1.A Case of Hepatic Portal Venous Gas as a Complication of Endoscopic Balloon Dilatation.
Chang Geun LEE ; Hyoun Woo KANG ; Min Keun SONG ; Jae Hak KIM ; Jun Kyu LEE ; Yun Jeong LIM ; Moon Soo KOH ; Jin Ho LEE
Journal of Korean Medical Science 2011;26(8):1108-1110
The development of hepatic portal venous gas (HPVG) is rare but it might be associated with serious disease and poor clinical outcome. Recently, several iatrogenic causes of HPVG have been reported. HPVG as a complication of endoscopic balloon dilatation is a previously unreported event. We experienced a case of HPVG after endoscopic balloon dilatation in a 31 yr-old man with pyloric stricture due to corrosive acids ingestion. The patient was treated conservatively with fluid resuscitation, antibiotics and Levin tube with natural drainage. Five days later, the follow-up CT scan showed spontaneous resolution of HPVG. This case reminded us the clinical importance and management strategy of HPVG. We report here a case of iatrogenic HPVG with a review of relevant literature.
Adult
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Balloon Dilation/*adverse effects
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Embolism, Air/etiology/*radiography/therapy
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Endoscopy, Gastrointestinal
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Hepatic Veins/*radiography
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Humans
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Male
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Portal Vein/*radiography
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Pyloric Stenosis/therapy
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Tomography, X-Ray Computed
2.Four Cases of a Cerebral Air Embolism Complicating a Percutaneous Transthoracic Needle Biopsy.
Soo Jung UM ; Soo Keol LEE ; Doo Kyung YANG ; Choonhee SON ; Ki Nam KIM ; Ki Nam LEE ; Yun Seong KIM
Korean Journal of Radiology 2009;10(1):81-84
A percutaneous transthoracic needle biopsy is a common procedure in the practice of pulmonology. An air embolism is a rare but potentially fatal complication of a percutaneous transthoracic needle biopsy. We report four cases of a cerebral air embolism that developed after a percutaneous transthoracic needle biopsy. Early diagnosis and the rapid application of hyperbaric oxygen therapy is the mainstay of therapy for an embolism. Prevention is the best course and it is essential that possible risk factors be avoided.
Adult
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Aged
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Biopsy, Needle/*adverse effects/methods
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Embolism, Air/*etiology/therapy
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Female
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Humans
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Hyperbaric Oxygenation
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Intracranial Embolism/*etiology/therapy
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Lung/*pathology
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Male
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Radiography, Interventional
3.Bilateral Paramedian Thalamic Contrast Enhancement on CT after Intra-arterial Thrombolysis.
Woong YOON ; Jeong Jin SEO ; Heoung Keun KANG
Korean Journal of Radiology 2005;6(1):41-43
A 58-year-old woman presented with an acute embolic occlusion of the distal basilar artery. She underwent angioplasty and intra-arterial thrombolysis. Angiography performed after recanalization revealed a single perforating thalamic artery. A nonenhanced CT scan carried out immediately after the procedure revealed hyperdense lesions in the bilateral paramedian portions of the thalami, which disappeared on the 24-hour follow-up CT scan. Three months later, the patient improved to functional independence, but had some memory dysfunction and vertical gaze palsy. This case suggests that contrast enhancement or extravasation can occur in the thalamus after intra-arterial thrombolysis performed to recanalize a basilar artery occlusion.
Angioplasty
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Basilar Artery/*radiography
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Contrast Media
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Female
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Humans
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Intracranial Embolism and Thrombosis/*radiography/*therapy
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Middle Aged
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Thalamus/*blood supply
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Thrombolytic Therapy
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*Tomography, X-Ray Computed
4.Symptomatic pulmonary lipiodol embolism after transarterial chemoembolization for hepatic malignant tumor: clinical presentation and chest imaging findings.
Haifeng XU ; Renjie YANG ; Xiaodong WANG ; Xu ZHU ; Hui CHEN
Chinese Medical Journal 2014;127(4):675-679
BACKGROUNDPulmonary lipiodol embolism after transarterial chemoembolization (TACE) was rare and life-threatening, occasionally reported in previous literatures. We aimed to review the records of 11 patients with pulmonary oily embolism and analyze their characteristics of radiographic findings and risk factors.
METHODSRecords of 478 consecutive patients who underwent 1 026 percutaneous TACE procedures were retrospectively analyzed. Eleven cases with respiratory symptoms were identified as having symptomatic pulmonary lipiodol embolism after TACE. Data of these patients, including clinical presentation, techniques of TACE, imaging features of tumor and chest imaging findings, were assessed.
RESULTSEleven (2.3%) of 478 consecutive patients who underwent percutaneous TACE procedures had a pulmonary oily embolism after procedures. The mean size of target tumors embolized was (13.6 ± 2.0) cm. All were hyper-vascular. The mean volume of lipiodol was (21.8 ± 8.2) ml. Pulmonary oily embolisms were revealed within 12-48 hours after TACE. The most severe respiratory symptoms and imaging abnormalities of the eight patients who survived presented between 2 and 5 days after TACE, becoming normal between 12 and 35 days after TACE. Three patients died. Chest CT revealed retention of radiopaque lipiodol in lungs.
CONCLUSIONSPulmonary lipiodol embolism occurs easily in patients who have large hyper-vascular hepatic malignant tumor. The high-density lipiodol deposition in the lung field can be used as diagnostic feature.
Antineoplastic Agents ; adverse effects ; Chemoembolization, Therapeutic ; adverse effects ; Embolism, Fat ; etiology ; Ethiodized Oil ; adverse effects ; Humans ; Liver Neoplasms ; therapy ; Pulmonary Embolism ; diagnostic imaging ; etiology ; Radiography, Thoracic ; Retrospective Studies
5.Acute Embolic Occlusion of the Left Common Iliac Artery Treated With Intra-Arterial Thrombolysis and Percutaneous Thrombectomy.
Wang Soo LEE ; Kwang Je LEE ; Wang Seong RYU
The Korean Journal of Internal Medicine 2009;24(2):153-155
Acute embolic occlusion of the common iliac artery is a rare medical emergency that is not only limbthreatening, but also potentially life-threatening. Several treatment options exist for acute limb ischemia, although no treatment is clearly best. We report a case of acute embolic occlusion of the left common iliac artery in a patient with atrial fibrillation who was treated successfully using mechanical thrombectomy following intra-arterial thrombolysis.
Acute Disease
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Arterial Occlusive Diseases/radiography/*therapy
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Combined Modality Therapy
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Embolism/radiography/*therapy
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Female
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Fibrinolytic Agents/*administration & dosage
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Humans
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*Iliac Artery/radiography
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Middle Aged
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*Thrombectomy
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*Thrombolytic Therapy
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Tomography, X-Ray Computed
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Treatment Outcome
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Urokinase-Type Plasminogen Activator/*administration & dosage
6.Retrograde Tempofilter II(TM) Placement within the Superior Vena Cava in a Patient with Acute Upper Extremity Deep Venous Thrombosis: the Filter Stands on Its Head.
Nam Yeol YIM ; Nam Kyu CHANG ; Jae Hoon LIM ; Jae Kyu KIM
Korean Journal of Radiology 2011;12(1):140-143
The Tempofilter II is a widely used temporary vena cava filter. Its unique design, which includes a long tethering catheter with a subcutaneous anchor, facilitates the deployment and retrieval of the device. Despite this, the Tempofilter II has been used only in the inferior vena cava of patients with lower extremity deep venous thrombosis. In this article, we present a case of superior vena cava filtering using the Tempofilter II in patients with upper extremity deep venous thrombosis.
Aged
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Female
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Humans
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Pulmonary Embolism/radiography
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Tomography, X-Ray Computed
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Upper Extremity Deep Vein Thrombosis/radiography/*therapy
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*Vena Cava Filters
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*Vena Cava, Superior
7.Fatal pulmonary embolism following percutaneous autologous marrow and MIIGTM115(Minimally-Invasive Injectable Graft) injection into simple bone cyst.
Korean Journal of Legal Medicine 2007;31(2):192-196
A 14-old girl presented to the general hospital with a fracture of the proximal metaphysis of the right humerus. Conventional radiography, CT and MR imaging revealed simple bone cyst of the right humerus. Percutaneous autologous marrow and MIIGTM115 injection into simple bone cyst were performed under general anesthesia. But the patient did not fully regain consciousness and showed no response to central pain. The post-interventional cardiac echocardiogram demonstrated pulmonary embolism. Despite subsequent thrombolytic therapy, the patient died 1hour later. The legal autopsy was performed at National Institute of Scientific Investigation.
Anesthesia, General
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Autopsy
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Bone Cysts*
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Bone Marrow*
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Consciousness
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Female
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Hospitals, General
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Humans
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Humerus
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Magnetic Resonance Imaging
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Pulmonary Embolism*
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Radiography
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Thrombolytic Therapy
8.Familial Occurrence of Pulmonary Embolism after Intravenous, Adipose Tissue-Derived Stem Cell Therapy.
Jae Woo JUNG ; Minsuk KWON ; Jae Chol CHOI ; Jong Wook SHIN ; In Won PARK ; Byoung Whui CHOI ; Jae Yeol KIM
Yonsei Medical Journal 2013;54(5):1293-1296
The therapeutic potential of human multipotent mesenchymal stromal cells, especially human adipose tissue-derived stem cells (hASC), is promising. However, there are concerns about the safety of infusion of hASC in human. Recently, we have experienced pulmonary embolism and infarct among family members who have taken multiple infusions of intravenous autologous hASC therapy. A 41-year-old man presented with chest pain for one month. Chest CT showed multiple pulmonary artery embolism and infarct at right lung. Serum D-dimer was 0.8 microg/mL (normal; 0-0.5 microg/mL). He had received intravenous autologous adipose tissue-derived stem cell therapy for cervical herniated intervertebral disc three times (one, two, and three months prior to the visit). His parents also received the same therapy five times and their chest CT also showed multiple pulmonary embolism. These cases represent artificial pulmonary embolisms and infarct after IV injection of hASC. Follow-up chest CT showed spontaneous resolution of lesions in all three patients.
Adipose Tissue/cytology
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Adult
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Cell- and Tissue-Based Therapy/*adverse effects
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Female
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Humans
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Male
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Mesenchymal Stem Cell Transplantation/*adverse effects
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Pulmonary Embolism/*etiology/radiography
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Pulmonary Infarction/etiology/radiography
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Tomography, X-Ray Computed
9.Percutaneous Aspiration Embolectomy Using Guiding Catheter for the Superior Mesenteric Artery Embolism.
Kyu Sung CHOI ; Ji Dae KIM ; Hyo Cheol KIM ; Sang Il MIN ; Seung Kee MIN ; Hwan Jun JAE ; Jin Wook CHUNG
Korean Journal of Radiology 2015;16(4):736-743
OBJECTIVE: To evaluate the technical feasibility and clinical outcome of percutaneous aspiration embolectomy for embolic occlusion of the superior mesenteric artery (SMA). MATERIALS AND METHODS: Between January 2010 and December 2013, 9 patients with embolic occlusion of the SMA were treated by percutaneous aspiration embolectomy in 2 academic teaching hospitals. The aspiration embolectomy procedure was performed with the 6-Fr and 7-Fr guiding catheter. Thrombolysis was performed with urokinase using a multiple-sidehole infusion catheter. The clinical outcome was investigated retrospectively. RESULTS: Superior mesenteric artery occlusion was initially diagnosed by computed tomography (CT) in all patients, and all patients had no obvious evidence of bowel infarction on CT scan. Percutaneous aspiration embolectomy was primarily performed in 6 patients, and thrombolysis was initially performed in 3 patients. In 3 patients who received primary thrombolysis, percutaneous aspiration was undertaken because the emboli were resistant to urokinase. Complete angiographic success was achieved in 6 patients and partial angiographic success was accomplished in 3 patients. One patient underwent bowel resection. One patient died of whole bowel necrosis and sepsis, and 8 patients survived without complications. CONCLUSION: Percutaneous aspiration embolectomy is a useful tool in recanalization of embolic occlusion of the SMA in select patients.
Adult
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Aged
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Aged, 80 and over
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Angiography/methods
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Embolectomy/*methods
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Embolism/complications/radiography/*surgery
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Female
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Humans
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Male
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Mesenteric Artery, Superior/radiography/*surgery
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Mesenteric Vascular Occlusion/etiology/radiography/*surgery
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Middle Aged
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Retrospective Studies
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Suction/instrumentation/methods
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Thrombolytic Therapy/methods
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Tomography, X-Ray Computed
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Treatment Outcome
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Urokinase-Type Plasminogen Activator/administration & dosage
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Vascular Access Devices
10.Effectiveness of Mechanical Embolectomy for Septic Embolus in the Cerebral Artery Complicated with Infective Endocarditis.
Gimoon KANG ; Tae Ki YANG ; Joon Hyouk CHOI ; Sang Taek HEO
Journal of Korean Medical Science 2013;28(8):1244-1247
There has been a controversy over data of thrombolytic and endovascular surgical treatment about cerebral infarction secondary to infective endocarditis. We report a woman who received early mechanical embolectomy as a treatment of acute stroke with infective endocarditis. A 35-yr-old woman was hospitalized due to right hemiparesis. Brain image showed cerebral infarction at the middle cerebral artery and echocardiography demonstrated vegetation at the mitral valve. She was successfully treated with embolectomy and parenteral antibiotics without any neurologic sequelae. This report shows that the early retrieve of septic cerebral emboli can be a helpful treatment of acute stroke associated with endocarditis.
Adult
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Anti-Bacterial Agents/therapeutic use
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Cerebral Arteries/radiography/*surgery
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Embolectomy
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Endocarditis/complications/*diagnosis/drug therapy
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Female
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Humans
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Intracranial Embolism/surgery
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Mitral Valve/ultrasonography
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Streptococcus/isolation & purification
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Stroke/*diagnosis/etiology/surgery
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Tomography, X-Ray Computed