A rare case of double biliary fistula (author's transl)

The authors report a rare case of a double cholecysto-duodenal and cholecysto-colic fistula.     

Case report: Conservative management of an arteriovenous fistula of the inferior epigastric artery

We present a case of pseudoaneurysm and arteriovenous fistula of the inferior epigastric artery secondary to the placement of a drain during a surgical intervention. We stress the utility of colour Doppler ultrasound and arteriography embolisation in diagnosis and treatment, respectively.     

罕见右冠状动脉左室瘘1例

患者,男,43岁。因查体发现心脏杂音,平常无任何不适感,为进一步检查治疗,来我院就诊。查体:胸骨左缘第5肋间闻及2级～6级舒张期连续性杂音,余无异常发现。彩色超声心动图示:右心房明显增大(44m m×50m m),左心室略增大(58m m),右心室(25m m),右冠状动脉起始部明显增宽(28m m),向后下沿右房和左房后方走行,于左室左后下游离壁近房室沟处与左室相通,瘤体最宽处(60m m)位于右房后下侧,其内可见17.0m m×22.3m m血栓。左室壁内段较细(11m m)。血流与频谱特征:a)左室侧后方近瓣环处可见五彩血流于舒张期进入左室;b)右房内可见少量收缩期三尖瓣返…     

A congenital long rectoscrotal fistula: A rare variant

Congenital rectoscrotal fistula is a rare variant of anorectal malformations (ARM) as per pena classification. Its nomenclature as well as the management, obviously has not been discussed in literature so far. One such rare case and its management in a male neonate have been discussed here. Non or occasionally deflating congenital recto scrotal fistula has to be managed like an intermediate ARM.     

Ileourethral fistula following cystectomy: A rare complication

Fistulae between the urinary and intestinal tracts of adult male patients usually result from trauma, inflammatory diseases, necrosis and infiltration of a neoplasm of either the bladder, prostate or colon, or radiation therapy. We report 2 patients who developed an ileourethral fistula following cystectomy which had been performed for carcinoma of the bladder in 1 patient and leukoplakia of the bladder in the other. The diagnosis of an ileourethral fistula was established by retrograde urethrography and a barium follow-through study. Computed tomography performed in 1 patient showed a tumor mass in the pelvis.     

Choledocho-gastric fistula. A rare complication of a cholangiocarcinoma

A case of choledocho-gastric fistula resulting from a cholangio-carcinoma is reported. The final diagnosis was obtained by ERCP, whereas CT, barium examination, and gastroscopy initially did not allow a conclusive diagnosis. The only clinical finding was epigastric pain. Choledocho-gastric fistula is extremely rare.     

A rare case of evisceration

A case of homicide is described where the body of a young woman was found in the countryside in a state of advanced decomposition. The autopsy revealed that almost all the internal organs were missing, but not due to putrefaction. The thoracic cavity was opened in the professional manner normally used during an autopsy. The remains of the small intestine were tied with strands of hair braided into a thin cord. Received: 13 July 1998 / Received in revised form: 19 April 1999     

A rare case of bladder diverticulosis

The incidence of bladder diverticula in the pediatric population is unknown as they are often asymptomatic. A minority of cases are a manifestation of a genetic syndrome. Primary diverticula have different features compared to secondary diverticula, which are generally caused by an obstructive or iatrogenic mechanism. This clinical case deals with a rare neonatal finding of bladder diverticulosis with alteration of the bladder, first detected with ultrasound. Voiding cystography and magnetic resonance allowed us to delineate their heterogeneity in size, their distribution in the bladder and to rule out other malformations of the urinary tract. The features of these diverticula focused the diagnosis of cutis laxa syndrome, a rare disease where bladder diverticulosis is only one sign of a more complex disease.     

A rare brainstem hemorrhage due to incomplete transvenous embolization of the cavernous sinus dural arteriovenous fistula: A case report

Endovascular embolization is generally thought to be safe and effective for the cavernous sinus dural arteriovenous fistula (CS DAVF); however, some complications have been reported. We report an extremely rare brainstem hemorrhage associated with transvenous embolization (TVE) of CS DAVF. A 66-year-old man presented with right-sided conjunctival chemosis and exophthalmos. His brain magnetic resonance image showed right CS DAVF. Thus, emergent TVE was performed. Although his symptoms improved after the first TVE, magnetic resonance image showed brainstem edema, and venous congestion was suspected because of incomplete TVE. Second TVE was performed. Thereafter, computed tomography showed brainstem hemorrhage, resulting in the occurrence of right abducent nerve palsy, right-sided facial palsy, and ataxia. The patient''s condition gradually improved, and a year has passed without recurrence. Incomplete TVE of CS DAVF can result in life-threatening complications, such as cerebral hemorrhage. To avoid these complications, the anatomical structure of the cavernous sinus should be understood accurately, and important drainage veins should be determined.     

罕见Castleman病1例

患者女性,52岁。主因胸闷2年入院。无发热、盗汗,无咳嗽、咳痰、咯血;无心慌、气短、心前区疼痛。左腋下可触及大小约1cm结节影。余未见明确异常。     

Duodenal fistula—A rare complication following the removal of an infected aortic graft: Case report

We present a rare case of fistulation from the duodenum into the prosthesis site of an aortic Y graft removed 8 months previously owing to infection. We have verified the topographical and anatomical location of the fistulation by fistula filling and CT and MR examination. To our knowledge such a postoperative complication has not been previously documented. In evaluating and comparing our observation we discuss their significance for topographical associations and prognosis and as an indication for surgical intervention.     

A rare case of occult uterine inversion at an Army community hospital: a case report

Uterine inversion is a rare occurrence in obstetrics, but it is a life-threatening complication. Most cases of inversion are caused by excessive cord traction during management of the third stage of labor. We describe a rare case of a complete uterine inversion in a 19-year-old G1P0 dependent spouse of a deployed active duty soldier. After failure of manual correction of the inversion, the patient was taken emergently to the operating room, where the inversion was successfully corrected using surgical methods. The patient required 3 units of packed red blood cells over the next 24 hours, but was discharged home in good condition on postoperative day 3. This case demonstrates the importance of a rapid diagnosis and management of uterine inversion, as it is a rare but serious complication of vaginal delivery.     

A rare case of left atrial myxofibromyosarcoma

Myxofibrosarcoma is an aggressive soft tissue sarcoma, previously known as myxoid variant of malignant fibrous histiocytoma. Primary cardiac myxofibrosarcomas are the rarest forms of cardiac malignant tumors that often remain asymptomatic until metastasis occurs. In this case report, we describe a rare left atrial cardiac myxofibrosarcoma in a patient with recurrent renal cell carcinoma. We discuss the multimodality imaging approach to diagnose and evaluate cardiac masses as well as imaging characteristics to differentiate cardiac masses from thrombus.