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H. Caillet P. Cauquil Y. Ajavon G. Rouhana J. P. Verdier D. Azoulay H. Bismuth J. P. Tessier 《European radiology》1992,2(4):330-334
Ruptures of the hepatic artery and hepatic pseudoaneurysms (PA) are rare but serious complications of hepatic transplantation. We conducted a retrospective study of 640 liver transplantations performed in our institution for a variety of pathologies. After surgery, seven major arterial bleeds occurred (0.9%). Of these seven cases, there were due to hepatic artery rupture (HAr) and four to PA rupture; all confirmed at either surgery (six cases) or autopsy (one case). Five of the seven patients died. In all cases the transplantation was difficult. All vascular injuries but one were caused by sepsis and occurred either after an undetermined cause septicemic syndrome (five cases) or graft dysfunction (one case). The last vascular injury was biliary drainage related. Six of the seven patients had imaging studies. Sonography (five cases) found a sub-hepatic hypoechoic collection in three cases but failed to do so in two. Duplex doppler (three cases) failed in all three cases to demonstrate a PA. Computed tomography (three cases) showed one PA, one perihilar sub-hepatic collection and failed in one. Conventional angiography (three cases) depicted a PA in all three cases. At the present time, our practice is to perform systematic angiography in patients with undetermined cause septicemic syndrome to research a PA. And if angiography is normal, to then puncture systematically any sub-hepatic collection to determine the bacteriological nature of this collection.
Correspondence to: H. Caillet 相似文献
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锁骨下动脉损伤及创伤性假性动脉瘤手术方法探讨 总被引:2,自引:0,他引:2
目的探讨锁骨下动脉损伤及创伤性动脉瘤的外科治疗方略。方法1991—2005年对2例锁骨下动脉损伤,6例锁骨下假性动脉瘤根据病变的部位、程度及受伤时间、累及范围等选择手术入路,采用血管缝扎、血管壁修补、血管吻合、血管移植、辅助体外循环及球囊止血技术实施手术。结果6例痊愈,1例动静脉狭窄,1例动脉闭塞伴臂丛损伤。平均失血800mL。结论锁骨下动脉损伤及假性动脉瘤手术复杂,术前对病变进行仔细评估,选择合理的切口及手术方法是减少并发症的关键。 相似文献
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Yancu Hertzanu M.D. Menachem Hirsch Louis Goleman 《Cardiovascular and interventional radiology》1987,10(4):230-233
Two unusual cases of delayed synthetic graft complications resulting from manufacturing defects of knitted Dacron are presented.
Computed tomography appears to be a suitable noninvasive alternative examination to angiography in this condition. 相似文献
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Bilateral traumatic caroticocavernous fistulae: total resolution following unilateral occlusion 总被引:1,自引:1,他引:0
Balloon occlusion is the accepted treatment for direct post-traumatic caroticocavernous fistula. We present a case of bilateral
traumatic fistulae associated with a pseudoaneurysm. Resolution of both fistulae occurred following treatment of one of them
by balloon occlusion of the internal carotid artery. This case highlights the importance of considering a more conservative
approach to bilateral fistulae or those associated with a pseudoaneurysm. We review other treatment options.
Received: 1 October 1999/Accepted: 20 October 1999 相似文献
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Byeoung Hoon Chung Mi Rin Lee Jae Do Yang Hee Chul Yu Yong Tae Hong Hong Pil Hwang 《World Journal of Clinical Cases》2021,9(16):4104-4109
BACKGROUNDAn impalement injury of the oral cavity is a common traumatic injury in children. In most cases, it is not accompanied by sequelae, but if foreign body residues are not found due to a minor injury, they may result in inflammatory responses and delayed vascular injuries in the surrounding tissues. Without early diagnosis and appropriate initial management, residual foreign bodies can cause serious complications and even mortality in some cases. CASE SUMMARYA 9-year-old boy suffered an intra-oral injury by a wooden chopstick, and the patient was discharged from the hospital after receiving conservative treatment for the injury. However, the patient was readmitted to the hospital due to intra-oral bleeding, and since neck hematoma and right internal carotid artery pseudoaneurysm formation were detected on computed tomography, emergency surgery was performed. A remnant fragment of a wooden chopstick was found during the operation, and a delayed rupture of the internal carotid artery caused by the foreign body was also found.CONCLUSIONThe failure of early detection and diagnosis of a residual foreign body may result in delayed vascular rupture. 相似文献
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Rupture from cavernous internal carotid artery pseudoaneurysm 11 years after transsphenoidal surgery
Carotid artery pseudoaneurysm is a rare complication of transsphenoidal surgery, usually diagnosed within 90 days post procedure. Sequelae of pseudoaneurysm rupture, such as severe epistaxis or carotid cavernous fistula (CCF), have significant morbidity and mortality. A case of epistaxis from pseudoaneurysm rupture over a decade after transsphenoidal surgery is presented, with staged treatment using coiling, endonasal mucosal flap repair and interval flow-diverting stent insertion. This case illustrates that pseudoaneurysm rupture occurs regardless of time course after transsphenoidal surgery, and treatment strategies using combined endovascular and endonasal techniques are reviewed. 相似文献
10.
IntroductionAlthough vascular anatomy of the rectum is complex, pseudoaneurysm followed by massive hemoperitoneum after rectal impalement injury is extremely rare.Case presentationA 43-year-old man presented with abdominal distension. One day earlier, he had undergone sigmoid loop colostomy for rectal implement injury at a local hospital. After the operation, he had become hemodynamically unstable. Digital rectal examination showed a penny-sized anterior rectal wall defect 6 cm from the anal verge. Computed tomography (CT) revealed a hematoma (12 × 10 × 15 cm) with bleeding in the pelvic cavity and an adjacent pseudoaneurysm in the rectum. A large amount of blood and massive hematoma were evacuated by surgery. The Hartmann procedure was performed, but the pseudoaneurysm was not resected. On the 11th postoperative day, hemoglobin decreased (11.6 g/dL–7.9 g/dL), and CT revealed a recurrent hematoma (6.0 × 4.2 cm) in the pelvic cavity, with a residual pseudoaneurysm. Angiography failed to localize the pseudoaneurysm. Consequently, prophylactic embolization at the anterior branch of both the internal iliac arteries was performed. The subsequent hospitalization course was uneventful.DiscussionRectal impalement injury may result in pseudoaneurysm of the rectal arteries. However, pseudoaneurysm rupture of the mid rectal artery, followed by massive hemoperitoneum, has not been reported in the English literature. From our experience, preoperative diagnosis of a pseudoaneurysm is crucial for definite surgical management. When surgical resection is indicated, it should include the underlying pseudoaneurysm.ConclusionAlthough pseudoaneurysm rupture causing hemoperitoneum after a rectal impalement injury is extremely rare, meticulous preoperative evaluation is necessary for correct management. 相似文献