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World Journal of Gastroenterology Jul 2008Takayasu's arteritis and Crohn's disease are chronic inflammatory diseases of uncertain aetiology. They rarely occur together, with only twenty nine cases of co-existent...
Takayasu's arteritis and Crohn's disease are chronic inflammatory diseases of uncertain aetiology. They rarely occur together, with only twenty nine cases of co-existent Takayasu's arteritis and Crohn's disease reported in the literature. In 88% of these cases, Takayasu's arteritis was diagnosed simultaneously or following a diagnosis of Crohn's disease. We present a case of a young Caucasian medical student, incidentally found to have bilateral carotid bruits on auscultation by a colleague. Magnetic resonance angiography revealed stenoses of the common carotid arteries with established collaterals, and a diagnosis of Type 1 Takayasu's arteritis was made. An 18(F)-fluorodeoxyglucose positron emission tomography scan revealed no active disease. Nine months later, she presented with a short history of abdominal pain, vomiting and abdominal distension. Barium follow-through and computer tomography revealed a terminal ileal stricture and proximal small bowel dilation. An extended right hemicoloectomy was performed and histopathology supported a diagnosis of Crohn's disease. This case report is presented with a particular focus on the temporal relationship between these two disease processes and explores whether their concurrence is more than just co-incidence.
Topics: Adult; Auscultation; Carotid Artery, Common; Colectomy; Collateral Circulation; Crohn Disease; Female; Humans; Incidental Findings; Magnetic Resonance Angiography; Takayasu Arteritis; Tomography, X-Ray Computed; Ultrasonography, Doppler, Color
PubMed: 18609696
DOI: 10.3748/wjg.14.4087 -
Indian Pediatrics May 2013Marfan syndrome rarely presents with peripheral artery and pulmonary artery aneurysms. We are presenting a case of a fifteen-year-old boy who presented to us with...
Marfan syndrome rarely presents with peripheral artery and pulmonary artery aneurysms. We are presenting a case of a fifteen-year-old boy who presented to us with progressive lower abdominal pulsatile swelling with bruit in the right inguinal region for one month. He had typical marfanoid habitus, though there was no history of similar illness in family. CT angiogram revealed the presence having giant right common iliac aneurysm along with interlobar pulmonary artery aneurysm. He had spontaneous rupture of aneurysm in right common iliac artery.
Topics: Adolescent; Aneurysm; Humans; Iliac Artery; Male; Marfan Syndrome; Rupture, Spontaneous
PubMed: 23778730
DOI: No ID Found -
Journal of Vascular Surgery Cases and... Dec 2017Large-vessel chronic traumatic arteriovenous fistulas are a rare complication after trauma. Delayed presentation can consist of one or more features of high-output...
Large-vessel chronic traumatic arteriovenous fistulas are a rare complication after trauma. Delayed presentation can consist of one or more features of high-output cardiac failure, pulsatile abdominal mass, bruit, limb ischemia, and venous congestion. We describe a patient with a complex iliocaval fistula secondary to a remote gunshot wound associated with a large 8.5-cm aortic aneurysm. Informed consent of the patient was obtained for publication of the case.
PubMed: 29349437
DOI: 10.1016/j.jvscit.2017.10.004 -
Polish Journal of Radiology 2016Delayed presentation of post-traumatic aortic pseudoaneurysm and its fistulous communication with the right renal vein is a very rare entity. Most of the cases described...
Juxtarenal Aortic Pseudoaneurysm - Right Renal Vein Fistula with Circumaortic Renal Collar-Delayed Manifestation of a Gunshot Injury - an Uncommon Entity Diagnosed with CT Angiography.
BACKGROUND
Delayed presentation of post-traumatic aortic pseudoaneurysm and its fistulous communication with the right renal vein is a very rare entity. Most of the cases described in literature are due to abdominal aortic aneurysm (AAA) rupture into the left renal vein. To the best of our knowledge, communication with the right renal vein has not been described in published literature. Our patient also had a circumaortic renal collar, which is a rare renal vein anomaly. Aortic pseudoaneurysm, its fistulous communication with the right renal vein and circumaortic renal collar in a single patient is of extremely rare occurrence.
CASE REPORT
A 29-year-old male presented to the cardiology department with complaints of breathlessness, abdominal pain and hematuria for the last 6 months. On clinical examination there was evidence of audible bruit over the abdomen. He had a past history of a gunshot injury around two years back. CT angiography revealed a large partially calcified pseudoaneurysm arising from the right lateral wall of the abdominal aorta with the neck of the pseudoaneurysm at juxtarenal location with a fistula between the anterior wall of the pseudoaneurysm and the posterior wall of the right renal vein. There was an associated incidental finding of circumaortic left renal vein with gross aneurysmal dilatation of both pre- and retro-aortic part of the renal vein.
CONCLUSIONS
Delayed presentation of aortic pseudoaneurysm with its fistulous communication with the right renal vein is a rare entity. CT angiography is a non-invasive modality for diagnosis of the exact site of communication, length of aneurysm, proximal and distal extent of the affected segment and its relationship with surrounding structures.
PubMed: 27057262
DOI: 10.12659/PJR.896032 -
Journal of Vascular Surgery Nov 2006We report the case of a 13-year-old boy who, at 3 years of age, was a rear seat-restrained passenger in a high-speed motor vehicle crash necessitating segmental...
We report the case of a 13-year-old boy who, at 3 years of age, was a rear seat-restrained passenger in a high-speed motor vehicle crash necessitating segmental small-bowel resection. The patient remained well for 10 years; then he began to have exercise-induced fatigue in his lower extremities. Routine physical examination revealed a bruit and thrill in the mid abdomen and diminished femoral pulses. Aortic stenosis was diagnosed and treated surgically. We discuss the pathophysiology of the lesion and review the literature. This is the first report of abdominal aortic stenosis 10 years after blunt abdominal trauma in a child.
Topics: Abdominal Injuries; Adolescent; Angioplasty; Aorta, Abdominal; Arterial Occlusive Diseases; Diagnosis, Differential; Follow-Up Studies; Humans; Male; Time Factors; Tomography, X-Ray Computed; Ultrasonography; Wounds, Nonpenetrating
PubMed: 17098550
DOI: 10.1016/j.jvs.2006.06.040 -
Annals of the Rheumatic Diseases Aug 1987The patient, a Caucasian woman of 22 years, developed malignant hypertension at the age of 16 years. An abdominal bruit was found on routine examination. She had two...
The patient, a Caucasian woman of 22 years, developed malignant hypertension at the age of 16 years. An abdominal bruit was found on routine examination. She had two spontaneous abortions and systemic lupus erythematosus was diagnosed at age 21 years. She was found to have a persistently low positive VDRL and antibodies to mitochondria were also present on repeated examinations, to a titre of 1/160. Because of angiographic findings, demonstrating an occlusion of the aorta, an endarterectomy of the descending thoracic and upper abdominal aorta was performed. This showed mainly intimal thickening and the presence of thrombus. She then had four further spontaneous abortions (with good blood pressure control). The lupus anticoagulant and antibodies to cardiolipin were found to be positive at this time.
Topics: Abortion, Habitual; Adult; Aortic Diseases; Arterial Occlusive Diseases; Autoantibodies; Blood Coagulation Factors; Cardiolipins; Endarterectomy; Female; Humans; Lupus Coagulation Inhibitor; Lupus Erythematosus, Systemic; Phospholipids; Pregnancy
PubMed: 3116955
DOI: 10.1136/ard.46.8.612 -
Medicina (Kaunas, Lithuania) 2008Spontaneous aorto-caval fistula is a rare complication of abdominal aortic aneurysm. A definitive diagnosis is sometimes difficult, as the classic diagnostic signs...
Spontaneous aorto-caval fistula is a rare complication of abdominal aortic aneurysm. A definitive diagnosis is sometimes difficult, as the classic diagnostic signs (pulsatile abdominal mass with bruit, high-output hearth failure, and acute dyspnea) are present in about half of the patients. Diagnosis may be suspected from clinical symptoms, but sometimes atypical clinical features may obscure the actual situation. Computed tomography findings include early detection of contrast medium in the dilated inferior vena cava, which is isodense with the adjacent aorta, an associated aortic aneurysm, loss of normal anatomic space between aorta and vena cava, and rarely one can even visualize the abnormal communication between aorta and vena cava. Prompt radiological diagnosis is of key importance in the management of these patients. We describe findings of multislice computed tomography of the patient with dissecting aortic aneurysm and aortocaval fistula, clinically presenting as left renal colic. Multislice computed tomography is the imaging modality of choice for diagnosis of abdominal vascular pathology as it is noninvasive, fast and demonstrates a high diagnostic accuracy.
Topics: Aortic Dissection; Aortic Aneurysm, Abdominal; Aortic Rupture; Arteriovenous Fistula; Humans; Male; Middle Aged; Renal Colic; Tomography, X-Ray Computed; Vena Cava, Inferior
PubMed: 18791339
DOI: No ID Found -
Journal of Vascular Surgery Nov 2002We describe the case of a 40-year-old man with an acquired renal arteriovenous fistula (AVF) treated with endovascular placement of a homemade polytetrafluoroethylene...
We describe the case of a 40-year-old man with an acquired renal arteriovenous fistula (AVF) treated with endovascular placement of a homemade polytetrafluoroethylene covered Palmaz stent (Johnson & Johnson, Warren, NJ). The patient was seen with a abdominal bruit 5 years after exploratory laparotomy for multiple knife stab wounds. An abdominal computed tomographic scan showed an atrophic right kidney and enlarged right renal vein and inferior vena cava. Arteriography confirmed a 5-mm to 7-mm AVF between the right renal artery and vein. In November 1999, the patient was taken to the operating room where a Palmaz 308 polytetrafluoroethylene covered stent was placed within the renal artery at the site of the fistula. Exclusion of the fistula was confirmed with arteriogram. To our knowledge, this is one of the earliest reports and the longest follow-up of the endovascular placement of a covered stent for treatment of an acquired renal AVF. Continued application of covered stent treatment for renal AVFs should prove less expensive with improved renal preservation and, with prefabricated stent grafts, prove less cumbersome and time consuming than coil embolization.
Topics: Adult; Arteriovenous Fistula; Humans; Male; Polytetrafluoroethylene; Radiography; Renal Artery; Renal Veins; Stents; Wounds, Penetrating
PubMed: 12422120
DOI: 10.1067/mva.2002.127969 -
Circulation Journal : Official Journal... Jun 2003A 53-year-old Japanese woman underwent investigation of her heart murmur. A continuous abdominal bruit was heard. Blood gas analysis and chest X-ray showed congestive...
A 53-year-old Japanese woman underwent investigation of her heart murmur. A continuous abdominal bruit was heard. Blood gas analysis and chest X-ray showed congestive heart failure. Enhanced computed tomography of the pelvis showed a 10 x 4 cm hypervascular tumor in the retroperitoneal space. Cardiac catheterization disclosed a cardiac output of 13.2 L/min and a step-up of oxygen at the right common iliac vein. Abdominal aortic angiography showed an extremely vascular pelvic tumor and rapid filling of the inferior vena cava. This is a rare case of a highly vascular pelvic tumor causing high-output heart failure because of th massive arteriovenous shunting.
Topics: Arteriovenous Fistula; Cardiac Output; Female; Heart Failure; Heart Murmurs; Humans; Middle Aged; Retroperitoneal Neoplasms; Sarcoma, Alveolar Soft Part; Vena Cava, Inferior
PubMed: 12808277
DOI: 10.1253/circj.67.554 -
Internal Medicine (Tokyo, Japan) Jul 2002We report a 69-year-old woman with liver cirrhosis due to chronic hepatitis C virus (HCV) infection in whom iatrogenic arteriovenous fistula (AVF) developed after...
We report a 69-year-old woman with liver cirrhosis due to chronic hepatitis C virus (HCV) infection in whom iatrogenic arteriovenous fistula (AVF) developed after sigmoidectomy. A soft mass with bruit led to the diagnosis of inferior mesenteric AVF. Most mesenteric AVF cases have portal hypertension, but this patients showed none of the usual symptoms of portal hypertension; however, she had a splenomegaly that became worse after sigmoidectomy. Clinicians should be aware of the possibility of AVF in patients with a history of abdominal surgery.
Topics: Aged; Arteriovenous Fistula; Colectomy; Female; Hepatitis C, Chronic; Humans; Liver Cirrhosis; Magnetic Resonance Angiography; Mesenteric Artery, Inferior; Mesenteric Veins; Postoperative Complications; Reoperation; Splenomegaly; Time Factors; Tomography, X-Ray Computed; Treatment Outcome; Ultrasonography, Doppler, Color
PubMed: 12132522
DOI: 10.2169/internalmedicine.41.543