Hemorrhage following pancreatitis may become complicated during the disease course and with possibly fatal consequences. Radiologic findings are as follows: the presence of hematomas, hemorrhagic pseudocysts, extravasation of contrast media or the formation of arterial pseudoaneurysms. The digital subtraction angiography findings are as follows: contrast extravasation due to arterial rupture; pseudoaneurysm formation; and luminal irregularity. A pseudoaneurysm is considered to be treated as soon as detected due to its risk of rupture. Endovascular management, which includes embolization using coils, N-butyl cyanoacrylate, gelatin sponge, stents, and thrombin, is an effective option for the treatment for pancreatitis-related bleeding.
Aneurysm, False ; Angiography, Digital Subtraction ; Cyanoacrylates ; Embolization, Therapeutic ; Endovascular Procedures ; Extravasation of Diagnostic and Therapeutic Materials ; Gelatin ; Hematoma ; Hemorrhage ; Pancreatitis ; Phenobarbital ; Porifera ; Rupture ; Stents ; Thrombin

Large-volume paracentesis-induced intraperitoneal hemorrhage due to pseudoaneurysm formation is rarely reported. Here, we present a 56-year-old man with alcoholic liver cirrhosis admitted for massive ascites. Large-volume paracentesis was performed. Three days later, he became pale and complained of dyspnea and abdominal distention with hypotension. Percutaneous iliac angiography revealed contrast media leakage from a branch of the left circumflex iliac artery with pseudoaneurysm. He was successfully treated with microcoil embolization. Several days later, ascitic fluid increased and large-volume paracentesis was performed again. Two days later, his hemoglobin level suddenly decreased. An abdominal computed tomography scan showed new active bleeding at the left lower lateral peritoneal cavity, just anterior to the metalic coils. Percutaneous iliac angiography revealed contrast media extravasation from a branch of the left inferior epigastric artery with formation of collateral vessel. Percutaneous embolization was successfully performed again. After coil embolization, there were no further bleeding episodes.
Aneurysm, False* ; Angiography ; Ascites ; Ascitic Fluid ; Contrast Media ; Dyspnea ; Embolization, Therapeutic ; Epigastric Arteries ; Extravasation of Diagnostic and Therapeutic Materials ; Hemorrhage* ; Humans ; Hypotension ; Iliac Artery ; Liver Cirrhosis ; Liver Cirrhosis, Alcoholic ; Middle Aged ; Paracentesis* ; Peritoneal Cavity

The incidence of contrast media extravasation has been increasing gradually. Most contrast media extravasations only can cause pain, swelling and erythema. However, in more severe cases, skin necrosis, ulceration, or compartment syndrome may occur, often necessitating a surgery. Early diagnosis and treatment should be established on the spot in order to avoid such a severe damage. We present a case of 42-year-old woman with a compartment syndrome in the right upper extremity caused by extravasation of computed tomography contrast media.
Adult ; Compartment Syndromes* ; Contrast Media ; Early Diagnosis ; Erythema ; Extravasation of Diagnostic and Therapeutic Materials* ; Female ; Humans ; Incidence ; Necrosis ; Skin ; Ulcer ; Upper Extremity*

Coil migration is an extremely rare but hazardous complication of aneurysmal coil embolization. Only 1 case report has described coil migration following endovascular exclusion to gastrointestinal (GI) tract. We report the experience of a case of colon penetration caused by embolization coil placed for internal iliac aneurysm. A 66-year-old man visited the Emergency Department for hematochezia that had persisted for 3 months. Stent insertion and coil embolization of left internal iliac artery aneurysm had been performed on the patient 18 months ago. Colonoscopy was performed. It suggested penetration of sigmoid colon by embolization coil and diverticulum. Angiography revealed extravasation of contrast media at left internal iliac artery. Covered stent deployment was done in the left internal iliac artery. One week after the stent insertion, the patient underwent anterior resection, aneurysm resection, and coil removal. The patient recovered without complications. He was discharged at 2 weeks after the operation.
Aged ; Aneurysm ; Angiography ; Colon* ; Colon, Sigmoid ; Colonoscopy ; Diverticulum ; Embolization, Therapeutic ; Emergency Service, Hospital ; Endovascular Procedures ; Extravasation of Diagnostic and Therapeutic Materials ; Gastrointestinal Hemorrhage ; Humans ; Iliac Aneurysm* ; Iliac Artery ; Intestinal Perforation ; Stents

The incidence of contrast media extravasation has been increasing gradually. Most contrast media extravasations only can cause pain, swelling and erythema. However, in more severe cases, skin necrosis, ulceration, or compartment syndrome may occur, often necessitating a surgery. Early diagnosis and treatment should be established on the spot in order to avoid such a severe damage. We present a case of 42-year-old woman with a compartment syndrome in the right upper extremity caused by extravasation of computed tomography contrast media.
Adult ; Compartment Syndromes ; Contrast Media ; Early Diagnosis ; Erythema ; Extravasation of Diagnostic and Therapeutic Materials ; Female ; Humans ; Incidence ; Necrosis ; Skin ; Ulcer ; Upper Extremity

Contrast extravasation on computed tomography angiography (CTA) is rare but becoming more common, with increasing use of CTA for various cerebral vascular diseases. We report on two cases of spontaneous subarachnoid hemorrhage (SAH) in which the CTA showed a saccular lesion of the upper basilar trunk suggesting a ruptured aneurysm. However, no vascular lesion was observed on immediate subsequent digital subtraction angiography (DSA). In one case, repeated follow up DSA was also negative. The patient was treated conservatively and discharged with no neurologic deficit. In the other case, the patient showed sudden mental deterioration on the third hospital day and her brain CT showed rebleeding. The immediate follow up DSA showed contrast stagnation in the vicinity of the upper basilar artery, suggestive of pseudoaneurysm. Double stent deployment at the disease segment was performed. Due to the frequent use of CTA, contrast extravasation is an increasingly common observation. Physicians should be aware that basilar artery extravasation can mimic the appearance of an aneurysm.
Aneurysm* ; Aneurysm, False ; Aneurysm, Ruptured ; Angiography* ; Angiography, Digital Subtraction ; Basilar Artery* ; Brain ; Extravasation of Diagnostic and Therapeutic Materials ; Follow-Up Studies ; Humans ; Neurologic Manifestations ; Stents ; Subarachnoid Hemorrhage* ; Vascular Diseases

Extravasation injury refers to leakage of corrosive liquids from veins, resulting in tissue damage. The authors report on a case of extravasation injury to the left hand after administration of fluid to the antecubital area in a patient with brain damage. In order to minimize the effects of extravasation injury, rapid diagnosis and management are needed. In patients with stiffness, pressure sores can develop requiring more careful management by the medical staff.
Brain* ; Diagnosis ; Extravasation of Diagnostic and Therapeutic Materials ; Extremities* ; Hand ; Humans ; Medical Staff ; Persistent Vegetative State ; Pressure Ulcer* ; Vancomycin ; Veins

Bleeding from pancreatic pseudocyst is a rare complication. Furthermore, massive upper gastrointestinal (GI) bleeding from gastro-cystic fistula formation and intracystic bleeding are both extremely rare and are also potentially fatal. A 53-year-old male was referred to the emergency room with melena and hematemesis. An urgent endoscopy revealed a massive gastric hematoma but showed no specific bleeding focus. Gastrocystic fistula formation and intracystic bleeding leakage to the stomach were suspicious in the follow-up endoscopy. A contrast-enhanced computed tomography scan demonstrated splenic artery pseudoaneurysm and extravasation of contrast media into the cyst that was abutted to the greater curvature side of the stomach. A splenic artery embolization was performed and no further bleeding occurred after embolization. Upper GI bleeding from gastro-cystic fistula and intracystic bleeding are rare but possible. Therefore, this possibility should be considered in the unknown cause of an upper GI bleeding in a patient with pancreatic pseudocyst.
Aneurysm, False ; Emergency Service, Hospital ; Endoscopy ; Extravasation of Diagnostic and Therapeutic Materials ; Fistula* ; Follow-Up Studies ; Hematemesis ; Hematoma ; Hemorrhage* ; Humans ; Male ; Melena ; Middle Aged ; Pancreatic Pseudocyst* ; Splenic Artery ; Stomach

Adult ; Cardiomyopathy, Hypertrophic ; surgery ; Catheter Ablation ; adverse effects ; methods ; Ethanol ; Extravasation of Diagnostic and Therapeutic Materials ; etiology ; therapy ; Female ; Humans

PURPOSE: Incidence of radiographic contrast media extravasation has increased owing to the escalating availability of contrast enhanced imaging. Potential complications of extravasation include localized swelling, itching sensation, hypesthesia, erythema, limitation of finger movement, compartment syndrome, skin sloughing, and necrosis. We describe clinical characteristics and treatment of computed tomography contrast media extravasation. METHODS: A retrospective chart review was performed on 26 consulted patients experiencing contrast extravasation, between January 2005 and December 2011. Age, signs, symptoms, types of contrast administered, volume of extravasation, treatment and patient outcomes were documented and evaluated, retrospectively. RESULTS: Extravasation of less than 100 mL occurred in 85%. Immediate surgical therapy was necessary in 23% of cases. There were no postoperative complications and it rendered excellent cosmetic outcomes. In 77% of cases, conservative management was recommended, such as elevation and immobilization of extremity, application of ice pack, and careful monitoring. CONCLUSION: Prevention is the most important for extravasation injuries. Diagnosis and treatment must be made on the spot in order to avoid severe soft tissue damage. Hand surgeons' decision on the necessity of surgical treatment within 6 hours is important in the prognosis of patients.
Compartment Syndromes ; Contrast Media ; Cosmetics ; Erythema ; Extravasation of Diagnostic and Therapeutic Materials ; Extremities ; Fingers ; Hand ; Humans ; Hypesthesia ; Ice ; Immobilization ; Incidence ; Necrosis ; Postoperative Complications ; Prognosis ; Pruritus ; Retrospective Studies ; Sensation ; Skin ; Upper Extremity