Recently, we have experienced a case of spontaneous rupture of the left iliac vein in a 62-year-old woman, who had been suffering from hemiparesis and chronic constipation. An urgent laparotomy was performed for massive hemoperitoneum without knowing the bleeding point, and laceration on the left external iliac vein was repaired. Spontaneous rupture of the iliac vein is extremely rare. However, it should be included in differential diagnoses of the patient with massive hemoperitoneum who have no known pathology or any evidence of blunt trauma.
Female ; Human ; Iliac Vein/*pathology ; Middle Aged ; Rupture, Spontaneous/etiology/pathology/therapy ; Tomography, X-Ray Computed ; Vascular Diseases/etiology/*pathology/therapy

We report a case of central venous stenosis due to a structural deformity caused by a tuberculosis-destroyed lung in a 65-year-old woman. The patient presented with left facial edema. She had a history of pulmonary tuberculosis, and the chest X-ray revealed a collapsed left lung. Angiography showed leftward deviation of the innominate vein leading to kinking and stenosis of the internal jugular vein. Stent insertion improved her facial edema.
Aged ; Brachiocephalic Veins/*pathology/radiography ; *Central Venous Pressure ; Constriction, Pathologic/*etiology/pathology/therapy ; Edema/therapy ; Female ; Humans ; Jugular Veins/pathology/radiography ; Stents ; Tuberculosis, Pulmonary/*complications/pathology/radiography ; Vascular Diseases/*etiology/pathology/therapy

Animals ; Diagnosis, Differential ; Disease Models, Animal ; Gastric Antral Vascular Ectasia ; diagnosis ; pathology ; Gastric Mucosa ; pathology ; Gastrointestinal Hemorrhage ; etiology ; pathology ; therapy ; Gastroscopy ; Humans ; Hypertension, Portal ; complications ; epidemiology ; pathology ; Intestinal Mucosa ; pathology ; Liver Cirrhosis ; complications ; pathology ; Liver Cirrhosis, Experimental ; complications ; pathology ; Rats ; Stomach Diseases ; epidemiology ; etiology ; pathology ; therapy

Cutaneous polyarteritis nodosa (CPAN) is an uncommon form of vasculitis involving small and medium sized arteries of unknown etiology. The disease can be differentiated from polyarteritis nodosa by its limitation to the skin and lack of progression to visceral involvement. The characteristic manifestations are subcutaneous nodule, livedo reticularis, and ulceration, mostly localized on the lower extremity. Arthralgia, myalgia, peripheral neuropathy, and constitutional symptoms such as fever and malaise may also be present. We describe a 34-yr-old woman presented with severe ischemic change of the fingertip and subcutaneous nodules without systemic manifestations as an unusual initial manifestation of CPAN. Therapy with corticosteroid and alprostadil induce a moderate improvement of skin lesions. However, necrosis of the finger got worse and the finger was amputated.
Vasodilator Agents/therapeutic use ; Skin Diseases, Vascular/*complications/drug therapy/pathology ; Polyarteritis Nodosa/*complications/drug therapy/pathology ; Humans ; Gangrene/*etiology/surgery ; Fingers ; Female ; Amputation ; Alprostadil/therapeutic use ; Adult ; Adrenal Cortex Hormones/therapeutic use

Castleman disease (CD) is a rare lymphoproliferative disorder of unknown etiology with different clinical manifestations. A previous healthy 50 year-old man was hospitalized for right upper quadrant (RUQ) abdominal pain. He had jaundice and a 1 cm-sized lymph node in the right supraclavicular area. Pancreas and biliary computed tomography (CT) showed masses at the right renal hilum and peripancreatic areas. Positron emission tomography (PET) showed widespread systemic lymphadenopathy. Excisional biopsy of the right supraclavicular node revealed a hyaline vascular variant of CD. Corticosteroid therapy was started and the extent of disease decreased. We here report a case of multicentric CD, the hyaline vascular variant, presenting with jaundice, diagnosed by excisional biopsy and successfully treated with corticosteroids.
Abdominal Pain/etiology ; Adrenal Cortex Hormones/therapeutic use ; Biopsy ; Giant Lymph Node Hyperplasia/*diagnosis/drug therapy/pathology ; Humans ; Jaundice/*complications ; Male ; Middle Aged ; Positron-Emission Tomography ; Tomography, X-Ray Computed ; Vascular Diseases/*diagnosis/pathology

A 47 year old male patient visited our hospital with the chief complaint of deterioration of the visual acuity in the left eye. The fundus examination revealed thick hard exudates, multiple aneurysms and telangiectasias of the retinal vessels in the posterior pole. Fluorescein angiography demonstrated massive leakage over an area of the aneurysms. Optical coherence tomography (Stratus OCT; Zeiss-Humphrey, Dubin, CA) revealed diffuse and marked thickening of the retina. Laser photocoagulation was performed under the diagnosis of Coats' disease. However, the treatment could not be performed satisfactorily. On the first and 6th weeks, an intravitreal injection of bevacizumab and triamcinolone acetonide was administered, and laser photocoagulation was again attempted. The effectiveness of eachagent on retinal edema was evaluated at the follow-up performed at 1, 2, 5, 7, 10 weeks and 6 months after the injection. At one week after the intravitreal bevacizumab injection, there was no improvement. An intravitreal injection of triamcinolone acetonide was performed 6 weeks after the initial diagnosis,which resulted in a reduction in the thickness of the macular edema. Therefore, laser photocoagulation was performed sufficiently on telangiectasias. The follow-up at 6 months showed a relative increase in the macular edema, but there was reduced leakage from the telangiectasias compared with the previous angiograph.
Angiogenesis Inhibitors/*therapeutic use ; Antibodies, Monoclonal/*therapeutic use ; Drug Therapy, Combination ; Fluorescein Angiography ; Glucocorticoids/*therapeutic use ; Humans ; Injections ; Laser Coagulation ; Macular Edema/*drug therapy/etiology ; Male ; Middle Aged ; Retinal Diseases/complications/*drug therapy/surgery ; Retinal Vessels/pathology ; Telangiectasis/complications/*drug therapy/surgery ; Tomography, Optical Coherence ; Triamcinolone Acetonide/*therapeutic use ; Vascular Endothelial Growth Factor A/antagonists & inhibitors ; Vitreous Body