Left ventricular pseudoaneurysm complicating a ruptured isolated congenital diverticulum

We report a case of 41-year-old woman who presented with chest tightness and shortness of breath. Transthoracic echocardiogram (TTE) showed left ventricular (LV) pseudoaneurysm of the inferior wall with preserved LV systolic function. Coronary angiogram was normal. Surgical repair of the pseudoaneurysm with a pericardial patch was performed, and pathological results confirmed rupture of an isolated congenital LV diverticulum, as the most likely etiology.     

Traumatic common hepatic artery injury causing isolated right hepatic ischemia due to a left accessory artery. A case report

IntroductionHepatic arterial liver flow is renowned for its redundancy. Previous studies have demonstrated that the common hepatic artery is not essential for liver survival. We present a case of a 31year-old involved in a high-speed motor vehicle accident whose liver survived thanks to the presence of an accessory hepatic artery.Presentaton of the caseWe present the case of a 31year-old male who sustained a traumatic injury of the proper hepatic artery following a motor vehicle accident. The patient suffered temporary right liver lobe ischemia due to the presence of an accessory left hepatic artery. This resulted in the selective formation of ‘biliary lakes' distinctively within the territory of the right hepatic artery supply.Simultaneously the patient developed a pseudo-aneurysm of the proper hepatic artery which required radiology intervention. At the time of pseudo-aneurysm embolisation, a rich network of arterial collaterals had formed between the accessory left hepatic and the inferior phrenic artery. On follow up the biliary lakes to the right lobe had resolved, but a small area at the periphery of the right lobe had encountered atrophy.DiscussionThis case report is an ‘in vivo’ demonstration of liver resilience to arterial flow re-distribution and demonstrates the ability of the biliary epithelium to recover from and ischemic injury.ConclusionParenchymal liver survival is mostly independent from flow within the common hepatic artery. Acute and chronic liver parenchyma changes following interruption of hepatic artery flow can still occur.     

注射毒品所致假性股动脉瘤治疗体会(附34例)

目的探讨注射毒品所致假性股动脉瘤的外科疗法。方法对34例注射毒品所致假性股动脉瘤病人的临床资料进行回顾分析。结果13例直接采用ePTFE人造血管行旁路髂外动脉和股浅动脉端侧吻合术,3例采用自体大隐静脉原位移植术,其中1例术后吻合口破裂出血改行ePTFE人造血管行旁路髂外动脉动脉和股浅端侧吻合术,18例股动脉结扎术。全部病例保肢成功。血管移植者术后复查彩色多普勒显示移植血管通畅。结论在患者不能采用合适的自体大隐静脉移植及人造血管移植时,运用结扎股动脉术是治疗注射毒品所致假性股动脉瘤的有效方法。     

A traumatic intra-renal pseudo-aneurysm in a child

Intra-renal pseudo-aneurysms after penetrating renal trauma have not been reported in children. We report a case of a 9-year-old girl who presented with gross haematuria 2 weeks following renal exploration for a penetrating injury. The diagnosis of intra-renal pseudoaneurysm was made by Doppler ultrasound and was successfully treated by selective arterial embolisation.     

Septic pseudo-aneurysm of the left main trunk in a dialysis patient

This case report relating the association between a septic pseudo-aneurysmof the left trunk and myocardial infarction underscores theimportance of early non-invasive imaging when acute myocardialinfarction is associated with frank clinical or biological signsof systemic sepsis.     

超声诊断颈外静脉假性静脉瘤1例

患者男,59岁,发现颈部肿物5个月。查体:颈部右侧可见直径约3cm质韧结节,无疼痛,无搏动,表面光滑,活动度可,无压痛;患者直立或用力屏气后有所增大。彩色多普勒超声:右侧颈外静脉近段内径约0.4cm,距锁骨下静脉约2.0～3.0cm处前方可见2.6cm×0.9cm×1.0cm椭圆形无回声区,边界清晰,后壁与颈外静脉前壁可见沟通,约0.4cm,其内可见泥沙样弱回声流动,受压后闭合(图1A)。彩色多普勒于该处探及由颈外静脉至该回声内的双向血流信号,频谱双向连续,     

彩超诊断颈外静脉假性静脉瘤2例

病例1,女,57岁.主因"右颈部无痛性包块"就诊,临床考虑静脉瘤,建议彩超检查.采用迈瑞C-7、Philips iE33彩超诊断仪,探头频率7、10 MHz,对右颈部包块及血管行纵、横及斜切扫查,右颈外静脉走行自然,内径18.3 mm,于前外侧壁(距颈外静脉起始部约42.2 mm处)见一破口,两断端向前外呈球形膨出,大小为26.5 mm×13.2 mm,外形规则,内见"细沙流动样"回声,CDFI于其内见"漩涡状"彩色血流信号,破口处见彩色血流信号(图1),双向静脉频谱.超声诊断:右颈外静脉假性静脉瘤.     

锁骨下动脉损伤开放手术与腔内手术治疗的比较

目的比较外科手术治疗和腔内手术治疗锁骨下动脉损伤及创伤性假性动脉瘤的方法和特点。方法收集21例锁骨下动脉损伤病例。开放手术12例,根据损伤的部位、程度及受伤时间、累及范围等,选择锁骨上、下切口,胸骨正中切口、经肋间联合左颈部切口等,采用血管壁修补、血管吻合、血管移植、血管缝扎,辅助体外循环及球囊止血技术。腔内治疗9例(中转手术1例),急性锁骨下动脉损伤伴出血性休克4例,外伤后锁骨下动脉闭塞2例,外伤性锁骨下假性动脉瘤2例,成功实施腔内治疗。结果患者均痊愈,开放手术组和腔内治疗组的平均手术时间、平均出血量、住院时间分别为4.5 h和2.1 h、1 800 ml和200 ml、21.3 d和9 d,两组差异显著(P<0.05)。随访4～30个月,1例血管手术修补病例出现部分血管狭窄,所有支架植入病例血管通畅,无严重狭窄及闭塞发生。结论锁骨下动脉损伤及创伤性假性动脉瘤腔内治疗较开放手术安全、可靠、微创、并发症少,疗效满意。     

Spontaneous primary pseudo-aneurysm of brachial artery on an adult patient mis-diagnosed for 8 years: Case report

Brachial artery PSA is extremely rare with only a few cases reported in the literature and all of them are secondary to a known etiology. This is the first report of an adult patient who was free of any medical treatment with primary spontaneous brachial artery pseudo-aneurysm which was mis-diagnosed for 8 years and treated surgically without any complications.     

Inter-valvular fibrosa pseudo-aneurysm as a late complication after aortic valve surgery

We describe the incidental finding of an inter-valvular fibrosapseudo-aneurysm in the absence of infective endocarditis 12years after a re-do operation for aortic valve replacement ina patient whose initial pathology was bicuspid aortic valvestenosis.