1.Essential vascular anatomy and choice of embolic materials in gastrointestinal bleeding
Somrach THAMTORAWAT ; Chandran NADARAJAN ; Satit ROJWATCHARAPIBARN
Gastrointestinal Intervention 2018;7(3):142-149
Non-variceal gastrointestinal bleeding is the significant emergency problem to manage in the hospital. Transcatheter arterial embolization is minimally invasive treatment, which becomes an essential role in controlling bleeding, leading to lifesaving. To reach the goal, the interventional radiologist should have fundamental of vascular anatomy and choice of embolic material, which is the key to success.
Emergencies
;
Hemorrhage
2.Novel Usage of Dexmetomidine In A Paediatric Patient With Giant Tongue Haemangioma
Mohd Zulfakar Mazlan ; Shamsul Kamalrujan Hassan ; Laila Abd Mukmin ; Mohd Hasyizan Hassan ; Huda Zainal Abiddin ; Irfan Mohamad ; Chandran Nadarajan ; Rubinderan Muthusamy ; Chong Soo Eu
Malaysian Journal of Medicine and Health Sciences 2016;12(2):53-55
Giant haemangioma of the tongue is a disease which can
obstruct the oropharyngeal airway and is presented with
obstructive symptoms. Due to its vascularity, inserting
laryngoscope for intubation can cause high risks, such as
inducing bleeding. Hypoxia and excessive bleeding must be
anticipated while securing the airway. We present a case of
novel usage of dexmetomidine as a conscious sedation agent for
awake fibre optic intubation in a 9-year-old child with
obstructive symptoms secondary to a huge tongue
haemangioma, who was presented for interventional
sclerotherapy of the lesion.
Tongue
3.SMA Syndrome – Wait & Nurture
Shier Khee Saw ; Ahmad Zuraimi Zulkifli ; Chandran Nadarajan ; Jien Yen Soh ; Mohd Azem Fathi Mohammad Azmi ; Syed Hassan Syed Abd Aziz ; Michael Pak-Kai Wong
Malaysian Journal of Medicine and Health Sciences 2022;18(No.6):353-355
Superior mesenteric artery (SMA) syndrome is rare with the common presentation of megaduodenum from entrapment of the third part of the duodenum (D3) by the SMA. We present a case report of a thin, fit 16-year-old boy,
active smoker complaining of generalized colicky abdominal pain associated with persistent postprandial vomiting.
Small bowel study demonstrated partial duodenal obstruction from compression of the third part of the duodenum
by the SMA. Computed tomography of the abdomen shows an aorto-mesenteric angle of 13 degrees with aorto-mesenteric distance of 0.32 cm, indicating SMA syndrome. His symptoms resolved spontaneously with watchful waiting
and nutritional care plan. The success was contributed to restoring the fat cushion around the SMA, hence, widening
the aorto-mesenteric angle. In conclusion, watchful waiting with a nutritional care plan is a feasible initial strategy
in the approach to SMA syndrome. However, should this strategy be unsuccessful, the choice of surgical treatment
is duodenojejunostomy.