Humans ; Aneurysm, False/etiology* ; Heart Aneurysm/complications* ; Heart Ventricles/surgery*

Humans ; Aneurysm, False/etiology* ; Heart Aneurysm/complications* ; Heart Ventricles/surgery*

Aneurysm, False/complications* ; Atrial Appendage ; Fistula/complications* ; Heart Aneurysm/complications* ; Humans ; Mitral Valve

Aneurysm, False/surgery* ; Heart Aneurysm/etiology* ; Heart Valve Prosthesis ; Heart Valve Prosthesis Implantation/adverse effects* ; Heart Ventricles/surgery* ; Humans ; Mitral Valve/surgery* ; Postoperative Complications

A Le Fort I osteotomy is a common procedure for correcting dental and facial deformities in orthognathic surgery. In rare cases, a delayed hemorrhage can occur as early as several hours or up to 12 weeks, postoperatively. The most frequently involved blood vessels in a delayed hemorrhage are the descending palatine artery, the internal maxillary artery, and the pterygoid venous plexus of veins. Intraoral bleeding accompanied by severe epistaxis in these cases makes it difficult to locate the precise bleeding focus. Eventual uncontrolled bleeding would require Merocel packing or surgical intervention. In general, a severe late postoperative hemorrhage is most effectively managed by angiography and embolization. Herein we describe a delayed hemorrhage case in which the cause was not evident on angiography. We were able to detect the bleeding point through an endoscopic nasal approach and treat it using direct cauterization.
Aneurysm, False ; Angiography ; Arteries ; Blood Vessels ; Cautery ; Congenital Abnormalities ; Epistaxis ; Hemorrhage ; Maxillary Artery ; Orthognathic Surgery ; Osteotomy ; Postoperative Complications ; Postoperative Hemorrhage ; Veins

Aortic injury during transforaminal lumbar interbody fusion (TLIF) is a rare but severe complication. We experienced aortic injury during TLIF at L3–4 with a 59-year-old woman diagnosed with an adjacent segment disease at L3–4. Severe bleeding occurred during disc space expansion, and the blood pressure dropped to 60/40 mmHg. The patient’s vital sign stabilized after compression with gauze and Gelfoam in addition to blood transfusion. The patient was treated with endovascular repair using a percutaneous technique after intertransverse fusion at L3–4 was completed. She recovered and is being followed-up in the outpatient department.
Aneurysm, False ; Aortic Rupture ; Blood Pressure ; Blood Transfusion ; Endovascular Procedures ; Female ; Gelatin Sponge, Absorbable ; Hemorrhage ; Humans ; Intervertebral Disc ; Intraoperative Complications ; Middle Aged ; Outpatients ; Vital Signs

PURPOSE: The lower extremity has received its fair share of attention as a vascular access site in patients who have exhausted their upper arm vessels. However, experiences with lower extremity arteriovenous grafts (AVGs) have so far been disappointing because of high infection rates and severe limb ischemia. We report our experience with hemodialysis access from the lower extremity. MATERIALS AND METHODS: A retrospective review of 60 lower extremity AVGs created between January 2003 and December 2011 was performed. Age, sex, etiology of end-stage renal disease and complications were tabulated. Primary and secondary patency rates were determined. RESULTS: The average age of the study population was 56 years and 38 patients were female. Renal failure was associated with hypertension in 40 (66.7%) patients, diabetes in 28 (46.7%) patients and cardiovascular disease in 9 (15.0%) patients. The follow-up period was 8–108 months. Fifty-four patients had bilateral central vein stenosis. Seven (11.7%) patients had primary failure of their AVG. There was no operation-related death. Primary and secondary patency rates were: 66% and 90% at 1 year, 40% and 90% at 2 years, 27% and 87% at 3 years, and 18% and 87% at 5 years, respectively. There were 105 postoperative complications that developed in 67 patients. Postoperative complications were: thrombosis (30), proximal vein stenosis (56), infection (9), bleeding with hematoma (1), perigraft seroma (3), steal syndrome (2), and pseudoaneurysm (4). CONCLUSION: A lower extremity AVG seems to be a viable option in patients with unusable upper extremity veins.
Aneurysm, False ; Arm ; Cardiovascular Diseases ; Constriction, Pathologic ; Extremities ; Female ; Follow-Up Studies ; Hematoma ; Hemorrhage ; Humans ; Hypertension ; Ischemia ; Kidney Failure, Chronic ; Lower Extremity* ; Postoperative Complications ; Renal Dialysis* ; Renal Insufficiency ; Retrospective Studies ; Seroma ; Thrombosis ; Transplants* ; Upper Extremity ; Veins

Blunt traumatic injuries to the superior gluteal artery are rare in clinic. A majority of injuries present as aneurysms following penetrating trauma, fracture pelvis or posterior dislocation of the hip joint. We reported a rare case of superior gluteal artery pseudoaneurysm following blunt trauma presenting as large expanding right gluteal hematoma without any bony injury. The gluteal hematoma was suspected clinically, confirmed by ultrasound and the arterial injury was diagnosed by CT angiography that revealed a large right gluteal hematoma with a focal contrast leakage forming a pseudoaneurysm within the hematoma. Pseudoaneurysm arose from the superior gluteal branch of right internal iliac artery, which was successfully angioembolized. The patient was discharged on day 4 of hospitalization with resolving gluteal hematoma. This report highlighted the importance of considering an arterial injury following blunt trauma to the buttocks with subsequent painful swelling. Acknowledgment of this rare injury pattern was necessary to facilitate rapid diagnosis and appropriate treatment.
Aneurysm, False ; etiology ; Buttocks ; Hematoma ; diagnostic imaging ; etiology ; Humans ; Iliac Artery ; injuries ; Male ; Middle Aged ; Tomography, X-Ray Computed ; Wounds, Nonpenetrating ; complications

With the promotion of standard radical resection of gastric cancer, the incidence of postoperative pseudoaneurysm is significantly increasing. Both the patient's own factors and iatrogenic factors are accoutable. Surgeons should clarify the causes of pseudoaneurysm, pay attention to the clinical symptoms and signs, and treat the patients appropriately. In order to avoid the occurrence of postoperative pseudoaneurysm, surgeons should carefully evaluate the preoperative conditions, perform precision operation and reduce the morbidity of postoperative infection and fistula.
Aneurysm, False ; prevention & control ; Gastrectomy ; Humans ; Incidence ; Morbidity ; Postoperative Complications ; prevention & control ; Stomach Neoplasms ; surgery

Any medical diagnosis should take a multimodal approach, especially those involving tumour-like conditions, as entities that mimic neoplasms have overlapping features and may present detrimental outcomes if they are underdiagnosed. These case reports present diagnostic pitfalls resulting from overdependence on a single diagnostic parameter for three musculoskeletal neoplasm mimics: brown tumour (BT) that was mistaken for giant cell tumour (GCT), methicillin-resistant Staphylococcus aureus osteomyelitis mistaken for osteosarcoma and a pseudoaneurysm mistaken for a soft tissue sarcoma. Literature reviews revealed five reports of BT simulating GCT, four reports of osteomyelitis mimicking osteosarcoma and five reports of a pseudoaneurysm imitating a soft tissue sarcoma. Our findings highlight the therapeutic dilemmas that arise with musculoskeletal mimics, as well as the importance of thorough investigation to distinguish mimickers from true neoplasms.
Adult ; Aneurysm, False ; diagnosis ; Biopsy ; Bone Diseases ; diagnosis ; Bone Diseases, Metabolic ; diagnosis ; Bone Neoplasms ; diagnosis ; Cell Proliferation ; Diagnosis, Differential ; Diagnostic Errors ; prevention & control ; Female ; Giant Cell Tumors ; diagnosis ; Humans ; Hyperparathyroidism ; complications ; Leukocytosis ; diagnosis ; Male ; Methicillin-Resistant Staphylococcus aureus ; Middle Aged ; Neoplasms ; diagnosis ; microbiology ; Osteomyelitis ; diagnosis ; microbiology ; Osteosarcoma ; diagnosis ; Sarcoma ; diagnosis ; Soft Tissue Neoplasms ; diagnosis ; Tibia ; pathology