arteria Ilíaca/cirugía , Aneurisma Ilíaco/microbiología , Aneurisma Ilíaco/cirugía , Aneurisma Ilíaco/terapia , Aneurisma Ilíaco/diagnóstico por imagen , Antibacterianos/uso terapéutico , Resultado del Tratamiento , Estudios RetrospectivosRESUMEN
BACKGROUND: Splenic artery pseudoaneurysm is a rare complication of recurrent pancreatitis usually presenting as an incidental finding on abdominal computed tomography. CASE PRESENTATION: We present the case of a 66-year-old north African male with a known history of previous pancreatitis who presented with upper gastrointestinal bleeding along with recurrent epigastric pain for 3 days. Investigations did not reveal any particular pancreatitis etiology. Computed tomography of the abdomen with contrast showed splenic artery pseudoaneurysm along with findings suggestive of acute pancreatitis. Upper and lower endoscopies failed to identify gastrointestinal the bleed source. The patient underwent intervention radiology embolization of the aneurysm sac with multiple coils via right retrograde common femoral artery-celiac access. The patient was discharged with a plan for capsule endoscopy in outpatient setting. CONCLUSION: Splenic artery pseudoaneurysm is a life-threatening complication and carries a high mortality rate if left untreated. Prompt identification through various imaging modalities, followed by urgent intervention, is crucial to avoid adverse outcomes.
Asunto(s)
Aneurisma Falso , Embolización Terapéutica , Arteria Esplénica , Tomografía Computarizada por Rayos X , Humanos , Aneurisma Falso/diagnóstico por imagen , Aneurisma Falso/terapia , Masculino , Arteria Esplénica/diagnóstico por imagen , Anciano , Pancreatitis/complicaciones , Hemorragia Gastrointestinal/etiología , Hemorragia Gastrointestinal/terapia , Dolor Abdominal/etiología , Resultado del TratamientoRESUMEN
A 53-year-old woman with a history of recurrent right lower quadrant pain presented with slightly bloody stools in April 2023. She was initially diagnosed with acute diverticulitis using an abdominal computed tomography (CT) scan and was treated conservatively. On the second day, however, she reported significant hematochezia. A subsequent contrast-enhanced CT scan revealed an extravasation in the ascending colon, which was promptly managed with colonoscopy. Despite initial hemostasis, she experienced recurrent bleeding. Another contrast-enhanced CT scan revealed a pseudoaneurysm with ongoing extravasation in the same area. Angiography confirmed a pseudoaneurysm in a branch of the ileocolic artery, which was successfully treated by embolization. She was discharged after an 18 day hospital stay. This case highlights a pseudoaneurysm caused by diverticulitis.
Asunto(s)
Aneurisma Falso , Diverticulitis del Colon , Embolización Terapéutica , Hemorragia Gastrointestinal , Humanos , Femenino , Aneurisma Falso/diagnóstico por imagen , Aneurisma Falso/complicaciones , Aneurisma Falso/etiología , Aneurisma Falso/terapia , Persona de Mediana Edad , Hemorragia Gastrointestinal/etiología , Hemorragia Gastrointestinal/diagnóstico por imagen , Embolización Terapéutica/métodos , Diverticulitis del Colon/complicaciones , Diverticulitis del Colon/diagnóstico por imagen , Tomografía Computarizada por Rayos X , Aneurisma Roto/complicaciones , Aneurisma Roto/diagnóstico por imagen , Íleon/irrigación sanguínea , Íleon/diagnóstico por imagen , Colonoscopía , Colon/irrigación sanguínea , Colon/diagnóstico por imagenRESUMEN
Background and Objectives: Transarterial chemoembolization (TACE) is a widely accepted treatment for hepatocellular carcinoma (HCC). Regarding TACE, arterial injuries, such as hepatic artery spasm or dissection, can also occur, although pseudoaneurysms are rare. We report a case of pseudoaneurysm following TACE. Materials and Methods: A 78-year-old man had been undergoing TACE for HCC in segment 8 of the liver for the past 5 years, with the most recent TACE procedure performed approximately 1 month prior. He presented to the emergency department with melena that persisted for 5 days. Computed tomography revealed a pseudoaneurysm in the S8 hepatic artery with hemobilia. Results: the pseudoaneurysm was successfully treated by N-Butyl-cyanoacrylate glue embolization. Conclusions: In patients that have undergone TACE presenting with melena and hemobilia identified on CT, consideration of hepatic artery pseudoaneurysm is crucial. Such cases can be safely and effectively treated with endovascular managements.
Asunto(s)
Aneurisma Falso , Carcinoma Hepatocelular , Quimioembolización Terapéutica , Arteria Hepática , Neoplasias Hepáticas , Humanos , Aneurisma Falso/terapia , Aneurisma Falso/etiología , Masculino , Anciano , Quimioembolización Terapéutica/métodos , Quimioembolización Terapéutica/efectos adversos , Neoplasias Hepáticas/terapia , Carcinoma Hepatocelular/terapia , Tomografía Computarizada por Rayos X , Procedimientos Endovasculares/métodos , Embolización Terapéutica/métodos , Resultado del Tratamiento , Hemobilia/etiología , Hemobilia/terapiaRESUMEN
The occurrence of the pseudoaneurysm of visceral arteries in the field of chronic pancreatitis is a very rare complication that represents a life-threatening condition. The higher frequency of this complication is in the necrotic form of pancreatic inflammation, especially in patients with formed peripancreatic necrotic collections. The degradation of the arterial wall leads to bleeding and transforms these necrotic collections into a pseudoaneurysm. Urgent endovascular angioembolization is the first choice in the therapeutic approach as a valid minimally invasive solution with very satisfactory immediate and long-term outcomes. This successfully avoids open surgery, which is associated with a high mortality rate in these patients, especially in acute-on-chronic pancreatitis.