Ruptured bronchial artery aneurysm mimicking aortic dissection.

A patient is presented in whom rupture of a bronchial artery aneurysm produced a clinical picture indistinguishable from an aortic dissection. This case emphasises the importance of considering alternative diagnoses when a patient presents with symptoms typical of a particular condition.     

Ruptured internal iliac artery aneurysm mimicking a hip fracture.

Internal iliac artery aneurysms are difficult to detect due to their wide range of clinical presentations. The mortality rate from ruptured internal aortic aneurysms is particularly high in part because of delayed diagnosis. This report reviews the management of a patient with a ruptured internal iliac artery aneurysm which presented mimicking a hip fracture.     

Ruptured pulmonary artery aneurysm: a surgical emergency

Idiopathic pulmonary artery aneurysm rupture was diagnosed in a 79-year-old man who presented with a dry cough. He was considered unlikely to tolerate extensive pulmonary artery reconstruction or lung resection; hence, he was salvaged by timely ligation of the distal pulmonary artery at the origin of the aneurysm.     

Ruptured mycotic pulmonary artery aneurysm: an unusual complication of right-sided endocarditis

Mycotic pulmonary aneurysm is an infrequently diagnosed complication of endocarditis. We report here a case of mycotic pulmonary aneurysm and a review of 25 cases from the literature. The mortality rate is greater than 50%. Prompt diagnosis is necessary because early intrasaccular embolization and/or surgical repair is essential to avoid death from rupture of the aneurysm.     

Ruptured idiopathic pulmonary artery aneurysm: unusual case of hemothorax treated by selective embolization

Aneurysm of the peripheral pulmonary arteries is rare. Rupture of pulmonary artery aneurysms manifesting as recurrent hemoptysis with exsanguination is well recognized. We report the case of a young woman who presented with massive hemothorax and shock at the sixth month of pregnancy due to a ruptured lingular artery aneurysm. She was treated with selective coil embolization of the lingular artery to achieve hemostasis. Subsequently, clot evacuation from the pleural space was done. This case is reported for its unsuspected presentation, rarity and to highlight the use of catheter coil embolization to achieve control of bleeding and exclusion of the aneurysm from the pulmonary circulation.     

Ruptured giant right coronary artery aneurysm percutaneously plugged

The endovascular management of a patient with a ruptured giant coronary aneurysm presenting with chest pain followed by anterior chest wall ecchymosis and shock is described. The inflow to a large, acutely leaking right coronary aneurysm was successfully sealed with the Amplatzer Vascular Plug device. The patient was estimated to be at very high risk for surgical intervention. The use of this device to seal an acutely leaking coronary aneurysm has not been previously described.     

Primary pulmonary artery sarcoma mimicking pulmonary thromboembolism

A 69-year-old woman presenting with dyspnea had a pericardial window created for fibrinous pericarditis. The patient subsequently developed pulmonary hypertension and a ventilation perfusion scan was compatible with pulmonary thromboembolism. A primary tumour of the pulmonary artery was suggested by angiography, computerized axial tomography and magnetic resonance imaging. Pathology confirmed a spindle cell pulmonary artery sarcoma.     

Huge pulmonary artery aneurysm

Pulmonary artery aneurysms (PAAs) are uncommon entities. PAAs are caused mostly by trauma (often iatrogenic), infections and Behcet’s disease (BD). Less common causes are pulmonary hypertension, congenital heart disease and neoplasm. BD is a multisystem disorder presenting with recurrent oral and genital ulcerations, as well as ocular involvement, and PAA is one of its rare complications. A case of huge PAA, in which the usual criteria for the clinical diagnosis of BD were present, is described. Transcatheter embolization resulted in clinical improvement.     

Main pulmonary artery aneurysm

Alterations of main pulmonary artery have been described in literature. Main pulmonary artery aneurysm is very rare with few available published data. We present a case of echocardiographic finding of a main pulmonary artery aneurysm in a 78-year-old Italian woman.     

Idiopathic pulmonary artery aneurysm

Pulmonary artery aneurysm is a rare clinical condition. It is known to be associated with certain congenital or acquired conditions, yet its etiology is not well understood. Its diagnosis is often not challenging. However, controversy still remains regarding its treatment. We report a case of idiopathic pulmonary artery aneurysm treated by surgical correction.     

Ruptured splenic artery aneurysm with resultant upper gastrointestinal bleeding

Summary A case of upper gastrointestinal bleeding secondary to rupture of a calcified splenic artery aneurysm into the stomach is reported. Upper gastrointestinal series revealed the aneurysm as a calcification adjacent to the stomach but it was not recognized as a source of bleeding until laparotomy. After operation the patient recovered completely.Splenic artery aneurysm should be included in the differential diagnosis of upper gastrointestinal bleeding of obscure cause. This case suggests that a clinical prodrome of abdominal pain may occur.Supported in part by the USPHS Training Grant AM-05095.     

Post-pleuropneumonectomy herniation of liver mimicking major pulmonary embolism

Following right-sided pneumonectomy and hemidiaphragm resection in a 58-year-old man with epithelioid mesothelioma, acute respiratory insufficiency and life-threatening circulatory collapse developed after a forced Valsalva maneuver. Major pulmonary embolism was diagnosed on clinical grounds, however computed tomography revealed herniation of the liver into the right hemithorax.     

Sarcoidosis mimicking ischaemic ventricular arrhythmia and pulmonary embolism

Sarcoidosis is a multisystem granulomatous disorder characterised pathologically by the presence of noncaseating granulomas in the organs involved. Cardiac involvement, although well known, is rare. We describe a 72-year-old patient who was admitted to the intensive care unit after coronary artery bypass grafting. She developed refractory right and left ventricular failure complicated by multiple organ failure and died three days later. Postmortem examination revealed extensive sarcoidosis. On hindsight, preoperative ventricular tachycardia and an abnormal perfusion-ventilation scintigraphy of the lungs were manifestations of an underlying sarcoidosis.     

Pulmonary artery sarcoma mimicking pulmonary thromboembolism

A 30 years old male patient was referred to our hospital with a diagnosis of pulmonary thromboembolism due to thorax-computerized tomography (CT) angiography, revealing a thrombus totally occluding left main pulmonary artery. The lesion was evaluated as tumoural mass. Positron emission tomography (PET)-CT revealed pathologic uptake at pulmonary artery mass. Due to localization of tumour, left pneumonectomy was performed. The pathological diagnosis revealed to be pulmonary artery sarcoma. The patient was presented because pulmonary artery sarcomas are very rare tumors and can mimick pulmonary thromboembolism. The true prevalence is underestimated as many pulmonary artery sarcomas are misdiagnosed as pulmonary thromboembolism. PET-CT may help to make a differential diagnosis.     

Isolated idiopathic pulmonary artery aneurysm

Aneurysm formation of the main pulmonary artery is rare. Its natural history is not well understood and there are no clear guidelines on optimal treatment. A 20-year-old woman with a huge saccular aneurysm of the main pulmonary artery, underwent repair with a pericardial patch and concomitant reconstruction of the pulmonary valve. The patient was doing well on follow-up at 6 months; echocardiography revealed a good repair with mild to moderate pulmonary regurgitation.