Bleeding cytomegalovirus ulcers of the colon: barium enema nad angiography.
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Biomedical subjects
Publications and source records attributed to S R Cho.
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Thickening of the wall of pulmonary veins in cyanotic congenital heart disease and the presence of hilar vessel anatomic variants may mislead a surgeon into incorrectly anastomosing the subclavian artery to the pulmonary vein when performing a Blalock-Taussig shunt. Emergency selective angiography is the study of choice for the identification of this operative complication.
Massive perineal bleeding due to trauma was successfully controlled by superselective embolization of the internal pudendal artery with a stainless steel mini coil. While in the standard selective procedure the internal iliac artery is embolized, the superselective technique allows preservation of the blood supply from the uninjured branches of the internal iliac artery.
The clinical and plain radiographic findings of thoracic aortic dissection may not be specific; thoracic aortography is the definitive diagnostic procedure. Ulcerlike projections of contrast material are not commonly found on thoracic aortography, but may be a precursor angiographic sign of dissection. Two patients with ulcerlike outpouchings are presented. In one, the evolution of aortic dissection was documented by three serial aortograms. It began with a small "ulcer" in the ascending aorta that became larger and finally progressed into the typical angiographic appearance. In the other, thoracic aortography demonstrated an ulcerlike projection in the ascending aorta. In both cases, the diagnosis of dissecting hematoma was confirmed by surgery and pathologic examination of the resected specimens. Thoracic aortography in several projections is necessary for demonstration of these ulcerlike outpouchings because they may be evident in only one projection. Conceivably, their recognition may permit earlier diagnosis of aortic dissection and the institution of appropriate treatment.
The unusual occurrence of nontraumatic torsion of the lung following pneumonia is presented. A bronchogram was important in confirming diagnosis. The patient was successfully treated with antibiotics and surgical manipulation. A brief explanation of the torsion is suggested.
Twenty patients were prospectively studied by computed tomography (CT) before and after undergoing translumbar aortography (TLA). Changes indicative of retroperitoneal bleeding were depicted by CT in all 20 patients despite the predominantly small size of the hematomas. CT scans obtained within two hours after TLA demonstrated: (a) thickening of the diaphragmatic crura, (b) enlargement of the left psoas muscle, and (c) obscuration of the aortic outline by soft-tissue density. Follow-up scans at 24 hours (10 patients) and one week (3 patients) revealed marked decrease in abnormalities, suggesting rapid resorption of the hematoma.
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A 51-year-old man with repeated and massive rectal bleeding was found to have a large angiodysplasia of the rectum. A superselective embolization of the distal part of the superior rectal artery with Ivalon controlled the rectal bleeding for 4 months. Lower gastrointestinal bleeding recurred and a recurrent lesion was re-embolized with Ivalon with excellent control of bleeding in a follow-up of 8 months. Embolization is an alternative to surgery for the treatment of rectal angiodysplasia and hopefully may result in a long-term cure.