Arteriovenous fistula （AVF） involving the inferior mesenteric vessels is rare, and the affected patients usually present with abdominal pain, mass, or features of established portal hypertension. Colonic ischemia is...Arteriovenous fistula （AVF） involving the inferior mesenteric vessels is rare, and the affected patients usually present with abdominal pain, mass, or features of established portal hypertension. Colonic ischemia is a less common and more serious manifestation of AVE We report a case of ischemic colitis secondary to inferior mesentedc AVF in a patient who underwent a previous liver transplantation, subsequently developed portal vein stenosis, and then presented with acute lower gastrointestinal bleeding. He underwent percutaneous transhepatic placement of a portal vein stent and left colectomy.展开更多
BACKGROUND Portal vein embolization(PVE)is an effective and relatively safe procedure performed prior to major hepatic resection to enhance future liver remnant.Nontarget embolization during PVE is rare,and if it occu...BACKGROUND Portal vein embolization(PVE)is an effective and relatively safe procedure performed prior to major hepatic resection to enhance future liver remnant.Nontarget embolization during PVE is rare,and if it occurs,it usually affects the future liver remnant.Intrahepatic portosystemic venous fistulas are extremely rare in non-cirrhotic livers.We report a case of non-targeted lung embolization during PVE due to an unrecognized intrahepatic portosystemic fistula.CASE SUMMARY A 60-year-old male presented with metastatic colon cancer of the liver.The patient underwent preoperative right PVE.During the embolization procedure,a small amount of glue and lipiodol emulsion was embolized to the heart and lungs through an unrecognized intrahepatic portosystemic fistula.The patient remained clinically stable and underwent the planned hepatic resection after 4 wk,with an uneventful postoperative course.CONCLUSION Conventional portograms and careful evaluation prior to PVE are advisable to avoid such complications.展开更多
BACKGROUND Brachial artery aneurysms are defined as dilations greater than 50%of the normal diameter,which are rare among all peripheral arterial aneurysms.While they are often present as pseudoaneurysms,true brachial...BACKGROUND Brachial artery aneurysms are defined as dilations greater than 50%of the normal diameter,which are rare among all peripheral arterial aneurysms.While they are often present as pseudoaneurysms,true brachial artery aneurysms are also detected rarely.In this case report,the surgical repair method of true brachial artery aneurysms,which is a rare condition,is explained.CASE SUMMARY Herein,we present a 61-year-old male patient with complaints of swelling and pain in the right arm antecubital region that had been progressing over 6 mo.Upon the diagnosis of a true brachial artery aneurysm associated with arteriovenous fistula,the aneurysm was surgically repaired with an autologous saphenous vein graft.The patient was discharged without any neurovascular complications postoperatively.CONCLUSION True brachial artery aneurysms are rare and there are not any recommendations for their management in the current literature.Even though the treatment of true aneurysms in this artery is primarily based on a surgical treatment,endovascular repair also might be an option.展开更多
Splenic arteriovenous fistulas(SAVFs) with splenic vein aneurysms are extremely rare entities. There have been no prior reports of SAVFs developing after laparoscopic pancreatectomy. Here, we report the first case. A ...Splenic arteriovenous fistulas(SAVFs) with splenic vein aneurysms are extremely rare entities. There have been no prior reports of SAVFs developing after laparoscopic pancreatectomy. Here, we report the first case. A 40-year-old man underwent a laparoscopic, spleen-preserving, distal pancreatectomy for an endocrine neoplasm of the pancreatic tail. Three months after surgery, a computed tomography(CT) scan demonstrated an SAVF with a dilated splenic vein. The SAVF, together with the splenic vein aneurysm, was successfully treated using percutaneous transarterial coil embolization of the splenic artery, including the SAVF and drainage vein. After the endovascular treatment, the patient's recovery was uneventful. He was discharged on postoperative day 6 and continues to be well 3 mo after discharge. An abdominal CT scan performed at his 3-mo follow-up demonstrated complete thrombosis of the splenic vein aneurysm, which had decreased to a 40 mm diameter. This is the first reported case of SAVF following a laparoscopic pancreatectomy and demonstrates the usefulness of endovascular treatment for this type of complication.展开更多
To the Editor:Transjugularintrahepaticportosystemicshunt(TIPS)isusuallyconsideredthechoiceformanagingcomplicationsofportal hypertensionsuchasrefractoryascites,esophagogastricvariceal bleedingandrecurrentbleedinguncont...To the Editor:Transjugularintrahepaticportosystemicshunt(TIPS)isusuallyconsideredthechoiceformanagingcomplicationsofportal hypertensionsuchasrefractoryascites,esophagogastricvariceal bleedingandrecurrentbleedinguncontrolledwithfirstline treatment.Inrecentyears,TIPShasbeensuccessfullyusedto treat Budd-Chiari syndrome, hepatic hydrothorax, and portal vein thrombosis.One of the key steps during TIPS is the portal vein puncture.展开更多
Pancreatic pseudocyst-portal vein fistulae are extremely rare, and cause serious complications, including life-threatening sepsis. We report a 57-year-old man with pancreatic pseudocyst who was admitted to our hospita...Pancreatic pseudocyst-portal vein fistulae are extremely rare, and cause serious complications, including life-threatening sepsis. We report a 57-year-old man with pancreatic pseudocyst who was admitted to our hospital complaining of prolonged abdominal pain. A pancreatic duct tube was placed into the main pancreatic duct, as the pseudocyst was communicated to the pancreatic duct. He fell into septic shock state two weeks later. An ultrasonography-guided percutaneous drainage of the pseudocyst was performed. The amylase level of drained pus was 80,000 U/l. Pancreatic pseudocyst-portal vein fistula was demonstrated by fisterography. Symptoms disappeared immediately after drainage. No recurrence was observed afterward.展开更多
We report a case of life-threatening hematemesis due to portal hypertension caused by an isolated arterioportal fistula (APF). Intrahepatic APFs are extremely rare and are a cause of presinusoidal portal hypertension....We report a case of life-threatening hematemesis due to portal hypertension caused by an isolated arterioportal fistula (APF). Intrahepatic APFs are extremely rare and are a cause of presinusoidal portal hypertension. Etiologies for APFs are comprised of precipitating trauma, malignancy, and hereditary hemorrhagic telangiectasia, but these were not the case in our patient. Idiopathic APFs are usually due to congenital vascular abnormalities and thus usually present in the pediatric setting. This is one of the first cases of adult-onset isolated APF who presented with portal hypertension and was successfully managed through endoscopic hemostasis and subsequent interventional radiological embolization.展开更多
基金A grant from the National R & D Program for Cancer Control,Ministry of Health & Welfare,Republic of Korea, No.0620220-1
文摘Arteriovenous fistula （AVF） involving the inferior mesenteric vessels is rare, and the affected patients usually present with abdominal pain, mass, or features of established portal hypertension. Colonic ischemia is a less common and more serious manifestation of AVE We report a case of ischemic colitis secondary to inferior mesentedc AVF in a patient who underwent a previous liver transplantation, subsequently developed portal vein stenosis, and then presented with acute lower gastrointestinal bleeding. He underwent percutaneous transhepatic placement of a portal vein stent and left colectomy.
文摘BACKGROUND Portal vein embolization(PVE)is an effective and relatively safe procedure performed prior to major hepatic resection to enhance future liver remnant.Nontarget embolization during PVE is rare,and if it occurs,it usually affects the future liver remnant.Intrahepatic portosystemic venous fistulas are extremely rare in non-cirrhotic livers.We report a case of non-targeted lung embolization during PVE due to an unrecognized intrahepatic portosystemic fistula.CASE SUMMARY A 60-year-old male presented with metastatic colon cancer of the liver.The patient underwent preoperative right PVE.During the embolization procedure,a small amount of glue and lipiodol emulsion was embolized to the heart and lungs through an unrecognized intrahepatic portosystemic fistula.The patient remained clinically stable and underwent the planned hepatic resection after 4 wk,with an uneventful postoperative course.CONCLUSION Conventional portograms and careful evaluation prior to PVE are advisable to avoid such complications.
文摘BACKGROUND Brachial artery aneurysms are defined as dilations greater than 50%of the normal diameter,which are rare among all peripheral arterial aneurysms.While they are often present as pseudoaneurysms,true brachial artery aneurysms are also detected rarely.In this case report,the surgical repair method of true brachial artery aneurysms,which is a rare condition,is explained.CASE SUMMARY Herein,we present a 61-year-old male patient with complaints of swelling and pain in the right arm antecubital region that had been progressing over 6 mo.Upon the diagnosis of a true brachial artery aneurysm associated with arteriovenous fistula,the aneurysm was surgically repaired with an autologous saphenous vein graft.The patient was discharged without any neurovascular complications postoperatively.CONCLUSION True brachial artery aneurysms are rare and there are not any recommendations for their management in the current literature.Even though the treatment of true aneurysms in this artery is primarily based on a surgical treatment,endovascular repair also might be an option.
文摘Splenic arteriovenous fistulas(SAVFs) with splenic vein aneurysms are extremely rare entities. There have been no prior reports of SAVFs developing after laparoscopic pancreatectomy. Here, we report the first case. A 40-year-old man underwent a laparoscopic, spleen-preserving, distal pancreatectomy for an endocrine neoplasm of the pancreatic tail. Three months after surgery, a computed tomography(CT) scan demonstrated an SAVF with a dilated splenic vein. The SAVF, together with the splenic vein aneurysm, was successfully treated using percutaneous transarterial coil embolization of the splenic artery, including the SAVF and drainage vein. After the endovascular treatment, the patient's recovery was uneventful. He was discharged on postoperative day 6 and continues to be well 3 mo after discharge. An abdominal CT scan performed at his 3-mo follow-up demonstrated complete thrombosis of the splenic vein aneurysm, which had decreased to a 40 mm diameter. This is the first reported case of SAVF following a laparoscopic pancreatectomy and demonstrates the usefulness of endovascular treatment for this type of complication.
基金supported by President fund of Qingdao Municipal Hospital(ZYZJJ2017116)
文摘To the Editor:Transjugularintrahepaticportosystemicshunt(TIPS)isusuallyconsideredthechoiceformanagingcomplicationsofportal hypertensionsuchasrefractoryascites,esophagogastricvariceal bleedingandrecurrentbleedinguncontrolledwithfirstline treatment.Inrecentyears,TIPShasbeensuccessfullyusedto treat Budd-Chiari syndrome, hepatic hydrothorax, and portal vein thrombosis.One of the key steps during TIPS is the portal vein puncture.
文摘Pancreatic pseudocyst-portal vein fistulae are extremely rare, and cause serious complications, including life-threatening sepsis. We report a 57-year-old man with pancreatic pseudocyst who was admitted to our hospital complaining of prolonged abdominal pain. A pancreatic duct tube was placed into the main pancreatic duct, as the pseudocyst was communicated to the pancreatic duct. He fell into septic shock state two weeks later. An ultrasonography-guided percutaneous drainage of the pseudocyst was performed. The amylase level of drained pus was 80,000 U/l. Pancreatic pseudocyst-portal vein fistula was demonstrated by fisterography. Symptoms disappeared immediately after drainage. No recurrence was observed afterward.
文摘We report a case of life-threatening hematemesis due to portal hypertension caused by an isolated arterioportal fistula (APF). Intrahepatic APFs are extremely rare and are a cause of presinusoidal portal hypertension. Etiologies for APFs are comprised of precipitating trauma, malignancy, and hereditary hemorrhagic telangiectasia, but these were not the case in our patient. Idiopathic APFs are usually due to congenital vascular abnormalities and thus usually present in the pediatric setting. This is one of the first cases of adult-onset isolated APF who presented with portal hypertension and was successfully managed through endoscopic hemostasis and subsequent interventional radiological embolization.
