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

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

Giant cell tumor of the bone (GCTB) is a benign bone tumor where it typically presents in the long bones, mainly at the knee regions. Rarely, benign GCTB can undergo sarcomatous malignant transformation (MGCTB). We report a case of a 63-year-old lady who presented with a swelling at the right side of the neck associated with dysphagia and voice changes. A contrast-enhanced computed tomography scan revealed a large mass seen arising from the hyoid bone with local mass effect and airway compression. However, no distant metastasis was seen. Multiple biopsies performed on the patient with the histopathology reports concluded as MGCTB. The tumor was unresectable. Therefore, the patient was treated with denosumab. She showed encouraging improvement post-treatment. We are highlighting this case report in view of the rare site of the disease and the use of denosumab in unresectable tumor with good response to therapy.
Giant Cell Tumors

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.