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Sample records for abdominal aorta due

  1. [Deviation of the abdominal aorta and common iliac arteries due to aging and kidney dystopia].

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    Zhelobtsov, P M

    1982-12-01

    A specific peculiarity in the relief changeability and position of the abdominal aorta, the common iliac arteries is a segmentary deformity occurring in aged persons as a result of atherosclerotic alterations in their walls. A congenital homolateral dystopia, horseshoe and double kidney are rather seldom developmental anomalies in mature persons. In newborns, however, they are found 6-7 times more often and together with other congenital defects of the kidneys make evidently an often cause of the fetal and infantile death.

  2. Acute spontaneous isolated dissection of abdominal aorta

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    Ali Akbar beigi

    2009-09-01

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    • Aortic dissection occurs when the layers of the aorta separate as a result of extra luminal cavity of blood through an intimal tear. Dissection limited to the abdominal aorta is rare. Unfortunately, the appropriate management of dissecting aneurysm of abdominal aorta is not documented yet. A 43 years old man was admitted to Al-zahra hospital in Isfahan with sudden onset of periumbilical abdominal pain. CT scan confirmed infrarenal dissection of abdominal aorta. Performing laparotomy, aorta was repaired using bifurcate collagen-coated Dacron graft. Surgical intervention with synthetic graft is recommended in patients with dissecting aortic aneurysm of infrarenal segments where the extent of dissection is limited and accessible.
    • Keywords: Aneurysm, Aortic dissection, Aortic aneurysm abdominal surgery.

  3. Abdominal aorta transplantation after programmed cryopreservation

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    Song Gu; Chang-Jian Liu; Tong Qiao; Xue-Mei Sun; Jun-Hao Chen

    2004-01-01

    AIM: To study the morphologic and cellular immunologic changes after homologous transplantation of the abdominal aorta in rats after programmed cryopreservation (-196°C).METHODS: Abdominal aorta was harvested from anesthetized Spraque Dawley (SD) rats for cryopreservation (group B) or immediate implantation (group A). The survival rates and apoptotic rates of aortic endothelial cells (ECs)were examined. The patency rates, histology and cellular immunologic changes of the abdominal aorta were examined on days 1, 3, 7, 14, 30, 60 after transplantation respectively.RESULTS: The survival rate of ECs after programmed cryopreservation was 90.1±1.79%, about 3.4% lower than that of uncryopreservation (93.5±1.96%). The apoptotic rates of ECs was increased after cryopreservation (7.15%vs 4.86%, P<0.05). The patency rate of group B was significantly higher than that of group A (91.6±12.9% vs 62.5±26.2%, P<0.01). CD4/CD8 ratio, TCR αβ and CD11b/CD18 ratio of group B were significantly lower than those of group A (P<0.05). Revivification of the cryopreserved abdominal aorta showed normal adventitia and intact smooth muscle cells.CONCLUSION: Cryopreservation can reduce homologous abdominal aortic antigenecity. Even if without administration of immunosuppressive agents, it is still feasible to implement homologous artery grafting in rats.

  4. Atrophic coarctation of the abdominal aorta.

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    Wiest, J W; Traverso, L W; Dainko, E A; Barker, W F

    1980-01-01

    Two cases illustrate the clinical manifestations and angiographic findings associated with segmental stenosis of the abdominal aorta. Such lesions represent the chronic occlusive stage of Takayasu's disease, a nonspecific inflammatory arteritis of uncertain etiology. While the disease is considered autoimmune, an infectious process may be involved. Complications typically associated with stenotic lesions of the abdominal aorta are secondary renal hypertension and ischemic symptoms secondary to vascular insufficiency. Surgical correction, the treatment of choice, has achieved excellent results for these well-localized lesions. Secondary renal hypertension was relieved by a spenorenal shunt and the disease has since been controlled with conservative management in the first patient. An aortofemoral bypass graft successfully alleviated the vascular insufficiency in the second patient, although the patient unfortunately expired from a refractory postoperative cardiac complication. Images Fig. 1. Fig. 2. Fig. 3. Fig. 4. PMID:6102453

  5. Surgery of gigantic infrarenal aneurysm of abdominal aorta

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    N. Rustempašić

    2005-08-01

    Full Text Available The case shows gigantic aneurysm of abdominal aorta, localized infrarenally, as well as aneurysms of bilateral iliac arteries, which were solved successfully by resection of aneurism of abdominal aorta, closure of iliac arteries near aortic bifurcation, and interposition of aorta-bifemural vascular graft. There were no postoperative complications,and final outcome was fully satisfactory.

  6. Multiple variations of the branches of abdominal aorta

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    Kafa IM

    2010-06-01

    Full Text Available Multiple variations were found in a 54-year-old male cadaver during routine dissections of abdominal retroperitoneal region. Right inferior phrenic artery was arising from right renal artery, while the right middle and superior suprarenal artery branched from the right inferior phrenic artery. Left inferior phrenic artery was originating from the abdominal aorta below celiac trunk. The left middle suprarenal artery appeared as the branch of celiac trunk. Double left renal artery was arising separately from the left side of the aorta. The upper left renal artery showed approximately 80º of kinking which then crossed the lower one and entered to the inferior pole of hilum of kidney. Left testicular artery was originating from the upper left renal artery after this kinking. The left and right fourth lumbar arteries and median sacral artery have branched from a common trunk posterior to the abdominal aorta.In spite of these abundant variations in the branches, abdominal aorta itself did not show any variation, spanning normally between the levels of T12–L4 vertebrae. The variations of abdominal aorta may have clinical importance, especially in surgical and radiologic investigations.

  7. [Inflammatory aneurysms of the abdominal aorta].

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    Tovar Martín, E; Acea Nebril, B

    1993-01-01

    Approximately 10 per cent of abdominal aneurysms have an excessively thick wall that sometimes involve duodenum, cava or colon by an inflammatory process. Between February 1986 and December 1992, 147 patients with abdominal aortic aneurysm (AAA) were treated surgically and in 13 (8.8%) the aneurysms were found to be inflammatory. Their mean age was 67.3 years (70.1 years in non inflammatory group) and all were symptomatics initially (abdominal pain in 53%, rupture in 23%, mass in 15%). The operative mortality for elective resection was 37% in patients with inflammatory abdominal aortic aneurysms (IAAA) decreasing to 9% in the AAA group without inflammatory involvement. We conclude that surgery is indicated in these patients to prevent rupture and to hasten the subsidense of inflammatory process ever with postoperative morbi-mortality increased.

  8. Ischemic colitis complicating reconstruction of the abdominal aorta

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    Schroeder, T V; Christoffersen, J K; Andersen, J

    1985-01-01

    A review of 23 patients with ischemic colitis after surgical treatment of the abdominal aorta disclosed a pathogenetic heterogeneous finding. Ligation of the inferior mesenteric artery, abolished collateral blood supply or nonocclusive low flow state, or both, was a common feature. An incidence...

  9. Abdominal aorta coarctation: The first three case reports in our literature

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    Gajin Predrag

    2010-01-01

    Full Text Available Introduction. Congenital coarctation of the thoracic aorta at the ligamentum arteriosum or the aortic arch is well recognized. But a much less common variety (0.5-2.0% of aortic coarctation is located in the distal thoracic aorta or abdominal aorta or both and is often called 'middle aortic syndrome' or 'midaortic dysplastic syndrome'. This represents serious pathological condition and indicates multidisciplinary therapy approach. Outline of Cases. From 1996 to 2007, at the Vascular Surgery Clinic of the Institute for Cardiovascular Diseases 'Dedinje', Belgrade, three patients were treated due to abdominal aorta coarctation, two females aged 55 and 50 and a 4-year-old child. The patients were treated surgically (by-pass with a prosthetic graft and patch angioplasty and endovascular-percutaneous transluminal angioplasty (PTA with and without a stent. The follow-up period was 3-70 months. In the 50-year-old patient, angiography showed severe narrowing of the suprarenal segment of the abdominal aorta. Thoraco-abdominal bypass with a 16 mm dacronic tubular graft was performed. In the 4-year-old patient angiography also showed a suprarenal aorta narrowing. In the first act patch angioplasty was performed and after PTA of the visceral arteries was done on several occasions. In the 55-year-old patient, after diagnostic angiography, infrarenal aorta coarctation was registered. PTA was performed with stent placement. All patients were asymptomatic on control check-ups. Conclusion. Abdominal coarctation is a pathological disease which is seldom found in vascular surgery. Angiography is of major importance for setting the diagnosis and for the control of the results of surgical and nonsurgical treatment. The combination of surgical and endovascular treatment in our patients showed very good results in the studied period.

  10. DOMINANCE OF CORONARY ARTERY DISEASE AMONG PATIENTS WITH ANEURYSM OF ABDOMINAL AORTA

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    Maja Zdravkovic

    2007-12-01

    Full Text Available Persons with aneurysm of the abdominal aorta have high prevalence of risk factors of cardiovascular disease. It cannot be stated with certainty whether these persons die in a large number due to the existence of risk factors or the genesis and complications of aneurysm itself. In patients with aneurysm of the abdominal aorta, there is a high correlation with the coronary artery disease; therefore, the aim of the study was to prove whether or not this is the case. The patients in preparation for the resection of the abdominal aorta aneurysm at the Institute of Cardiovascular Disease underwent the examination. The study included 377 examinees, of whom 341 males and 36 females, aged 45 to 83 years, during the three-year interval (from 2004 to 2006. The aim of the study was to determine the dominance of the coronary artery disease among the patients with aneurysm of the abdominal aorta. In the process of analyzing the data obtained from patients and medical evidence, it was found out that a large number of the abdominal aortic aneurysm patients were at the same time the coronary artery disease patients (55,2%; Hi=15,04; p80 kg was larger, as well as the percentage of patients with hypertension (89% and increased levels of cholesterol and triglycerides (67%. There was a great number of those with the inherited factor (40%. It has been proven that the risk factors for the development of coronary artery disease are in direct association with the risk factors for the abdominal aortic aneurysm. Also, there is a great predominance of the coronary artery disease among the patients with aneurysm of the abdominal aorta. The coronary artery disease is one of the main risk factors. If we managed to prevent the appearance of this disease or achieve the timely diagnosing of it and eventual curing, we would be able to decrease the development of the abdominal aortic aneurysm well as the consequences and further complications.

  11. Os ramos colaterais da aorta abdominal em jaguatirica (Leopardus pardalis

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    Luane L. Pinheiro

    2014-05-01

    Full Text Available A jaguatirica (Leopardus pardalis é uma das espécies de felino silvestre que pouco foi investigada quanto a sua morfologia. Assim, o estudo objetivou detalhar a origem e distribuição dos ramos colaterais da aorta abdominal deste animal. Avaliou-se dois exemplares, sendo um macho e uma fêmea, jovens, provenientes de Paragominas-PA, doados ao Laboratório de Pesquisa Morfológica Animal (LaPMA da Universidade Federal Rural da Amazônia (UFRA. O sistema arterial foi preenchido com látex pigmentado de vermelho e os cadáveres foram preservados com solução de formaldeído tamponado a 10%. A aorta abdominal do L. pardalis teve origem entre T12 e L1, sendo a artéria celíaca o primeiro ramo visceral no sentido crânio-caudal, resultando nas artérias hepática, gástrica esquerda e esplênica. A artéria mesentérica cranial surgiu como segundo ramo da aorta abdominal, originando as artérias jejunais. Na sequência localizamos artéria pancreáticoduodenal caudal, artérias ileais, artérias ileocólicas, artérias renais direita e esquerda, artérias adrenais direita e esquerda e artérias ováricas ou testiculares direita e esquerda. Parietalmente, a aorta abdominal originou em média seis ramos lombares, bem como a artéria frenicoabdominal, as artérias circunflexas ilíacas profundas e artérias ilíacas externa e interna. A aorta abdominal gerou ainda a artéria mesentérica caudal, a qual dividiu-se em artérias cólica esquerda e retal cranial. A artéria cólica esquerda seguiu cranialmente paralela ao cólon descendente irrigando-o, originando em média 18 ramos, e anastomosando-se com a artéria cólica média. A artéria retal cranial seguiu em direção caudal distribuindo oito ramos à porção final do cólon descendente e ao reto, e uniu-se com a artéria retal média. Por fim, a aorta abdominal emitiu como ramo terminal a artéria sacral mediana. A vascularização arterial abdominal desta espécie é bastante semelhante ao

  12. Complete occlusion of the infrarenal abdominal aorta: management and results in 64 patients.

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    Liddicoat, J E; Bekassy, S M; Dang, M H; De Bakey, M E

    1975-03-01

    Sixty-four patients with complete occlusion of the infrarenal abdominal aorta were reviewed. The clinical findings, diagnostic procedures, and surgical management are described. Sixty-one patients underwent thromboendarterectomy and bypass grafts from the infrarenal abdominal aorta to the iliac or common femoral arteries. Because purulent material was found in the retroperitoneum of two patients, the proximal anastomosis was performed to the descending thoracic aorta in one patient and to the upper abdominal aorta in the other. One patient underwent thromboendarterectomy and patch graft angioplasty. The hospital mortality rate was 4.6 percent. Sixty-one patients discharged from the hospital were followed (average length of follow-up was 37 months). There were three late deaths (4.9 percent). Two patients have had occlusion of one limb of their bypass grafts and, along with four others, have developed recurrent symptoms of vascular insufficiency of the lower extremities. These symptoms were due to progressive atherosclerotic occlusive disease of the distal arterial tree for which additional distal procedures were required.

  13. Mycotic Abdominal Aortic Aneurysm Secondary to Septic Embolism of a Thoracic Aorta Graft Infection.

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    Blanco Amil, Carla Lorena; Vidal Rey, Jorge; López Arquillo, Irene; Pérez Rodríguez, María Teresa; Encisa de Sá, José Manuel

    2016-05-01

    Mycotic aneurysms account for 1% of abdominal aortic aneurysms. There are very few cases published that describe the formation of mycotic aneurysms after septic embolism due to graft infection. We present the first case to our knowledge to be described in the literature of a mycotic aneurysm caused by septic embolism derived from a thoracic aorta graft infection, treated with conventional surgery leading to a successful outcome and evolution.

  14. Branches of the abdominal aorta in Aotus azarae infulatus

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    Bianca Mendonça Faria

    2016-05-01

    Full Text Available The genus Aotus is found in South America and is known for its nocturnal habit. The morphology of the genus is poorly understood even though it is used in biomedical research. The objective of this study was to identify the collateral branches of the abdominal aorta of two females and one male Aotus azarae infulatus (commonly known as the night monkey. The vessels were observed and stained with Neoprene latex and radiopaque contrast. The animals were fixed in an aqueous solution of 10% formaldehyde via intramuscular and intracavitary routes, dissected and radiographed. It was observed that the celiac artery was divided into three subjacent branches, the gastric, hepatic and splenic arteries. The left and right renal arteries originated from a common trunk in two animals (animals 1 and 2, while the adrenal artery in one of the animals was derived from the celiac trunk and renal artery (animal 2. In one animal the mesenteric artery flow gave rise to individual cranial rectal, sigmoid and left colic arteries (animal 3. In the three animals the abdominal aorta bifurcated in the final portion of the abdomen, with the external and internal iliac artery on each side, and then the median sacral artery. These anatomical variations need to be identified and reported because these animals are frequently used in clinical and surgical, veterinary practices.

  15. Morphological description of collateral branches from the abdominal aorta of lesser anteater (Tamandua tetradactyla

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    Breno Costa Macedo

    2013-03-01

    Full Text Available Tamandua tetradactyla, Xenarthra, is a native species from South America which, due to the few number of studies on its biology, still has many unknown aspects in its morphology. Taking into account the importance of morphological data for various studies, this paper aimed to elucidate the branching of the abdominal aorta in this species to foster the development of further studies. To do this, 4 specimens were used, 2 male and 2 female, all young, from the Bauxite Mine – Paragominas, Para, Brazil, donated after death due to running over to the Animal Morphology Research Laboratory (LaPMA of Universidade Federal Rural da Amazonia (UFRA. The arterial system was filled with contrasted latex and the animals were fixed in a formaldehyde solution (10%, and then dissected, in order to evidence the abdominal aorta and its collateral branches. The parietal branches consisted of 1 pair of caudal phrenic arteries, 2 pairs of intercostal arteries, and 3 pairs of lumbar arteries. Among the visceral branches, stood out: celiac artery; cranial mesenteric artery; adrenal arteries; renal arteries; caudal mesenteric artery; and external, internal, and median sacral iliac arteries, formed from the final portion of the abdominal aorta. Testicular and ovarian arteries originated from the renal arteries, differing from that described in various species.

  16. Angiograms of the Abdominal Aorta in a Patient of Middle Aortic Syndrome

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    Zhou Yafeng; Yang Xiangjun; Song Jianping; Jiang Tingbo; Li Xun; Hui Jie; Liu Zhihua; Jiang Wenping

    2007-01-01

    A 42-year old woman of middle aortic syndrome presented with severe hypertension for 20 years, whose abdominal aorta angiography revealed long segment and nearly complete occlusion in the mid portion of abdominal aorta, and extensively enlarged collateral vascular supply to the lower portion of abdominal aorta. The pressures proximal and distal to stenosis were 185/110 and 95/70 mmHg, and the pressure gradient across the stenosis was 90/40 mmHg. After the operation of thoraco-abdominal bypass graft, the pressure difference between the upper and lower extremities eventually disappeared.

  17. Screening for abdominal aortic aneurysms Rastreamento de aneurismas da aorta abdominal

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    Telmo Pedro Bonamigo

    2003-01-01

    Full Text Available OBJECTIVE AND METHODS: Screening for abdominal aortic aneurysms may be useful to decrease mortality related to rupture. We conducted a study to assess the prevalence of abdominal aortic aneurysms in southern Brazil and to define risk factors associated with high prevalence of this disorder. The screening was conducted using abdominal ultrasound. Three groups were studied: Group 1 - cardiology clinic patients; Group 2 - individuals with severe ischemic disease and previous coronary surgery, or important lesions on cardiac catheterism; Group 3 - individuals without cardiac disease selected from the general population. All individuals were male and older than 54 years of age. The ultrasonographic diagnosis of aneurysm was based on an anteroposterior abdominal aorta diameter of 3 cm, or on an abdominal aorta diameter 0.5 cm greater than that of the supra-renal aorta. RESULTS: A total of 2.281 people were screened for abdominal aortic aneurysms in all groups: Group 1 - 768 individuals, Group 2 - 501 individuals, and Group 3 - 1012 individuals. The prevalence of aneurysms was 4.3%, 6.8% and 1.7%, respectively. Age and cigarette smoking were significantly associated with increased prevalence of aneurysms, as was the diagnosis of peripheral artery disease. DISCUSSION: We concluded that screening may be an important tool to prevent the mortality associated with abdominal aortic aneurysms surgery. Additionally, the cost of screening can be decreased if only individuals presenting significant risk factors, such as coronary and peripheral artery disease, smokers and relatives of aneurysm patients, are examined.OBJETIVO E MÉTODOS: O rastreamento de aneurisma da aorta abdominal infra-renal é importante pois pode diminuir a mortalidade relacionada à ruptura. Realizamos um estudo para definir a prevalência desses aneurismas em diversos segmentos da população em nossa região do Brasil. O rastreamento foi realizado utilizando-se a ecografia de abdômen. Tr

  18. Ramos colaterais parietais e terminais da aorta abdominal em Myocastor coypus (nutria Terminal and parietal colateral branches of the abdominal aorta in Myocastor coypus (nutria

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    Paulete de Oliveira Vargas Culau

    2008-08-01

    Full Text Available Neste estudo, utilizaram-se 30 nutrias, 15 fêmeas e 15 machos, com o sistema arterial aórtico-abdominal preenchido com látex 603, pigmentado em vermelho, e fixado em uma solução aquosa de formaldeído a 20%. A aorta abdominal emitiu de sua superfície dorsal de 6 a 8 artérias lombares únicas. Das artérias renais, direita e esquerda, originaram-se as artérias frênico-abdominal para irrigar parte do diafragma e da parede abdominal lateral cranial. A aorta abdominal lançou dorsalmente, a artéria sacral mediana, cranialmente a sua bifurcação em artérias ilíacas comuns. As artérias ilíacas comuns, ramos terminais da aorta abdominal, originaram as artérias ilíacas interna e externa. A artéria ilíaca interna distribuiu-se nas vísceras da cavidade pélvica. A artéria ilíaca externa emitiu uma artéria umbilical e, antes de alcançar o anel femoral, lançou a artéria circunflexa ilíaca profunda para a parede abdominal lateral, em seus dois terços caudais. A artéria ilíaca externa lançou o tronco pudendo-epigástrico, que originou a artéria epigástrica caudal, para a parede abdominal ventral e a artéria pudenda externa, que saiu pelo canal inguinal, para irrigar a genitália externa. Os ramos parietais diretos da aorta abdominal foram as artérias lombares e a artéria sacral mediana, enquanto as artérias frênico-abdominal, circunflexa ilíaca profunda e epigástrica caudal, foram ramos colaterais parietais indiretos. Os ramos terminais da artéria aorta abdominal foram as artérias ilíacas comuns com seus ramos, as artérias ilíacas interna e externa.For this study it was used 30 nutria, 15 females and 15 males, with its abdominal aorta system full filled with latex 603, stained in red, and fixed in an aqueous solution of formaldehyde 20%. The abdominal aorta emitted from its dorsal surface 6 to 8 single lumbar arteries. From the renal arteries, left and right, it has been originated the phrenicoabdominal arteries

  19. Observer variation in vascular CT measurements of the abdominal aorta

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    England, Andrew [Department of Radiology, South Manchester University Hospitals NHS Trust, Southmoor Road, Manchester M23 9LT (United Kingdom); Department of Medical Imaging and Radiotherapy, University of Liverpool, Johnson Building, Quadrangle, Brownlow Hill, Liverpool L69 3GB (United Kingdom)], E-mail: a.england@liverpool.ac.uk; Butterfield, John S.; Ashleigh, Raymond J. [Department of Radiology, South Manchester University Hospitals NHS Trust, Southmoor Road, Manchester M23 9LT (United Kingdom)

    2008-11-15

    Aim: To assess the inter-observer variation between a radiographer and radiologist when performing CT measurement of the abdominal aorta before endovascular aortic aneurysm repair (EVAR). Methods: A total of 30 consecutive patients who were considered anatomically suitable for EVAR had aortic measurements performed independently by a vascular radioogist and then by a radiographer training vascular and CT imaging. All measurements were performed on a computer workstation using electronic callipers, each patient had 12 anatomical sites evaluated (eight diameters, four vessel lengths). Statistical analysis was performed by the computer package SPSS for Windows 11.01. Results: Of the 30 patients, mean difference in measurements between observers was 2.3 mm {+-} 1.2 mm and 6.0 mm {+-} 6.4 mm for diameter and vessel length measurements, respectively. Two hundred and seven (86%) diameter measurements were {<=}2 mm of each other and 233 (97%) were within {<=}5 mm. Eighty-two (57%) length measurements were within {<=}5 mm, and 100 (83%) within 10 mm or less. Widest variation existed for measurements of common iliac diameter and aortic neck length, where coefficients of variance were 38.2 (95% CI 35.7-41.0) and 40.0 (95% CI 36.2-44.6), respectively. Conclusion: A good level of agreement exists between a trained radiographer and radiologist when comparing vascular CT measurements of the aorta. It is technically feasible for a radiographer to perform these measurements, and improvements in variability may be achieved from a more standardised technique and automated vessel analysis software. Further research is required to establish the overall variability between different observer types when undertaking vascular CT measurements.

  20. Traumatic dissection and rupture of the abdominal aorta as a complication of the Heimlich maneuver.

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    Desai, Shaun C; Chute, Dennis J; Desai, Bharati C; Koloski, Eugene R

    2008-11-01

    Although the Heimlich maneuver is considered the best intervention for relieving acute upper airway obstruction, several complications have been reported in the literature. These complications can occur as a result of an increase in abdominal pressure leading to a variety of well-documented visceral injuries, including the great vessels. Acute abdominal aortic thrombosis after the Heimlich maneuver is a rare but recognized event; however, to date no case of traumatic dissection and rupture of the abdominal aorta has been described. We report the first known case, to our knowledge, of a traumatic dissection and rupture of the abdominal aorta after a forcefully applied Heimlich maneuver.

  1. Evaluation of the normal thoracic and abdominal aorta diameters by computerized tomography; Avaliacao dos diametros normais da aorta toracica e abdominal pela tomografia computadorizada

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    Lucarelli, Claudio Luiz

    1995-07-01

    The study was undertaken to evaluate, through computerized tomography, the diameters of the normal thoracic and abdominal aorta, as well as they are connected to gender, age and body surface area; and the ratio between measurements obtained at the ascending and descending limbs of the thoracic aorta, and between the abdominal aortic diameters. For that reason, we measured the widest anteroposterior diameters of the thoracic aortas at the levels of the arch, the root, the pulmonary artery, and the thoracic-abdominal transition, as well as the level of the emergence of the superior mesenteric artery, of the renal hila and just cephalad to the bifurcation of the abdominal aortas of 350 patients without cardiovascular diseases who had undergone computerized tomography of the thorax and/or abdomen for any other reasons. Observation and statistic analyses led us to conclude that: 1) both the thoracic and abdominal aortic diameters are reduced from their proximal to their distal portions; 2) the body surface influences the size of the aorta, although only extreme variations alter the vessel's caliber; 3) vessel diameter was observed to gradually increase with age; 4) men were found to have larger diameters than age matched women; 5) the ratio between the ascending and descending aortic diameters varies according to gender and age; 6) the relations between abdominal aortic diameters measured at the level of renal hila and cephalad to the bifurcation are independent from gender and age. But the relation between those measured at the level of the superior mesenteric artery and cephalad to the bifurcation are linked to gender, but not to age. (author)

  2. The value of anterior displacement of the abdominal aorta in diagnosing neuroblastoma in children.

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    Schiavon, Jose Luiz de Oliveira; Caran, Eliana Maria Monteiro; Odone Filho, Vicente; Lederman, Henrique Manoel

    2016-01-01

    To determine the value of anterior displacement of the abdominal aorta, when present at any level or only at the level of the adrenal gland, contralateral to the mass, in diagnosing neuroblastoma on computed tomography or magnetic resonance imaging in children up to 7 years of age. Imaging examinations of 66 patients were classified by consensus as for the presence of anterior aorta displacement and were compared with the pathology report. We found anterior abdominal aorta displacement in 26 (39.39%) of the 66 patients evaluated. Among those 26 patients, we identified neuroblastoma in 22 (84.62%), nephroblastoma in 3 (11.54%), and Burkitt lymphoma in 1 (3.85%). The positive predictive value was 84.62%, and the specificity was 88.24%. The displacement of the aorta was at the adrenal level, contralateral to the mass, in 14 cases, all of which were attributed to neuroblastoma. When the abdominal aorta is displaced at the level of the adrenal gland, contralateral to the mass, it can be said that the diagnosis is neuroblastoma, whereas abdominal aorta displacement occurring at other abdominal levels has a positive predictive value for neuroblastoma of approximately 85%.

  3. The value of anterior displacement of the abdominal aorta in diagnosing neuroblastoma in children*

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    Schiavon, Jose Luiz de Oliveira; Caran, Eliana Maria Monteiro; Odone Filho, Vicente; Lederman, Henrique Manoel

    2016-01-01

    Objective To determine the value of anterior displacement of the abdominal aorta, when present at any level or only at the level of the adrenal gland, contralateral to the mass, in diagnosing neuroblastoma on computed tomography or magnetic resonance imaging in children up to 7 years of age. Materials and Methods Imaging examinations of 66 patients were classified by consensus as for the presence of anterior aorta displacement and were compared with the pathology report. Results We found anterior abdominal aorta displacement in 26 (39.39%) of the 66 patients evaluated. Among those 26 patients, we identified neuroblastoma in 22 (84.62%), nephroblastoma in 3 (11.54%), and Burkitt lymphoma in 1 (3.85%). The positive predictive value was 84.62%, and the specificity was 88.24%. The displacement of the aorta was at the adrenal level, contralateral to the mass, in 14 cases, all of which were attributed to neuroblastoma. Conclusion When the abdominal aorta is displaced at the level of the adrenal gland, contralateral to the mass, it can be said that the diagnosis is neuroblastoma, whereas abdominal aorta displacement occurring at other abdominal levels has a positive predictive value for neuroblastoma of approximately 85%. PMID:28100931

  4. The value of anterior displacement of the abdominal aorta in diagnosing neuroblastoma in children

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    Jose Luiz de Oliveira Schiavon

    Full Text Available Abstract Objective: To determine the value of anterior displacement of the abdominal aorta, when present at any level or only at the level of the adrenal gland, contralateral to the mass, in diagnosing neuroblastoma on computed tomography or magnetic resonance imaging in children up to 7 years of age. Materials and Methods: Imaging examinations of 66 patients were classified by consensus as for the presence of anterior aorta displacement and were compared with the pathology report. Results: We found anterior abdominal aorta displacement in 26 (39.39% of the 66 patients evaluated. Among those 26 patients, we identified neuroblastoma in 22 (84.62%, nephroblastoma in 3 (11.54%, and Burkitt lymphoma in 1 (3.85%. The positive predictive value was 84.62%, and the specificity was 88.24%. The displacement of the aorta was at the adrenal level, contralateral to the mass, in 14 cases, all of which were attributed to neuroblastoma. Conclusion: When the abdominal aorta is displaced at the level of the adrenal gland, contralateral to the mass, it can be said that the diagnosis is neuroblastoma, whereas abdominal aorta displacement occurring at other abdominal levels has a positive predictive value for neuroblastoma of approximately 85%.

  5. The value of anterior displacement of the abdominal aorta in diagnosing neuroblastoma in children

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    Schiavon, Jose Luiz de Oliveira; Caran, Eliana Maria Monteiro; Lederman, Henrique Manoel, E-mail: schiavon00@gmail.com [Universidade Federal de Sao Paulo (EPM/UNIFESP), Sao Paulo, SP (Brazil). Escola Paulista de Medicina; Odone Filho, Vicente [Universidade de Sao Paulo (FM/USP), Sao Paulo, SP (Brazil). Faculdade de Medicina

    2016-11-15

    Objective: To determine the value of anterior displacement of the abdominal aorta, when present at any level or only at the level of the adrenal gland, contralateral to the mass, in diagnosing neuroblastoma on computed tomography or magnetic resonance imaging in children up to 7 years of age. Materials and Methods: Imaging examinations of 66 patients were classified by consensus as for the presence of anterior aorta displacement and were compared with the pathology report. Results: We found anterior abdominal aorta displacement in 26 (39.39%) of the 66 patients evaluated. Among those 26 patients, we identified neuroblastoma in 22 (84.62%), nephroblastoma in 3 (11.54%), and Burkitt lymphoma in 1 (3.85%). The positive predictive value was 84.62%, and the specificity was 88.24%. The displacement of the aorta was at the adrenal level, contralateral to the mass, in 14 cases, all of which were attributed to neuroblastoma. Conclusion: When the abdominal aorta is displaced at the level of the adrenal gland, contralateral to the mass, it can be said that the diagnosis is neuroblastoma, whereas abdominal aorta displacement occurring at other abdominal levels has a positive predictive value for neuroblastoma of approximately 85%. (author)

  6. Overexpression of Vascular Endothelial Growth Factor in Restenotic Abdominal Aorta of Rabbits

    Institute of Scientific and Technical Information of China (English)

    尹瑞兴; 杨德寨; 吴海; 黄凯; 巫相宏; 陈宇明

    2002-01-01

    Objective To investigatethe expression of vascular endothelial growth factor (VEGF) in the wall of normal and restenotic abdominal aorta of rabbits. Methods Restenotic model was developed by balloon-injured abdominal aorta in eight male New Zealand White rabbits fed with a 2.0% cholesterol diet beginning two weeks before operation and continuing four weeks after procedure. At the end of 4 weeks after injury, the animals underwent total body perfusion fixation. Then, the abdominal aorta from iliac artery root to the diaphragm was harvested and post-fixed in 10 % neutral formalin for 16hours. Eight male animals fed with general diet were used for a normal control. The VEGF protein level in normal and restenotic abdominal aorta of rabbits was studied by means of immunohistochemistry. Results VEGF protein was detected in 5 (62.5 % ) of 8normal abdominal aorta, 3 showed faint staining, and the remaining 2 showed moderate VEGF expression.VEGF expression at the protein level was identified in all 8 restenotic specimens, 2 showed faint staining, 4showed moderate staining, and the remaining 2showed strong VEGF expression. In contrast to normal vessels, VEGF in restenotic specimens was distinctly expressed at sites that contained clustered macrophages and proliferating smooth muscle cells as well as endothelial cells. VEGF immunostaining was more extensive in restenotic specimens (2. 00 ± 0.76)than in normal vessels (0.82 ±0. 83, P < 0.01) .Microvessels were found in 7 of the 8 restenotic lesions, but only one lesion showed VEGF staining in endothelial cells of the microvessels. Conclusion VEGF expression is consistently more intense in sections of restenotic abdominal aorta than in those of normal abdominal aorta. The VEGF expressed by the smooth muscle cells and foamy macrophages in the restenotic arteries may act as a local and endogenous regulator of endothelial cell functions, including maintenance and repair of luminal endothelium, and formation of intimal

  7. Tuberculous aneurysm of the abdominal aorta: endovascular repair using stent grafts in two cases

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    Liu, Wei Chiang; Kwak, Byung Kook; Kim, Kyo Nam [Sung Ae General Hospital, Seoul (Korea, Republic of); And Others

    2000-12-01

    Tuberculous aneurysm of the aorta is exceedingly rare. To date, the standard therapy for mycotic aneurysm of the abdominal aorta has been surgery involving in-situ graft placement or extra-anatomic bypass surgery followed by effective anti-tuberculous medication. Only recently has the use of a stent graft in the treatment of tuberculous aortic aneurysm been described in the literature. We report two cases in which a tuberculous aneurysm of the abdominal aorta was successfully repaired using endovascular stent grafts. One case involved is a 42-year-old woman with a large suprarenal abdominal aortic aneurysm and a right psoas abscess, and the other, a 41-year-old man in whom an abdominal aortic aneurysm ruptured during surgical drainage of a psoas abscess. (author)

  8. The relationship between wall shear stress distributions and intimal thickening in the human abdominal aorta

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    Butany Jagdish

    2003-11-01

    Full Text Available Abstract Purpose The goal of this work was to determine wall shear stress (WSS patterns in the human abdominal aorta and to compare these patterns to measurements of intimal thickness (IT from autopsy samples. Methods The WSS was experimentally measured using the laser photochromic dye tracer technique in an anatomically faithful in vitro model based on CT scans of the abdominal aorta in a healthy 35-year-old subject. IT was quantified as a function of circumferential and axial position using light microscopy in ten human autopsy specimens. Results The histomorphometric analysis suggests that IT increases with age and that the distribution of intimal thickening changes with age. The lowest WSS in the flow model was found on the posterior wall inferior to the inferior mesenteric artery, and coincided with the region of most prominent IT in the autopsy samples. Local geometrical features in the flow model, such as the expansion at the inferior mesenteric artery (common in younger individuals, strongly influenced WSS patterns. The WSS was found to correlate negatively with IT (r2 = 0.3099; P = 0.0047. Conclusion Low WSS in the abdominal aorta is co-localized with IT and may be related to atherogenesis. Also, rates of IT in the abdominal aorta are possibly influenced by age-related geometrical changes.

  9. Calcification detection of abdominal aorta in CT images and 3D visualization in VR devices.

    Science.gov (United States)

    Garcia-Berna, Jose A; Sanchez-Gomez, Juan M; Hermanns, Judith; Garcia-Mateos, Gines; Fernandez-Aleman, Jose L

    2016-08-01

    Automatic calcification detection in abdominal aorta consists of a set of computer vision techniques to quantify the amount of calcium that is found around this artery. Knowing that information, it is possible to perform statistical studies that relate vascular diseases with the presence of calcium in these structures. To facilitate the detection in CT images, a contrast is usually injected into the circulatory system of the patients to distinguish the aorta from other body tissues and organs. This contrast increases the absorption of X-rays by human blood, making it easier the measurement of calcifications. Based on this idea, a new system capable of detecting and tracking the aorta artery has been developed with an estimation of the calcium found surrounding the aorta. Besides, the system is complemented with a 3D visualization mode of the image set which is designed for the new generation of immersive VR devices.

  10. A mycotic aneurysm of the abdominal aorta in a child

    NARCIS (Netherlands)

    W. Suijker (W.); J.H.L.J. Bergmeijer (Jan Hein); J.J. Hamming (J.); J.C. Molenaar

    1991-01-01

    textabstractA 6-year-old boy with a previous history of intracardiac correction of a partial atrioventricular canal defect presented with infective endocarditis. Despite antibiotic therapy and reoperation, he developed a mycotic abdominal aneurysm. In situ aortoiliac reconstruction with a prosthesis

  11. Ultra-sonografia da aorta abdominal e de seus ramos em cães Ultrasonography of abdominal aorta and its branches in dogs

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    Lilian Kamikawa

    2007-04-01

    Full Text Available O ultra-som bidimensional e o ultra-som Doppler foram utilizados para avaliar a biometria e a hemodinâmica da aorta abdominal e artérias ilíacas externas de 131cães clinicamente normais. Os resultados da avaliação biométrica da aorta abdominal indicaram um diâmetro médio de 0,80cm para o seu segmento diafragmático (AOD; 0,74cm para o seu segmento caudal às artérias renais (AOR e 0,69cm para o segmento cranial à sua bifurcação (AOT. A artéria ilíaca externa direita (AIED apresentou o diâmetro médio de 0,42cm e a artéria ilíaca externa esquerda (AIEE o diâmetro médio de 0,39. O estudo hemodinâmico da aorta abdominal apresentou velocidade de pico sistólico médio de 104,00cm/s para AOR; 99,61cm/s para AOT; 85,47cm/s para AIED e 99,51cm/s para AIEE. Verificaram-se correlações de diferentes intensidades entre os diâmetros vasculares em diferentes pontos de tomadas e os fatores biométricos corpóreos (CRL. Correlações baixas foram observadas quando esses diâmetros foram confrontados com a idade.A duplex ultrasound system incorporating a pulsed wave Doppler ultrasound probe with conventional B-mode real-time imaging was used to evaluate the biometric and the hemodynamic of abdominal aorta and external iliac arteries of a hundred and thirty one normal dogs. Results of biometrics of abdominal aorta, presented a mean diameter of 0.80cm in its diaphragmatic segment (AOD; 0.74cm in its segment caudal to the renal arteries (AOR and 0.69cm in the segment cranial to its termination (AOT. The right-external-iliac artery (AIED presented a mean diameter of 0.42cm and the left-external iliac artery (AIEE a mean diameter of 0.39cm. The hemodynamic study of the abdominal aorta presented a medium systolic peak velocity to AOR of 104cm per sec.; to AOT of 99.61cm per sec.; to AIED of 85.47cm per sec. and to AIEE of 99.51cm per sec. Correlations of different intensities between the vascular diameters have been verified between the

  12. Mega aorta syndrome: a case of thoracic and abdominal aortic aneurysm.

    Science.gov (United States)

    Wu, William C; Mitchell, Christopher A; Linklater, Derek

    2010-07-01

    An 83-year-old woman presented to the emergency department (ED) via emergency medical services with the chief complaint of "strokelike symptoms." Physical examination revealed altered mental status, tachycardia, hypotension, and a large nonpulsatile periumbilical mass. Bedside ultrasound revealed a 9-cm abdominal aortic aneurysm with absent central flow. Computed tomography scan demonstrated diffuse thoracic and abdominal aortic dilation with rupture into the mediastinum along with left hemothorax. Repeat beside ultrasound demonstrated abdominal aortic aneurysm rupture not seen on the computed tomography scan. Despite aggressive resuscitation, the patient developed bradycardia, which devolved into pulseless electric activity cardiac arrest. She was unable to be resuscitated. The patient's diffuse aneurysmal dilation places her into the small category of patients with a disease entity known as mega aorta syndrome (MAS). Mega aorta syndrome is defined as aneurysmal dilation of the aorta to greater than 6 cm in diameter. Although not in our case, most cases of MAS are symptomatic before catastrophic presentation. The disease progression for these patients is slow and occurs over years. When this disease is recognized early, a surgery known as the elephant trunk procedure can be performed. This operation replaces the entire aorta in multiple stages. This gives the emergency physician a critical role in the diagnosis and outcome of these patients because they may come through the ED for an unrelated complaint early in the disease process. This case report illustrates an advanced case of MAS.

  13. Anestesia para intervenção cirúrgica endovascular na aorta abdominal Anestesia para intervención quirúrgica endovascular en la aorta abdominal Anesthesia for endovascular surgery of the abdominal aorta

    Directory of Open Access Journals (Sweden)

    Michelle Nacur Lorentz

    2008-10-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: O procedimento endovascular para correção de aneurisma de aorta é menos invasivo que o convencional, além de apresentar outras vantagens, como ausência de incisão abdominal, ausência de pinçamento da aorta e menor tempo de recuperação pós-operatória. Por se tratar de procedimento cirúrgico relativamente novo e apresentar uma série de alterações que devem ser conhecidas pelo anestesiologista foi realizado este trabalho com o objetivo de revisar os aspectos mais relevantes do procedimento endovascular e possibilitar manuseio anestésico mais adequado no perioperatório. CONTEÚDO: Apresentação sucinta da técnica cirúrgica para reparo de aneurismas via endovascular, as possíveis vantagens e desvantagens do procedimento, bem como as complicações potenciais. Além disso, foram abordados os cuidados perioperatórios que o procedimento exige e as técnicas anestésicas que podem ser utilizadas. CONCLUSÕES: O conhecimento das alterações provenientes do procedimento endovascular possibilita conduta anestésica mais adequada e melhora dos resultados perioperatórios nesses pacientes.JUSTIFICATIVA Y OBJETIVOS: El procedimiento endovascular para la corrección del aneurisma de aorta es menos invasivo que el convencional, además de presentar otras ventajas como la ausencia de incisión abdominal, ausencia de pinzamiento de la aorta y un menor tiempo de recuperación postoperatoria. Por tratarse de un procedimiento quirúrgico relativamente nuevo y por presentar una serie de alteraciones que deben ser conocidas por el anestesiólogo, se realizó este trabajo con el objetivo de revisar los aspectos más relevantes del procedimiento endovascular y posibilitar el manejo anestésico más adecuado en el perioperatorio. CONTENIDO: Sencilla presentación de la técnica quirúrgica para la cura de aneurismas vía endovascular, las posibles ventajas y desventajas del procedimiento, como también las complicaciones

  14. Thrombosis of abdominal aorta during cisplatin-based chemotherapy of testicular seminoma - a case report

    Directory of Open Access Journals (Sweden)

    Gehrckens Ralf

    2009-12-01

    Full Text Available Abstract Background Vascular complications occurring during cisplatin-based chemotherapy of germ cell tumours are inadequately recognized to date. Case Presentation A 49 year old man with advanced seminoma underwent two courses of chemotherapy according to the PEB regimen. Upon restaging, two thrombotic deposits were noted in the descending part of the thoracic aorta and in the infrarenal abdominal aorta, respectively. Although thrombotic plaques caused aortic occlusion of about 30%, no clinical signs of malperfusion of limbs were registered. The patient was placed on anticoagulant therapy. Six months after completion of chemotherapy, thrombotic deposits had completely resolved. In the absence of other predisposing factors, it must be assumed that cisplatin-based chemotherapy represented a strong stimulus for arterial thrombosis in the aorta. Conclusions This is the first case of endo-aortic thrombosis during chemotherapy for testicular germ cell cancer. Providers of chemotherapy must be aware of arterial thrombosis even in young patients with testicular cancer.

  15. Aneurisma de aorta abdominal na infância

    Directory of Open Access Journals (Sweden)

    Abdo Farret Neto

    Full Text Available The authors report a case of an abdominal aortic aneurism involving all visceral branches minus the Inferior Mesenteric artery in a 4-year-old girl. There was sugestive evidence that the arterial disease had an inflamatory or infectious etiologic factor. The most probable etiological factors could be salmonelas infection of the arterial wall or Takayasu's disease secondary to tuberculosis. The treatment with antibiotic to salmonelas infection during ten days, followed by tuberculostatic therapy for six months was chosen. Concerning the age, the arteries involved and the inflamatory aspect of the aneurysm, the surgical option became an alternative to the clinic treatment in case of any future evidence of the aneurysm enlargement. The patient became asymptomatic as soon as the antibiotic has been started. The control of the aneurysm evolution will be made by ecography each three months.

  16. Thymoquinone protects end organs from abdominal aorta ischemia/reperfusion injury in a rat model

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    Mehmet Salih Aydin

    2015-02-01

    Full Text Available Introduction: Previous studies have demonstrated that thymoquinone has protective effects against ischemia reperfusion injury to various organs like lungs, kidneys and liver in different experimental models. Objective: We aimed to determine whether thymoquinone has favorable effects on lung, renal, heart tissues and oxidative stress in abdominal aorta ischemia-reperfusion injury. Methods: Thirty rats were divided into three groups as sham (n=10, control (n=10 and thymoquinone (TQ treatment group (n=10. Control and TQ-treatment groups underwent abdominal aorta ischemia for 45 minutes followed by a 120-min period of reperfusion. In the TQ-treatment group, thymoquinone was given 5 minutes. before reperfusion at a dose of 20 mg/kg via an intraperitoneal route. Total antioxidant capacity, total oxidative status (TOS, and oxidative stress index (OSI in blood serum were measured and lung, kidney, and heart tissue histopathology were evaluated with light microscopy. Results: Total oxidative status and oxidative stress index activity in blood samples were statistically higher in the control group compared to the sham and TQ-treatment groups (P<0.001 for TOS and OSI. Control group injury scores were statistically higher compared to sham and TQ-treatment groups (P<0.001 for all comparisons. Conclusion: Thymoquinone administered intraperitoneally was effective in reducing oxidative stress and histopathologic injury in an acute abdominal aorta ischemia-reperfusion rat model.

  17. Clinical analysis of abdominal aorta block in operation of gynecologic tumor

    Institute of Scientific and Technical Information of China (English)

    MU Yu-lan; TANG Chun-sheng; WEN Ze-qing; YIN Fu-bo; LIU Ming

    2006-01-01

    Objective:To evaluate the clinical effects of the abdominal aorta block in controlling haemorrhage during operations of the gynecologic tumor. Methods: From July 1965 to January 2005, we collected patients (n= 49) of gynecologic tumor complicated with haemorrhage during operations, who were divided into 3 groups: preventive blocking group (PG, n= 12), treatment blocking group (TG, n= 20) used abdominal aorta block technique with sterilized cotton band and silica gel tube, and control group (CG, n=17) which were used the regular haemostatic methods, such as ligature, suture and ribbon gauze packing.During operations, the vital signs including the amount of bleeding and transfusion were measured. Results: Compared with the CG, the amount of bleeding and transfusion in the PG and TG decreased significantly (P<0.01). After using the technique, 32 cases of haemorrhage were controlled completely. All patients finished operation smoothly in the end and the vital signs were stable. The vision field of operation was clear and the operating time was shortened dramatically (3.0 h vs 5.7 h and 3.8 h vs 5.7 h, P<0.01). No complications caused by the block occurred in the post-operation. Conclusion: Lower abdominal aorta block is safe and effective in controlling haemorrhage during operations of the gynecologic tumor.

  18. Endotension: rupture of abdominal aortic aneurysm Endotensão: ruptura de aneurisma de aorta abdominal

    Directory of Open Access Journals (Sweden)

    Alexandre Campos Moraes Amato

    2012-06-01

    Full Text Available Aortic endovascular exclusion technique called 'chimney' consists of placing stents through abdominal aortic visceral branches and a prosthesis that excludes the thoraco-abdominal aneurysm. Stents and an aortic endoprosthesis are placed in the renal arteries. This method is primarily used when open surgery is too risky. The mechanism that provides aneurysm sac increase without the visible presence of endoleaks has not been fully elucidated. The expansion of the aneurysm sac, due to endotension, is difficult to diagnose, even with the use of advanced imaging tests. Its diagnosis is made by exclusion. We present a case of a late complication in a high-risk patient after a 'chimney' endovascular procedure. Following the surgery, the patient presented a ruptured aneurysm sac without a visible endoleak. A second intervention was not feasible due to the high risk of occluding all of the branches, and complicated by previous 'chimney'. Endotension is a possible cause of aneurysm rupture and death.A técnica de exclusão endovascular conhecida como 'chaminé' consiste na colocação de stent em ramos viscerais e de endoprótese excluindo o aneurisma toracoabdominal. São colocados stents revestidos nas artérias renais e uma endoprótese aórtica, que o método utilizado quando a cirurgia aberta tem risco muito alto. O mecanismo que causa a expansão aneurismática sem a presença detectável de vazamento pelos métodos de imagem não está completamente esclarecido. A expansão do saco aneurismático por endotensão é de difícil diagnóstico, mesmo com o uso de técnicas de imagem avançadas, como tomografia computadorizada e eco-Doppler, sendo o diagnóstico por exclusão. Apresenta-se um caso de complicação tardia após o tratamento endovascular pela técnica da 'chaminé'. Após a cirurgia, o paciente apresentou ruptura sem endoleak visível. Outro procedimento endovascular foi impossibilitado pela técnica da 'chaminé', que dificulta novos

  19. A case of Behcet's disease with aneurysms of common carotid arteries and abdominal aorta

    Energy Technology Data Exchange (ETDEWEB)

    Choo, Yeon Myung; Chang, Kee Hyun; Choi, Sung Jae [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    1984-06-15

    One case of Behcet's disease with multiple aneurysms in both common carotid arteries and abdominal aorta is presented with brief review of the literatures. A 26-year-old woman had slowly enlarging pulsatile masses in both sides of neck and recurrent ulcerations in oral cavity and genitalia. One day prior to admission, aphasia, right facial nerve palsy and right hemiplegia suddenly developed. Brain CT showed acute infarction in left basal ganglia. Both Carotid Angiography and abdominal Aortography demonstrated multiple aneurysms in both common carotid arteries and abdominal aorta with organizing thrombi and thromboembolism of internal carotid artery.

  20. [Curriculum vitae aortae].

    Science.gov (United States)

    Solberg, S

    1998-12-10

    The Greek word aorta means lifter. The vessel was so termed because Aristotle, who first described it, assumed that the heart was lifted by/hanging in aorta. Leonardo da Vinci described the detailed anatomy of aorta. During the 17th century our present understanding of the aorta and the circulation of blood took form due to the descriptions given by William Harvey. The first known operation for abdominal aortic aneurysm was performed in London in 1817 by Sir Astley Cooper who ligated the infrarenal aorta above the aneurysm. Puncture with needles and application of electricity were later tried in order to induce thromboses in the aneurysm. In 1948 Albert Einstein was operated with wrapping of his abdominal aneurysm with cellophane. In 1955 he suffered rupture and died after having refused operation. In 1951 the first successful operation for abdominal aortic aneurysm was performed in Paris by Charles Dubost. With slight modifications, the same operative technique is used today.

  1. Non-visualized aorta in abdominal aortic aneurysm screening: Screening outcomes and the influence of subject and programme characteristics.

    Science.gov (United States)

    Bennett, Damien; Stewart, Diane; Kearns, Deirdre; Mairs, Adrian; Ellis, Peter

    2017-01-01

    Objectives To compare abdominal aortic aneurysm screening outcomes of men with non-visualized aorta at original scan with subsequent scans and to determine predictors of non-visualized aorta. Methods In the Northern Ireland Abdominal Aortic Aneurysm screening programme, outcomes (discharge, annual surveillance, three-monthly surveillance, or vascular referral) and patient and programme characteristics (age, deprivation quintile, family history, technician experience, and screening location) for men with non-visualized aorta were investigated at original scan, and first and second rescans. Results Non-visualized aorta proportions were 2.9, 11.4, and 4.7% at original, first, and second rescan, respectively. There were no differences in screening outcomes between scanning stages (98.4, 97.6, and 97.4% abdominal aortic aneurysm in men with non-visualized aorta on first or subsequent rescans is no more than for those with visualized aorta on original scanning. Men from deprived areas are much more likely to have non-visualized aorta at original scan.

  2. PET/CT imaging of abdominal aorta with intramural hematomas, penetrating ulcer, and saccular pseudoaneurysm.

    Science.gov (United States)

    Nguyen, Vien X; Nguyen, Ba D

    2014-05-01

    Acute aortic syndromes, encompassing intramural hematoma, penetrating ulcer, and pseudoaneurysm, are best demonstrated by angiographic CT and magnetic resonance imaging. These imaging modalities provide an accurate evaluation and allow timely therapies of these frequently symptomatic lesions, thus reducing their morbidity and mortality. The inflammatory pathogenesis of these acute aortic syndromes may exhibit positive PET findings predictive of prognosis and outcomes of these vascular events. The authors present a case of PET/CT imaging showing asymptomatic intramural hematomas with penetrating ulcer and saccular pseudoaneurysm of the proximal abdominal aorta.

  3. Rotura de aneurisma de aorta abdominal: su importancia como diagnostico diferencial en abdomen agudo

    Directory of Open Access Journals (Sweden)

    Vanessa Orellana-Villazón

    2008-01-01

    Full Text Available El aneurisma aórtico abdominal (AAA roto es una forma de presentación poco frecuente de los AAA. Presentamos un caso de rotura de aneurisma de aorta abdominal (AAAr de un paciente varón de 76 años de edad que ingresa al servicio de emergencias del Hospital Elizabeth Setón por presentar dolor abdominal punzante en región lumbar derecha de inicio súbito e intensidad creciente, llegando a perder el conocimiento. La impresión diagnóstica inicial incluye cólico ureteral e hipertensión arterial; sin embargo después realizar una ecografía abdominal y posteriormente una tomografía abdominal se concluye con el diagnostico de AAAr. El paciente es sometido a cirugía de emergencia, y después de permanecer tres días en terapia intensiva y tres días en sala, es dado de alta. Consideramos importante informar este caso clínico por la frecuencia con que se le confunde con patologías renales o abdomen agudo, pese a la sintomatología característica que presenta, que en muchos casos lleva a un diagnostico retrasado y posteriormente a la muerte.

  4. ROTURA DE ANEURISMA DE AORTA ABDOMINAL: SU IMPORTANCIA COMO DIAGNOSTICO DIFERENCIAL EN ABDOMEN AGUDO

    Directory of Open Access Journals (Sweden)

    Vanessa Orellana-Villazón

    2012-02-01

    Full Text Available El aneurisma aórtico abdominal (AAA roto es una forma de presentación poco frecuente de los AAA. Presentamos un caso de rotura de aneurisma de aorta abdominal (AAAr de un paciente varón de 76 años de edad que ingresa al servicio de emergencias del Hospital Elizabeth Setón por presentar dolor abdominal punzante en región lumbar derecha de inicio súbito e intensidad creciente, llegando a perder el conocimiento. La impresión diagnóstica inicial incluye cólico ureteral e hipertensión arterial; sin embargo después realizar una ecografía abdominal y posteriormente una tomografía abdominal se concluye con el diagnostico de AAAr. El paciente es sometido a cirugía de emergencia, y después de permanecer tres días en terapia intensiva y tres días en sala, es dado de alta. Consideramos importante informar este caso clínico por la frecuencia con que se le confunde con patologías renales o abdomen agudo, pese a la sintomatología característica que presenta, que en muchos casos lleva a un diagnostico retrasado y posteriormente a la muerte.

  5. Oclusión de la aorta abdominal infrarrenal. Reconstrucción endovascular con stent

    Directory of Open Access Journals (Sweden)

    Carlos Fernández-Pereira

    2008-01-01

    Full Text Available Introducción La oclusión total de la aorta abdominal es de presentación poco frecuente y afecta más a menudo a mujeres de edad mediana con antecedentes de tabaquismo y dislipidemia. El punto de partida de la terapéutica endovascular en la aorta fue la angioplastia en las arterias ilíacas y fue progresando desde el balón hasta la colocación de stents.ObjetivoComunicar nuestros resultados inmediatos y el seguimiento a mediano plazo de pacientes con oclusión de la aorta abdominal tratadas con stents por vía endovascular.Material y métodosDesde octubre de 1998 a mayo de 2005 en nuestro servicio se trataron 5 pacientes de sexo femenino por oclusión total de la aorta abdominal, con síntomas de claudicación grave de ambos miembros inferiores. Los procedimientos se realizaron con anestesia local y sedación. Por vía femoral, se intenta recanalizar con las cuerdas de Whooley o hidrófila Glidewire. Posteriormente se realiza un angiograma abdominal e intercambio por cuerda Amplatz con la cual se avanza el balón para realizar las dilataciones antes de implantar el stent. Las pacientes con lesiones ilíacas también se trataron con stent. El índice tobillo-brazo era de 0,71. El promedio de hospitalización fue de 2 días. Al alta se indicaron clopidogrel y aspirina como medicación antiplaquetaria, excepto la primera paciente (ticlopidina y aspirina. El seguimiento fue clínico y por ecografía Doppler color a la semana, al mes, a los 6 meses y a los 12 meses.ResultadosLas pacientes eran de sexo femenino, con antecedentes de tabaquismo y dislipidemia. Todos los procedimientos fueron técnicamente exitosos, con mejoría del índice tobillo-brazo a 0,98. Una paciente presentó un hematoma inguinal en el sitio de punción, con buena evolución posterior. En el seguimiento alejado clínico y por ultrasonido se observó una permeabilidad de la aorta del 100%, con estenosis en una paciente tratada a nivel de la arteria ilíaca en el segmento no

  6. Calcified aneurysm of the abdominal aorta 12 years after umbilical artery catheterization

    Energy Technology Data Exchange (ETDEWEB)

    Blondiaux, Eleonore; Miquel, Julie [Rouen University Hospital Charles Nicolle, Department of Radiology, Rouen (France); Thomas, Pascale; Watelet, Jacques [Rouen University Hospital Charles Nicolle, Department of Vascular Surgery, Rouen (France); Laloum, Denis [Caen University Hospital, Pediatric Intensive Care Unit, Department of Neonatal Medicine, Caen (France); Dacher, Jean-Nicolas [Rouen University Hospital Charles Nicolle, Department of Radiology, Rouen (France); UFR Medecine et Pharmacie, Laboratoire Quant-If, Rouen Cedex 01 (France)

    2008-02-15

    We report a 12-year-old boy who presented with abdominal pain and who was found to have an aneurysm of the abdominal aorta (AAA). The patient was born from a quadruplet pregnancy induced by in vitro fertilization. Postnatal transient respiratory distress required assisted ventilation that had been monitored by two consecutive umbilical arterial catheters (UAC). AAA is a rare condition in childhood. Infection and/or trauma are known to be the most frequent causes. Most of the reported cases have occurred in children in whom a UAC had been placed during the neonatal period. In this patient the delay between UAC placement and diagnosis was considerable. At the time of this report the patient had remained well during a follow-up of 8 years after treatment. (orig.)

  7. Hybrid treatment of bullet embolism at the abdominal aortic bifurcation, complicated with thoracoabdominal aorta pseudoaneurysm and common iliac artery occlusion: case report

    Directory of Open Access Journals (Sweden)

    Patrick Bastos Metzger

    2014-03-01

    Full Text Available Embolization due to a firearm projectile entering the bloodstream is a rare event that is unlikely to be suspected during initial treatment of trauma patients. We describe and discuss a case of bullet embolism of the abdominal aortic bifurcation, complicated by a pseudoaneurysm of the thoracoabdominal aorta and occlusion of the right common iliac artery, but successfully treated using a combination of endovascular methods and conventional surgery.

  8. Thrombosis of abdominal aorta in congenital afibrinogenemia: case report and review of literature.

    Science.gov (United States)

    Sartori, M T; Teresa, S M; Milan, M; Marta, M; de Bon, E; Emiliano, D B; Fadin, M; Mariangela, F; Pesavento, R; Raffaele, P; Zanon, E; Ezio, Z

    2015-01-01

    Thrombotic events in congenital hypo-afibrinogenemia have been rarely reported, either in association or not with replacement therapy or thrombotic risk factors. We describe clinical findings and management of thrombosis of abdominal aorta with peripheral embolism in a patient with congenital afibrinogenemia. A review of arterial thrombosis in inherited hypo-afibrinogenemia was also performed. The patient with a severe bleeding history requiring prophylaxis with fibrinogen concentrates (FC) was admitted for ischaemia of the 4th right toe. An angio-CT of abdominal aorta showed a thrombosis from the origin of renal arteries to the carrefour with a distal floating part. No thrombotic risk factors were found; a previous traumatic lesion of aortic wall might have triggered the thrombus formation, whereas the role of FC prophylaxis remains uncertain. The patient was successfully treated with FC, enoxaparin followed by fondaparinux, and low-dose aspirin without bleeding or thrombosis recurrence. After 2 years, aortic thrombus was almost completely recovered. Sixteen hypo/afibrinogenemia patients with arterial thrombosis were found in Literature, showing that thrombosis often occurs at a young age, involves large vessels, its recurrence is not unusual, and therapeutic strategy is not defined yet. Our therapeutic approach was effective and also safe, but further studies are needed to improve the knowledge of pathogenesis and the anti-thrombotic management in this peculiar setting.

  9. A practical MRI technique for detecting Abdominal Aorta Aneurism and Peripheral Arterial Disease

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    Aykut Aktas

    2014-12-01

    Full Text Available Aim: Peripheral Arterial Disease(PAD and abdominal aorta aneurysm(AAA are frequent problems in geriatric population. In DSA, CTA or MRA techniques contrast agents has to be used for diagnosis that can be nephrotoxic for elderly patients. Magnetic resonans imaging (MRI is the most powerful, non-ionising radiological diagnostic tool that has the highest soft tissue contrast resolution. The aim of our study was to investigate the effectivity of MRI by the means of detecting the AAA and PAD in comparison with DSA. Material and Method: After getting ethical commitee approvel and informed consent, we have performed Balanced turbo field echo(B-TFE MRI technique without contrast agent in 1.5 Tesla MRI device before DSA examination. The luminal diameters of renal arteries, infrarenal abdominal aorta, iliac and femoral arteries was measured by using Philips DICOM Viewer R2.2 application. The intraclass corelation coefficient and reliability used to check if the techniques could be used for each other and the t-test was used to measure the differences between them. Results: There has been a high relationship between B-TFE and DSA in detecting the pathologies of larger arteries like aorta. In the case of small arterial pathologies, there is relatively lower relationship between BTFE and DSA. Discussion: For the diagnosis of AAA and PAD, DSA is the gold standart technique but it is invasive and patients have radiation exposure. In the follow up of geriatric patients with larger arterial pathologies B-TFE can be used instead of contrast enhanced MRA and invasive DSA.

  10. In vitro contractility of normal and aneurysmal abdominal aorta muscle coat sections in human and animal material.

    Science.gov (United States)

    Gnus, Jan; Czerski, Albert; Zawadzki, Wojciech; Witkiewicz, Wojciech; Hauzer, Willy; Rusiecka, Agnieszka; Ferenc, Stanisław

    2012-01-01

    The objective of the study was to demonstrate spontaneous contractile activity of the smooth muscle coat of the aorta in human and animal material. Spontaneous contractility of smooth muscle tissue, or tonus, is essential for the proper function of many internal organs as observed in the many types of muscle cells which make up the internal structures. The spontaneous contractile activity of the muscle tissue in blood vessels is particularly marked in resistance vessels, regulating circulation within organs or tissues. It can also be observed in large blood vessels such as arteries and veins. The contractile activity of muscular tissue isolated from arteries is the result of a number of factors, including endogenous paracrine substances, neurotransmitters released at postganglionic endings (mostly within the sympathetic system), cells capable of spontaneously generation of functional potentials (pacemaking cells) and the vascular endothelium. Pacemaking cells present in the aortic wall are an important factor in the development of the spontaneous contractility of the muscular coat of the aorta. They are capable of generating functional potentials, resulting in the constant tonus of the smooth muscular coat (comprising the aortic wall) due to tonic contraction. In vitro studies were carried out on abdominal aortic sections collected from 30 New Zealand rabbits with a body mass of 3-4 kilograms each and also on aneurysmal abdominal aortic sections collected during elective aneurysm repair procedures in humans (10 abdominal aortic sections). The 1.5 cm-long sections were mounted in chambers of an automated water bath. The sections were oriented in a transverse and longitudal fashion in order to compare contractility. The incubation medium consisted of Krebs-Henseleit buffer. Spontaneous contractile activity was observed during the study, characterized by rhythmic contractions of the muscular layer of the aorta. The contractile tension within the sections was 0.15 m

  11. Aneurisma de aorta abdominal na infância Abdominal aortic aneurism in childhood

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    Abdo Farret Neto

    1998-04-01

    Full Text Available The authors report a case of an abdominal aortic aneurism involving all visceral branches minus the Inferior Mesenteric artery in a 4-year-old girl. There was sugestive evidence that the arterial disease had an inflamatory or infectious etiologic factor. The most probable etiological factors could be salmonelas infection of the arterial wall or Takayasu's disease secondary to tuberculosis. The treatment with antibiotic to salmonelas infection during ten days, followed by tuberculostatic therapy for six months was chosen. Concerning the age, the arteries involved and the inflamatory aspect of the aneurysm, the surgical option became an alternative to the clinic treatment in case of any future evidence of the aneurysm enlargement. The patient became asymptomatic as soon as the antibiotic has been started. The control of the aneurysm evolution will be made by ecography each three months.

  12. Effects and mechanism of different adrenergic receptor antagonists on left ventricular hypertrophy subsequent to coarctation of abdominal aorta in rats

    Institute of Scientific and Technical Information of China (English)

    HU Qin; LI Long-gui; ZHANG Yun

    2004-01-01

    To study the changes of a collagen-binding protein (Colligin) and myosin heavy chain isoform (α/β-MHC) gene and protein in left ventricular hypertrophy subsequent to coarctation of abdominal aorta in rats and the ef-fects of three kinds of adrenergic receptor blockers: Carvedilol (CAR), Metoprolol (MET) and Terazosin (TER) on these changes, and to elucidate the effects and new mechanism of CAR on left ventricular hypearophy regression. Methods: A model of hypertrophy induced by coarctation of abdominal aorta(CAA) was used in this study. Thirty two male istar rats were divided randomly into four groups 4 weeks after CAA operation: CAA, CAR, MET and TER.emodynamics, ventric-ular remodeling parameters, expressions of Colligin and α/β-MHC mRNA, protein expressions of Collagen Ⅰ /Ⅲ and Colligin were investigated in the four groups and sham operation group. Results: Left ventricle hypertrophy was observed clearly 16 weeks after operation. The ratio of α/β-MHC mRNA decreased, while expressions of Collagen Ⅰ/Ⅲ proteins and Colligin mRNA/protein increased( P < 0.05). CAR could ameliorate left ventricle hypertrophy prior to MET and TER. CAR could also change the expressions of α/β-MHC, Collagen Ⅰ/Ⅲ and Colligin in both gene and protein levels ( P < 0.05), while MET and TER have no effect on them ( P > 0.05). Conclusion: The effects of CAR on extracellular matrix proteins and MHC isoform shift regression of left ventricle may be due to antiproliferative or antioxidative mechanism, which was indepen-dent of beta-adrenergic receptor antagonist.

  13. Análise da correlação entre síndrome de pseudo-exfoliação e aneurisma de aorta abdominal Analysis of correlation between pseudoexfoliation syndrome and aneurysm of the abdominal aorta

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    Paulo de Tarso Ponte Pierre Filho

    2004-06-01

    Full Text Available OBJETIVO: Examinar a correlação sugerida entre síndrome de pseudo-exfoliação e aneurisma de aorta abdominal. MÉTODOS: Sessenta e cinco pacientes recentemente operados por aneurisma de aorta abdominal e 51 controles com aterosclerose periférica, sem aneurisma, submeteram-se ao exame oftalmológico sob dilatação pupilar para investigar a presença de síndrome de pseudo-exfoliação. RESULTADOS: Não houve diferenças estatisticamente significantes entre a média de idade, distribuição por sexo e raça entre os 2 grupos (p > 0,05. Dois dos 65 pacientes com aneurisma de aorta e um dos 51 controles apresentaram síndrome de pseudo-exfoliação (p = 1,00. CONCLUSÃO: A prevalência de síndrome de pseudo-exfoliação em pacientes operados por aneurisma de aorta abdominal e em pacientes com aterosclerose periférica foi similar. Este achado não confirma a associação proposta entre síndrome de pseudo-exfoliação e aneurisma de aorta abdominal.PURPOSE: To investigate the suggested association between pseudoexfoliation syndrome and aneurysm of the abdominal aorta. METHODS: 65 patients recently operated for abdominal aortic aneurysm and 51 controls with peripheral atherosclerosis, without aneurysm, underwent an ophthalmologic examination under pupillary dilatation to detect the presence of pseudoexfoliation syndrome. RESULTS: There were no significant differences regarding mean age and distribution by gender and race between the groups (p > 0.05. Two of 65 patients with aortic aneurysm and one of 51 controls presented pseudoexfoliation syndrome (p = 1.00. CONCLUSION: The prevalence of pseudoexfoliation syndrome in patients operated for abdominal aortic aneurysm and in patients with peripheral atherosclerosis were similar. This finding does not support the proposed association between pseudoexfoliation syndrome and abdominal aortic aneurysm.

  14. Analysis of axial prestretch in the abdominal aorta with reference to post mortem interval and degree of atherosclerosis.

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    Horny, Lukas; Adamek, Tomas; Kulvajtova, Marketa

    2014-05-01

    It is a well-known fact that the length of an artery in situ and the length of an excised artery differs. Retraction of blood vessels is usually observed. This prestretch plays an important role in arterial physiology. We have recently determined that the decrease of axial prestretch in the human abdominal aorta is so closely correlated with age that it is suitable for forensic applications (estimation of the age at time of death for cadavers of unknown identity). Since post mortem autolysis may affect the reliability of an estimate based on axial prestretch, the present study aims to detail analysis of the effect of post mortem time. The abdominal aorta is a prominent site of atherosclerotic changes (ATH), which may potentially affect longitudinal prestretch. Thus ATH was also involved in the analysis. Axial prestretch in the human abdominal aorta, post mortem interval (PMI), and the degree of ATH were documented in 365 regular autopsies. The data was first age adjusted to remove any supposed correlation with age. After the age adjustment of the sample, the correlation analysis showed no significant PMI effects on the prestretch in non-putrefied bodies. Analysis of the prestretch variance with respect to ATH suggested that ATH is not a suitable factor to explain the prestretch variability remaining after the age adjustment. It was concluded that, although atherosclerotic plaques may certainly change the biomechanics of arteries, they do not significantly affect the longitudinal prestretch in the human abdominal aorta.

  15. Abdominal Compartment Syndrome due to OHSS

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    Firoozeh Veisi

    2012-03-01

    Full Text Available Abdominal compartment syndrome is a dangerous clinical situation, usually following abdominal injuries&operations. It is seldom observed in patients with gynecologic and obstetric problems. Abdominalcompartment syndrome may be consequence ovarian hyperstimulation syndrome. A 28-year-old womanpresented as a sever ovarian hyperstimulation.The increased IAP indicated that OHSS may beconsidered a compartment syndrome. Abdominal compartment syndrome needs laparotomy orparacentesis for reduction of pressure.

  16. Cirurgia da aorta descendente e tóraco-abdominal com técnica de oclusão proximal isolada da aorta ("open distal" Surgical treatment of descending thoracic and thoracoabdominal aorta with the "open distal" technique

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    Bayard Gontijo Filho

    1995-09-01

    Full Text Available O presente relato apresenta a experiência obtida em um período de 4 anos (jan/91 - jan/95 com a técnica "open distal" descrita por Cooley, em 1990³, para tratamento cirúrgico de doenças da aorta torácica descendente e aorta tóraco-abdominal. Nesse período foram realizadas 35 operações (25 para aorta descendente e 10 para aorta tóraco-abdominal. Os aneurismas de origem degenerativa e as dissecções aórticas ocorreram em freqüência semelhante (48,5% e 40%, respectivamente; em 8 pacientes havia rotura da aorta, parcialmente tamponada pelo pulmão (5 casos, órgãos abdominais (2 casos e esófago (1 caso. O acesso cirúrgico foi obtido por toracotomia póstero-lateral esquerda ou tóraco-freno-laparotomia. Heparina foi usada na dose de 1,5 mg/kg e todo sangue do campo cirúrgico foi coletado a um reservatório e reinfundido pela veia femoral. Houve 4 (11.4% óbitos hospitalares e 2 (5,8% pacientes portadores de aneurisma tóraco-abdominal desenvolveram paraplegia. A morbi-mortalidade do grupo foi diretamente relacionada à condição clínica per-operatória e à extensão do segmento aórtico acometido. Na nossa opinião, a técnica "open distal" é um método alternativo simples e eficaz no tratamento cirúrgico das doenças da aorta descendente e tóraco-abdominal. Em casos de ressecções extensas com períodos longos de oclusão aórtica, métodos para proteção medular deverão ser avaliadosSince Jan/91 we have been using the "open distal" technique (ODT described by Cooley, for surgical treatment of diseases of the descending thoracic and thoracoabdominal aorta. From jan/91 to jan/95, the technique was used in 35 instances (25 for descending aorta and 10 for thoracoabdominal aorta. Degenerative aneurysms and aortic dissections had similar incidence in this group (48.5% and 40.0%, respectively. In 8 patients the aorta was ruptured which was partially occluded by the lung (5 cases, abdominal organs (2 cases and esophagus (1

  17. Resultados da cirurgia do aneurisma da aorta abdominal em pacientes jovens Outcomes after surgical repair of abdominal aortic aneurysms in young patients

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    Telmo P. Bonamigo

    2009-06-01

    Full Text Available CONTEXTO: A presença de aneurisma da aorta abdominal (AAA é rara em pacientes jovens. OBJETIVO: Avaliar os resultados da cirurgia do AAA em pacientes com idade BACKGROUND: Abdominal aortic aneurysms (AAA are rare in young patients. OBJECTIVE: To evaluate outcomes after AAA repair in patients aged < 50 years. METHODS: Between June 1979 and January 2008, 946 patients underwent elective repair for an infrarenal AAA performed by the first author. Of these, 13 patients (1.4% were < 50 years old at surgery. Demographic characteristics and surgical data were analyzed, as well as early and late outcomes after surgical intervention. RESULTS: Mean age was 46±3.4 years (ranging from 43 to 50 years. Most patients were men (76.9%, hypertensive (76.9% and smokers (61.5%. Perioperative morbidity and mortality rates were low (15.4% and 0%, respectively; one patient had respiratory infection and another patient had unstable angina. Median follow-up was 85.5 months, and two patients died due to ischemic cardiopathy and cerebrovascular accident during the follow-up period. CONCLUSION: AAA repair in young patients is a safe procedure, with good long-term results. In our study, there were no perioperative deaths, and a good long-term survival was observed.

  18. Extra-anatomic endovascular repair of an abdominal aortic aneurysm with a horseshoe kidney supplied by the aneurysmal aorta.

    Science.gov (United States)

    Rey, Jorge; Golpanian, Samuel; Yang, Jane K; Moreno, Enrique; Velazquez, Omaida C; Goldstein, Lee J; Chahwala, Veer

    2015-07-01

    Abdominal aortic aneurysm complicated by a horseshoe kidney (HSK, fused kidney) represents a unique challenge for repair. Renal arteries arising from the aneurysmal aorta can further complicate intervention. Reports exist describing the repair of these complex anatomies using fenestrated endografts, hybrid open repairs (debranching), and open aneurysmorrhaphy with preservation of renal circulation. We describe an extra-anatomic, fully endovascular repair of an abdominal aortic aneurysm with a HSK partially supplied by a renal artery arising from the aneurysm. We successfully applied aortouni-iliac endografting, femorofemoral bypass, and retrograde renal artery perfusion via the contralateral femoral artery to exclude the abdominal aortic aneurysm and preserve circulation to the HSK.

  19. Bullet embolization to the external iliac artery after gunshot injury to the abdominal aorta: a case report

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    Jaha Luan

    2011-08-01

    Full Text Available Abstract Introduction Abdominal vascular trauma is fairly common in modern civilian life and is a highly lethal injury. However, if the projectile is small enough, if its energy is diminished when passing through the tissue and if the arterial system is elastic enough, the entry wound into the artery may close without exsanguination and therefore may not be fatal. A projectile captured may even travel downstream until it is arrested by the smaller distal vasculature. The occurrence of this phenomenon is rare and was first described by Trimble in 1968. Case presentation Here we present a case of a 29-year-old Albanian man who, due to a gunshot injury to the back, suffered fracture of his twelfth thoracic and first lumbar vertebra, injury to the posterior wall of his abdominal aorta and then bullet embolism to his left external iliac artery. It is interesting that the signs of distal ischemia developed several hours after the exploratory surgery, raising the possibility that the bullet migrated in the interim or that there was a failure to recognize it during the exploratory surgery. Conclusion In all cases where there is a gunshot injury to the abdomen or chest without an exit wound and with no projectile in the area, there should be a high index of suspicion for possible bullet embolism, particularly in the presence of the distal ischemia.

  20. 3D segmentation of abdominal aorta from CT-scan and MR images.

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    Duquette, Anthony Adam; Jodoin, Pierre-Marc; Bouchot, Olivier; Lalande, Alain

    2012-06-01

    We designed a generic method for segmenting the aneurismal sac of an abdominal aortic aneurysm (AAA) both from multi-slice MR and CT-scan examinations. It is a semi-automatic method requiring little human intervention and based on graph cut theory to segment the lumen interface and the aortic wall of AAAs. Our segmentation method works independently on MRI and CT-scan volumes and has been tested on a 44 patient dataset and 10 synthetic images. Segmentation and maximum diameter estimation were compared to manual tracing from 4 experts. An inter-observer study was performed in order to measure the variability range of a human observer. Based on three metrics (the maximum aortic diameter, the volume overlap and the Hausdorff distance) the variability of the results obtained by our method is shown to be similar to that of a human operator, both for the lumen interface and the aortic wall. As will be shown, the average distance obtained with our method is less than one standard deviation away from each expert, both for healthy subjects and for patients with AAA. Our semi-automatic method provides reliable contours of the abdominal aorta from CT-scan or MRI, allowing rapid and reproducible evaluations of AAA.

  1. Optical pathology study of human abdominal aorta tissues using confocal micro resonance Raman spectroscopy

    Science.gov (United States)

    Liu, Cheng-hui; Boydston-White, Susie; Wang, Wubao; Sordillo, Laura A.; Shi, Lingyan; Weisberg, Arel; Tomaselli, Vincent P.; Sordillo, Peter P.; Alfano, Robert R.

    2016-03-01

    Resonance Raman (RR) spectroscopic technique has a high potential for label-free and in-situ detection of biomedical lesions in vivo. This study evaluates the ability of RR spectroscopy method as an optical histopathology tool to detect the atherosclerotic plaque states of abdominal aorta in vitro. This part demonstrates the RR spectral molecular fingerprint features from different sites of the atherosclerotic abdominal aortic wall tissues. Total 57 sites of five pieces aortic samples in intimal and adventitial wall from an autopsy specimen were examined using confocal micro Raman system of WITec 300R with excitation wavelength of 532nm. The preliminary RR spectral biomarkers of molecular fingerprints indicated that typical calcified atherosclerotic plaque (RR peak at 964cm-1) tissue; fibrolipid plaque (RR peaks at 1007, 1161, 1517 and 2888cm-1) tissue, lipid pool with the fatty precipitation cholesterol) with collagen type I (RR peaks at 864, 1452, 1658, 2888 and 2948cm-1) in the soft tissue were observed and investigated.

  2. Aortoenteric Fistula as a Complication of Open Reconstruction and Endovascular Repair of Abdominal Aorta

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    Marek Tagowski

    2014-01-01

    Full Text Available The paper intends to present a review of imaging characteristics of secondary aortoenteric fistula (AEF. Mechanical injury, infection, and adherence of a bowel segment to the aorta or aortic graft are major etiologic factors of AEF after open aortic repair. The pathogenesis of AEF formation after endovascular abdominal aortic repair is related to mechanical failure of the stent-graft, to stent graft infection, and to persistent pressurization of the aneurysmal sac. The major clinical manifestations of AEF comprise haematemesis, melaena, abdominal pain, sepsis, and fever. CT is the initial diagnostic modality of choice in a stable patient. However, the majority of reported CT appearances are not specific. In case of equivocal CT scans and clinical suspicion of AEF, scintigraphy, 67Ga citrate scans or 18F-FDG PET/CT is useful. Diagnostic accuracy of endoscopy in evaluation of AEF is low; nevertheless it allows to evaluate other than AEF etiologies of gastrointestinal bleeding. Without adequate therapy, AEF is lethal. Conventional surgical treatment is associated with high morbidity and mortality. The endovascular repair may be an option in hemodynamically unstable and high-risk surgical patients. We also illustrate an example of a secondary AEF with highly specific albeit rare radiologic picture from our institution.

  3. Descrição morfológica dos ramos colaterais viscerais da aorta abdominal do macaco-de-cheiro Morphological description of the collateral visceral branches from abdominal aorta of squirrel monkey

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    Maria Rogéria Menezes da Silva

    2011-01-01

    Full Text Available O Saimiri sciureus é um primata não humano existente na região amazônica e não consta na lista de animais em perigo de extinção, de acordo com o IBAMA. Neste trabalho, sistematizou-se os ramos colaterais viscerais da aorta abdominal de seis animais sendo três machos e três fêmeas, os quais tiveram o sistema circulatório preenchido com látex Neoprene, adicionado de contraste radiográfico. O resultado observado foi que a aorta abdominal emitiu ventralmente, como ramo colateral visceral, a artéria celíaca, que se trifurcou nas artérias gástrica esquerda, hepática e lienal. Os ramos da artéria celíaca promovem a irrigação do estômago, duodeno, fígado, pâncreas e baço. A seguir, a aorta abdominal emitiu a artéria mesentérica cranial, de calibre maior que a artéria celíaca e justaposta caudalmente. A artéria mesentérica cranial emitiu ramos que vascularizaram a parte final do duodeno, pâncreas, jejuno, íleo, ceco, cólon maior e cólon menor. A aorta abdominal emitiu lateralmente as artérias renais direita e esquerda. A artéria adrenal esquerda surgiu como um ramo colateral direto da artéria celíaca e a artéria adrenal direita surgiu da artéria renal direita. A artéria mesentérica caudal foi emitida da superfície ventral da aorta abdominal, logo abaixo das artérias renais. Em L6, a aorta abdominal se bifurcou, dando origem às artérias ilíacas externas direita e esquerda e estas deram origem à artéria ilíaca interna e femoral direita e esquerda. As artérias testiculares ou ováricas tiveram origem na artéria ilíaca interna. A continuidade da aorta abdominal deu origem à artéria sacral mediana e a continuidade desta é chamada de artéria caudal mediana. O estudo da espécie em questão é de suma importância para gerar conhecimentos a respeito dos primatas não humanos existentes em nosso país. Dessa forma, pode-se dizer que o Saimiri sciureus é um importante modelo biológico para o

  4. Ateromatosis de la aorta abdominal y su relación con el estilo de vida

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    Annia Esther Vives Iglesias

    Full Text Available Introducción: el estilo de vida es la manera personal de vivir. Las decisiones que se tomen al trabajar, alimentarse, afrontar las situaciones difíciles, realizar ejercicios físicos, entre otras, lo van a conformar y afectarán de forma positiva o negativa el estado de salud del individuo. Objetivo: identificar la presencia de ateromatosis de la aorta abdominal en dos grupos de pacientes con estilos de vida diferentes. Métodos: se realizó una investigación de tipo comparativa entre dos grupos de pacientes con estilos de vida diferentes, uno saludable (115 pacientes y otro grupo con estilo de vida no saludable (254 pacientes, lo cual fue determinado mediante una encuesta. A todos los pacientes involucrados en el estudio se les realizó ultrasonido abdominal para dar salida a los objetivos del mismo junto a los resultados de la encuesta. Resultados: hubo un predominio del sexo femenino en las edades de 40 a 61 años en ambos grupos. Los pacientes que exhibían un estilo de vida no saludable, con una dieta predominantemente omnívora y con una actividad física sedentaria presentaron ateromatosis de la aorta abdominal en un 99 %. En el grupo de estudio que tenía un estilo de vida saludable, solo se encontraron placas de ateroma en dos pacientes, lo que equivale a un 1,7 %. Las principales enfermedades crónicas asociadas fueron la diabetes mellitus y la hipertensión arterial, y los factores de riesgo como el hábito de fumar, las hiperlipidemias, así como la esteatosis hepática y pancreática, predominaron en el grupo con un estilo de vida no saludable. Conclusión: los hábitos que determinan un estilo de vida no saludable van a determinar que se desarrollen factores de riesgo y enfermedades en el individuo.

  5. Ruptura de aneurismas de aorta abdominal. Herramienta informática para su predicción // Rupture of abdominal aortic aneurysm. Software for its prediction

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    Guillermo Villalta‐Alonso

    2011-01-01

    Full Text Available La ruptura de los aneurismas de aorta abdominal representa un evento clínico muy importantedebido a su alta tasa de mortalidad. Los indicadores empleados actualmente para decidir eltratamiento a pacientes con aneurismas son el diámetro máximo transversal y la tasa de crecimiento,los que pueden ser considerados insuficientes, pues no tienen una base teórica físicamentefundamentada. En el presente artículo se definen los fundamentos para el diseño de una herramientainformática para PC que permita predecir, con suficiente precisión para ser clínicamente relevante, elriesgo de ruptura de aneurismas de aorta abdominal sobre bases personalizadas del paciente. Laherramienta consta de 3 módulos, que están diseñados para procesar toda la información delpaciente e integrarla mediante un modelo que incorpora la interrelación de los factores biomecánicosde diferentes naturalezas (biológicos, estructurales y geométrico y escalas (temporal y dimensional,con el objetivo de calcular un indicador numérico y personalizado del riesgo de ruptura. Estaherramienta debe constituir un elemento auxiliar del facultativo médico en la toma de decisionesrespecto del tratamiento adecuado a pacientes con aneurisma.Palabras claves: AAA, riesgo de ruptura, modelo multiescala, predicción, herramienta informática.___________________________________________________________________AbstractThe rupture of abdominal aortic aneurysm (AAA represents an important clinical event due to its highmortality rate. Currently the criteria to decide on the treatment of AAA patients are the peaktransverse diameter and the growth rate which can be considered insufficient because they have nota reasonable physical base. The foundations for the design of PC software to predict, with sufficientaccuracy to be clinically relevant, the risk of AAA rupture on patient-specific basis are defined in thispaper. The software consists of 3 modules which are designed for processing all

  6. Lipolysis of emulsion models of triglyceride-rich lipoproteins is altered in male patients with abdominal aorta aneurysm

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    J.J. Hosni

    2007-03-01

    Full Text Available Disorders of the lipid metabolism may play a role in the genesis of abdominal aorta aneurysm. The present study examined the intravascular catabolism of chylomicrons, the lipoproteins that carry the dietary lipids absorbed by the intestine in the circulation in patients with abdominal aorta aneurysm. Thirteen male patients (72 ± 5 years with abdominal aorta aneurysm with normal plasma lipid profile and 13 healthy male control subjects (73 ± 5 years participated in the study. The method of chylomicron-like emulsions was used to evaluate this metabolism. The emulsion labeled with 14C-cholesteryl oleate and ³H-triolein was injected intravenously in both groups. Blood samples were taken at regular intervals over 60 min to determine the decay curves. The fractional clearance rate (FCR of the radioactive labels was calculated by compartmental analysis. The FCR of the emulsion with ³H-triolein was smaller in the aortic aneurysm patients than in controls (0.025 ± 0.017 vs 0.039 ± 0.019 min-1; P < 0.05, but the FCR of14C-cholesteryl oleate of both groups did not differ. In conclusion, as indicated by the triglyceride FCR, chylomicron lipolysis is diminished in male patients with aortic aneurysm, whereas the remnant removal which is traced by the cholesteryl oleate FCR is not altered. The results suggest that defects in the chylomicron metabolism may represent a risk factor for development of abdominal aortic aneurysm.

  7. The effects of aneurysm repair using an aortic prosthesis on the electrical parameters of the muscular layer of the abdominal aorta.

    Science.gov (United States)

    Hauzer, W; Czerski, A; Zawadzki, W; Gnus, J; Ratajczak, K; Nowak, M; Janeczek, M; Witkiewicz, W; Niespielak, P

    2014-12-01

    The study was carried out on 10 swine of 20-30 kg body weight. Five animals were assigned to each of 2 groups. An aneurysm of the abdominal aorta was created experimentally in animals from the first and second study group. After 4 weeks, animals from the second group were subject to aneurysm repair using an aortic prosthesis. During the experiment, we measured the myoelectric activity of the muscular layer of the abdominal aorta and aneurysmal lesion with the ultrasonographic technique. Measurements of the aorta and aneurysmal lesion and histopathological analyses were carried out post-mortem. We found a statistically significant decrease in the myoelectric activity of the aorta on the aorta-straight prosthesis interface and a significant decrease in the thickness of the muscular layer of the aorta on the aorta-prosthesis interface. No similar changes were found for experimentally induced aneurysms of the abdominal aorta. A straight prosthesis graft may not be the perfect option in the treatment of abdominal aortic aneurysm, as it contributes to the remodelling of the tissue on the prosthesis-aorta interface. This may result in the relapse of an aneurysm and post-operative complications.

  8. Reação histopatológica da parede da aorta abdominal ao stent não recoberto Histopathological reaction of the abdominal aorta wall to non-covered stents

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    Rubio Bombonato

    2006-06-01

    Full Text Available OBJETIVO: Avaliar a reação histopatológica da parede aorta abdominal, em suínos, no nível das artérias renais, na presença de stent metálico não recoberto. MÉTODO: Foi estudada histopatologicamente a aorta abdominal de 10 suínos, com peso médio de 86,6 quilos e idade média de 6 meses, submetidos a implante de stent metálico posicionado na aorta, no nível das artérias renais, após 100 dias do implante. Os stents foram liberados por auto-expansão com laparotomia. Os cortes histológicos foram realizados nos seguintes locais: 1 transição entre a aorta normal e aorta contendo stent; 2 aorta contendo o stent; 3 porção contendo os óstios das artérias renais, 4 linfonodos periaórticos e, 5 parênquima renal. As lâminas foram coradas pela técnica da hematoxilina e eosina. RESULTADOS: Os achados macroscópicos revelaram: linfonodomegalia periaórtica; espessamento da parede aórtica; artérias lombares e renais pérvias; estrutura anatômica renal normal. Análises microscópicas, próximas aos stents, evidenciaram espessamento da parede vascular, secundário à fibrose intimal e camada média comprometida com fibrose intersticial. Medidas micrométricas da parede aórtica com o stent, comparada à aorta sem o stent, apresentaram aumento da espessura da parede (75,9% por hiperplasia da camada íntima secundária à proliferação de fibroblastos; depósitos de colágeno com infiltrado inflamatório e granulomas do tipo corpo estranho. CONCLUSÃO: O stent de aço inoxidável descoberto, implantado na aorta de suínos, produziu importante reação inflamatória, com fibrose nas camadas média e íntima, evidenciada pelas análises histopatológicas e a sua presença não comprometeu o estado pérvio da aorta e dos ramos lombares e renais.OBJECTIVE: To evaluate the histopathological reaction of the abdominal aorta wall in pigs' renal arteries to the presence of non-covered stainless steel stents. METHODS: The abdominal aorta of

  9. MDCT of the abdominal aorta: basics, technical improvements, and clinical applications

    Energy Technology Data Exchange (ETDEWEB)

    Catalano, C.; Fraioli, F.; Danti, M.; Napoli, A.; Votta, V.; Lanciotti, K.; Bertoletti, L.; Passariello, R. [Dept. of Radiological Sciences, Univ. of Rome ' ' La Sapienza' ' (Italy)

    2003-11-01

    The recent introduction into clinical practice of multidetector-row spiral CT (MDCT) [1] with simultaneous acquisition of multiple channels has had a substantial effect on CT angiography allowing the acquisition of large volumes at high resolution, with excellent visualization of small branches also, including distal collaterals of the celiac trunk and superior and inferior mesenteric arteries (Fig. 1 a, b). Other advantages of multidetector-row over single-slice spiral CT include better separation of different vascular phases of enhancement, more efficient use of contrast material administered intravenously, and comparable, if not better, image quality. For example, the entire abdomen can now be (a) routinely imaged in its entirety with thin sections in a single short breath-hold, (b) repeatedly scanned during early arterial, late arterial, and venous phases, and (c) examined with high-quality multiplanar reconstructions, which are easily generated immediately. In this article we focus on and review the major aspects, advantages, and clinical applications of MDCT in the evaluation of the abdominal aorta. (orig.)

  10. Inferior venacaval compression due to excessive abdominal packing

    Directory of Open Access Journals (Sweden)

    M.C.B. Santhosh

    2014-06-01

    Full Text Available Inferior venacaval compression is a common problem in late pregnancy. It can also occur due to compression of inferior venacava by abdominal or pelvic tumors. We report a case of acute iatrogenic inferior venacaval compression due to excessive abdominal packing during an intraabdominal surgery.

  11. Identification of the main determinants of abdominal aorta size: a screening by Pocket Size Imaging Device.

    Science.gov (United States)

    Esposito, Roberta; Ilardi, Federica; Schiano Lomoriello, Vincenzo; Sorrentino, Regina; Sellitto, Vincenzo; Giugliano, Giuseppe; Esposito, Giovanni; Trimarco, Bruno; Galderisi, Maurizio

    2017-01-13

    Ultrasound exam as a screening test for abdominal aorta (AA) can visualize the aorta in 99% of patients and has a sensitivity and specificity approaching 100% in screening settings for aortic aneurysm. Pocket Size Imaging Device (PSID) has a potential value as a screening tool, because of its possible use in several clinical settings. Our aim was to assess the impact of demographics and cardiovascular (CV) risk factors on AA size by using PSID in an outpatient screening. Consecutive patients, referring for a CV assessment in a 6 months period, were screened. AA was visualized by subcostal view in longitudinal and transverse plans in order to determine the greatest anterior-posterior diameter. After excluding 5 patients with AA aneurysm, 508 outpatients were enrolled. All patients underwent a sequential assessment including clinical history with collection of CV risk factors, physical examination, PSID exam and standard Doppler echoc exam using a 2.5 transducer with harmonic capability, both by expert ultrasound operators, during the same morning. Standard echocardiography operators were blinded on PSID exam and viceversa. Diagnostic accuracy of AA size by PSID was tested successfully with standard echo machine in a subgroup (n = 102) (rho = 0.966, p < 0.0001). AA diameter was larger in men than in women and in ≥50 -years old subjects than in those <50 -years old (both p < 0.0001). AA was larger in patients with coronary artery disease (CAD) (p < 0.0001). By a multivariate model, male sex (p < 0.0001), age and body mass index (both p < 0.0001), CAD (p < 0.01) and heart rate (p = 0.018) were independent predictors of AA size (cumulative R (2) = 0.184, p < 0.0001). PSID is a reliable tool for the screening of determinants of AA size. AA diameter is greater in men and strongly influenced by aging and overweight. CAD may be also associated to increased AA diameter.

  12. Hemodynamic flow modeling through an abdominal aorta aneurysm using data mining tools.

    Science.gov (United States)

    Filipovic, Nenad; Ivanovic, Milos; Krstajic, Damjan; Kojic, Milos

    2011-03-01

    Geometrical changes of blood vessels, called aneurysm, occur often in humans with possible catastrophic outcome. Then, the blood flow is enormously affected, as well as the blood hemodynamic interaction forces acting on the arterial wall. These forces are the cause of the wall rupture. A mechanical quantity characteristic for the blood-wall interaction is the wall shear stress, which also has direct physiological effects on the endothelial cell behavior. Therefore, it is very important to have an insight into the blood flow and shear stress distribution when an aneurysm is developed in order to help correlating the mechanical conditions with the pathogenesis of pathological changes on the blood vessels. This insight can further help in improving the prevention of cardiovascular diseases evolution. Computational fluid dynamics (CFD) has been used in general as a tool to generate results for the mechanical conditions within blood vessels with and without aneurysms. However, aneurysms are very patient specific and reliable results from CFD analyses can be obtained by a cumbersome and time-consuming process of the computational model generation followed by huge computations. In order to make the CFD analyses efficient and suitable for future everyday clinical practice, we have here employed data mining (DM) techniques. The focus was to combine the CFD and DM methods for the estimation of the wall shear stresses in an abdominal aorta aneurysm (AAA) underprescribed geometrical changes. Additionally, computing on the grid infrastructure was performed to improve efficiency, since thousands of CFD runs were needed for creating machine learning data. We used several DM techniques and found that our DM models provide good prediction of the shear stress at the AAA in comparison with full CFD model results on real patient data.

  13. Características ultraestruturais do segmento abdominal da aorta de rato albino = Mural features of the abdominal aortic segment of albino rat

    Directory of Open Access Journals (Sweden)

    2007-10-01

    Full Text Available O objetivo da presente pesquisa foi investigar as peculiaridades ultraestruturais da parede da aorta de rato. Foram utilizados sete ratos albinos, adultos jovens, dos quais foram coletados fragmentos da aorta abdominal infra-renal. Após a coleta, os segmentosvasculares foram fixados e encaminhados para a rotina de microscopia eletrônica de transmissão e varredura. As lamelas elásticas aparecem interpostas às fibras musculares lisas, sendo essa disposição principalmente notada na túnica média da parede vascular. Entre asfibras musculares lisas e as lamelas elásticas, observa-se um inter-relacionamento aparentemente estreito, feito por conexão e ancoramento entre ambos os elementos murais por meio de lamelas de colágeno. A túnica íntima da aorta abdominal do rato mostraalgumas peculiaridades ultraestruturais marcantes, tais como a interrupção, em certos locais da parede, de continuidade da lâmina elástica interna, interrupção acompanhada por poros endoteliais, de certa extensão, suprajacentes à falha na estrutura elástica intimal. Este padrão de constituição mural, com destaque aos ancoramentos elástico-musculares, via o colágeno, parece garantir propriedades fundamentais da parede vascular, concernentes à hemodinâmica, tal como o cisalhamento, normalmente notado entre os estratos superpostosda parede vascular, bem como a contratilidade e a visco-elasticidade da parede arterial.The objective of the present research was to investigate the ultrastructural peculiarities of the aortic wall of the rat. Seven young adult rats were used, from which fragments of theinfrarenal abdominal aorta were collected. After collection, the vascular segments were fixed and sent for analysis by scanning electron microscope. The elastic lamellae appear interposed with smooth muscular fibers; this pattern was verified mainly at the medial layer structure. Among the mural elements a well defined interrelationship was established through

  14. Anestesia para aneurismectomia de aorta abdominal infra-renal: experiência com 104 casos consecutivos no HCFMRP-USP

    OpenAIRE

    Breno José Santiago Bezerra de Lima

    2006-01-01

    Introdução. A morbi-mortalidade durante e após anestesia para aneurismectomia de aorta abdominal é alta, pois esta doença acomete pacientes após a sétima década de vida e que possuem várias doenças concomitantes. Objetivos. Analisar e discutir as condutas anestésicas utilizadas nos períodos pré e intra-operatório no Serviço de Anestesiologia do HCFMRP-USP. Casuística e Método. Foram analisados os prontuários de 104 pacientes submetidos à aneurismectomia de aorta no tocante às condutas utiliza...

  15. Morphological aspects of mural thrombi deposition residual lumen route in infrarenal abdominal aorta aneurisms Morfologia da deposição de trombos murais: trajeto da luz residual em aneurismas de aorta abdominal infra-renal

    Directory of Open Access Journals (Sweden)

    Thiago Adriano Silva Guimarães

    2008-01-01

    Full Text Available PURPOSE: To assess the most frequent deposition site of mural thrombi in infrarenal abdominal aorta aneurisms, as well as the route of the residual lumen. METHODS: Assessment of CT scan images from 100 patients presenting asymptomatic abdominal aorta aneurism, and followed at HC-FMRP-USP. RESULTS: In 53% of the cases the mural thrombus was deposited on the anterior wall; from these, in 22%, the residual lumen described a predominantly right sided route; in 22%, a left sided route; on the mid line in 5%; and crossing over the mid line in 1%. In 23%, the deposition of thrombi was concentric. In 11% it occured on the posterior wall; from these, in 5%, the route of the residual anterior lumen was predominantly right sided; in 5%, left sided; and crossed over the mid line in 1%. In 13% complex morfological deposition patterns were found. CONCLUSION: Mural thrombi formation was predominantly found on the anterior wall of the aneurismatic mass, with the route of the residual lumen projecting towards the posterior wall.OBJETIVOS: Avaliar o local mais freqüente de deposição do trombo mural em aneurismas de aorta abdominal infrarenal, bem como o trajeto da luz residual. MÉTODOS: Avaliação de tomografias de 100 pacientes do HC-FMRP-USP apresentando aneurisma de aorta abdominal assintomático. RESULTADOS: O trombo mural se deposita na parede anterior em 53% dos casos, sendo que a luz residual posterior descreveu um trajeto predominantemente à direita em 22% dos casos, à esquerda em 22%, na linha mediana em 5% e cruzando da direita para a esquerda em 4%. 23% dos casos apresentaram deposição concêntrica do trombo e 11% apresentaram deposição na parede posterior, sendo o trajeto da luz residual anterior predominante a direita em 5% dos casos, a esquerda em 5% e cruzando a linha mediana em 1%. Padrões morfológicos complexos de deposição do trombo foram encontrados em 13% dos casos. CONCLUSÃO: A formação do trombo mural predominou na parede

  16. Quantitative X-ray CT analysis of calcification of the abdominal aorta and its relationship to obesity

    Energy Technology Data Exchange (ETDEWEB)

    Shinagawa, Toshio; Hiraiwa, Yoshio; Mizuno, Seio; Kusunoki, Norio; Nitta, Yu; Matsubara, Takao; Iwainaka, Yoichi; Konishi, Hideo (Toyama Red Cross Hospital (Japan))

    1992-04-01

    Quantitative analysis of abdominal aorta calcification by X-ray CT is useful method for non-invasive diagnosis of atherosclerosis. We recently examined the relationship between the X-ray CT measurement of abdominal aorta calcification and the degree of obesity. For this purpose, the body mass index (BMI) and the subcutaneous fat thickness (determined by X-ray CT at the umbilical level) were analyzed in relation to the abdominal aorta calcification index (ACI) in 845 patients (453 males and 392 females aged 40-79 years). Patients with BMI under 20 were classified as 'lean', those with BMI between 20-26 as 'normal' and those with BMI over 26 as 'obese'. 1. Among males, the ACI was highest in lean individuals and lowest in obese individuals. The difference in ACI between lean and obese males was significant in the middle aged group (40-65 years). Among females, no relationship was observed between the degree of obesity and ACI. 2. Among males, ACI was higher in individuals with low subcutaneous fat thickness and lower in individuals with greater subcutaneous fat thickness. The difference was significant in the middle aged group. Among females, no relationship was observed between the two parameters. 3. When the visceral fat to subcutaneous fat ratio (V/S) in 85 males and females aged 60-69 years was analyzed in relation to ACI, ACI tended to decrease as the V/S increased, in both males and females. 4. Relationships between BMI and subcutaneous fat thickness, between BMI and lipids and between lipids and ACI were also analyzed. (author).

  17. Reduction of contrast medium volume in abdominal aorta CTA: Multiphasic injection technique versus a test bolus volume

    Energy Technology Data Exchange (ETDEWEB)

    Nijhof, Wouter H., E-mail: w.h.nijhof@student.utwente.nl [University of Twente, MIRA-Institute for Biomedical Technology and Technical Medicine, P.O. Box 21, 7500 AE Enschede (Netherlands); Vos, Charlotte S. van der, E-mail: c.s.vandervos@student.utwente.nl [University of Twente, MIRA-Institute for Biomedical Technology and Technical Medicine, P.O. Box 21, 7500 AE Enschede (Netherlands); Anninga, Bauke, E-mail: b.anninga@student.utwente.nl [University of Twente, MIRA-Institute for Biomedical Technology and Technical Medicine, P.O. Box 21, 7500 AE Enschede (Netherlands); Jager, Gerrit J., E-mail: g.jager@JBZ.nl [Department of Radiology, Jeroen Bosch Hospital, Henri Dunantstraat 1, 5223 GZ ’s-Hertogenbosch (Netherlands); Rutten, Matthieu J.C.M., E-mail: mj.rutten@online.nl [Department of Radiology, Jeroen Bosch Hospital, Henri Dunantstraat 1, 5223 GZ ’s-Hertogenbosch (Netherlands)

    2013-09-15

    Objective: The purpose of this study is to reduce the administered contrast medium volume in abdominal CTA by using a test bolus injection, with the preservation of adequate quantitative and qualitative vessel enhancement. Study design: For this technical efficacy study 30 patients, who were referred for a CTA examination of the abdominal aorta, were included. Randomly 15 patients were assigned to undergo a multiphasic injection protocol and received 89 mL of contrast medium (Optiray 350) (protocol I). Fifteen patients were assigned to the test bolus injection protocol (protocol II), which implies injection of a 10 mL test bolus of Optiray 350 prior to performing CTA with a 40 mL of contrast medium. Quantitative assessment of vascular enhancement was performed by measuring the amount of Hounsfield Units in the aorta at 30 positions from the celiac trunk to the iliac arteries in both groups. Qualitative assessment was performed by three radiologists who scored the images at a 5-point scale. Results: Quantitative assessment showed that there was no significant difference in vascular enhancement for patients between the two protocols, with mean attenuation values of 280.9 ± 50.84 HU and 258.60 ± 39.28 HU, respectively. The image quality of protocol I was rated 4.31 (range: 3.67/5.00) and of protocol II 4.11 (range: 2.67/5.00). These differences were not statistically significant. Conclusion: This study showed that by using a test bolus injection and the administration of 50 mL of contrast medium overall, CTA of the abdominal aorta can reliably be performed, with regard to quantitative and qualitative adequate vessel enhancement.

  18. Aneurisma de la aorta abdominal: Tratamiento endovascular con una endoprótesis fenestrada Abdominal aortic aneurysm: Endovascular treatment with fenestrated endoprothesis

    Directory of Open Access Journals (Sweden)

    Román Rostagno

    2008-12-01

    Full Text Available El tratamiento endovascular de los aneurismas de aorta abdominal es una alternativa a la cirugía abierta para pacientes de alto riesgo. Consiste en la exclusión del saco aneurismático mediante la interposición de una endoprótesis colocada por vía femoral. El tratamiento endovascular no puede ser utilizado en todos los pacientes. Una limitación frecuente la constituye el nacimiento de una arteria visceral desde el saco aneurismático. Para contrarrestar esta limitación recientemente se han desarrollado endoprótesis fenestradas que presentan orificios que se corresponden con el nacimiento de las arterias involucradas en el aneurisma evitando su oclusión, permitiendo de esta manera el tratamiento endovascular. En esta comunicación se presenta un caso de tratamiento endovascular de un aneurisma de aorta abdominal mediante la colocación de una endoprótesis fenestrada en un paciente cuya arteria renal izquierda nacía directamente del saco aneurismático.Endovascular treatment of the abdominal aortic aneurysm is consider an alternative to open surgery for high risk patients. Its goal is to exclude the aneurysm from the circulation by using an endoprothesis introduced from a femoral approach. Patients must be strictly selected to avoid possible complications. The most frequent limitation is related to anatomic contraindications such as visceral arteries involved in the aneurysm. Fenestrated endograft have been recently developed to allow endovascular treatment when anatomic features contraindicate classic endovascular procedures. Fenestrated endograft have holes that match with the origin of the visceral arteries maintaining its potency. In this paper we report the endovascular treatment of an abdominal aortic aneurysm by using a fenestrated endoprothesis in a patient whose left renal artery is originated from the aneurysm.

  19. Vertebral Bone Erosions Due to Aortic Abdominal Aneurysm: A Case Report

    Directory of Open Access Journals (Sweden)

    Jamal Hossin

    2009-01-01

    Full Text Available   "nOsteolytic aortic abdominal aneurysm has rarely been reported as the cause of spinal lesions. Patients presenting with pain secondary to an abdominal aortic aneurysm demands prompt attention. Such cases could be encountered in a neurosurgical field such as a lumbar disc disease, spondylosis, or a cauda equina tumor. "nWe represent a 65-year-old male who was referred by a neurosurgeon for lumbosacral MRI due to new onset low back pain since a week ago with extension of the radiculer pain to the left lower extremity. MRI revealed erosions on the left anterior border with sclerotic changes in the body of L4 and the left psoas muscle appeared wider than the right psoas muscle with a non homogeneous signal intensity. Follow-up multi slice CT revealed a 6.5 cm diameter saccular abdominal aortic aneurysm 5.5 cm beneath the origin of the left renal artery and just before the bifurcation of the abdominal aorta with aortic wall calcifications and a large retroperitoneal hematoma.  

  20. Evaluation of personal dosimetry in abdominal aorta endo prosthesis procedures; Avaliacao da dosimetria pessoal em procedimentos de endoproteses de aorta abdominal

    Energy Technology Data Exchange (ETDEWEB)

    Bacchim Neto, Fernando A.; Alves, Allan F.F.; Freitas, Carlos C.M. de; Pina, Diana R. [Universidade Estadual Paulista Julio de Mesquita Filho (FMB/UNESP), Botucatu, SP (Brazil). Faculdade de Medicina

    2016-07-01

    The objective of this paper is to evaluate the currently dosimetry technique employed in the medical staff during interventional radiology procedures. Thermoluminescent dosimeters were positioned in different regions of the primary interventionist during procedures of stent graft in abdominal aortic aneurysms. The equivalent dose rate profile shows a tendency of difference between dose rate found in the chest in relation to the abdomen, hands and feet. Statistically, dose rates found in the hands differ from those found in the chest with p=0.05. These results suggest that only a dosimeter placed on the chest does not describe faithfully the radiation doses to which these professionals are occupationally exposed. (author)

  1. Kidney Failure Due to Abdominal Compartment Syndrome Following Snakebite.

    Science.gov (United States)

    Jalalzadeh, Mojgan; Ghadiani, Mohammad Hassan

    2017-01-01

    Treatment of snakebite complications is challenging, as it is difficult to distinguish what kind of antivenins should be used. Kidney failure as a result of rhabdomyolysis or hemolysis may happen due to accumulated fluids that increase the pressure in the abdomen. This case report describes acute kidney failure probably due to intra-abdominal hypertension following an unknown bite.

  2. Anatomical description of arterial branches of thoracic and abdominal aorta in the coati (Nasua nasua (Carnivora, Procyonidae

    Directory of Open Access Journals (Sweden)

    Daniel Arrais Biihrer

    2015-05-01

    Full Text Available The coati (Nasua nasua is a widely distributed species in South America, also in Brazil. This study aimed to observe and describe the branching morphology of the main arterial branches of thoracic and abdominal aorta in the coati, by comparing the findings with existing literature on the other domestic and wild species. For this study, two adult male specimens were used, collected from highways in the state of Minas Gerais, Brazil, victims of roadkill. The specimens were fixed in formalin solution and their aortic branches were filled with latex for subsequent dissection and analysis. It was observed that the left subclavian artery is a direct branch of the aortic arch, there is no formation of a bicarotid or celiac-mesenteric trunk, facts similarly described in domestic carnivores. Thus, it was noticed that the arterial branches of aorta in the coati, both in the thoracic and abdominal cavities, show a distribution very similar to that observed in domestic carnivores, something which reflects their evolutionary closeness within the Carnivora order. Thus, this study proves to be relevant by deepening anatomical knowledge on this wild species, enabling that aspects already known in canine veterinary medicine are applied to the coati.

  3. Correção endovascular do aneurisma da aorta abdominal: análise dos resultados de único centro

    Directory of Open Access Journals (Sweden)

    Eduardo Rafael Novero

    2012-02-01

    Full Text Available OBJETIVO: Avaliar os resultados clínicos imediatos e em médio prazo do tratamento endovascular em pacientes portadores de aneurisma da aorta abdominal em um centro de referência para doenças cardiovasculares. MATERIAIS E MÉTODOS: Estudo retrospectivo de uma série de pacientes submetidos a tratamento endovascular de aneurisma da aorta abdominal, no período de janeiro de 2009 a julho de 2010. Foram avaliados as características demográficas, o sucesso técnico, o sucesso terapêutico, a morbimortalidade, as complicações e a taxa de reintervenções perioperatórias imediatos, e após um ano de acompanhamento. RESULTADOS: Foram analisados 102 pacientes consecutivos com idade média de 72 ± 9 anos, sendo 79% deles do sexo masculino. Houve sucesso técnico em 97,1% e êxito terapêutico em 81% dos casos. A mortalidade perioperatória foi de 0,9% e a anual, de 7,8%. Foram necessárias reintervenções em 18,8% dos pacientes durante o seguimento. CONCLUSÃO: Em nosso estudo, os resultados obtidos justificam a realização desse procedimento nos pacientes com anatomia adequada.

  4. Zn-Li alloy after extrusion and drawing: Structural, mechanical characterization, and biodegradation in abdominal aorta of rat.

    Science.gov (United States)

    Zhao, Shan; Seitz, Jan-M; Eifler, Rainer; Maier, Hans J; Guillory, Roger J; Earley, Elisha J; Drelich, Adam; Goldman, Jeremy; Drelich, Jaroslaw W

    2017-07-01

    Zinc shows great promise as a bio-degradable metal. Our early in vivo investigations implanting pure zinc wires into the abdominal aorta of Sprague-Dawley rats revealed that metallic zinc does not promote restenotic responses and may suppress the activities of inflammatory and smooth muscle cells. However, the low tensile strength of zinc remains a major concern. A cast billet of the Zn-Li alloy was produced in a vacuum induction caster under argon atmosphere, followed by a wire drawing process. Two phases of the binary alloy identified by x-ray diffraction include the zinc phase and intermetallic LiZn4 phase. Mechanical testing proved that incorporating 0.1wt% of Li into Zn increased its ultimate tensile strength from 116±13MPa (pure Zn) to 274±61MPa while the ductility was held at 17±7%. Implantation of 10mm Zn-Li wire segments into abdominal aorta of rats revealed an excellent biocompatibility of this material in the arterial environment. The biodegradation rate for Zn-Li was found to be about 0.008mm/yr and 0.045mm/yr at 2 and 12months, respectively. Copyright © 2017 Elsevier B.V. All rights reserved.

  5. Infected abdominal aortic aneurysm due to Morganella morganii: CT findings.

    Science.gov (United States)

    Kwon, Oh Young; Lee, Jong Seok; Choi, Han Sung; Hong, Hoon Pyo; Ko, Young Gwan

    2011-02-01

    An infected aortic aneurysm, or mycotic aneurysm, is a rare arterial dilatation due to destruction of the infected vessel wall. Common pathogens resulting in an infected aortic aneurysm are Salmonella and Clostridium species, as well as Staphylococcus aureus; Morganella morganii, on the other hand, is very rare. An infected abdominal aortic aneurysm has tendencies to grow rapidly and to rupture. The mortality rate is high in patients undergoing emergent surgical intervention. We report the case of a 65-year-old man who presented with an infected abdominal aortic aneurysm caused by M. morganii. A high index of suspicion and imaging tests are necessary in order to diagnose an infected aortic aneurysm.

  6. [Application of temporary balloon occlusion of the abdominal aorta in the treatment of complete placenta previa complicated with placenta accreta].

    Science.gov (United States)

    Cui, S H; Zhi, Y X; Zhang, K; Zhang, L D; Shen, L N; Gao, Y N

    2016-09-25

    Objective: To investigate the value of temporary balloon occlusion of the abdominal aorta in the treatment of complete placenta previa with placenta accreta. Methods: From January 2015 to February 2016, 24 cases of complete placenta previa with placenta accreta were treated with temporary balloon occlusion of the abdominal aorta(the study group)before cesarean, and 24 cases of complete placenta previa with placenta accreta did not receive balloon occlusion(the control group). The operation time, intraoperative blood loss, intraoperative blood transfusion volume, the perioperative hemoglobin level, the hysterectomy rate and the related complications were compared retrospectively.Also, the hospitalization time, the blood coagulation parameters after operation, including activated partial thromboplastin time(APTT), fibrinogen(FIB), D-Dimer and reperfusion injury parameters including creatine phosphokinase(CK), creatine phosphokinase isoenzyme(CK-MB), lactate dehydrogenase(LDH)and serum creatinine were compared between the 2 groups. Results: The blood loss[750 ml(400- 2 000 ml)vs 2 000 ml(1 500- 2 375 ml); Z=-3.214, P=0.001]and blood transfusion volume[200 ml(0-800 ml)vs 800 ml(0-1 200 ml); Z=- 2.173, P=0.030]in the study group were lower than in the control group. The hemoglobin difference between before and after operation in the study group was lower than the control group[(12.8±13.4)g/L vs(22.9±20.1)g/L; t=-2.041, P=0.047]. In the study group, there were still bleeding in 13 cases after releasing the balloon, 5 of them received uterine artery embolization, 5 cases received uterine artery ligation, and 3 cases received uterine packing. One case had venous thrombosis in the right lower limb. Two cases(8%,2/24)in the control group had hysterectomy, while none in the study group, there was no statistical significance(P= 0.489). Conclusions: Temporary balloon occlusion of the abdominal aorta can effectively reduce blood loss and blood transfusion in the treatment of

  7. Preoperative infrarenal abdominal aorta balloon catheter occlusion combined with Bakri tamponade reduced maternal morbidity of placenta increta/percreta.

    Science.gov (United States)

    Zeng, Chanjuan; Yang, Mengyuan; Ding, Yiling; Yu, Ling; Deng, Wen; Hu, Yu; Gong, Xiujuan

    2017-09-01

    Placenta increta/percreta is an increasingly common and life-threatening obstetric complication. It poses a management challenge to clinicians. The present study aimed to evaluate efficacy and safety of preoperative placement of infrarenal abdominal aorta balloon catheter (IAABC) alone or combined with Bakri tamponade for the management of cases with placenta increta/percreta. We retrospectively analyzed all cases with placenta increta/percreta at a tertiary referral teaching hospital in China between the year 2014 and 2017. Statistical analysis considered the individual subgroups: IAABC placed group and control group (without IAABC), and compared their maternal-fetal outcomes. The study covered 86 cases with placenta increta. For cases in the IAABC placed group (n = 48), significant reductions were noted in maternal morbidity including estimated blood loss (EBL), EBL ≥ 2000 mL, blood products transfusions, postpartum hemorrhage, operative time, intensive care unit admission, and postoperative days (P tamponade. In the control group, 10 cases were successful in preserving uterus by Bakri tamponade. Four cases failed and needed reoperation (3 uterine arterial embolism, 1 hysterectomy). There were no differences in fetal outcomes between the 2 groups. Eighteen cases were diagnosed with placenta percreta. Almost all the cases (17/18) inevitably underwent caesarean hysterectomy. Only 1 case was treated with a combination of IAABC and Bakri tamponade, and successfully reserved uterus. No differences were observed in any other outcomes, except for a significant less mean operative time (P = .017) in cases with IAABC placed (n = 10), compared with those without IAABC (n = 8). Only 1 case had a femoral artery thrombosis directly related to IAABC placement and recovered after conservative treatment. There was no maternal or neonatal death in this study. Prophylactic insertion of IAABC alone or combined with Bakri tamponade should be safe and

  8. Tratamento farmacológico e interações medicamentosas em pacientes com aneurisma da aorta abdominal

    Directory of Open Access Journals (Sweden)

    Heverton Alves Peres

    2015-01-01

    Full Text Available O aneurisma da aorta abdominal (AAA ocorre quando há uma dilatação anormal e irreversível da artéria superior a 50% do calibre esperado para o vaso e associa-se a uma mortalidade de 80 a 90%. O controle dos principais fatores de risco como a hipertensão, dislipidemia, tabagismo e doenças trombóticas em aneurismas pequenos é feito por vários medicamentos que evitam o desenvolvimento e ruptura do aneurisma, no entanto, o uso destes associados a outros medicamentos pode desencadear interações medicamentosas relevantes sendo crucial o conhecimento sobre estas. Atualmente, há poucos dados na literatura sobre o tratamento farmacológico e interações medicamentosas em pacientes com AAA, sendo o objetivo desta revisão, descrever a farmacoterapia e interações medicamentosas em pacientes com AAA.

  9. Effects of arterial blood flow on walls of the abdominal aorta: distributions of wall shear stress and oscillatory shear index determined by phase-contrast magnetic resonance imaging.

    Science.gov (United States)

    Sughimoto, Koichi; Shimamura, Yoshiaki; Tezuka, Chie; Tsubota, Ken'ichi; Liu, Hao; Okumura, Kenichiro; Masuda, Yoshitada; Haneishi, Hideaki

    2016-07-01

    Although abdominal aortic aneurysms (AAAs) occur mostly inferior to the renal artery, the mechanism of the development of AAA in relation to its specific location is not yet clearly understood. The objective of this study was to evaluate the hypothesis that even healthy volunteers may manifest specific flow characteristics of blood flow and alter wall shear or oscillatory shear stress in the areas where AAAs commonly develop. Eight healthy male volunteers were enrolled in this prospective study, aged from 24 to 27. Phase-contrast magnetic resonance imaging (MRI) was performed with electrocardiographic triggering. Flow-sensitive four-dimensional MR imaging of the abdominal aorta, with three-directional velocity encoding, including simple morphological image acquisition, was performed. Information on specific locations on the aortic wall was applied to the flow encodes to calculate wall shear stress (WSS) and oscillatory shear index (OSI). While time-framed WSS showed the highest peak of 1.14 ± 0.25 Pa in the juxtaposition of the renal artery, the WSS plateaued to 0.61 Pa at the anterior wall of the abdominal aorta. The OSI peaked distal to the renal arteries at the posterior wall of the abdominal aorta of 0.249 ± 0.148, and was constantly elevated in the whole abdominal aorta at more than 0.14. All subjects were found to have elevated OSI in regions where AAAs commonly occur. These findings indicate that areas of constant peaked oscillatory shear stress in the infra-renal aorta may be one of the factors that lead to morphological changes over time, even in healthy individuals.

  10. Biliary peritonitis due to "fallen" hydatid cyst after abdominal trauma.

    Science.gov (United States)

    Kara, Melih; Tihan, Deniz; Fersahoglu, Tuba; Cavda, Faruk; Titiz, Izzet

    2008-01-01

    Hepatic hydatid cysts may cause serious complications. Intraperitoneal rupture of hepatic hydatid cyst is rarely seen and the prognosis can be fatal. By experience, we know that it might be difficult to diagnose an unruptured cyst expulsed into the peritoneal cavity. In this report, we present the case of a 54-year-old man with an intraperitoneal cystic mass of 10 cm of diameter which had extruded out from the liver due to a blunt abdominal trauma.

  11. Vasorelaxant activities of Danhong injection and their differential effects on the rat abdominal aorta and mesenteric artery.

    Science.gov (United States)

    Su, Xianming; Zhi, Xiaowen; Cui, Ting; Zheng, Qiaowei; Wang, Shixiang; Cao, Yongxiao; Cui, Changcong; Feng, Weiyi

    2015-01-01

    Previous studies have found that Danhong injection (DHI), an extensively used herbal extract preparation in China, might be a powerful vasodilator. The aims of this study were to determine the vascular activity of DHI and its effects on arteries of different sizes. The results showed that DHI significantly inhibited rat-hindquarters and rabbit-ear vasoconstriction elicited by norepinephrine (NE) perfusion and markedly relaxed KCl-contracted and NE-contracted rat abdominal aortic and mesenteric artery rings. The endothelium made only a minor contribution to the vasorelaxant effect of DHI on artery segments. The vasorelaxant effect of DHI varied with the artery size, with larger arteries exhibiting a more sensitive and potent vasodilator response. DHI relaxed NE-induced vasoconstriction probably through inhibition of the intracellular Ca2+ release through the inositol triphosphate receptor system in the abdominal aorta and mesenteric artery, along with blockage of extracellular Ca2+ influx through the receptor-linked Ca2+ channels in the mesenteric artery. In addition, DHI completely relaxed KCl-induced contraction in both of the arteries, suggesting that inhibition of Ca2+ influx through voltage-gated Ca2+ channels is involved in the vasorelaxant effect of DHI. This elucidation of the vascular effects of DHI and the underlying mechanisms could lead to improved clinical applications.

  12. Aneurismas complejos de la aorta abdominal: cirugía abierta frente a exclusión endovascular avanzada. Estudio comparativo.

    OpenAIRE

    2015-01-01

    Justificación del estudio e hipótesis de trabajo: la enfermedad aneurismática de la aorta se estima que afecta al 2%-7% de los varones mayores de 60 años. Dichas estimaciones, extrapoladas a la población de España, se corresponderían con 140.000-350.000 personas portadoras de una aneurisma de aorta abdominal. En siete de cada cien personas acaece la rotura del aneurisma, siendo actualmente la décima causa de muerte en varones mayores de 55 años. En aquellos pacientes de alto riesgo para la ci...

  13. Late diagnosis of Takayasu's arteritis with repeated attacks of heart failure and uncontrolled hypertension due to abdominal aortic thrombosis: case report and review of the literature.

    Science.gov (United States)

    Wang, Huan; Lai, Baochun; Wu, Xiaoying; Han, Tao; Chen, Hui

    2015-01-01

    Takayasu's arteritis (TA) is a chronic, idiopathic, inflammatory disease affecting the aorta and its branches. To date, only one case involving abdominal aortic thrombosis due to TA has been reported. After bilateral artificial subclavian-iliac bypass, a case of abdominal aortic thrombosis due to TA received a delayed diagnosis in a 44-year-old Chinese male who experienced recurrent episodes of heart failure and uncontrolled hypertension with claudication of two extremities. Abdominal color Doppler sonography and computed tomography aortography (CTA) showed occlusion of the abdominal aorta and bilateral renal artery stenosis. After vascular bypass and during 1 year follow-up, his cardiac function improved and blood pressure was well controlled, with reduced serum creatinine. Postoperative CTA still showed abdominal aortic thrombosis resulting in arterial occlusion extending from the left renal artery initial segment level to the bilateral common iliac artery and the bifurcation of the renal artery, except for the vascular bypass. Abdominal aortic thrombosis due to TA is very rare and potentially life threatening, probably becoming an atherosclerosis risk factor. Doppler sonography and CTA results are important for diagnosis. Artificial vascular bypass can be used for TA in debilitated patients with diffuse aortic disease.

  14. [Ruptured aneurysms of the abdominal aorta. A study of their incidence and mortality].

    Science.gov (United States)

    Acea Nebril, B; Tovar Martín, E; Díaz Pardeiro, P; Fernández Pintos, J; Caamaño Martínez, S

    1993-01-01

    Between 1986 and 1992, 133 patients with abdominal aneurysms presented to our Department of Vascular Surgery. Of these, 97 (73%) were elective cases and 36 (27%) had ruptured. In all these patients resections were undertaken. Postoperative complications occurred in 28 patients (28%) for elective resection and in 17 patients (47%) for ruptured aneurysms (p < 0.05), with mortality rates of 46 and 94%, respectively (p < 0.005). The postoperative mortality for elective resection was 13% and for rupture 44% (p < 0.001).

  15. Abdominal aorta aneurysms in children: single-center experience of six patients.

    Science.gov (United States)

    Ye, Caisheng; Yin, Henghui; Lin, Ying; Zhou, Li; Ye, Runyi; Li, Xiaoxi; Han, Anjia; Wang, Shenming

    2012-01-01

    Abdominal aortic aneurysms (AAA) are rare in children and are associated with significant morbidity and mortality as in adults. We summarize our experience in the diagnosis and management of AAAs in 6 children at a single institution. The clinical data of 6 pediatric patients with AAAs treated at our hospital from November 2005 to November 2008 were retrospectively analyzed. There were 4 males and 2 females with a mean age at diagnosis of 8 years (range, 17 months to 18 years). All patients presented with pulsatile abdominal masses. Color Doppler ultrasonography and computed tomography angiography were the primary diagnostic tools. One patient has a history of tuberous sclerosis, and 1 had Takayasu's arteritis; no risk factors or identifiable causes were found in the other patients. All of the AAAs identified were infrarenal. Surgical reconstruction with aneurysm resection and prosthetic graft placement was performed successfully in all 6 cases. No intraoperative or postoperative complications occurred. Mean follow-up has been 48 months (range, 32 to 69). In 1 patient, recurrence was noted at 3 years postoperatively. The patient's family declined further surgery, and the patient died, likely of rupture of the aneurysm at 41 months postoperatively. All other patients are currently alive and well. Our experience indicates that good outcomes can be obtained in children with AAAs with prompt and accurate diagnosis and surgical management with artificial grafts. Copyright © 2012 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  16. Patient-Specific Simulation Models of the Abdominal Aorta With and Without Aneurysms

    DEFF Research Database (Denmark)

    Enevoldsen, Marie Sand

    relations for computational analysis, and evaluation of the material model predictability. The constitutive framework applied is the four fiber family (4FF) model. This model assumes that the wall is a constrained mixture of an amorphous isotropic elastin dominated matrix reinforced by collagen fibers....... The collagen fibers are grouped in four directions of orientation. The purpose of the first study was to investigate whether significant risk factors related to AAA development can be identified from a specific pattern in the material parameters of the 4FF model. Smoking is a leading self-inflicted risk factor......This research study presents computational simulation models for analysis of parameters which are in evidence of development and clinical management of abdominal aortic aneurysms (AAA). The research covers three main areas: interpretation of material parameters, implementation of the constitutive...

  17. Hérnias incisionais no pós-operatório de correção de aneurisma de aorta abdominal

    OpenAIRE

    2012-01-01

    CONTEXTO: A incidência de hérnia incisional no pós-operatório da correção aberta de aneurisma de aorta abdominal é alta, variando de 10 a 37% e mais de três vezes mais comum do que em pacientes submetidos à correção para doença obstrutiva aorto-ilíaca. OBJETIVO: Apresentar a incidência de hérnia incisional em um grupo de pacientes acompanhados no pós-operatório da correção aberta de aneurisma de aorta abdominal. MÉTODOS: Série de casos em uma população de 144 pacientes operados por aneurisma ...

  18. Detección de aneurisma de la aorta abdominal en una población derivada para ecocardiografía transtorácica

    Directory of Open Access Journals (Sweden)

    Clotilde S. Berensztein

    2006-01-01

    Full Text Available Se evaluó: 1 la factibilidad de realizar una ecografía limitada a la aorta abdominal en pacientes a quienes se indica un ecocardiograma transtorácico, 2 las variables clínicas y ecocardiográficas que se correlacionan con el diámetro de la aorta abdominal, 3 la prevalencia de aneurisma de la aorta abdominal (AAA y 4 los factores de riesgo clínicos para AAA. Se evaluaron prospectivamente 280 pacientes consecutivos (media de edad: 68, rango 18 a 93 años, 118 de sexo masculino [42%]. Se verificó que: 1 el examen ecográfico de la aorta abdominal es factible en la mayoría de los pacientes (95,36% [IC 95% 92,88-97,84%], 2 el diámetro de la aorta abdominal se correlaciona con el sexo masculino, la edad, los antecedentes personales de enfermedad vascular periférica y los antecedentes de familiares de primer grado con AAA; también se correlaciona con el diámetro de la raíz aórtica (RA y con el grosor parietal relativo (GPR, 3 existe una prevalencia alta de AAA en la población estudiada (4,49% [IC 95% 1,99-7,00%], particularmente en los varones = 65 años (12,33% [IC 95% 4,60-20,05%] y 4 el sexo masculino, la hipertensión arterial, la dislipemia, el tabaquismo, la diabetes, los antecedentes personales de cardiopatía isquémica o de vasculopatía periférica y los antecedentes de familiares de primer grado con AAA son factores de riesgo para AAA. En conclusión, estaría justificada la realización de una ecografía abdominal como extensión de la ecocardiografía transtorácica en varones = 65 años, en particular si coexisten otros factores de riesgo para AAA.

  19. [Risk factors for long-term result of endovascular treatment for auto-immune disease related abdominal aorta pseudo-aneurysm].

    Science.gov (United States)

    Ye, W; Di, X; Liu, Q; Li, Y J; Zheng, Y H; Zeng, R; Song, X J; Liu, Z L; Liu, C W

    2016-12-06

    Objective: To summarize results of endovascular treatment for auto-immune disease related abdominal aorta pseudo-aneurysm(AIPA), and to analysis clinical predictors of long term major adverse clinical events(MACE). Methods: Retrospectively collected endovascular treatment for AIPA cases in Peking Union Medical College Hospital within 2000 to 2015. Twenty-nine cases with AIPA treated by endovascular therapy were enrolled in this study. Twenty five cases were male, range from 23 to 67 years old, mean age was (39.3±11.4) years old.Demographic characters, locations of aneurysms, type to auto-immune disease, immuno medical therapy, operation strategy and long term follow-up data were reported. Statistical analysis was made to verify clinical predictors of long-term MACE. Results: Among the 29 cases, 22 cases with bechet's disease, 4 cases with Takayasu's arteritis, 2 cases with systemic lupus erythematosus, 1 cases with polyarteritis nodosa. Eight cases had ruptured or pending ruptured pesudo-aneurysms, the rest 21 cases had dull pain or no overt symptome. Twenty-four cases had infra-renal artery aneurysms, two were para-and supra-renal artery, two were supra-celiac artery, and the rest one had multiple aneurysms involved thoracic and abdominal aorta.All the cases received regular immune medical therapy except the three emergency cases. All the operations were under general anaesthesia. Nineteen cases underwent classical Endovascular aortic aneurysm repair (EVAR), 5 cases underwent fenestration EVAR, the rest 5 cases underwent hybrid procedure. All the 29 operations were successful, without conversion to open surgery. Major peri-operation complication included 3 incision infection, 3 pulmonary infection. No death occurred. All the cases received regular follow-up from 1 to 120 months. There were five recurrence of pseudo-aneurysm, 1 case suffered from iliac limb occlusion. 5 cases received re-intervention procedure. No occlusion of revascularizal visceral artery was

  20. Assessment of the abdominal aorta and its visceral branches by contrast-enhanced dynamic volumetric hepatic parallel magnetic resonance imaging: feasibility, reliability and accuracy

    Energy Technology Data Exchange (ETDEWEB)

    Werder, Robert; Weishaupt, Dominik; Marincek, Borut [University Hospital Zurich, Institute of Diagnostic Radiology, Zurich (Switzerland); Nanz, Daniel [University Hospital Zurich, Department of Medical Radiology, Zurich (Switzerland); Lutz, Amelie M.; Willmann, Juergen K. [University Hospital Zurich, Institute of Diagnostic Radiology, Zurich (Switzerland); Stanford University, MIPS, Department of Radiology, Palo Alto, CA (United States); McCormack, Lucas [University Hospital Zurich, Department of Visceral and Transplantation Surgery, Zurich (Switzerland); Seifert, Burkhardt [University of Zurich, Department of Biostatistics, Zurich (Switzerland)

    2007-02-15

    The purpose of this study was to evaluate a new three-dimensional gradient-echo (GRE) MR sequence performed with a parallel acquisition technique to shorten breath-hold times (parallel GRE MRI) in the detection of arterial variants and stenosis of the abdominal aorta and its visceral branches. A total of 102 patients underwent dynamic parallel GRE MRI, timed to the arterial phase by a test bolus (mean breath-hold time, 17 s). For both quantitative and qualitative analysis, the abdominal aorta and its visceral branches were divided into 13 arterial segments. In a subanalysis of 55/102 patients, the accuracy of parallel GRE MRI compared to MDCT in the detection arterial variants and stenosis was calculated for two independent readers. Mean SNRs and CNRs were 47.2 and 35.6, respectively. Image quality was rated good or excellent in 1,234/1,326 segments (93%). Hepatic and renal arterial variants were identified with an accuracy of 93 and 95%, respectively (reader 1) and 98 and 100%, respectively (reader 2). Both readers detected arterial stenosis with an accuracy of 98%. Interobserver agreement was good to excellent for the detection of hepatic ({kappa}=0.69) and renal ({kappa}=0.92) variants and for the diagnosis of stenosis ({kappa}=0.96). Dynamic three-dimensional parallel GRE MRI is feasible and allows a reliable and accurate diagnosis of arterial variants and stenosis of the abdominal aorta and its visceral branches in a short breath-hold-time. (orig.)

  1. Clinical evaluation of balloon occlusion of the lower abdominal aorta in patients with placenta previa and previous cesarean section: A retrospective study on 43 cases.

    Science.gov (United States)

    Chen, Manru; Xie, Lan

    2016-10-01

    This study investigated the efficacy of balloon occlusion of the lower abdominal aorta in cesarean section surgery for the patients with placenta previa and previous cesarean section. The patients who had placenta previa and underwent cesarean section (CS) were evaluated. The patients treated with CS to terminate the pregnancy were used as control group (23 cases); the patients treated with the preset abdominal aorta balloon before CS was taken as study group (20 cases). The investigated indicators included the intraoperative blood loss, blood loss within postoperative 24 h, the transfusion amount of red cell suspension (RCS), hospital stay, incidence rate of disseminated intravascular coagulation (DIC), the asphyxia, premature delivery and the mortality of the newborns. The two groups are comparable. The intraoperative blood loss, blood loss within postoperative 24 h, the transfusion amount of RCS and the percentage of uterus resection in the study group were significantly lower (P < 0.05) than that in the control group. The percentage of uterine cavity filling with ribbon gauze in the study group was higher than the control group (P < 0.05). The balloon occlusion of lower abdominal aorta seems effective in reducing postpartum hemorrhage and the blood transfusion and decreasing the risk of hysterectomy without harming the newborns. Copyright © 2016 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

  2. Isolated duodenal rupture due to blunt abdominal trauma

    Directory of Open Access Journals (Sweden)

    Celik Atilla

    2006-01-01

    Full Text Available Duodenal rupture following blunt abdominal trauma is rare and it usually seen with other abdominal organ injuries. It represents approximately 2% to 20% of patients with blunt abdominal injury and often occurs after blows to the upper abdomen, or abdominal compression from high-riding seat belts. Two cases of blunt duodenal rupture successfully treated surgically, are presented with their preoperative diagnosis and final out comes.

  3. Influence of Selective Biochemical and Morphological Agents on Natural History of Aneurysm of Abdominal Aorta Development.

    Science.gov (United States)

    Wołoszko, Tomasz; Skórski, Maciej; Kwasiborski, Przemysław; Kmin, Ewelina; Gałązka, Zbigniew; Pogorzelski, Ryszard

    2016-02-09

    BACKGROUND The development of abdominal aortic aneurysm (AAA) is probably influenced by many factors. The role of some of these factors, such as intraluminal thrombus (ILT) or cystatin C serum levels, remains controversial. Proving their influence could have therapeutic implications for some patients with AAA. Associations between the rate of increase in diameter of an aneurysm and ILT, as well as other factors, including biochemical factors (C-Reactive Protein - CRP, cystatin C), age, sex, and comorbidities, could predict disease progression in individual patients. MATERIAL AND METHODS Seventy patients with small AAA were included into the study. The patients were followed using ultrasound and CT imaging. We evaluated aneurysm dimensions and aneurysm wall thickness, as well as ILT and its dimensions, aneurysm wall morphology, CRP, and cystatin C. RESULTS We observed significant growth of AAA and thinning of aneurysmal wall. Aneurysms over 4 cm grew significantly faster in the second year of observation. ILT grew together with AAA size. Age, sex, smoking, dyslipidemias, or controlled arterial hypertension had no influence on aneurysm progression rate. Changes in serum of CRP concentration did not reach statistical significance, but cystatin C levels did. CONCLUSIONS Presence and size of ILT, wall thickness, and cystatin C levels may be considered in prediction of AAA progression. ILT might exert a protective influence on the risk of aneurysm rupture. However, larger aneurysms containing larger thrombi grow faster and their walls undergo more rapid degradation, which in turn increases the risk of rupture. This matter requires further studies.

  4. Implantation of an Andrastent XL in an adult with advanced chronic heart failure due to coarctation of the aorta.

    Science.gov (United States)

    Białkowski, Jacek; Szkutnik, Małgorzata; Fiszer, Roland; Wolny, Tomasz; Knapik, Tomasz; Nowalany-Kozielska, Ewa; Zembala, Marian

    2011-01-01

    We report the case of a 49 year-old-man with congenital coarctation of the aorta (CoA), admitted in a critical clinical condition due to advanced secondary cardiomyopathy and chronic heart failure. An Andrastent XL was implanted successfully in the CoA. The procedure resulted in an almost completely resolved CoA and prompt clinical improvement in the patient.

  5. Standardized Volume Rendering for Magnetic Resonance Angiography Measurements in the Abdominal Aorta

    Energy Technology Data Exchange (ETDEWEB)

    Persson, A.; Brismar, T.B.; Lundstroem, C.; Dahlstroem, N.; Othberg, F.; Smedby, Oe. [Linkoeping Univ. Hospital (Sweden). Center for Medical Image Science and Visualization (CMIV)

    2006-03-15

    Purpose: To compare three methods for standardizing volume rendering technique (VRT) protocols by studying aortic diameter measurements in magnetic resonance angiography (MRA) datasets. Material and Methods: Datasets from 20 patients previously examined with gadolinium-enhanced MRA and with digital subtraction angiography (DSA) for abdominal aortic aneurysm were retrospectively evaluated by three independent readers. The MRA datasets were viewed using VRT with three different standardized transfer functions: the percentile method (Pc-VRT), the maximum-likelihood method (ML-VRT), and the partial range histogram method (PRH-VRT). The aortic diameters obtained with these three methods were compared with freely chosen VRT parameters (F-VRT) and with maximum intensity projection (MIP) concerning inter-reader variability and agreement with the reference method DSA. Results: F-VRT parameters and PRH-VRT gave significantly higher diameter values than DSA, whereas Pc-VRT gave significantly lower values than DSA. The highest interobserver variability was found for F-VRT parameters and MIP, and the lowest for Pc-VRT and PRH-VRT. All standardized VRT methods were significantly superior to both MIP and F-VRT in this respect. The agreement with DSA was best for PRH-VRT, which was the only method with a mean error below 1 mm and which also had the narrowest limits of agreement (95% of cases between 2.1 mm below and 3.1 mm above DSA). Conclusion: All the standardized VRT methods compare favorably with MIP and VRT with freely selected parameters as regards interobserver variability. The partial range histogram method, although systematically overestimating vessel diameters, gives results closest to those of DSA.

  6. Simulation of blood flow within the abdominal aorta. Computational fluid dynamics in abdominal aortic aneurysms before and after interventions; Simulation des Blutflusses in der abdominellen Aorta. Die numerische Simulation des Blutflusses in abdominellen Aortenaneurysmen vor und nach Intervention

    Energy Technology Data Exchange (ETDEWEB)

    Frauenfelder, T.; Alkadhi, H.; Marincek, B.; Schertler, T. [Universitaetsspital Zuerich, Institut fuer Diagnostische Radiologie, Zuerich (Switzerland); Boutsianis, E. [ETH Zuerich, Labor fuer Computerwissenschaften und Engineering, Zuerich (Switzerland)

    2007-11-15

    The goal of numeric analysis of aortic blood flow is to evaluate the mechanisms leading to an aortic aneurysm with regard to the risk of a rupture and to describe the effect of interventional therapy. Numeric analysis is based on virtual models of vascular structures and the physical characteristics of the vessel wall, of blood as fluidum, and the blood flow. Using this information, numeric analysis solves the appropriate equations. The results can be displayed quantitatively and qualitatively. The results of numeric flow simulation show that in abdominal aortic aneurysms the wall pressure, which is of vital importance for the risk of rupture, depends on several factors, one being the location of the intraluminal thrombus. In models of aneurysms after stent grafting, numeric analysis can be used to evaluate factors leading to stent migration. Although numeric analysis of aortic blood flow still has several limitations, recent studies have shown that this method has the potential for improved estimation of the rupture risk of aortic aneurysms in the near future. (orig.) [German] Das Ziel der numerischen Simulation des Blutflusses in der Aorta ist, die Mechanik der Entstehung von Aortenaneurysmen im Hinblick auf das Rupturrisiko zu untersuchen und die Wirkungen interventioneller Massnahmen zu beschreiben. Die Grundlage der numerischen Simulation sind virtuelle Modelle von Gefaessen und die physikalischen Eigenschaften der Gefaessbestandteile, des Blutes und der Stroemung. Basierend auf diesen Angaben werden mit Hilfe numerischer Methoden die stroemungsmechanischen Probleme des Blutflusses naeherungsweise geloest. Die Ergebnisse koennen dann quantitativ und qualitativ dargestellt werden. Die Ergebnisse der numerischen Flusssimulation zeigen, dass in abdominellen Aortenaneurysmen die Hoehe des Wanddrucks, der von entscheidender Bedeutung fuer das Rupturrisiko ist, von verschiedenen Faktoren, wie z. B. der Lage des Wandthrombus, abhaengt. In Modellen mit Stentgrafts

  7. Hérnias incisionais no pós-operatório de correção de aneurisma de aorta abdominal Postoperative incisional hernias after open abdominal aortic aneurysm repair

    OpenAIRE

    2012-01-01

    CONTEXTO: A incidência de hérnia incisional no pós-operatório da correção aberta de aneurisma de aorta abdominal é alta, variando de 10 a 37% e mais de três vezes mais comum do que em pacientes submetidos à correção para doença obstrutiva aorto-ilíaca. OBJETIVO: Apresentar a incidência de hérnia incisional em um grupo de pacientes acompanhados no pós-operatório da correção aberta de aneurisma de aorta abdominal. MÉTODOS: Série de casos em uma população de 144 pacientes operados por aneurisma ...

  8. Effects of Labisia pumila var alata extracts on the lipid profile, serum antioxidant status and abdominal aorta of high-cholesterol diet rats.

    Science.gov (United States)

    Dianita, Roza; Jantan, Ibrahim; Jalil, Juriyati; Amran, Athirah Zawani

    2016-07-15

    Previous studies on Labisia pumila var. alata (LPva) have showed that it could inhibit low-density lipoprotein (LDL) oxidation and provide protection on myocardial infarction in rats. We hypothesized that LPva extracts can modulate the lipid profiles and serum antioxidant status of hypercholesterolemic rats. In the present study, we investigated the effects of aqueous and 80% ethanol extracts of LPva on atherogenic and serum antioxidant parameters as well as changes in abdominal aorta of high-cholesterol diet rats. The major components of the extracts, gallic acid, flavonoids and alkyl resorcinols were analyzed by using a validated reversed phase HPLC method. The rats were induced to hypercholesterolemic status with daily intake of 2% cholesterol for a duration of 8 weeks. Three different doses (100, 200 and 400mg/kg) of the extracts were administered daily on the 4th week onwards. The rats were then sacrificed and the blood was collected via abdominal aorta and serum was separated by centrifugation for biochemical analysis. Part of the aorta tissues were excised immediately for histopathological examination. The serum of LPva treated rats showed significant reduction in serum aspartate aminotransferase (AST), alanine aminotransferase (ALT) and lactate dehydrogenase (LDH) levels and the abdominal aorta showed a significant decrease of atheroma lesions in treated rats. Serum lipid profiles of treated rats showed a decrease in total cholesterol, total triglycerides and low-density lipoprotein (LDL) levels as compared to control group. The atherogenic indices in treated rats were significantly improved along with an increasing level of serum high-density lipoprotein (HDL). The extracts also exhibited significant increase of antioxidant enzymes and decrease of MDA as a product of lipid peroxidation. LPva extracts can reduce the risk of dyslipidemia by improving the serum lipid profiles and modulating serum antioxidants. Copyright © 2016 Elsevier GmbH. All rights

  9. Detection of atherosclerotic plaque progression in the abdominal aorta of rabbits with 3T magnetic resonance imaging

    Institute of Scientific and Technical Information of China (English)

    MA Xiao-hai; ZHAO Lei; ZHAO Quan-ming; FENG Ting-ting; SHANG Jian-feng; ZHANG Zhao-qi

    2012-01-01

    Background With features of high tissue contrast,MRI can be used for the qualitative and quantitative evaluation of atherosclerosis plaques.In this study we investigated the development of atherosclerosis plaque with high resolution 3T MRI in a rabbit model and compared the findings with the histopathological results.Method Twenty male New Zealand white rabbits were randomly allocated into an experimental group (n=16) and a control group (n=4).Atherosclerotic lesions were induced in the abdominal aorta by balloon injury and cholesterol feeding.Multiple sequences MRI examination (ToF,T1WI,T2WI,and CE T1WI) were performed at the 2nd,3rd,and 4th months after aortic denudation.Vessel wall thickness,total vessel area,lumen area,and vessel wall area were recorded.Plaque components were analyzed using histological results as a standard reference.Results Seventeen rabbits (14 in the experimental group and 3 in the control group) received all three MR examinations.Gradually,from 2 months to 4 months,vessel wall thickness and area in the experimental group increased significantly compared with the control group (P <0.01).In the lumen area progressive stenosis was not found,even a slight dilation had developed in the experimental group.Lipid,fibretic and calcified plaques can be differentiated by MR image.According to histological results,MRI had good performance in detection of lipid plaque.Conclusion MRI can be used to monitor progression of atherosclerosis and differentiate plaque components.

  10. [Prevalence and influence of risk factors on coronary shunting operations in patients with aterosclerosis of abdominal aorta and peripheral vessels].

    Science.gov (United States)

    Konstantinov, B A; Bazylev, V V; Belov, Iu V; Kizyma, A G

    2008-01-01

    Retrospective study analysis concerning the prevalence of risk factors for unfavorable outcomes after coronary operations in patients with peripheral arterial atherosclerosis is presented. Meta-analysis of individual risk factors was carried out. Frequency of complications after coronary shunting in patients with various concomitant diseases is evaluated. The multifactorial relative risk affecting hospital lethality is defined. The study includes 131 patients with generalized atherosclerosis, which have underwent myocardial revascularization at the first stage (the main group) and at the second stage have been operated on abdominal aorta and peripheral arteries. 1128 patients without peripheral arterial atherosclerosis have made the control group. They underwent only coronary shunting. All patients were treated from December of 1994 till June of 2006. Relying on the results of the study cumulative relative risk for unfavorable outcomes after revascularization is 1.8 times higher in patients from the main group than in patients from the control group, and the risk for primary complications is 2.03 times higher. Concomitant atherosclerotic arterial involvement among cardiosurgical patients is associated with high risk for stroke in postoperative period. In case of chronic renal failure risk factors are cumulated. In the main group lethality made 5% , which was higher as compared with the control group. Correlation of such risk factors as heart failure and renal failure (creatinine level more than 1.8 mg/dl) with lethality has been revealed among patients from the main group. Lethality risk raises in 5.30 times in the presence of heart failure in medical history, and raises in 13.15 times in case of initially elevated creatinine level. Age of patient didn't have any influence on lethality in early postoperative period.

  11. Calcification of coronary arteries and abdominal aorta in relation to traditional and novel risk factors of atherosclerosis in hemodialysis patients

    Directory of Open Access Journals (Sweden)

    Pencak Przemysław

    2013-01-01

    Full Text Available Abstract Background Process of accelerated atherosclerosis specific for uremia increases cardiovascular risk in patients with chronic kidney disease (CKD and may be influenced by the different structure of arteries. The study assesses the influence of traditional and novel risk factors on calcification of coronary arteries (CAC and abdominal aorta (AAC in hemodialysis patients (HD. Methods CAC and AAC were assessed by CT in 104 prevalent adult HD and 14 apparently healthy subjects with normal kidney function (control group. Mineral metabolism parameters, plasma levels of FGF-23, MGP, osteoprotegerin, osteopontin, fetuin-A, CRP, IL-6 and TNF-α were measured. Results CAC and AAC (calcification score ≥ 1 were found in 76 (73.1% and 83 (79.8% HD respectively, more frequent than in the control group. In 7 HD with AAC no CAC were detected. The frequency and severity of calcifications increased with age. Both CAC and AAC were more frequently detected in diabetics (OR = 17.37 and 13.00, respectively. CAC score was significantly greater in males. CAC and AAC scores were correlated significantly with pack-years of smoking and plasma osteoprotegrin levels. However the independent contribution of plasma osteoprotegerin levels was not confirmed in multiple regression analysis. Age (OR = 1.13 and hemodialysis vintage (OR = 1.14 were the independent risk factor favoring the occurrence of CAC; while age (OR = 1.20 was the only predictor of AAC occurrence in HD. Conclusions 1. AAC precedes the occurrence of CAC in HD patients. 2. The exposition to uremic milieu and systemic chronic microinflammation has more deteriorative effect on the CAC than the AAC.

  12. 基于高斯混合模型的腹主动脉图像分割%Image Segmentation of Abdominal Aorta Based on Gaussian Mixture Model

    Institute of Scientific and Technical Information of China (English)

    刘海华; 郭杰龙

    2015-01-01

    为了有效地分割腹主动脉图像,提出了基于适度空间约束的高斯混合模型分割算法。该算法将三维空间邻域信息融入高斯混合模型中,利用最大期望算法( EM)获取腹部血管灰度图像的估计参数,从而分割出血管图像。实验结果表明:所提出的方法不仅能准确地分割腹主动脉的血管分支图像,而且对于图像噪声的抑制有较好的效果。%To segment the abdominal aorta from CT images effectively, a improved segmentation algorithm based on Gaussian mixture model with space constraints is proposed.This algorithm integrates 3D neighborhood information into Gaussian mixture model, then estimates the parameters of Gaussian mixture model by using EM algorithm to segment the aorta from gray image of abdominal aorta.The experiments demonstrate that the proposed not only achieves the better segmentation of aortic branches, but also inhibits noise in images by considering the spatial neighborhood information.

  13. Use of ascending-abdominal aorta bypass grafts in the complex coarctation of the aorta%应用升主动脉-腹主动脉搭桥术治疗复杂主动脉缩窄

    Institute of Scientific and Technical Information of China (English)

    马全林

    2013-01-01

    Objective:To study a handy、safe and effective surgical treatment of complex coarctation of the aorta .Method:2 patients with complex coarctation of the aorta underwent ascending -abdominal aorta bypass grafts during general anesthesia and normal tempera-ture.Results:the blood pressure of pectoral limb evidently depress and the blood pressure of pelvic limb satisfactorily raise without neu -roloyic complication .Conclusion:the method is simple and effective ,there is low complication and cost .%目的:探讨手术治疗复杂主动脉缩窄的简便、安全、有效的方法。方法:在全麻和常温下经胸腹正中联合切口行升主动脉-腹主动脉搭桥术。结果:手术治疗3例患者,上肢血压下降明显,下肢血压升高满意,无神经系统和其他严重并发症。结论:该手术显露和操作简单,适应证广,疗效确切,并发症少。

  14. Quantificação morfométrica de Chlamydia pneumoniae e Mycoplasma pneumoniae em aneurismas de aorta abdominal humana Morphometrical quantification of Chlamydia pneumoniae and Mycoplasma pneumoniae in human atherosclerotic abdominal aortic aneurysms

    Directory of Open Access Journals (Sweden)

    Lucas José Tachotti Pires

    2007-09-01

    Full Text Available OBJETIVO: A inflamação aterosclerótica, com possível papel de agentes infecciosos, pode contribuir na patogênese dos aneurismas da aorta abdominal (AAA. O achado de Chamydia pneumoniae (CP nessas lesões, em estudos prévios, sem quantificação, variou de 0-100%. O objetivo é quantificar a presença de CP e de Mycoplasma pneumoniae (MP nos AAA. MÉTODO: A espessura, o número de células positivas para CP detectadas por imunoperoxidase e a porcentagem de área ocupada por MP detectada por hibridização "in situ", nas três camadas da aorta, foram medidos com sistema de análise de imagens, em 10 aortas abdominais aneurismáticas. Usouse três grupos-controle: 1 amostras das mesmas aortas, fora do aneurisma, exceto se a dilatação tomasse toda a porção sub-renal da artéria (n=7; 2 aortas com aterosclerose grave, mas sem aneurismas (n=10; 3 aortas sem aterosclerose ou com grau leve da doença (n=10. Todos os espécimes foram obtidos em necropsias. Usou-se o teste de Wald para comparar os grupos; fixou-se o nível de significância em 5%. RESULTADOS: A íntima era mais fina e a média mais espessa nos casos normais que nos outros grupos (p0,05. Também se detectou MP em todos os grupos. Este agente predominou no grupo de pacientes com aterosclerose, mas sem aneurisma na íntima e na adventícia; entretanto, as diferenças entre os grupos não foram significativas (p>0,05. CONCLUSÕES: Nossos dados sugerem que os agentes enfocados não têm papel importante na patogênese dos AAA.OBJECTIVE: Atherosclerotic inflammation, with a possible role of infectious agents, could contribute to the pathogenesis of abdominal aortic aneurysms (AAA. Finding of Chlamydia pneumoniae (CP in these lesions in previous, non-quantifying studies ranged from 0-100%. The objective is to quantify the presence of CP and Mycoplasma pneumoniae (MP in AAA. METHODS: Thickness, number of cells positive for CP by immunohistochemistry and percent area occupied by MP

  15. Study on Anatomical Features of CT Images of Abdominal Aorta in Adults%成人腹主动脉CT影像解剖学研究

    Institute of Scientific and Technical Information of China (English)

    杨飞; 王大伟; 朱晓龙; 陈静; 崔书君; 刘怀军

    2015-01-01

    Objective To analyze the anatomical features of the abdominal aorta in adults through MSCT (Multi-Slice Spiral Computerized Tomography).Methods Imaging records of 213 patients (118 cases of male patients; 95 cases of female cases; 109 elder patients; 104 young patients) who had undergone abdominal enhanced MSCT or CTA (Computerized Tomography Angiography) in the hospital were collected to measure the anteroposterior and transverse diameter of abdominal aorta in the cross-sectional images. Results Altogether 213 abdominal aortas were revealed, among which the anteroposterior and transverse diameter of abdominal aorta in male patients were larger than those in female cases; those in older patients were greater than young patients; the anteroposterior diameter of abdominal aortas was greater than the transverse diameter with statistically significant differences (P<0.05).Conclusion MSCT demonstrated excellent abilities in display of anatomical features of abdominal aortic dissections, which could provide clinical guidance and significant blood supply anatomical information in vivo in a non-invasive way for surgical abdominal operations, liver or kidney transplantation and interventional treatment.%目的:采用多层螺旋CT(MSCT)分析成人腹主动脉的影像学解剖特点。方法收集因各种原因在我院行腹部MSCT增强扫描或腹部CT血管造影检查的213例患者,其中男性118例,女性95例,老年人(≥60岁)109例,非老年人(<60岁)104例,在横断面图像上测量腹主动脉管腔的前后径、左右径。结果共检出213支腹主动脉。男性腹主动脉左右径、前后径均大于女性;老年组腹主动脉左右径、前后径均大于非老年组;腹主动脉前后径大于左右径;上述差异均有统计学意义(P<0.05)。结论 MSCT能够很好地显示腹主动脉血管的解剖情况,可无创性地为外科腹部手术、肝肾移植及介入治疗提供有价值的活体血供解

  16. Correção endovascular de aneurisma de aorta abdominal em paciente com rim em ferradura: relato de caso Endovascular repair of an abdominal aortic aneurysm in patient with horseshoe kidney: a case report

    Directory of Open Access Journals (Sweden)

    Eduardo Keller Saadi

    2008-09-01

    Full Text Available O rim em ferradura é uma anomalia congênita rara que pode causar várias dificuldades técnicas durante a correção convencional de aneurisma de aorta abdominal. Relatamos o caso de uma paciente de 68 anos com rim em ferradura, aneurisma de aorta abdominal sintomático e disfunção renal leve. A paciente foi submetida a correção endovascular, sendo utilizada uma endoprótese bifurcada. O pós-operatório foi livre de complicações. O diagnóstico e a técnica endovascular são discutidos, assim como a literatura revisada.Horseshoe kidney is a rare congenital anomaly that may cause various technical problems during conventional repairs of abdominal aortic aneurysms. We report the case of a 68-year-old woman with a horseshoe kidney, symptomatic abdominal aortic aneurysm and mild renal failure. The patient underwent endovascular repair using a bifurcated endoprosthesis. The postoperative was uneventful. We describe the diagnosis and the endovascular technique and literature review.

  17. Tratamento endovascular de aneurisma de aorta abdominal em paciente com rim em ferradura: relato de caso Endovascular treatment of abdominal aortic aneurysm in patient with horseshoe kidney: a case report

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    José Manoel da Silva Silvestre

    2013-03-01

    Full Text Available O rim em ferradura é uma das anomalias urológicas congênitas mais comuns e está presente em cerca de 0,12% dos pacientes com aneurisma de aorta abdominal. O reparo cirúrgico convencional está associado a dificuldades técnicas que provavelmente aumentam a morbidade e a mortalidade, mas que podem ser evitadas com o tratamento endovascular. Relatamos um caso de um paciente de 64 anos com rim em ferradura e aneurisma de aorta abdominal, que foi submetido ao reparo endovascular do aneurisma com sucesso.The horseshoe kidney is one of the most common urologic anomalies and is present in about 0,12% of the patients with abdominal aortic aneurysm. The conventional surgical repair is associated with technical difficulties that probably increase morbidity and mortality, but can be averted by the endovascular treatment. We report a case of a 64-year-old patient with horseshoe kidney and abdominal aortic aneurysm, who underwent endovascular repair with success.

  18. Evaluación del riesgo de ruptura de aneurismas de aorta abdominal personalizados mediante factores biomecánicos/Patient-specific abdominal aortic aneurysms rupture risk assessment by means of biomechanical factors

    Directory of Open Access Journals (Sweden)

    Ariel Zúñiga‐Reyes

    2014-05-01

    Full Text Available El Aneurisma de Aorta Abdominal es la dilatación localizada, irreversible y progresiva que experimenta la pared aortica. Esta patología ha sido reconocida como un importante problema de salud, puesto que su ruptura está asociada mayormente a consecuencias fatales. La falta de criterios fiables, respecto a los actualmente utilizados, para la evaluación del riesgo de ruptura, constituye un inconveniente en la gestión clínica de la enfermedad. El presente trabajo tiene como objetivo evaluar el riesgo de ruptura de Aneurismas de Aorta Abdominal, mediante indicadores numéricos, como es previsto por el enfoque biomecánico. Fueron utilizadas técnicas de modelación por elementos finitos para determinar el comportamiento del flujo sanguíneo y el estado tensional de la pared arterial. Los resultados mostraron que ninguno de los aneurismas analizados presenta riesgo de ruptura elevado y que la evaluación del riesgo de ruptura mediante índices numéricos, es un camino viable para prever la ruptura de un aneurisma específico.Palabras claves: aneurisma de aorta abdominal, factores biomecánicos, interacción fluido-sólido, riesgo de ruptura.______________________________________________________________________________AbstractAbdominal Aortic Aneurysm is a localized, progressive and permanent dilation of the infra-renal aorta.AAA has increasingly been recognized as an important health problem in the last decades. The AAA rupture is mostly associated with fatal consequences. The lack of more reliable criteria for rupture riskassessing, results in a problem in the clinical management of the disease. This paper aims to assess the rupture risk of abdominal aortic aneurysms by means of numerical indexes, as envisaged by the biomechanical approach. Finite Volume Techniques were used to determine the blood flow behavior within aneurysmatic sac and the structural state of the arterial wall. The results showed that none of the assessed aneurysms is at

  19. Proposta para padronização do relatório de tomografia computadorizada nos aneurismas da aorta abdominal A proposal for standardizing computed tomography reports on abdominal aortic aneurysms

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    Fabiola Goda Torlai

    2006-08-01

    Full Text Available OBJETIVO: Propor um modelo de padronização de relatório para aneurisma da aorta abdominal na tomografia computadorizada. MATERIAIS E MÉTODOS: Foram realizadas, no período de abril a outubro de 2004, entrevistas com integrantes da Disciplina de Cirurgia Vascular da nossa instituição, para elaboração de um modelo de padronização de relatório de tomografia computadorizada para o estudo do aneurisma da aorta abdominal. A partir deste modelo foi elaborado um questionário, enviado a nove outros cirurgiões, todos com experiência em cirurgia da aorta abdominal. O índice de resposta aos questionários foi de 55,5% (5/9. RESULTADOS: Os parâmetros de interesse citados mais freqüentemente para a avaliação dos aneurismas de aorta abdominal foram: diâmetro máximo do colo proximal, extensão do colo proximal até a artéria renal mais baixa, forma do colo proximal, diâmetro máximo do aneurisma e diâmetro das artérias ilíacas comuns. Estes dados permitiram elaborar uma proposta de modelo para padronização de relatório na tomografia computadorizada. CONCLUSÃO: Um modelo para a análise tomográfica padronizada do aneurisma de aorta abdominal permite atender às necessidades dos cirurgiões vasculares para acompanhar a evolução e planejar o tratamento destes pacientes.OBJECTIVE: To propose a model to standardize computed tomography reports on abdominal aortic aneurysms. MATERIALS AND METHODS: Interviews were carried out with members of Vascular Surgery Division of our institution, in the period between April and October 2004, aiming at developing a standardized model of computed tomography reports on abdominal aortic aneurysms. Based on this model, a questionnaire was elaborated and sent to other nine surgeons, all of them experienced in the field of abdominal aortic surgery. The questionnaires response rate was 55.5% (5/9. RESULTS: The most frequently mentioned parameters of interest for evaluation of abdominal aortic aneurysms

  20. Prevalência de dilatação da aorta abdominal em coronariopatas idosos Prevalence of abdominal aortic dilatation in patients aged 60 years or older with coronary disease

    Directory of Open Access Journals (Sweden)

    Guilherme Vieira Meirelles

    2007-06-01

    Full Text Available CONTEXTO: A realização de programas de triagem para o aneurisma da aorta abdominal de forma indiscriminada auxiliará uma pequena porcentagem de indivíduos, mas ao considerarmos grupos com fatores de risco relacionados à dilatação da aorta, aumentando a probabilidade da doença, este permitirá um direcionamento adequado dos recursos e um benefício maior à população. Programas direcionados pelas sociedades médicas, permitindo um diagnóstico precoce das doenças vasculares e conseqüentemente um melhor preparo do doente, promoveriam melhores taxas de sobrevida com menor morbidade. OBJETIVO: Avaliar a prevalência da dilatação da aorta abdominal em uma amostra de pacientes idosos com mais de 60 anos de idade, portadores de coronariopatia aterosclerótica diagnosticada por cineangiocoronariografia. MÉTODOS: Para a seleção dessa amostra, levou-se em consideração o fato de que a avaliação pré-operatória de cirurgia vascular não tenhasido a indicação do cateterismo. Procedeu-se então a avaliação, baseada na anamnese, exame físico e Doppler ultra-som da aorta abdominal. A análise estatística iniciou-se com o teste qui-quadrado, com a posterior análise de regressão logística multivariada e regressão logística univariada, considerando significativo um p BACKGROUND: Indiscriminate screening programs for abdominal aortic aneurysm will help a small percentage of individuals. However, when considering groups with risk factors associated with aortic dilatation, which increases the probability of the disease, such programs will provide an adequate allocation of resources and a greater benefit to the population. Programs guided by medical societies, providing an early diagnosis of vascular diseases and consequently a better preparation of patients, would result in better survival rates with lower morbidity. OBJECTIVE: To evaluate the prevalence of abdominal aortic dilatation in patients aged 60 years or older with

  1. Abdominal Aortic Aneurysm (AAA)

    Science.gov (United States)

    ... News Physician Resources Professions Site Index A-Z Abdominal Aortic Aneurysm (AAA) Abdominal aortic aneurysm (AAA) occurs when atherosclerosis ... an abdominal aortic aneurysm treated? What is an abdominal aortic aneurysm? The aorta, the largest artery in the body, ...

  2. Acceptability of virtual unenhanced CT of the aorta as a replacement for the conventional unenhanced phase

    Energy Technology Data Exchange (ETDEWEB)

    Shaida, N., E-mail: nadeem.shaida@addenbrookes.nhs.uk [Department of Radiology, Addenbrooke' s Hospital, Cambridge (United Kingdom); Bowden, D.J.; Barrett, T.; Godfrey, E.M.; Taylor, A.; Winterbottom, A.P.; See, T.C. [Department of Radiology, Addenbrooke' s Hospital, Cambridge (United Kingdom); Lomas, D.J. [Department of Radiology, University of Cambridge, Addenbrooke' s Hospital, Cambridge (United Kingdom); Shaw, A.S. [Department of Radiology, Addenbrooke' s Hospital, Cambridge (United Kingdom)

    2012-05-15

    Aim: To evaluate whether virtual unenhanced (VU) computed tomography (CT) images generated of the aorta were of sufficient quality to replace the conventional unenhanced (CU) images. Materials and methods: Forty-nine patients undergoing examination of the thoracic or abdominal aorta were examined using a dual-energy protocol. VU images were generated from the arterial phase images and compared to the CU images. Objective analysis was performed by drawing paired regions of interest (ROIs) within the thoracic and abdominal aorta and measuring the radiodensity in Hounsfield units attenuation within the ROIs. Subjective analysis was performed by two experienced readers evaluating the VU images in terms of noise, quality, calcium loss, and overall acceptability. Results: The attenuation was significantly higher in the VU images compared to the CU images within the thoracic aorta (p < 0.01) but not within the abdominal aorta (p = 0.15). Overall the VU images of the abdominal aorta were deemed acceptable as replacements for the CU images in 93% of cases. For the thoracic aorta, the VU images were deemed acceptable in only 12% of cases, primarily due to pulsation artefact. Conclusion: VU images of the abdominal aorta are acceptable as replacements for the CU images in the vast majority of cases; however, they are not suitable as replacements for the CU images of the thoracic aorta.

  3. The value of true-FISP sequence added to conventional gadolinium-enhanced MRA of abdominal aorta and its major branches

    Energy Technology Data Exchange (ETDEWEB)

    Iozzelli, Andrea [University of Milan School of Medicine, Department of Medical and Surgical Sciences, Radiology Unit, IRCCS Policlinico San Donato, via Morandi 30, 20097 San Donato Milanese, Milan (Italy)], E-mail: andrea.iozzelli@poste.it; D' Orta, Giovanni [University of Milan School of Medicine, Department of Medical and Surgical Sciences, Radiology Unit, IRCCS Policlinico San Donato, via Morandi 30, 20097 San Donato Milanese, Milan (Italy)], E-mail: ammos@tiscali.it; Aliprandi, Alberto [University of Milan School of Medicine, Department of Medical and Surgical Sciences, Radiology Unit, IRCCS Policlinico San Donato, via Morandi 30, 20097 San Donato Milanese, Milan (Italy)], E-mail: a.aliprandi@grupposandonato.it; Secchi, Francesco [University of Milan School of Medicine, Department of Medical and Surgical Sciences, Radiology Unit, IRCCS Policlinico San Donato, via Morandi 30, 20097 San Donato Milanese, Milan (Italy)], E-mail: francisecchi@virgilio.it; Di Leo, Giovanni [University of Milan School of Medicine, Department of Medical and Surgical Sciences, Radiology Unit, IRCCS Policlinico San Donato, via Morandi 30, 20097 San Donato Milanese, Milan (Italy)], E-mail: gianni.dileo77@virgilio.it; Sardanelli, Francesco [University of Milan School of Medicine, Department of Medical and Surgical Sciences, Radiology Unit, IRCCS Policlinico San Donato, via Morandi 30, 20097 San Donato Milanese, Milan (Italy)], E-mail: f.sardanelli@grupposandonato.it

    2009-12-15

    To test true-fast imaging with steady-state precession (true-FISP) added to gadolinium-based MR angiography (Gd-MRA) for imaging abdominal aorta and major abdominal vessels, 35 consecutive patients (age 67 {+-} 11 years) with known or suspected abdominal and/or peripheral vascular disease were studied with sagittal and axial 2D true-FISP during free breathing and coronal 3D fast low-angle shot (FLASH) Gd-MRA (breath-holding, 0.2 mmol/kg of Gd-DOTA at 2 ml/s). We evaluated: suprarenal aorta, celiac trunk, superior mesenteric artery, right renal artery, left renal artery, infrarenal aorta, inferior mesenteric artery, aortic bifurcation/common iliac arteries, lumbar arteries and aortic atheromasia. The possible presence of accessory renal arteries, collateral vasculature and vascular prosthesis/stent was evaluated. A quality four-point score was assigned to each item on both sequences, from 0 (not visible) to 3 (good-to-excellent image quality) and Wilcoxon test was used. Main diagnoses resulted: normal or atheromasic aorta (n = 25); aortic aneurysm (n = 2); patent aorto-iliac surgical prosthesis (n = 2); patent vascular iliac stent (n = 2); aneurysm of iliac artery (n = 1); patent aortic endovascular prosthesis (n = 1); patent aorto-femural bypass (n = 1) and aorto-iliac surgical prosthesis endoleak (n = 1). We also found three patients with accessory renal arteries, two with collateral circulation, and three with surgical aorto-iliac prosthesis. The score of true-FISP (25.9 {+-} 4.1, median 27) was significantly higher (p = 0.003) than that of Gd-MRA (23.9 {+-} 3.6, median 24). True-FISP was superior for visualizing inferior mesenteric artery (score 2.5 {+-} 1.1 vs. 1.0 {+-} 1.4; p < 0.001) and atheromasic plaques (2.5 {+-} 1.1 vs. 1.2 {+-} 1.1; p < 0.001). One collateral vasculature was demonstrated only with Gd-MRA. Summarizing, true-FISP is a power and fast non-breath-hold sequence to be added to Gd-MRA, obtaining an information increase.

  4. [Arterial reconstructive surgery of a coarctation of the abdominal aorta with involvement of renal and visceral arteries. Clinical and imagiologic evaluation 26 years after the operation].

    Science.gov (United States)

    Dinis da Gama, A

    2009-01-01

    The clinical case of a 13 years old female is reported, with the diagnosis of congenital coarctation of the abdominal aorta, with involvement of renal and visceral arteries, causing arterial hypertension and a systolic bruit in the auscultation of the epigastric and umbilical areas. Conventional angiography disclosed a stenotic process of the upper abdominal aorta, with concomitant ostial stenosis of the renal and digestive arteries, and post-stenotic dilatation of the celiac axis and superior mesenteric artery. The physical development of the patient, close to the adult pattern, allowed the performance of a complex revascularization procedure,accomplished in May 1984, consisting in the implantation of an aorto-aortic bypass graft, through the diaphragm, followed by visceral and renal revascularization, by means of independent prosthesis taken from the aortic bypass. The post-operative course was uneventful and blood pressure returned immediately to normal levels. Reviewed recently, the patient was found in good clinical condition,asymptomatic and with normal blood pressure, developing a normal family, social and Professional life. An Angio-CT evaluation, performed in February 2010, almost 26 years after the operation, revealed the complex revascularization procedure patent and working in excellent condition. To our knowledge, this seems to be the longest follow up of such a procedure employed successfully in a very rare clinical entity, thus justifying its presentation and divulgation.

  5. Hérnias incisionais no pós-operatório de correção de aneurisma de aorta abdominal Postoperative incisional hernias after open abdominal aortic aneurysm repair

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    Fábio Hüsemann Menezes

    2012-09-01

    Full Text Available CONTEXTO: A incidência de hérnia incisional no pós-operatório da correção aberta de aneurisma de aorta abdominal é alta, variando de 10 a 37% e mais de três vezes mais comum do que em pacientes submetidos à correção para doença obstrutiva aorto-ilíaca. OBJETIVO: Apresentar a incidência de hérnia incisional em um grupo de pacientes acompanhados no pós-operatório da correção aberta de aneurisma de aorta abdominal. MÉTODOS: Série de casos em uma população de 144 pacientes operados por aneurisma de aorta abdominal, entre junho de 1989 e junho de 2010, e que estão em acompanhamento regular no Ambulatório de Moléstias Vasculares. RESULTADOS: O seguimento médio dos pacientes foi de 63 meses (1 a 238. A idade média foi de 67 anos (45 a 91 e o tamanho médio dos aneurismas foi de 6,54 cm. Foram realizadas 130 laparotomias medianas xifo-púbicas e 13 acessos extraperitoniais pelo flanco esquerdo. Nestes pacientes, a incidência de hérnia incisional foi de 18,5 e 7,7%, respectivamente, para incisões na linha média ou no flanco (p=0,315. Um paciente apresentou abaulamento da musculatura oblíqua por denervação. Foi realizada uma laparotomia transversa, que não apresentou hérnia no pós-operatório tardio. CONCLUSÕES: A incidência de hérnia incisional na cirurgia aberta para correção de aneurisma de aorta abdominal é alta, ocorre com maior frequência em incisões da linha média e tem relação direta com a técnica empregada para o fechamento da aponeurose, exigindo do cirurgião atenção especial para este tempo cirúrgico para evitar a causa mais comum de reoperação em tal grupo de pacientes.BACKGROUND: The incidence of incisional hernia in the post operatory of patients submitted to open abdominal aortic aneurysm repair is high, ranging from 10 to 37%, and is more than three times higher than the incidence of hernias in patients operated for aorto-iliac occlusion. OBJECTIVE: To evaluate the incidence of

  6. Correlation of the CT values of abdominal aorta,renal artery and renal cortex with its thickness on 64-MDCT contrast en-hanced images

    Institute of Scientific and Technical Information of China (English)

    Alomary Mahfooz-Naef; Vikash; Wang Qiu-xia; Zhang Jin-hua; Hu Dao-yu

    2015-01-01

    Objective:To investigate the correlation of abdominal aorta CT value,renal artery CT value and renal cor-tex thickness with renal cortex CT value on contrast enhanced 64-slice CT images.Methods:96 patients (50 men and 46 women;16~74 years)with normal kidney function,which was confirmed by kidney function test were enrolled in this stud-y,including bilateral kidneys of 92 cases and unilateral kidney of 4 cases (total of 188 kidneys;92 left,96 right).After intra-venous (IV)injection of contrast agent the kidneys of the selected patients were scanned by MDCT.The scans were per-formed in arterial,venous and 3min delayed phases.All statistical analyses were performed by using IBM SPSS 20.0.Graphs were generated using Graph Pad Prism 5 software.Quantitative data were presented as mean ± standard deviation,while qualitative data were presented as frequency (%).P<0.05 was considered to be statistically significant.Results:The mean renal cortex thickness was (5.19±0.81)mm in all kidneys.In the arterial phase,a statistically significant positive correla-tion between renal cortex CT values and abdominal aortic CT values was showed (r= 0.584;P<0.001).A statistically sig-nificant positive correlation between renal cortex CT values and renal cortex thickness was demonstrated (r= 0.533,P<0.0001).Likewise,there was a positive correlation between renal cortex CT value and renal artery CT values (r= 0.43,P<0.001).Conclusion:It is a promising approach to assess the individual kidney function by measuring abdominal aorta CT value,renal artery CT value,renal cortex CT value and renal cortex thickness using contrast MDCT.

  7. Mortalidade relacionada ao tratamento endovascular do aneurisma da aorta abdominal com o uso dos modelos revisados Procedure-related mortality of endovascular abdominal aortic aneurysm repair using revised reporting standards

    Directory of Open Access Journals (Sweden)

    Gosen Gabriel Konig

    2007-03-01

    Full Text Available OBJETIVO: O objetivo do estudo foi avaliar a definição da mortalidade relacionada ao procedimento após tratamento endovascular do aneurisma de aorta abdominal (EVAR como definido pelo Committee for Standardized Reporting Practices in Vascular Surgery. MÉTODO: Dados de pacientes com aneurisma de aorta abdominal foram analisados do banco de dados EUROSTAR. Os pacientes foram submetidos ao EVAR entre junho de 1996 a fevereiro de 2004 e foram estudados retrospectivamente. A probabilidade explicita da causa de morte foi registrada. O intervalo entre a operação, alta hospitalar ou intervenção secundária até a morte foi registrado. RESULTADOS: De um total de 5612 pacientes, 589 (10,5% faleceram após o EVAR em acompanhamento total e qualquer causa de morte foi inclusa. Cento e quarenta e um pacientes (12,5% morreram devido a causa relacionada ao aneurisma, sendo que 28 (4,8% foram rupturas, 25 (4,2% infecções do implante e 88 (14,9% foram pacientes que morreram num prazo de 30 dias após o procedimento inicial (definição atualmente utilizada, também conhecido como resultado clínico a curto prazo. Além disso, 25 pacientes faleceram após 30 dias, mas continuavam ainda hospitalizados (ou transferidos a home-care para reavaliação posterior, ou necessitaram intervenção secundária. Levando em conta a duração da admissão ao hospital e a mortalidade imediata após o procedimento relacionada a intervenções secundárias, 49 mortes tardias também podem ser relacionadas ao EVAR. CONCLUSÃO: Morte tardia compõe uma proporção considerável da mortalidade relacionada ao EVAR dentro do tempo de análise revisado.OBJECTIVE: The aim of this study was to evaluate the definition of Procedure-related mortality after endovascular aneurysm repair (EVAR as defined by the Committee for Standardized Reporting Practices in Vascular Surgery. METHODS: Data on patients with an AAA were taken from the EUROSTAR database. The patients underwent EVAR

  8. Antegrade approach for TAVR with total occlusion of the descending aorta.

    Science.gov (United States)

    Levisay, Justin P; Salinger, Michael H; Feldman, Ted

    2014-04-01

    The antegrade approach for aortic valve interventions is well known but has not been widely used for transcatheter aortic valve replacement (TAVR) procedures. We encountered a patient with no possibility of retrograde access due to a totally occluded abdominal aorta who had a failed attempt at apical TAVR. We describe antegrade TAVR despite occlusion of the abdominal aorta, with the arterial limb of the requisite veno-arterial loop created using bilateral arm access, a novel version of the previously described antegrade approach.

  9. Modelo experimental de influência dos vasa vasorum na estrutura da parede de aorta abdominal em suínos

    OpenAIRE

    Alexandre Bueno da Silva

    2012-01-01

    Introdução A visão tradicional afirma que as células miointimais responsáveis pela hiperplasia intimal derivam das células musculares lisas da média e que, através da mudança de seu fenótipo para um estado proliferativo, migram para a região intimal Esta visão tem sido contestada em algumas publicações que tem demonstrado o importante papel da adventícia na fisiopatologia da hiperplasia intimal. Objetivo: Analisar as alterações da estrutura da parede da aorta abdominal de suínos secundária a ...

  10. A proposal for standardizing computed tomography reports on abdominal aortic aneurysms; Proposta para padronizacao do relatorio de tomografia computadorizada nos aneurismas da aorta abdominal

    Energy Technology Data Exchange (ETDEWEB)

    Torlai, Fabiola Goda; Meirelles, Gustavo S. Portes [Universidade Federal de Sao Paulo (UNIFESP/EPM), SP (Brazil); Miranda Junior, Fausto; Fonseca, Jose Honorio A.P. da [Universidade Federal de Sao Paulo (UNIFESP/EPM), SP (Brazil). Dept. de Cirurgia; Ajzen, Sergio; D' Ippolito, Giuseppe [Universidade Federal de Sao Paulo (UNIFESP/EPM), SP (Brazil). Dept. de Diagnostico por Imagem]. E-mail: giuseppe_dr@uol.com.br

    2006-07-15

    Objective: to propose a model to standardize computed tomography reports on abdominal aortic aneurysms. Materials and methods: interviews were carried out with members of the Vascular Surgery Division of our institution, in the period between April and October 2004, aiming at developing a standardized model of computed tomography reports on abdominal aortic aneurysms. Based on this model, a questionnaire was elaborated and sent to other nine surgeons, all of them experienced in the field of abdominal aortic surgery. The questionnaires response rate was 55.5% (5/9). Results: the most frequently mentioned parameters of interest for evaluation of abdominal aortic aneurysms were: maximum diameter of proximal aortic neck, proximal aortic neck length to lower renal arteries, shape of proximal aortic neck, maximum diameter of the aneurysm and diameter of the common iliac arteries. These data allowed the development of a proposal for a model to standardize computed tomography reports. Conclusion: a model for standardized tomographic analysis of abdominal aortic aneurysms has met vascular surgeons' needs for following-up patients and planning their treatment. (author)

  11. Long-term renin-angiotensin blocking therapy in hypertensive patients with normal aorta may attenuate the formation of abdominal aortic aneurysms.

    Science.gov (United States)

    Silverberg, Daniel; Younis, Anan; Savion, Naphtali; Harari, Gil; Yakubovitch, Dmitry; Sheick Yousif, Basheer; Halak, Moshe; Grossman, Ehud; Schneiderman, Jacob

    2014-08-01

    Renin-angiotensin system (RAS) has been implicated in the pathogenesis of abdominal aortic aneurysm (AAA). Angiotensin II type 1 receptor blocker (ARB), when given with angiotensin II prevents AAA formation in mice, but found ineffective in attenuating the progression of preexisting AAA. This study was designed to evaluate the effect of chronic RAS blockers on abdominal aortic diameter in hypertensive patients without known aortic aneurysm. Consecutive hypertensive outpatients (n = 122) were stratified according to antihypertensive therapy they received for 12 months or more, consisting of ARB (n = 45), angiotensin converting enzyme inhibitor (ACE-I; n = 45), or nonARB/nonACE-I (control therapy; n = 32). Abdominal ultrasonography was performed to measure maximal subrenal aortic diameter. Eighty-four patients were reexamined by ultrasonography 8 months later. The correlation between the different antihypertensive therapies and aortic diameter was examined. Aortic diameters were significantly smaller in ARB than in control patients in the baseline and follow-up measurements (P = .004; P = .0004, respectively). Risk factor adjusted covariance analysis showed significant differences between ARB or ACE-I treated groups and controls (P = .006 or P = .046, respectively). Ultrasound that was performed 8 months later showed smaller increases in mean aortic diameters of the ARB and ACE-I groups than in controls. Both ARB and ACE-I therapy attenuated expansion of nonaneurysmal abdominal aorta in humans. These results indicate that RAS blockade given before advancement of aortic medial remodeling may slow down the development of AAA.

  12. New approach of assessing hypovolemic shock class 1 during acute emergencies: Ultrasonographic inferior vena cava and abdominal aorta diameter ratio

    Science.gov (United States)

    Ahmad, Rashidi; Kunji, Mohamad Iqhbal; Hj Abd Kareem, Meera Mohaideen; Halim, Shamimi A.

    2013-09-01

    In a patient with hypovolemic shock class 1, the vital signs and biochemical properties are almost normal. The alteration of hemodynamic parameters and biochemical values occurs mainly in advanced hypovolemia state (neuroendocrine response). The availability of ultrasound machine at healthcare centers makes the measurement of vascular calibre feasible and possible. Inspiration and expiration inferior vena cava diameter changes predict hypovolemic shock class 1 but in acute emergencies this method is impractical. The purpose of this study is to develop a new approach in identifying hypovolemic shock at early phase by measuring the inferior vena cava and aorta diameter ratio using bedside ultrasound machine.

  13. Comparison of ultrasonography, computed tomography and magnetic resonance imaging with intraoperative measurements in the evaluation of abdominal aortic aneurysms; Comparacao entre ultrassonografia, tomografia computadorizada e ressonancia nuclear magnetica com medidas intra-operatorias na avaliacao dos aneurismas de aorta abdominal

    Energy Technology Data Exchange (ETDEWEB)

    Azevedo, Francisco das Chagas de; Zerati, Antonio Eduardo; Blasbalg, Roberto; Wolosker, Nelson; Puech-Leao, Pedro [Sao Paulo Univ., SP (Brazil). Faculdade de Medicina. Hospital das Clinicas]. E-mail: nwolosker@yahoo.com.br

    2005-01-15

    Purpose: To study the imaging exams more commonly used for abdominal aortic aneurysms evaluation - ultrasonography, conventional computerized tomography, helical computerized tomography and nuclear magnetic angio resonance - comparing the preoperative measurements reached by those radiological methods with the measurements made during the surgical procedures. Methods: Patients who had indication of elective transperitoneal surgical treatment for their abdominal aortic aneurysms were included in the study. The initial diagnosis of the aortic dilatation was made by ultrasonography and, after the surgical treatment was indicated, the patient was submitted to another imaging method.Sixty patients were divided into 3 groups according to the complementary imaging method (conventional computerised tomography, helical computerized tomography, nuclear magnetic angio resonance). The ultrasonography of the first 20 patients were joined in a fourth group. There were considered in the study the measurements of the transversal diameter of the proximal neck, maximum transversal diameter of the aneurysm, straight-line length and transversal diameter of the common iliac arteries given by the imaging methods. The same measurements were made by using a caliper during the surgical procedure, and then compared to the values obtained from the radiological exams.Results: The maximum transverse diameter had a range measurement variation of 4.5 to 13.6 cm in the intraoperative, with no statistically significant differences when compared with all the imaging tests. The ultrasonography, however, overestimated the measurements of the proximal neck and the common iliac arteries, in comparison with intraoperative measures. The length of the aorta aneurysm obtained by the conventional computerized tomography was significantly lower if compared to the measures done with the calliper during the operation. The helical computerized tomography and the nuclear magnetic angio resonance provided

  14. 胸主动脉供血与腹主动脉供血肺隔离症的对比分析%Comparative analysis of imaging features of pulmonary sequestration supplied by thoracic aorta and supplied by abdominal aor-ta

    Institute of Scientific and Technical Information of China (English)

    田丽; 郝娟娟; 张静玉; 李玉山; 张泽坤

    2014-01-01

    Objective:To compare and analyze the imaging features of pulmonary sequestration (PS)supplied by tho-racic aorta and supplied by abdominal aorta.Methods:A retrospective analysis was performed in 23 patients with PS con-firmed by pathology after operation and the CT images were comparatively analyzed according to the source of blood sup-ply.Results:Of the 23 patients with PS,16 cases were supplied by thoracic aorta and 7 of them had two supplying arteries, 7 cases were supplied by abdominal aorta.The lesions appeared as mass with soft tissue density in 21 cases.One case sup-plied by thoracic aorta showed cystic heterogeneous density.In one case supplied by thoracic aorta,focal thick vessel was shown.The average diameter and length of the supplying arteries from thoracic aorta were (4.8±2.2)mm and (37±12) mm respectively,while these from abdominal aorta were (3.3±0.5)mm and (104±42)mm respectively.The length of sup-plying arteries and volume of sequestrated lung tissues supplied by thoracic aorta were smaller than those supplied by ab-dominal aorta (P<0.001).Conclusion:PS supplied by thoracic and abdominal aorta share similar imaging features.The length of supplying arteries and the volume of sequestrated lung tissues supplied by thoracic aorta are different from those supplied by abdominal aorta.%目的:对比分析胸主动脉供血与腹主动脉供血肺隔离症的影像学征象。方法:回顾性分析经术后病理证实的23例肺隔离症病例,对比分析胸主动脉供血及腹主动脉供血肺隔离症的CT 图像。结果:23例肺隔离症中,16例由胸主动脉供血,其中7例有2支供血动脉;7例由腹主动脉供血。21例表现为实性软组织密度,1例胸主动脉供血者表现为囊实性不均匀密度,1例胸主动脉供血者表现为局部粗大血管。胸主动脉供血动脉直径(4.8±2.2)mm,长度(37±12)mm,腹主动脉供血动脉直径(3.3±0.5)mm,长度(104±42)mm。胸

  15. Cide-A Gene Expression in Patients with Obesity Qualified for Endovascular Treatment of Abdominal Aorta Aneurysm

    Directory of Open Access Journals (Sweden)

    Feldo Marcin

    2015-02-01

    Full Text Available CIDE-A gene and the genes of LRP group play a key role in the regulation of the body weight and lipid metabolism in mammals. CIDE-A is defined as a potential human obesity gene and the LRP1 gene is associated with the development of abdominal aortic aneurysm (AAA.

  16. TRATAMIENTO PERCUTÁNEO CON PRÓTESIS ENDOVASCULAR DE COARTACIÓN DE AORTA ABDOMINAL EN UN ADULTO / Percutaneous treatment with endovascular prosthesis of abdominal aortic coarctation in an adult

    Directory of Open Access Journals (Sweden)

    Luis Felipe Vega Fleites

    2010-12-01

    Full Text Available Resumen: La coartación de la aorta abdominal es una afección vascular no hereditaria poco frecuente, que afecta a hombres y mujeres por igual. Recientemente ha sido nombrada como “Síndrome aórtico medio”, y los hallazgos clínicos son similares a los de la CoAo típica. Para el diagnóstico, se debe recurrir a la resonancia magnética o a la arteriografía, y las opciones terapéuticas incluyen la dilatación percutánea con catéter-globo, el tratamiento quirúrgico y, por último, como opción más novedosa, la implantación de prótesis endovasculares. En este artículo presentamos el caso de una mujer de 45 años de edad, exfumadora, con antecedentes de artritis reumatoidea e hipertensión arterial que presentaba claudicación de miembros inferiores durante la marcha. Existía una disminución bilateral marcada de los pulsos femorales y el Doppler, y mostró un componente amortiguado en ambas arterias femorales y poplíteas. La AngioTAC encontró una estenosis significativa del tercio distal de la aorta abdominal infrarrenal, con hipoplasia marcada de la ilíaca derecha. La aortografía corroboró el diagnóstico (gradiente de 80 mmHg. A través de dos introductores arteriales por las arterias femorales se avanzaron dos catéteres-globo MATCH-35 de 5.0x80 mm que se inflaron simultáneamente y posteriormente, se implantó un stent MEDTRONIC “Bridge Assurant” de 10 x 30 mm en el segmento estenótico, sin complicaciones. El gradiente residual fue de 10 mmHg. La paciente evolucionó favorablemente y fue egresada a las 24 horas del procedimiento. / Abstract: Coarctation of the abdominal aorta is an uncommon, non-inherited vascular condition that affects men and women alike. It has been recently named as "middle aortic syndrome", and the clinical findings are similar to those of typical aortic coarctation. For diagnosis, one must make use of magnetic resonance imaging or arteriography, and therapeutic options include percutaneous

  17. Abdominal aorta morphometric study for endovascular treatment of aortic aneurysms: comparison between spiral CT and angiography; Estudo morfometrico da aorta abdominal para tratamento endovascular dos aneurismas aorticos: comparacao entre tomografia helicoidal e angiografia

    Energy Technology Data Exchange (ETDEWEB)

    Espinosa, Gaudencio [Universidade Federal, Rio de Janeiro, RJ (Brazil). Hospital Universitario Clementino Fraga Filho. Dept. de Cirurgia Vascular; Marchiori, Edson [Universidade Federal Fluminense, Niteroi, RJ (Brazil). Dept. de Radiologia]. E-mail: edmarchiori@zipmail.com.br; Caramalho, Monica Ferreira [Hospital Miguel Couto, Rio de Janeiro (Brazil); Barzola, Pedro [Medtronic-AVE do Brasil, Sao Paulo, SP (Brazil); Araujo, Adalberto Pereira de

    2002-12-01

    Purpose: To compare the computed tomography and angiography study of abdominal aortic aneurysms for posterior endograft implant. Method: From June 1997 to March 2001, 113 patients with abdominal aortic aneurysm were submitted to study of the aorto-iliac axis with abdominal spiral computed tomography and angiography with calibrated catheter. The patient's ages ranged from 51 and 88 years (mean: 69). There were 104 males and nine females. Results: When comparing the mean computed tomography and angiography diameters, we observed that there was a statistical difference for the infra-renal neck (p<0.05) and for the aortic aneurysm diameters (p<0.001). There was no statistical difference for the iliac artery diameters (p>0.05). When comparing the mean lengths, we observed that there was a statistical difference for the aortic infra-renal neck (p<0.05), for the distance between the renal artery and the aortic bifurcation (p<0.05) and for the common iliac artery lengths (p<0.05). There was also a statistical difference for the length between the renal artery and the internal iliac artery (p<0.05). Conclusions: In the AAA pre-procedure imaging study there were statistical differences between the computed tomography and angiographic measurement studies. We believe that computed tomography is a superior method for the evaluation of diameters and the angiography with a calibrated catheter for the length evaluation. We conclude, that both methods are complementary and must be undertaken for accurate evaluation of all candidates for aortic endograft implant. (author)

  18. Muerte súbita por disección de aorta torácica secundaria a coartación de aorta Sudden death due to thoracic aorta dissection associated with aortic coarctation

    National Research Council Canada - National Science Library

    A. Rico; J. Lucena; M. Blanco; R. Marín; E. Barrero; M. Santos

    2008-01-01

    La disección aórtica es un cuadro catastrófico caracterizado porque la sangre penetra y separa los planos laminares de la media, formando un nuevo conducto lleno de sangre dentro de la pared de la aorta...

  19. Exovascular application of epigallocatechin-3-O-gallate-releasing electrospun poly(L-lactide glycolic acid) fiber sheets to reduce intimal hyperplasia in injured abdominal aorta.

    Science.gov (United States)

    Lee, Mi Hee; Kwon, Byeong-ju; Koo, Min-Ah; Jang, Eui Hwa; Seon, Gyeung Mi; Park, Jong-Chul

    2015-09-21

    Intimal hyperplasia is an excessive ingrowth of tissue resulting in chronic structural lesions commonly found at sites of atherosclerotic lesions, arterial angioplasty, vascular graft anastomoses, and other vascular abnormalities. Epigallocatechin-3-O-gallate (EGCG) was shown to elicit antioxidant, anti-proliferative, and anti-thrombogenic effects. In this study, we used an electrospinning technique to synthesize EGCG-eluting biodegradable poly(L-lactide glycolic acid) (PLGA) fiber sheets for local delivery of EGCG and investigated the effect of their exovascular application on intimal hyperplasia following balloon-induced abdominal aorta injury in a rabbit experimental model. The morphology of the composite sheets was characterized using scanning electron microscopy and Fourier transform-infrared spectroscopy. EGCG was loaded and dispersed into the PLGA-based electrospun fibers. The EGCG-loaded PLGA sheets exhibited sustained EGCG release following the initial 24 h of burst release in phosphate-buffered saline. In vivo studies demonstrated significant inhibition of intimal hyperplasia following the application of the EGCG-eluting electrospun PLGA fiber sheets, compared with vehicle PLGA controls. In conclusion, our results show that exovascular application of EGCG-eluting PLGA electrospun fiber sheets may provide a useful system for the effective local delivery of drugs for the prevention of intimal hyperplasia.

  20. Endovascular abdominal aortic aneurysm repair: surveillance of endoleak using maximum transverse diameter of aorta on non-enhanced CT

    Energy Technology Data Exchange (ETDEWEB)

    Nagayama, Hiroki; Sueyoshi, Eijun; Sakamoto, Ichiro; Uetani, Masataka [Dept. of Radiology, Nagasaki Univ. School of Medicine, Nagasaki (Japan)], E-mail: sueyo@nagasaki-u.ac.jp

    2012-07-15

    Background. Repeat volumetric analysis of abdominal aortic aneurysm (AAA) after endovascular AAA repair (EVAR) is time-consuming and requires advanced processing, dedicated equipment, and skilled operators. Purpose. To clarify the validity of measuring the maximal short-axis diameter (Dmax) of AAA in follow-up non-enhanced axial CT as a means of detecting substantial endoleaks after EVAR. Material and Methods. CT images were retrospectively reviewed in 47 patients (7 women, 40 men; mean age, 76.2 years) who had no endoleak on initial contrast-enhanced CT after EVAR. Regular follow-up CT studies were performed every 6 months. At each CT study, the Dmax on the CT axial image was measured and compared with that on the last CT (115 data-sets). Contrast-enhanced CT was regarded as the standard of reference to decide the presence or absence of endoleaks. The appearance of endoleak was defined as the end point of this study. Results. Endoleaks were detected in 17 patients during the follow-up period. Mean Dmax changes for 6 months were significant between positive and negative endoleak cases (1.8 {+-} 1.9 vs. -1.1 {+-} 3.0 mm, P < 0.0001). When the Dmax change {<=} 0 mm for 6 months was used as the threshold for negative endoleak, the sensitivity, specificity, positive predictive value, and negative predictive value were 74.5, 82.4, 96.1, and 35.9%, respectively. When Dmax change {<=}-1 mm was used as the threshold, the sensitivity, specificity, PPV, and NPV were 38.8, 100, 100, and 22.1%, respectively. Conclusion. Contrast-enhanced CT is not required for the evaluation of endoleaks when the Dmax decreases by at least 1 mm over 6 months after EVAR.

  1. Avaliação pós-operatória do tratamento endovascular de aneurismas da aorta abdominal por angiotomografia com multidetectores Post-operative evaluation of endovascularly treated abdominal aortic aneurysms by multidetector computed tomography angiography

    Directory of Open Access Journals (Sweden)

    Fabiana Barroso Thomaz

    2008-08-01

    Full Text Available OBJETIVO: Este estudo tem como objetivo a avaliação pós-operatória do tratamento endovascular de aneurismas da aorta abdominal por angiotomografia com multidetectores. MATERIAIS E MÉTODOS: Foram analisadas, retrospectivamente, angiotomografias de 166 pacientes (137 homens e 29 mulheres com idade média de 73 anos portadores de aneurisma da aorta abdominal submetidos a terapêutica endovascular, no período de junho de 2005 a agosto de 2006. Os exames foram feitos em tomógrafo multidetector de 64 canais e os parâmetros adotados foram: colimação, 0,625 mm; pitch, 0,6-1; mAs, 300-400; kV, 120. Em todos os casos foi utilizado meio de contraste iodado não-iônico (350 mg/ml administrado por meio de bomba infusora, com fluxo de 4 ml/s a 5 ml/s e com volume variável de 70 ml a 100 ml. Os exames foram avaliados quanto à presença de complicações. RESULTADOS: Dos 166 exames realizados, 93 pacientes não apresentaram complicações e 73 apresentaram os seguintes achados: endoleak (n=37, trombose circunferencial da endoprótese (n=29, angulação (n=17, coleção no sítio de punção (n=10, migração da prótese (n=7, dissecção dos vasos de acesso (n=7 e oclusão (n=6. CONCLUSÃO: O endoleak foi a complicação mais prevalente em nosso estudo, sendo o tipo II o mais comum.OBJECTIVE: The present study was aimed at evaluating endovascularly treated abdominal aortic aneurysms by multidetector computed tomography angiography. MATERIALS AND METHODS: Multidetector computed tomography angiography studies of 166 patients were retrospectively analyzed. The sample included 137 men and 29 women with mean age of 73 years who had undergone endovascular treatment for abdominal aortic aneurysm in the period between June 2005 and August 2006. Images were acquired in a 64-channel multidetector tomograph adopting the following parameters: 0.625 mm collimation, pitch 0.6-1, 300-400 mAs, and 120 kV. A nonionic iodinated contrast agent (350 mg/ml was injected

  2. Abdominal aortic aneurysm

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/000162.htm Abdominal aortic aneurysm To use the sharing features on this page, ... blood to the abdomen, pelvis, and legs. An abdominal aortic aneurysm occurs when an area of the aorta becomes ...

  3. When the diameter of the abdominal aorta should be considered as abnormal? A new ultrasonographic index using the wrist circumference as a body build reference

    Energy Technology Data Exchange (ETDEWEB)

    Sconfienza, Luca Maria, E-mail: io@lucasconfienza.it [Servizio di Radiologia, IRCCS Policlinico San Donato, Piazza Malan 2 – 20097 San Donato Milanese, Milano (Italy); Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Piazza Malan 2 – 20097 San Donato Milanese, Milano (Italy); Santagostino, Ilaria, E-mail: isantagostino@hotmail.it [Scuola di Specializzazione in Radiodiagnostica, Università degli Studi di Milano, Via Festa del Perdono 7, 20100 Milano (Italy); Di Leo, Giovanni, E-mail: gianni.dileo77@gmail.com [Servizio di Radiologia, IRCCS Policlinico San Donato, Piazza Malan 2 – 20097 San Donato Milanese, Milano (Italy); Piazza, Raffaella; Gozzi, Gino, E-mail: radiologia.como@hsacomo.org [Diagnostica per Immagini, Ospedale Sant’Anna, Via Ravona 1, 22020 San Fermo della Battaglia, Como (Italy); Trimarchi, Santi, E-mail: satrimarchi@gmail.com [Chirurgia Vascolare II, IRCCS Policlinico San Donato, Piazza Malan 2 – 20097 San Donato Milanese, Milano (Italy); Sardanelli, Francesco, E-mail: francesco.sardanelli@unimi.it [Servizio di Radiologia, IRCCS Policlinico San Donato, Piazza Malan 2 – 20097 San Donato Milanese, Milano (Italy); Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Piazza Malan 2 – 20097 San Donato Milanese, Milano (Italy)

    2013-10-01

    Purpose: To use US to evaluate the normal values of aortic diameter (AD), stratifying the population by age, gender and body build, as measured using wrist circumference (WC). Materials and methods: Between April 2010 and February 2012, consecutive patients ≥ 30 years of age, without history of abdominal aortic aneurysm (AAA) were prospectively enrolled. They underwent an abdominal ultrasonography for reasons other than aorta evaluation. AD was measured at the infrarenal (AD{sub 1}), intermediate (AD{sub 2}), and iliac bifurcation (AD{sub 3}) levels: a diameter ≥ 3 cm was considered as an aneurysm. The maximal aortic diameter (AD{sub max}) was measured for AAA patients. WC was measured; AD/WC ratio was calculated and presented in percentage: the range of normal values was obtained excluding AAA cases and calculated as mean ± 1.96 × standard deviation. Pearson correlation coefficient was used. Results: We recruited 1200 patients, 15 (1.25%; age range = 64–86 years) had AAA. AD ranges of the other patients were: AD{sub 1} = 0.74–1.84 cm, AD{sub 2} = 0.78–1.85 cm, and AD{sub 3} = 0.68–1.76 cm for females; AD{sub 1} = 0.86–2.02 cm, AD{sub 2} = 0.91–2.08 cm, and AD{sub 3} = 0.84–1.95 cm for males. AD{sub 2}/WC ratio of non-AAA patients range was 4–15%, with only one outlier at 18%, while AD{sub max}/WC ratio of AAA patients range was 15–35% (p < 0.001). ADs were significantly correlated with WC (r = 0.253, p < 0.001 for AD{sub 1}, r = 0.318, p < 0.001 for AD{sub 2} and r = 0.280, p < 0.001 for AD{sub 3}). Conclusion: The definition of normal AD should consider body build. An AD{sub 2}/WC ratio of 15% may be regarded as a threshold to differentiate AAA- from non-AAA patients. Patients with AD{sub 2}/WC values comprised between 12% and 15% may be at risk for AAA.

  4. Aneurismas da aorta Aortic aneurysms

    Directory of Open Access Journals (Sweden)

    Januário M Souza

    1992-09-01

    Full Text Available Entre janeiro de 1979 e janeiro de 1992, foram realizadas 212 operações para correção de aneurismas e de dissecções da aorta. Neste trabalho serão analisados 104 procedimentos cirúrgicos (em 97 pacientes para correção de aneurismas. A idade dos pacientes variou de 14 a 79 anos (média 59,5 anos e o sexo predominante foi o masculino, com 75 pacientes. Os aneurismas localizavam-se na aorta ascendente em 46 pacientes, na croça em 8, na aorta descendente em 8, na aorta toráco-abdominal em 8, na aorta abdominal em 21, na aorta descendente e abdominal em 2, na aorta ascendente e tóraco-abdominal em 2, na aorta ascendente e descendente em 1, na aorta ascendente, croça e descendente em 1. Doenças cardiovasculares associadas estavam presentes em 39 pacientes, sendo valvopatia aórtica em 18 (excluídos os pacientes com ectasiaânulo-aórtíca, insuficiência coronária em 17, coarctação da aorta em 2, persistência do canal arterial em 1 e valvopatia mitral e aórtica em 1. A mortalidade imediata (hospitalar e/ou 30 dias foi de 14,4%, sendo de 27,7% (5/18 para pacientes com mais de 70 anos e de 11,3% (9/79 para pacientes com idade inferior a 70 anos. Os aneurismas localizados na aorta ascendente e croça foram operados como o auxílio de circulação extracorpórea. Parada circulatória e hipotermia profunda foram utilizadas em todos os pacientes com aneurisma da croça. O estudo tomográfico e angiográfico deve ser de toda a aorta, pela possibilidade de aneurismas de localizações múltiplas.Among 212 patients undergoing operation for aortic aneurysm and aortic dissection between January 1979 and January 1992, 97 were operated on for aneurysms. The aneurysms were localized in: ascending aorta in 46 patients, transverse aortic arch in 8, descending aorta in 8, thoracoabdominal aorta in 8, abdominal (infrarenal aorta in 21, descending and abdominal aorta in 2, ascending and thoracoabdominal aorta in 2, ascending and descending in 1

  5. Giant Candida mycetoma in an ascending aorta tubular graft.

    Science.gov (United States)

    Di Benedetto, Giuseppe; Citro, Rodolfo; Longobardi, Antonio; Mastrogiovanni, Generoso; Panza, Antonio; Iesu, Severino; Bossone, Eduardo

    2013-09-01

    We report the case of a 46-year-old male hospitalized for abdominal pain and fever with history of a David procedure followed by an aortic valve replacement due to severe aortic regurgitation. Transesophageal echocardiography (TEE) and computed tomography showed a large mass floating in the aorta. After surgical excision of the vegetation, attached to the Dacron prosthesis, histological examination revealed Candida hyphae and spores confirming the diagnosis of a mycetoma in an ascending aorta tubular graft. At six-month follow-up, the patient was in good clinical condition without recurrence of the fungal mass on TEE. © 2013 Wiley Periodicals, Inc.

  6. Influencia de la geometría de aneurismas de aorta abdominal en la dinámica del flujo sanguíneo y en su riesgo de ruptura

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    G. Vilalta

    2009-05-01

    Full Text Available La ruptura de aneurisma de aorta abdominal (AAA representa un evento clínico muy importante, con una tasa de mortalidad relativamente elevada. En un esfuerzo por aumentar la comprensión sobre este complejo fenómeno, en el presente trabajo se estudia la influencia de la geometría de los aneurismas de aorta abdominal en el riesgo de ruptura. Para esto se ha utilizado un modelo geométrico realista, obtenido por la transformación de imágenes 2D de tomografía computarizada (CT, sometido a un flujo pulsátil fisiológicamente realista, con el objetivo de evaluar e identificar las regiones donde ocurren las principales perturbaciones en los patrones de flujo, cómo ésta modifica los campos de velocidades y de tensiones hemodinámicas en el interior del saco aneurismático, así como la influencia de los diferentes factores biomécanicos relacionados con la geometría que caracterizan el aneurisma. Se presenta una explicación de las modificaciones de las estructuras vorticales y de la distribución de tensiones durante el ciclo cardíaco. Igualmente se determina un indicador numérico (Parámetro de Severidad que integra los 3 factores biomecánicos geométricos y que permite evaluar el riesgo de ruptura del aneurisma para un estado de desarrollo determinado. Los resultados confirman que la asimetría de los aneurismas de aorta abdominal es uno de los principales factores que influyen en su ruptura.The rupture of abdominal aortic aneurysm (AAA represents an important clinical event, with a relatively high mortality rate. In an effort to increase understanding about this complex phenomenon, this paper studies the influence of abdominal aortic aneurysms geometry on the risk of rupture. Patient specific AAA model, created by 2D reconstruction of computed tomography image, was used to identify regions of disturbed patterns flow and how it modifies the velocity field and hemodynamic stress on the inside of the aneurysmatic sac as well as the

  7. Cardiovascular effects of simultaneous occlusion of the inferior vena cava and aorta in patients treated with hypoxic abdominal perfusion for chemotherapy

    NARCIS (Netherlands)

    J. Hofland (Johannes); R. Tenbrinck (Robert); M.G.A. van IJken (Marc); C.H.J. van Eijck (Casper); A.M.M. Eggermont (Alexander); W. Erdmann (Wilhelm)

    2002-01-01

    textabstractBACKGROUND: Animal studies suggest less cardiovascular disturbance if the aorta and vena cava are occluded simultaneously. We set out to establish the effects of simultaneous clamping in humans, because oncologists suggested that perfusion for chemotherapy could be done

  8. Desarrollo de un modelo predictivo de mortalidad a largo plazo y complicaciones relacionadas con la endoprótesis, en la reparacion endovascular de aneurismas de aorta abdominal infrarrenal

    OpenAIRE

    Gómez Palonés, Francisco Julián

    2015-01-01

    Desde el inicio de la reparación endovascular de aneurismas de aorta abdominal infra renal, la progresión de dicho tratamiento ha superado en numero al realizado anualmente mediante cirugía abierta convencional, en la mayoría de servicios de Cirugía Vascular. A ello ha contribuido principalmente la menor mortalidad operatoria los 30 días y al atractivo que supone para pacientes un procedimiento menos agresivo y para los profesionales, el ofrecer una alternativa en casos en los que la cirugía...

  9. Surgery for adult coarctation with the ascending-abdominal aorta bypass procedure%升主动脉-腹主动脉转流术治疗成人主动脉缩窄

    Institute of Scientific and Technical Information of China (English)

    刘巍; 孙立忠; 王晓龙; 程卫平; 朱俊明; 刘永民; 陈雷; 乔志钰; 里程楠

    2011-01-01

    Objective To explore the surgical effects and follow-up results in treating adult aortic coarctation patients using ascending aorta-abdominal aorta vascular prosthesis bypass and summarize the clinical experiences. Methods From May 2008 to July 2009, ascending aorta-abdominal aorta vascular prosthesis bypass surgery was performed in nine patients with adult aortic coarctation, among which, four were male, and five were female, with the average age of 42.6 years old. All patients had upper extremity hypertension, the systolic blood pressure difference between their upper extremities and lower extremities was 55 - 100 mm Hg, mean (70.2 ± 15. 6) mm Hg. Among which, seven cases showed descending aorta aneurysmal dilatation at coarctation segment distal end, with the wall thinning; two cases showed long segment stenosis; three cases showed aortic wall near coarctation segment was calcified. All cases belonged to complex aortic coarctation. All patients underwent radial artery and dorsalis pedis artery puncture manometry, the surgical effects were evaluated according to mean pressure difference changes between radial artery and dorsalis pedis artery before and after operations. Results All patients were cured and dispertension has been significantly improved, before operation, the mean pressure difference between radial artery and dorsalis pedis artery was 36 - 63 mm Hg, mean [(48.2 ± 5.6 ) mm Hg]; 24 hours after operation, the mean pressure difference between radial artery and dorsalis pedis artery was 0 - 13 mm Hg, mean [(6.2 ± 1.6) mm Hg], significantly reduced ( P <per extremity hypertension disappeared, no need for oral antihypertensive drugs, the mean pressure differences between upper extremities and lower extremities after operations were all less than 20 mm Hg, thoracoabodominal aorta main vessels multi-slice CT examination three months after operation showed that bypass vascular prosthesis was unobetructed, two cases showed that autologous artery at aortic

  10. Lead intoxication due to ayurvedic medications as a cause of abdominal pain in adults.

    Science.gov (United States)

    Mehta, Varun; Midha, Vandana; Mahajan, Ramit; Narang, Vikram; Wander, Praneet; Sood, Ridhi; Sood, Ajit

    2017-02-01

    Though a majority of cases of lead intoxication come from occupational exposures, traditional and folk remedies have also been reported to contain toxic amounts of lead. We present a large series of patients with lead poisoning due to intake of Ayurvedic medicines, all of whom presented with unexplained abdominal pain. This was a retrospective, observational case series from a tertiary care center in India. The charts of patients who underwent blood lead level (BLL) testing as a part of workup for unexplained abdominal pain between 2005 and 2013 were reviewed. The patients with lead intoxication (BLLs >25 μg/dl) were identified and demographics, history, possible risk factors, clinical presentation and investigations were reviewed. Treatment details, duration, time to symptomatic recovery, laboratory follow-up and adverse events during therapy were recorded. BLLs were tested in 786 patients with unexplained abdominal pain and high levels were identified in 75 (9.5%) patients, of which a majority (73 patients, 9.3%) had history of Ayurvedic medication intake and only two had occupational exposure. Five randomly chosen Ayurvedic medications were analyzed and lead levels were impermissibly high (14-34,950 ppm) in all of them. Besides pain in abdomen, other presenting complaints were constipation, hypertension, neurological symptoms and acute kidney injury. Anemia and abnormal liver biochemical tests were observed in all the 73 patients. Discontinuing the Ayurvedic medicines and chelation with d-penicillamine led to improvement in symptoms and reduction in BLLs in all patients within 3-4 months. The patients presenting with severe recurrent abdominal pain, anemia and history of use of Ayurvedic medicines should be evaluated for lead toxicity. Early diagnosis in such cases can prevent unnecessary investigations and interventions, and permits early commencement of the treatment.

  11. Comparação entre os tratamentos aberto e endovascular dos aneurismas da aorta abdominal em pacientes de alto risco cirúrgico Comparison between open and endovascular treatment of abdominal aortic aneurysms in high surgical risk patients

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    Célio Teixeira Mendonça

    2005-09-01

    Full Text Available OBJETIVO: Comparar os resultados dos tratamentos aberto e endovascular de aneurismas da aorta abdominal em pacientes de alto risco cirúrgico. MÉTODOS: O tratamento aberto foi realizado em 31 pacientes, e o endovascular, em 18. Sucesso no tratamento endovascular foi definido como perviedade da endoprótese sem endoleaks ou conversão para tratamento aberto. RESULTADOS: Não houve diferença na mortalidade perioperatória entre o tratamento aberto (dois óbitos [6,45%] em 31 e o endovascular (um óbito [5,55%] em 18 (P = 0,899; também não houve diferença entre a mortalidade tardia no tratamento aberto (dois óbitos [6,9%] em 29 e no endovascular (dois óbitos [11,7%] em 17 (P = 0,572. A taxa de sucesso imediato foi de 100% (31/31 no tratamento aberto e de 66,7% (12/18 no endovascular (P = 0,0006; a taxa de sucesso tardio foi de 100% (27/27 no tratamento aberto e de 73,3% (11/15 no endovascular (P = 0,0047. Os valores médios do tempo de internação na UTI, tempo de internação hospitalar e da perda de sangue para os grupos dos tratamentos aberto e endovascular foram: 65,6 versus 34,1 horas*, 9 versus 5,6 dias* e 932 versus 225 ml*, respectivamente (*P OBJECTIVE: To compare the results of open repair and endoluminal repair of abdominal aortic aneurysms in high surgical risk patients. METHODS: Open repair was performed in 31 patients, and endoluminal repair was performed in 18. Success in the endoluminal repair group was defined as continuing graft function without endoleak or conversion to open repair. RESULTS: No significant difference was found between the perioperative mortality rate for open repair (two deaths [6.45%] in 31 patients and endoluminal repair (one death [5.55%] in 18 patients (P = 0.899; similarly, no significant difference was seen in late mortality between open repair (two deaths [6.9%] in 29 patients and endoluminal repair (two deaths [11.7%] in 17 patients (P = 0.572; The rate of immediate success was 100% (31/31 for

  12. Endovascular repair for abdominal aortic aneurysm followed by type B dissection.

    Science.gov (United States)

    Shingaki, Masami; Kato, Masaaki; Motoki, Manabu; Kubo, Yoji; Isaji, Toshihiko; Okubo, Nobukazu

    2016-10-01

    An 86-year-old man with an abdominal aortic aneurysm was diagnosed with type B aortic dissection accompanied by a patent false lumen that started at the distal arch of the thoracic aorta and terminated at the left common iliac artery. Meticulous preoperative assessment detected 3 large intimal tears in the descending aorta, abdominal aortic aneurysm, and left common iliac artery. We performed single-stage thoracic and abdominal endovascular aneurysm repair and concomitant axillary-axillary bypass. The abdominal aortic aneurysm with type B aortic dissection was successfully treated using a single-stage endovascular stent graft, without any complications due to the careful preoperative examinations.

  13. Fatores de morbimortalidade na cirurgia eletiva do aneurisma da aorta abdominal infra-renal: experiência de 134 casos Morbidity and mortality factors in the elective surgery of infrarenal abdominal aortic aneurysm: a case study with 134 patients

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    Aquiles Tadashi Ywata de Carvalho

    2008-09-01

    Full Text Available CONTEXTO: O tratamento cirúrgico convencional do aneurisma da aorta abdominal (AAA infra-renal pode resultar em complicações graves. A fim de otimizar os resultados na evolução do tratamento, é importante que sejam identificados os pacientes predispostos a determinadas complicações e instituídas condutas preventivas. OBJETIVOS: Avaliar a taxa de mortalidade operatória precoce, analisar as complicações pós-operatórias e identificar os fatores de risco relacionados com a morbimortalidade. MÉTODO: Foram analisados 134 pacientes com AAA infra-renal submetidos a correção cirúrgica eletiva no período de fevereiro de 2001 a dezembro de 2005. RESULTADOS: A taxa de mortalidade foi de 5,2%, sendo secundária principalmente a infarto agudo de miocárdio (IAM e isquemia mesentérica. As complicações cardíacas foram as mais freqüentes, seguidas das pulmonares e renais. A presença de diabetes melito (DM, insuficiência cardíaca congestiva (ICC, insuficiência coronariana (ICO e cintilografia miocárdica positiva para isquemia estiveram associadas às complicações cardíacas. A idade avançada, a doença pulmonar obstrutiva crônica (DPOC e a capacidade vital forçada reduzida aumentaram os riscos de atelectasia e pneumonia. História de nefropatia, tempo de pinçamento aórtico prolongado e níveis de uréia elevados aumentaram os riscos de insuficiência respiratória aguda (IRA. A isquemia dos membros inferiores esteve associada ao tabagismo e à idade avançada, e a maior taxa de mortalidade, à presença de coronariopatia, tempos prolongados de pinçamento aórtico e de cirurgia. CONCLUSÃO: A taxa de morbimortalidade esteve compatível com a literatura nacional e internacional, sendo secundária às complicações cardíacas, respiratórias e renais. Os fatores de risco identificados no pré e transoperatório estiveram relacionados com essas complicações.BACKGROUND: Conventional surgical treatment of infrarenal abdominal

  14. Abdominal aorta morphometric study for endovascular treatment of aortic aneurysms: comparison between spiral CT and angiography Estudo morfométrico da aorta abdominal para tratamento endovascular dos aneurismas aórticos: comparação entre tomografia helicoidal e angiografia

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    Gaudencio Espinosa

    2002-12-01

    Full Text Available PURPOSE: To compare the computed tomography and angiography study of abdominal aortic aneurysms for posterior endograft implant. METHOD: From June 1997 to March 2001, 113 patients with abdominal aortic aneurysm were submitted to study of the aorto-iliac axis with abdominal spiral computed tomography and angiography with calibrated catheter. The patient's ages ranged from 51 and 88 years (mean: 69. There were 104 males and nine females. RESULTS: When comparing the mean computed tomography and angiography diameters, we observed that there was a statistical difference for the infra-renal neck (p0.05. When comparing the mean lengths, we observed that there was a statistical difference for the aortic infra-renal neck (pOBJETIVOS: Este trabalho visa comparar a acurácia da tomografia computadorizada e da angiografia para avaliar os aneurismas de aorta abdominal (AAA para posterior implante de endoprótese vascular. MÉTODO: De junho de 1997 até março de 2001, foram atendidos 113 pacientes portadores de AAA, tendo sido submetidos a estudo por tomografia helicoidal computadorizada de abdome e pelve e angiografia com cateter centimetrado do eixo arterial aorto-ilíaco. A idade dos pacientes variou entre 51 e 88 anos (S:69a., sendo 104 do sexo masculino e nove do feminino. RESULTADOS: Quando comparadas as médias dos diâmetros aferidas pela tomografia computadorizada e pela angiografia, notou-se que a diferença do diâmetro foi significativa para o colo aórtico infra-renal (r 0,05. Quando comparadas as médias das extensões aferidas pela tomografia computadorizada e pela angiografia, notou-se que a diferença das extensões foi significativa para o colo aórtico infra-renal (r < 0,05, para a distância entre a artéria renal e a bifurcação aórtica (r < 0,05 e para as artérias ilíacas comuns (r < 0,05. A comparação entre as médias também foi significativa para a extensão entre a artéria renal e a artéria ilíaca interna (r < 0

  15. Abdominal intra-compartment syndrome - a non-hydraulic model of abdominal compartment syndrome due to post-hepatectomy hemorrhage in a man with a localized frozen abdomen due to extensive adhesions: a case report.

    Science.gov (United States)

    Bressan, Alexsander K; Kirkpatrick, Andrew W; Ball, Chad G

    2016-09-15

    Postoperative hemorrhage is a significant cause of morbidity and mortality following liver resection. It typically presents early within the postoperative period, and conservative management is possible in the majority of cases. We present a case of late post-hepatectomy hemorrhage associated with overt abdominal compartment syndrome resulting from a localized functional compartment within the abdomen. A 68-year-old white man was readmitted with sudden onset of upper abdominal pain, vomiting, and hemodynamic instability 8 days after an uneventful hepatic resection for metachronous colon cancer metastasis. A frozen abdomen with adhesions due to complicated previous abdominal surgeries was encountered at the first intervention, but the surgery itself and initial recovery were otherwise unremarkable. Prompt response to fluid resuscitation at admission was followed by a computed tomography of his abdomen that revealed active arterial hemorrhage in the liver resection site and hemoperitoneum (estimated volume abdomen, which we evacuated. Dramatic improvement in his ventilatory pressure was immediate. His abdomen was left open and a negative pressure device was placed for temporary abdominal closure. The fascia was formally closed after 48 hours. He was discharged home at postoperative day 6. Intra-abdominal pressure and radiologic findings of intra-abdominal hemorrhage should be carefully interpreted in patients with extensive intra-abdominal adhesions. A high index of suspicion and detailed understanding of abdominal compartment mechanics are paramount for the timely diagnosis of abdominal compartment syndrome in these patients. Clinicians should be aware that abnormal anatomy (such as adhesions) coupled with localized pathophysiology (such as hemorrhage) can create a so-named abdominal intra-compartment syndrome requiring extra vigilance to diagnose.

  16. Características ultraestruturais do segmento abdominal da aorta de rato albino - DOI: 10.4025/actascibiolsci.v29i4.825 Mural features of the abdominal aortic segment of albino rat - DOI: 10.4025/actascibiolsci.v29i4.825

    Directory of Open Access Journals (Sweden)

    Karina Simões

    2008-02-01

    Full Text Available O objetivo da presente pesquisa foi investigar as peculiaridades ultraestruturais da parede da aorta de rato. Foram utilizados sete ratos albinos, adultos jovens, dos quais foram coletados fragmentos da aorta abdominal infra-renal. Após a coleta, os segmentos vasculares foram fixados e encaminhados para a rotina de microscopia eletrônica de transmissão e varredura. As lamelas elásticas aparecem interpostas às fibras musculares lisas, sendo essa disposição principalmente notada na túnica média da parede vascular. Entre as fibras musculares lisas e as lamelas elásticas, observa-se um inter-relacionamento aparentemente estreito, feito por conexão e ancoramento entre ambos os elementos murais por meio de lamelas de colágeno. A túnica íntima da aorta abdominal do rato mostra algumas peculiaridades ultraestruturais marcantes, tais como a interrupção, em certos locais da parede, de continuidade da lâmina elástica interna, interrupção acompanhada por poros endoteliais, de certa extensão, suprajacentes à falha na estrutura elástica intimal. Este padrão de constituição mural, com destaque aos ancoramentos elástico-musculares, via o colágeno, parece garantir propriedades fundamentais da parede vascular, concernentes à hemodinâmica, tal como o cisalhamento, normalmente notado entre os estratos superpostos da parede vascular, bem como a contratilidade e a visco-elasticidade da parede arterial.The objective of the present research was to investigate the ultrastructural peculiarities of the aortic wall of the rat. Seven young adult rats were used, from which fragments of the infrarenal abdominal aorta were collected. After collection, the vascular segments were fixed and sent for analysis by scanning electron microscope. The elastic lamellae appear interposed with smooth muscular fibers; this pattern was verified mainly at the medial layer structure. Among the mural elements a well defined interrelationship was established through

  17. The culture and detection of nanobacteria in abdominal aorta atherosclerotic plaque%腹主动脉粥样硬化斑块中纳米细菌的培养与鉴定

    Institute of Scientific and Technical Information of China (English)

    耿文茂; 张倩; 吴亚光; 秦成坤; 苏忠学

    2012-01-01

    目的 观察腹主动脉粥样硬化斑块中是否存在纳米细菌,并对其进行鉴定.方法 12例腹主动脉粥样硬化斑块及12例正常动脉血管组织研磨,取上清液培养.8周后收集培养瓶底白色粉末,用纳米细菌单克隆抗体间接免疫荧光法对其进行检测,并利用电镜进一步观察.结果 12例动脉粥样硬化斑块中10例纳米细菌检测阳性,2例阴性,12例正常动脉血管组织中1例纳米细菌检测阳性,11例阴性,差异有统计学意义(P<0.05).纳米细菌单克隆抗体间接免疫荧光检测时可发出绿色荧光,电镜下测量纳米细菌直径约为100 ~ 300 nm.结论 腹主动脉粥样硬化斑块中存在纳米细菌,它可能导致粥样硬化斑块不稳定.%Objective To investigate whether the nanobacteria exists in abdominal aorta atherosclerotic plaque or not and detect it.Methods 12 case of abdominal aorta atherosclerotic plaques and 12 case of normal artery were grinded,the supematant fluid was cultured for eight weeks.Subsequently,the white extract from the culture flask was detected by nanobacteria monoclonal antibody immunofluorescence and electron microscope.Results Nanobacteria was positive in 10 case of atherosclerotic plaques but only in 1 case of normal artery,the difference was statistically significant (P < 0.05).Green fluorescence could be present during indirect immunofluorescence detection.The size of nanobacreria was measured ranging from 100nm to 300nm by electron microscope analysis.Conclusion Nanobacteria was detected in abdominal aorta atherosclerotic plaques and might led to atherosclerotic plaques instability.

  18. Estudo comparativo entre tratamento endovascular e cirurgia convencional na correção eletiva de aneurisma de aorta abdominal: revisão bibliográfica Endovascular elective treatment of the abdominal aortic aneurysm versus conventional open repair: a comparative study

    Directory of Open Access Journals (Sweden)

    Ana Carolina P. Simão

    2009-12-01

    Full Text Available O tratamento eletivo do aneurisma de aorta abdominal é recomendado pela alta morbiletalidade decorrente da eventual ruptura. O objetivo deste trabalho foi comparar o reparo endovascular eletivo com a cirurgia aberta e avaliar as mortalidades hospitalar e perioperatória, em 1 ano, por todas as causas e relacionadas ao aneurisma, a permanência hospitalar, as complicações, as taxas de sobrevida, conversão e reintervenção, a durabilidade do enxerto, o custo-benefício e a relação desses dados com o treinamento da equipe médica responsável pelo tratamento. Realizou-se uma revisão da literatura sobre reparo endovascular versus cirurgia convencional. Foram observados vantagem na sobrevivência perioperatória e menor estresse pós-cirúrgico; no entanto, os benefícios iniciais são perdidos por complicações e reintervenções tardias. Trabalhos baseados nas primeiras gerações de endopróteses superestimam as taxas de mortalidade em curto prazo, complicações e reintervenções. A durabilidade do enxerto, a real vantagem na sobrevida e o custo-benefício são incertos, e outros estudos são necessários para o seguimento em longo prazo.The elective treatment of the abdominal aortic aneurysm is recommended due to the high morbidity and mortality of a possible rupture. The objective of this study was to compare the elective endovascular aneurysm repair with open repair and to analyze the in-hospital and perioperative mortality rate during 1 year related to all causes and to the aneurysm, as well as the postoperative length of hospital stay, complications, survival rates, conversion and reintervention, graft durability, cost-benefit ratio, and relation with the medical team’s experience. A review of the scientific literature about endovascular versus open repair was carried out. We found a higher rate of perioperative survival and less postoperative stress; nevertheless, the initial benefits were lost due to late complications and

  19. Acute renal failure due to abdominal compartment syndrome: report on four cases and literature review

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    Cleva Roberto de

    2001-01-01

    Full Text Available We report on 4 cases of abdominal compartment syndrome complicated by acute renal failure that were promptly reversed by different abdominal decompression methods. Case 1: A 57-year-old obese woman in the post-operative period after giant incisional hernia correction with an intra-abdominal pressure of 24 mm Hg. She was sedated and curarized, and the intra-abdominal pressure fell to 15 mm Hg. Case 2: A 73-year-old woman with acute inflammatory abdomen was undergoing exploratory laparotomy when a hypertensive pneumoperitoneum was noticed. During the surgery, enhancement of urinary output was observed. Case 3: An 18-year-old man who underwent hepatectomy and developed coagulopathy and hepatic bleeding that required abdominal packing, developed oliguria with a transvesical intra-abdominal pressure of 22 mm Hg. During reoperation, the compresses were removed with a prompt improvement in urinary flow. Case 4: A 46-year-old man with hepatic cirrhosis was admitted after incisional hernia repair with intra-abdominal pressure of 16 mm Hg. After paracentesis, the intra-abdominal pressure fell to 11 mm Hg.

  20. “REBOA” – Is it Really Safe? A Case with Massive Intracranial Hemorrhage Possibly due to Endovascular Balloon Occlusion of the Aorta (REBOA)

    Science.gov (United States)

    Uchino, Hayaki; Tamura, Nobuichiro; Echigoya, Ryosuke; Ikegami, Tetsunori; Fukuoka, Toshio

    2016-01-01

    Patient: Female, 86 Final Diagnosis: Polytrauma Symptoms: Shock Medication: — Clinical Procedure: Resuscitative endovascular balloon occlusion of the aorta Specialty: Orthopedics and Traumatology Objective: Unusual or unexpected effect of treatment Background: Non-compressible torso hemorrhage continues to be the leading cause of preventable death in trauma patients. Recent case series report that resuscitative endovascular balloon occlusion of the aorta (REBOA) in the trauma population is a technically feasible method to manage the patients with exsanguinating hemorrhage. On the other hand, it seems that REBOA is being widely promoted prematurely. Complications due to REBOA haven’t been reported much in the literature, and they could have been underestimated. Case Report: An 86-year-old female presented to our emergency department following a pedestrian-vehicle accident. On admission, she was hemodynamically unstable with systolic blood pressure (SBP) of 78 mm Hg. She responded to fluid administration, and computed tomography (CT) scan showed cerebral contusion, subarachnoid hemorrhage, pelvic fracture with contrast extravasation, and thoracic spine fracture. Her condition deteriorated after the CT scan, and she became hemodynamically unstable. REBOA was inserted and inflated. Her blood pressure recovered and even became as high as SBP of 180 mm Hg. Transarterial embolization for pelvic fracture was successfully performed. A subsequent head CT scan showed massive intracranial hemorrhage with penetration to the ventricle, which was fatal. She died on the same day due to cerebral herniation. Conclusions: REBOA is now considered as an alternative to resuscitative thoracotomy or even widely indicated to control hemorrhage. We should be more cautious about using REBOA for polytrauma patients since it could make hemorrhage worse. Further research, assessing its potential complications and safety, will be required to elucidate clear indications for REBOA in trauma

  1. Effect of Xuebijing injection on cardiac muscle in the rats undergoing abdominal aorta clamping with sepsis%血必净对腹主动脉阻断合并脓毒症大鼠心肌的影响

    Institute of Scientific and Technical Information of China (English)

    夏文芳; 周青山; 徐洁

    2014-01-01

    Objective It is to observe the protecting effect of Xuebijing injection (XBJ) on cardiac muscle in the rats un-dergoing abdominal aorta clamping complicating with sepsis .Methods 32 Wistar rats were randomly divided into control group (S group), abdominal aorta clamping complicating with sepsis group (I/R+LPS group), Xuebijing injection group (XBJ group ) .The rats in XBJ group were pretreated with XBJ 30 min before abdominal aorta separated , 8 mL/kg by caudal vein in-jection, in 2 h after abdominal aorta ischemia reperfusion injury , they were given LPS20 mg/kg by intraperitoneal injection . All the animals were killed in 8 h after abdominal aorta blocking , and their cardiac tissue was gotten to do HE staining to ob-serve pathological damage , the expression of TNF -αandβ2 adrenoreceptor ( AR) in the tissue was detected by immunohisto-chemistry technique .Results①Cardiac tissue pathology results showed that: no obvious pathological change was found in S group;In I/R+LPS group myocardial cells were swelling with wider intermuscular space , little blood vessel was obviously hy-peremia with agglutination of many red blood cells which were also leaked much in the space , myocardial fibers were degenera-tion and necrosis , many inflammatory cells gathered in the space , even the structure was indistinct in cardiac tissue;In XBJ group , myocardial tissue was disorder in which the cells were slight swelling , and less leak of red blood cells and infiltration of inflammatory cells in the space was found .②Immunohistochemistry detection results showed that the expression of TNF -ɑin cardiac cells:S groupXBJ group>I/R+LPS group, the difference between S group and I/R+LPS group was significant but not in XBJ group compared with the other two groups .Conclusion XBJ pretreatment has some protecting effect on early myocardial injury in the rats undergoing abdominal aorta clamping complicating with sepsis , it can decrease the expression of TNF-αwith no obvious effect

  2. Estenose carotídea acima de 70% em pacientes no pré-operatório de cirurgia da aorta abdominal: freqüência e fatores de risco Frequency and risk factors for carotid stenosis above 70% in patients undergoing abdominal aortic surgery

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    André Ventura Ferreira

    2006-03-01

    Full Text Available OBJETIVO: Analisar a freqüência e os fatores de risco associados à estenose carotídea acima de 70% em pacientes que serão submetidos a cirurgias de aorta abdominal. MATERIAL E MÉTODO: Foram analisados 94 pacientes que realizaram ultra-som Doppler de carótidas no pré-operatório de cirurgias de aorta abdominal entre janeiro de 2000 e janeiro de 2003, pela disciplina de Cirurgia Vascular da Santa Casa de São Paulo. RESULTADOS: Sessenta e sete pacientes (71% eram homens. Dentre os 94 pacientes, 42 (44,6% tinham doença oclusiva aorto-ilíaca, e 52 (53,4%, aneurismas da aorta abdominal (AAA. A análise dos dados mostrou uma prevalência de estenose de carótidas acima de 70% em 8,33% dos pacientes com AAA e em 13,51% dos pacientes com doença oclusiva aorto-ilíaca, diferença esta sem significância estatística (P = 0,5. Nos pacientes que apresentavam antecedente de isquemia cerebral - acidente vascular cerebral (AVC ou ataque isquêmico transitório (AIT -, houve uma prevalência estatisticamente maior de estenose carotídea entre 70 e 99%. Outros fatores de risco para aterosclerose, como sexo masculino, diabetes, hipertensão arterial e tabagismo, não foram preditivos da presença de estenose carotídea acima de 70%. CONCLUSÃO: A freqüência de estenose da carótida acima de 70% em pacientes no pré-operatório de cirurgia de aorta foi de 9,57%, e a presença de antecedente de AVC ou AIT na história foi preditiva de estenose acima de 70% neste grupo de pacientes.OBJECTIVE: To analyze the frequency and risk factors of carotid stenosis above 70% in patients undergoing abdominal aortic reconstruction. MATERIAL AND METHOD: Ninety-four patients who underwent Doppler ultrasound preoperative screening for abdominal aortic surgery between January 2000 and January 2003 were analyzed by the Vascular Surgery Unit of the Santa Casa of São Paulo (Faculty of Medical Sciences. RESULTS: Sixty-seven (71% patients were male. Of the 94 patients, 42

  3. An Intra-Abdominal Pseudocyst around a Ventriculoperitoneal Shunt due to Streptococcus Infection 7 Years after Shunt Surgery

    Directory of Open Access Journals (Sweden)

    Arata Tomiyama

    2014-01-01

    Full Text Available In 1999, a 50-year-old woman underwent ventriculoperitoneal (VP shunt surgery for hydrocephalus after subarachnoid hemorrhage. She was hospitalized for fever and recurrent systemic seizures in November 2006. Head computed tomography (CT showed only old changes. The seizures and fever were controlled by medicinal therapy. However, in December, her consciousness level suddenly decreased, and she showed progressive lower abdominal distension. Head CT showed marked ventriculomegaly, and abdominal CT showed a giant cystic mass at the shunt-tube tip in the lower abdominal cavity. Because thick pus was aspirated from the intra-abdominal mass, we diagnosed the patient with acute obstructive hydrocephalus due to an infected abdominal pseudocyst. Laparotomy and direct cyst drainage were performed, and antibiotic therapy against Streptococcus, the causative pathogen, was administered. The VP shunt tube was replaced. The postoperative course was uneventful, and postoperative CT showed hydrocephalus improvement and no pseudocyst recurrence. Abdominal pseudocysts, which are rare after VP shunt surgeries, usually occur after the subacute postoperative course in younger cerebral hemorrhagic cases. Our case was quite rare because the cyst developed in the chronic phase in an older patient and was caused by streptococcal infection. The cyst components should be examined before cyst drainage when choosing surgical strategies.

  4. Lesão pulmonar de reperfusão por oclusão da aorta abdominal: modelo experimental em ratos

    Directory of Open Access Journals (Sweden)

    PINHEIRO BRUNO DO VALLE

    2000-01-01

    Full Text Available Introdução: Procedimentos cirúrgicos com oclusão da aorta têm sido associados a lesão pulmonar de reperfusão. O objetivo deste trabalho foi estudar a presença de edema pulmonar em um modelo de lesão de reperfusão por oclusão da aorta em ratos. Material e métodos: 33 ratos Wistar foram anestesiados com tiopental sódico (20mg/kg, via intraperitoneal, seguindo-se laparotomia por incisão mediana, para isolamento da aorta e cava inferior. A seguir, os animais foram randomizados em três grupos. Grupo isquemia-reperfusão (GIR, n = 5: animais submetidos a 30min de oclusão dos vasos, seguindo-se 120min de reperfusão. Grupo isquemia (GI, n = 5: animais submetidos a 30min de oclusão dos vasos. Grupo controle (GC, n = 5: animais submetidos apenas ao procedimento cirúrgico, sem oclusão dos vasos, acompanhados por 150min. Após o sacrifício, em 15 animais foram realizados estudos histopatológicos dos pulmões. Para caracterização de edema, foi realizada a análise morfométrica por contagem de pontos, determinando-se o índice de edema alveolar. Realizou-se também uma análise semiquantitativa da infiltração de polimorfonucleares nos pulmões. Em 18 animais retirou-se o pulmão direito para a determinação da relação entre os pesos úmido e seco. O índice de edema alveolar e a relação peso úmido/peso seco foram comparados entre os grupos através de ANOVA, com a correção de Bonferroni para comparação entre os grupos dois a dois. Resultados: Os animais do GIR apresentaram maior edema alveolar em relação aos do GI e GC (0,24; 0,18; 0,17; respectivamente, com p < 0,001. Não houve diferenças nas relações peso úmido/peso seco dos três grupos. Houve maior infiltração de células inflamatórias nos pulmões dos ratos submetidos a isquemia-reperfusão. Os autores concluem que a oclusão e desoclusão da aorta infra-renal está associada à lesão pulmonar. Essa lesão não foi induzida pela elevação da press

  5. 64-Slice CT angiography of the abdominal aorta and abdominal arteries: comparison of the diagnostic efficacy of iobitridol 350 mgI/ml versus iomeprol 400 mgI/ml in a prospective, randomised, double-blind multi-centre trial

    Energy Technology Data Exchange (ETDEWEB)

    Loewe, Christian; Schernthaner, Melanie; Lammer, Johannes [Medical University Vienna, Section of Cardiovascular and Interventional Radiology, Department of Radiology, Vienna (Austria); Becker, Christoph R.; Hittinger, Markus [University Hospital Grosshadern, Department of Clinical Radiology, Munich (Germany); Berletti, Riccardo; Favat, Massimo [Belluno Civil Hospital, Department of Radiology, Belluno (Italy); Cametti, Carlo Alberto; Marangoni, Roberto [ASL TO2 Ospedale San G. Bosco, Department of Radiology, Torino (Italy); Caudron, Jerome; Lestrat, Jean-Pierre [University Hospital of Rouen, Department of Radiology, Rouen (France); Coudyzer, Walter; Heye, Sam [UZ Leuven, Department of Radiology, Leuven (Belgium); Mey, Johan de; Nieboer, Koenraad [UZ Brussel, Department of Radiology, Brussels (Belgium); Heautot, Jean-Francois; Larralde, Antoine [Pontchaillou Hospital, Department of Radiology, Rennes (France); Reimer, Peter; Schwarz, Martin [Staedt. Klinikum Karlsruhe, Department of Radiology, Karlsruhe (Germany)

    2010-03-15

    The purpose of this study was to assess the influence of iodine concentration on diagnostic efficacy in multi-detector-row computed tomography (MDCT) angiography of the abdominal aorta and abdominal arteries. IRB approval and informed consent were obtained. In this double-blind trial, patients were randomised to undergo MDCT angiography of the abdominal arteries during administration of iobitridol (350 mgI/ml) or iomeprol (400 mgI/ml). Each centre applied its own technique for delivery of contrast medium, regardless of iodine concentration. Diagnostic efficacy, image quality, visualisation of the arterial wall and arterial enhancement were evaluated. A total of 153 patients received iobitridol and 154 received iomeprol. The ability to reach a diagnosis was ''satisfactory'' to ''totally satisfactory'' in 152 (99.3%) and 153 (99.4%) patients respectively. Image quality was rated as being ''good'' to ''excellent'' in 94.7 and 94.8% segments respectively. Similar results were observed for image quality of arterial walls (84.3 vs. 83.2%). The mean relative changes in arterial enhancement between baseline and arterial phase images showed no statistically significant differences. This study demonstrated the non-inferiority of the 350 versus 400 mgI/ml iodine concentration, in terms of diagnostic efficacy, in abdominal MDCT angiography. It also confirmed the high robustness and reliability of this technique across multi-national practices. (orig.)

  6. 64-Slice CT angiography of the abdominal aorta and abdominal arteries: comparison of the diagnostic efficacy of iobitridol 350 mgI/ml versus iomeprol 400 mgI/ml in a prospective, randomised, double-blind multi-centre trial.

    Science.gov (United States)

    Loewe, Christian; Becker, Christoph R; Berletti, Riccardo; Cametti, Carlo Alberto; Caudron, Jerome; Coudyzer, Walter; De Mey, Johan; Favat, Massimo; Heautot, Jean-François; Heye, Sam; Hittinger, Markus; Larralde, Antoine; Lestrat, Jean-Pierre; Marangoni, Roberto; Nieboer, Koenraad; Reimer, Peter; Schwarz, Martin; Schernthaner, Melanie; Lammer, Johannes

    2010-03-01

    The purpose of this study was to assess the influence of iodine concentration on diagnostic efficacy in multi-detector-row computed tomography (MDCT) angiography of the abdominal aorta and abdominal arteries. IRB approval and informed consent were obtained. In this double-blind trial, patients were randomised to undergo MDCT angiography of the abdominal arteries during administration of iobitridol (350 mgI/ml) or iomeprol (400 mgI/ml). Each centre applied its own technique for delivery of contrast medium, regardless of iodine concentration. Diagnostic efficacy, image quality, visualisation of the arterial wall and arterial enhancement were evaluated. A total of 153 patients received iobitridol and 154 received iomeprol. The ability to reach a diagnosis was "satisfactory" to "totally satisfactory" in 152 (99.3%) and 153 (99.4%) patients respectively. Image quality was rated as being "good" to "excellent" in 94.7 and 94.8% segments respectively. Similar results were observed for image quality of arterial walls (84.3 vs. 83.2%). The mean relative changes in arterial enhancement between baseline and arterial phase images showed no statistically significant differences. This study demonstrated the non-inferiority of the 350 versus 400 mgI/ml iodine concentration, in terms of diagnostic efficacy, in abdominal MDCT angiography. It also confirmed the high robustness and reliability of this technique across multi-national practices.

  7. Sac enlargement due to seroma after endovascular abdominal aortic aneurysm repair with the Endologix PowerLink device.

    Science.gov (United States)

    Nano, Giovanni; Dalainas, Ilias; Bianchi, Paolo G; Gotti, Riccardo; Casana, Renato; Malacrida, Giovanni; Tealdi, Domenico G

    2006-01-01

    A patient who had undergone endovascular repair of an abdominal aortic aneurysm with the Endologix PowerLink bifurcated system presented with delayed aortic aneurysm enlargement due to assumed endotension. He was treated with aortic sac evacuation and wrapping of the endograft. This is the first report of endotension and aneurysm sac enlargement after implantation of the PowerLink endograft.

  8. Ectopic abdominal pregnancy due to uterine perforation after an attempt to terminate pregnancy: a case presentation

    Directory of Open Access Journals (Sweden)

    Alexander Abreu

    2017-07-01

    Full Text Available Resumen El embarazo ectópico abdominal secundario tiene una baja frecuencia de presentación en la práctica clínica, pero puede llevar al incremento de la mortalidad materna. Se presenta el caso de una paciente con embarazo abdominal secundario a una perforación uterina, causada por una interrupción voluntaria del embarazo. Este evolucionó durante nueve semanas con dolor abdominal y sangramiento vaginal escaso. A la paciente se le realizaron diagnósticos como enfermedad inflamatoria pélvica aguda, infección del tracto urinario, restos ovulares post aborto y definitivamente se concluyó como embarazo ectópico abdominal mediante ecografía abdominal. Se le realizó laparotomía exploradora y se extrajo el feto y la placenta sin dificultades con una evolución postoperatoria favorable hacia la curación. Se concluyó que la perforación uterina durante el curetaje de la cavidad pudo pasar inadvertida, llevando a implantación abdominal secundaria del embarazo con un cuadro clínico variable. En dicho cuadro, el ultrasonido juega un papel fundamental para su diagnóstico, siendo el manejo laparotómico el más apropiado en estos casos.

  9. Effect of increased intra-abdominal pressure due to pneumoperitoneum on liver functions and liver histopathology in a rat model with intra-abdominal sepsis.

    Science.gov (United States)

    Youssef, Youssef Farouk; Noseer, Mona

    2008-04-01

    Intra-abdominal sepsis was induced by open cecal ligation and puncture (OCLP) technique. Sixty rats were randomly divided into three equal groups each of 20. G1 was used as a control. G2 were subjected to laparotomy and closure after 12 hours from (OCLP) via the same incision. In G3, pneumoperitoneum was induced 12 hours after OCLP and maintained at 12 mmHg for about 30 minutes. Blood samples were taken for liver functions after 12 & 24 hours from OCLP procedure, and Liver biopsies were taken for histopathological examination after 24 hours. The results showed that liver functions were markedly increased in G3 after pneumoperitoneum, compared to Gs 1 & 2. The histopathological changes in liver biopsies due to sepsis were more marked in cases exposed to pneumoperitoneum than that exposed to conventional laparotomy. The intra-abdominal sepsis affected liver functions and caused pathogenesis. The increased intra-abdominal pressure induced more liver insults, compared to that gained after open surgery.

  10. Role of F-18 FDG PET/CT in the management of infected abdominal aortic aneurysm due to salmonella

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Seung Jin; Lee, Jin Soo; Cheong, Moon Hyun; Byun, Sung Su; Hyun, In Young [Inha University College of Medicine, Incheon (Korea, Republic of)

    2007-12-15

    We present a case of infected abdominal aortic aneurysm due to salmonella enteritidis. F-18 FDG PET/CT was performed to diagnosis and during follow-up after antibiotic treatment. Computed tomography (CT) is considered to be the best diagnostic imaging modality in infected aortic lesions. In this case, a combination of CT and FDG PET/CT provided accurate information for the diagnosis of infected abdominal aortic aneurysm. Moreover, FDG PET/CT made an important contribution of monitoring disease activity during antibiotic treatment.

  11. [Acute and chronic aortic diseases of the thoracic and abdominal aorta of the adult - 2014 AS SMC Guidelines on the classification and diagnosis of aortic diseases].

    Science.gov (United States)

    Gavorník, Peter; Dukát, Andrej; Gašpar, Ľudovít

    2015-01-01

    In addition to organovascular arterial ischemic diseases (cardiovascular, vasculovascular, neurovascular, extre-mitovascular, renovascular, genitovascular, bronchopulmovascular, mesenteriovascular, osteoarthromusculovascular, dermovascular, oculovascular, otovascular, stomatovascular etc.), aortic diseases contribute to the wide spectrum of arterial diseases: aortic aneurysms (AA), acute aortic syndromes (AAS) including aortic dissection (AD), intramural haematoma (IMH), penetrating atherosclerotic ulcer (PAU) and traumatic aortic injury (TAI), pseudoaneurysm, aortic rupture, atherosclerosis, vasculitis as well as genetic diseases (e.g. Turner syndrome, Marfan syndrome, Ehlers-Danlos syndrome) and congenital abnormalities including the coarctation of the aorta (CoA). Similarly to other arterial diseases, aortic diseases may be diagnosed after a long period of subclinical development or they may have an acute presentation. Acute aortic syndrome is often the first sign of the disease, which needs rapid diagnosis and decisionmaking to reduce the extremely poor prognosis. Key clinical-etiology-anatomy-patophysiology (CEAP) diagnostic aspects of aortic diseases are discussed in this document (project Vessels).

  12. Abdominal angina due to recurrence of cancer of the papilla of Vater: a case report

    Directory of Open Access Journals (Sweden)

    Rapaccini Gian

    2009-12-01

    Full Text Available Abstract Introduction Abdominal angina is usually caused by atherosclerotic disease, and other causes are considered uncommon. This is the first report of a case of abdominal angina secondary to neoplastic vascular stenosis caused by local recurrence of an adenocarcinoma of the papilla of Vater. Case presentation An 80-year-old woman of Caucasian origin presented with abdominal pain and diarrhea. She had undergone a pancreaticoduodenectomy for adenocarcinoma of the papilla of Vater four years earlier. Computed tomography revealed a mass surrounding her celiac trunk and superior mesenteric artery. Her abdominal pain responded poorly to analgesic drugs, but disappeared when oral feedings were withheld. A duplex ultrasonography of the patient's splanchnic vessels was consistent with vascular stenosis. Parenteral nutrition was started and the patient remained pain free until her death. Conclusion Pain relief is an important therapeutic target in patients with cancer. In this case, abdominal pain was successfully managed only after the ischemic cause had been identified. The conventional analgesic therapy algorithm based on nonsteroidal anti-inflammatory drugs and opioids had been costly and pointless, whereas the simple withdrawal of oral feeding spared the patient of the discomfort of additional invasive procedures and allowed her to spend her remaining days in a completely pain-free state.

  13. Comparison of ultrasonography, computed tomography and magnetic resonance imaging with intraoperative measurements in the evaluation of abdominal aortic aneurysms Comparação entre ultrassonografia, tomografia computadorizada e ressonância nuclear magnética com medidas intra-operatórias na avaliação dos aneurismas de aorta abdominal

    Directory of Open Access Journals (Sweden)

    Francisco das Chagas de Azevedo

    2005-02-01

    Full Text Available PURPOSE: To study the imaging exams more commonly used for abdominal aortic aneurysms evaluation - ultrasonography, conventional computerized tomography, helical computerized tomography and nuclear magnetic angioresonance - comparing the preoperative measurements reached by those radiological methods with the measurements made during the surgical procedures. METHODS: Patients who had indication of elective transperitoneal surgical treatment for their abdominal aortic aneurysms were included in the study. The initial diagnosis of the aortic dilatation was made by ultrasonography and, after the surgical treatment was indicated, the patient was submitted to another imaging method. Sixty patients were divided into 3 groups according to the complementary imaging method (conventional computerised tomography, helical computerized tomography, nuclear magnetic angioresonance. The ultrasonography of the first 20 patients were joined in a fourth group. There were considered in the study the measurements of the transversal diameter of the proximal neck, maximum transversal diameter of the aneurysm, straight-line length and transversal diameter of the common iliac arteries given by the imaging methods. The same measurements were made by using a caliper during the surgical procedure, and then compared to the values obtained from the radiological exams. RESULTS: The maximum transverse diameter had a range measurement variation of 4.5 to 13.6 cm in the intraoperative, with no statistically significant differences when compared with all the imaging tests. The ultrasonography, however, overestimated the measurements of the proximal neck and the common iliac arteries, in comparison with intraoperative measures. The length of the aorta aneurysm obtained by the conventional computerized tomography was significantly lower if compared to the measures done with the calliper during the operation. The helical computerized tomography and the nuclear magnetic

  14. Synchronous infection of the aorta and the testis: emphysematous epididymo-orchitis, abdominal aortic mycotic aneurysm, and testicular artery pseudoaneurysm diagnosed by use of MDCT.

    Science.gov (United States)

    Hegde, Rahul G; Balani, Ankit; Merchant, Suleman A; Joshi, Anagha R

    2014-07-01

    We report clinical details and imaging findings for a case of emphysematous epididymo-orchitis with co-existing mycotic abdominal aortic aneurysm and a testicular artery pseudoaneurysm in a diabetic 65-year-old male. We report imaging findings from ultrasonography (USG) and contrast-enhanced multidetector computed tomography (MDCT). Use of MDCT to identify, confirm, and define the extent of the disease, and its utility in understanding the pathogenesis of this rare condition are highlighted. For such lethal infections, early diagnosis and intervention can be lifesaving; imaging can be of crucial importance in this.

  15. Multiple tuberculous aneurysms of the aorta.

    Science.gov (United States)

    Pierret, Charles; Tourtier, Jean-Pierre; Grand, Bertrand; Boddaert, Guillaume; Laurian, Claude; de Kerangal, Xavier

    2011-06-01

    Tuberculous aneurysms of the aorta are quite rare, but are exceptional when found in multiple locations. We report the case of multiple tuberculous aortic aneurysms of the thoracic and abdominal aorta in a 19-year-old female discovered when she consulted for thrombocytopenic purpura. The treatment for both locations included prolonged antituberculous therapy and surgical resection with cryopreserved aortic allograft patch for the reconstruction.

  16. Postoperative infection of an abdominal mesh due to methicillin resistant Staphylococcus Aureus - A case report

    Directory of Open Access Journals (Sweden)

    Ashok R

    2004-01-01

    Full Text Available Methicillin resistant Stephylococcus aureus (MRSA infection has now become a major problem in hospitals. We present a case of postoperative infection MRSA where the primary source of the infection was found to be an abdominal mesh that was used to reinforce the abdominal wall. After one year of surgery, the patient developed wound dehiscence and discharge. MRSA was isolated from the wound, mesh, external nares, throat and axilla. Initially she was started on clindamycin and discharged from the hospital. After 5 months, patient came back to the hospital with infection at the same site. The patient was then treated with vancomycin and MRSA clearance. She responded to the treatment with complete healing of the wound and clearance of MRSA.

  17. Treatment of infrarenal abdominal aortic dissection concomitant with an aneurysm

    Institute of Scientific and Technical Information of China (English)

    WANG Li-xin; ZHU Ting; FU Wei-guo; WANG Yu-qi; XI Xun; GUO Da-qiao; CHEN Bin; JIANG Jun-hao; YANG Ju; SHI Zhen-yu

    2007-01-01

    @@ Aortic dissection occurs when layers of the aortic walls are separated by the blood flow through an intimal tear. Dissection of the aorta most frequently originates in the ascending aorta (70%), followed by the descending aorta (22%), the aortic arch (7%) and the abdominal aorta (1/%).1 The dissection limited to the abdominal aorta is rare.2 An isolated abdominal aortic dissection (IAAD) concomitant with an abdominal aortic aneurysm (AAA) is uncommon. We present here one patient with IAAD and AAA treated by endovascular therapy.

  18. 急性腹主动脉闭塞合并双肾动脉闭塞1例临床分析%Clinical Analysis on One Case of Acute Occlusion of the Abdominal Aorta with Concomitant Bilateral Renal Artery Occlusion

    Institute of Scientific and Technical Information of China (English)

    刘同库; 汪建中; 盖越

    2014-01-01

    目的:探讨急性腹主动脉闭塞合并双肾动脉闭塞的病因与抢救措施。方法对突然出现腰腹痛和双下肢疼痛伴麻木4h的患者行腹主动脉造影,造影证实该患者为腹主动脉合并双肾动脉完全闭塞,行介入治疗和清栓术治疗。结果清除部分血栓,患者恢复血流5 min后发生高血钾,引发心脏骤停死亡。结论急性腹主动脉闭塞合并双肾动脉闭塞死亡率高,主要死因是心脏毒性物质的吸收、高血钾、酸中毒、肾衰竭致心脏骤停,抢救成功的关键是尽早开通患者闭塞血管。%Objective To investigate the cause and rescue measures of the acute abdominal aorta occlusion with bilateral renal artery occlusion. Method The patient suffered suddenly from lumbar and abdominal pain and the lower limbs pain with numbness lasting for 4 hours,and was confirmed to be the acute occlusion of the abdominal aorta and bilateral renal artery by abdominal aorta angiography. The patient was treated by interventional therapy. Results The part of blood clots were removed from the abdominal aorta lesions. The blood flow was restored after 5 mins, the patient died of hyperkalemia and cardiac arrest. Conclusion The mortality rate of the acute abdominal aorta occlusion with bilateral renal artery occlusion is very high. The main cause of death is the cardiac arrest caused by the absorption of toxic substances, hyperkalemia, acidosis and renal failure. It is the key of successful rescue to open the occluded blood vessels as soon as possible.

  19. Avaliação da incidência e de fatores de risco para a colite isquêmica após reparo de aneurisma de aorta abdominal Avaliation of Incidence and risk factors for ischemic colitis following abdominal aortic aneurism repair

    Directory of Open Access Journals (Sweden)

    Gilmara Pandolfo

    2007-09-01

    Full Text Available Este estudo teve como objetivo principal determinar a incidência da colite isquêmica após o reparo de aneurisma de aorta abdominal, bem como identificar fatores de risco para o desenvolvimento da mesma. Foram estudados 11 pacientes submetidos a reparo cirúrgico eletivo de aneurisma de aorta abdominal no Serviço de Cirurgia Cardiovascular do HSL-PUCRS. A incidência de colite isquêmica foi determinada através de retossigmoidoscopia flexível, com biópsia, realizada em todos os pacientes no 7º pós-operatório. A incidência da doença foi comparada com variáveis clínicas como: sexo; idade; presença de comorbidades associadas; choque trans-operatório; fluxo na artéria mesentérica inferior (AMI; complicações pós-operatórias; e o desfecho final. Em nossa amostra, a incidência da colite isquêmica após o reparo de aneurisma de aorta abdominal foi 36%, sendo destes 25% da forma gangrenosa. A ocorrência de isquemia do cólon foi mais freqüente em associação com o diagnóstico de doença pulmonar obstrutiva crônica, e em pacientes que apresentavam fluxo na artéria mesentérica inferior no pré-operatório (pIschemic colitis is a relatively uncommon complication following abdominal aortic aneurism repair. However, patients with this disease have higher rates of mortality when compared to ischemic colitis alone. The objective of our study is to investigate the incidence and risk factors associated with the occurrence of ischemic colitis following abdominal aortic aneurism repair. We studied eleven patients treated by surgery for aortic aneurism at Hospital São Lucas da PUCRS (HSL-PUCRS. The patients were evaluated for other clinical conditions and were submitted to flexible reto-sigmoidoscopy at the seventh day after surgery. Incidence of ischemic colitis was 36% and it was associated with chronic obstructive pulmonar disease and the presence of blood flow through the inferior mesenteric artery before surgery. Among the

  20. The role of imaging in the transluminal treatment of abdominal aortic aneurysm; Trattamento transluminare degli aneurismi dell'aorta addominale

    Energy Technology Data Exchange (ETDEWEB)

    Meregaglia, D.R.; Piglionica, M.R.; Ferrari, S.; Strada, M.; Deleo, G.; Biasi, G.M. [Ospedale E. Bassini. Azienda Ospedaliera S. Gerardo. Divisione e Cattedra di Chirurgia Vascolare, Monza (Italy); Pavlidis, P. [Red Cross Hospital. Divisione di Chirurgia Vascolare, Athens (Greece)

    1999-03-01

    The authors emphasized the importance of diagnostic imaging: a) in the selection of patients to be treated with the transluminal approach; b) during stent-graft positioning; c) in the follow-up of treated patients. Diagnostic imaging plays a basic role in the endovascular treatment of abdominal aortic aneurysm (AAA), much more than that required for traditional surgical treatment. In particular, pretreatment planning is critical and requires sophisticated imaging, including Spiral CT with 3D reconstruction and angiographic evaluation using catheters with calibrated markers. [Italian] Gli autori intendono evidenziare il ruolo svolto dalla diagnostica per immagini nella selezione dei pazienti candidati all'intevento endovascolare nell'asserire il corretto posizionamento dell'endoprotesi e nei controlli. La diagnostica per immagini ha un ruolo fondamentale nel trattamento endovascolare degli aneurismi aortici, ruolo nettamente amplificati rispetto a quanto richiesto dal trattamento chirurgico tradizionale. In particolare critico e' il lo studio preoperatorio che necessita di metodiche diagnostiche sofisticate come la TC spirale con ricostruzione volumetrica e l'angiografia digitale con catetere centimetrato.

  1. MSCT对不同体重注射不同对比剂量在主动脉CTA中的探讨%Research on Thoracico-Abdominal Aorta CTA with Different Dosage of Contrast Medium by Weight

    Institute of Scientific and Technical Information of China (English)

    付传明; 徐霖; 陈伦刚; 周选民; 龚晓虹; 陈文; 吴德红

    2011-01-01

    Objective: To evaluate the thoracico-abdominal aorta imaging effect on 64-slice MSCT with different dosage of contrast medium (CM) according to different weights. Methods: 60 suspecting aortic-diseases patients informed consented were divided into three groups averagely: In group A, 20 patients with the weight over 75 kg were injected 75 mL contrast medium and 25 mL physiological saline; in group B, 20 patients with the weight between 60-70 kg were injected 60 mL contrast medium and 40 mL physiological saline; in group C, 20 patients with weight under 60 kg were injected 50 mL contrast medium and 50 mL physiological saline. All groups were injected at the same injection rate. Before CT scanning, Patients' weight, height, blood pressure and heart rate were measured then received real-time monitoring and triggering sean to measure diameter of the intersecting surface of the blood vessel, the CT values of aorta ascending, thoracic aorta (T7), lumbar arteries (L2) aorta descending and the crotch of the artery. Two professional radiology diagramming doctors evaluated the recombined images of the aorta and branched blood vessels, and statistically analyzed the intensified extent of the blood vessels, diameter of the intersecting surface of the blood vessels, weight, height blood pressure and heart rate. Results: Of three groups, the average CT values of aorta ascending, thoracic aorta (T7), lumbar arteries (L2) aorta descending and the crotch of the artery are 317.08 Hu, 320.27 Hu, 317.61 Hu respectively. The diameters of the blood vessels are 26.45 mm, 23.91 mm, 21.57 mm, the average weights are 79.98 kg, 68.60 kg, 49.50 kg, the average heights are 180.81cm, 171.70cm, 152.50cm, the systolic blood pressure are 126/78mmHg,130/78 mmHg, 124/80 mmHg, the heart rates are 74.8, 76.5, 74.5 beat/min, the delayed scan time 7.3 s, 6.7 s, 6.1 s.The intensified CT values as well as clarity of the recombined blood vessels and display of crotch of the artery are of no statistical

  2. Diffuse abdominal pain, nausea and vomiting due to retroperitoneal fibrosis: a rare but often missed diagnosis.

    Science.gov (United States)

    Netzer, P; Binek, J; Hammer, B

    1997-10-01

    Retroperitoneal fibrosis is a rare chronic inflammatory disease usually involving the ureters, retroperitoneal vessels and nerves; however, any intestinal organ may also be involved. In recent years, a few successful immunosuppressive treatments of this disease have been described and surgery can, therefore, probably be avoided in most cases. We report here on a case of secondary retroperitoneal fibrosis with compression and midline deviation of the ureters and impaired renal function which was probably caused by ergotamine abuse because of migraine. The patient complained of diffuse abdominal pain, nausea and vomiting. After immunosuppressive treatment with azathioprine and prednisone for a year, we observed a complete resolution of the retroperitoneal mass on computed tomography, although renal function remained impaired. Eleven months after the cessation of treatment, the patient had not relapsed.

  3. 叶酸摄入量差异对大鼠同型半胱氨酸及腹主动脉的影响%Effects of different folic acid intakes on the homocysteine and abdominal aorta of rats

    Institute of Scientific and Technical Information of China (English)

    闫文强; 周迎; 施铃灵; 石磊; 张泽旭; 郭毛毛; 姚洪; 韩红柳; 王飞通

    2016-01-01

    Objective To observe the effects of different folic acid intake on homocysteine ( Hcy) and abdominal a-orta of rats.Methods A total of 30 adult male SD rats were randomly divided into 3 groups: a folic acid deficiency group, a normal folic acid group and an excessive folic acid group .The concentrations of Hcy and folic acid were meas-ured on Weeks 1, 4 and 7.The HE slice of the abdominal aorta were made and observed under a microscope for the changes of endothelial cells , internal membrance , medial membrance and outer membrance .Results On Week 7, re-markably increased levels of folic acid were measured in the normal folic acid group and the excessive folic acid group , compared with the folic acid deficiency group (P<0.05).The normal folic acid group and the excessive folic acid group produced markedly lower amounts of serum Hcy than the folic acid deficiency group (P<0.05).According to microscop-ic examination , the folic acid deficiency group showed close arrangement of endothelial cells , intact internal membrane and normal medial and outer membrances , which were similar with the normal folic acid group and the excessive folic acid group.Conclusion A short-term lack of folic acid can not lead to an obvious increase in serum Hcy .A long-term lack of folic acid can result in the rising of serum Hcy level .%目的:通过给予大鼠不同量值的叶酸,观察叶酸对大鼠同型半胱氨酸( Hcy)及腹主动脉的影响。方法选取30只成年雄性SD大鼠,按照随机数字表法分为无叶酸组、叶酸正常组及灌胃叶酸组。分别于第1周、第4周及第7周采取血清,测定血清叶酸及Hcy浓度。制作腹主动脉HE切片,于显微镜下观察内皮、内膜、中膜及外膜的变化。结果与无叶酸组相比,叶酸正常组和灌胃叶酸组第7周的血清叶酸浓度显著升高,差异有统计学意义(P<0.05);叶酸正常组和灌胃叶酸组的血清Hcy浓度显著降低,

  4. An abdominal aortic rupture due to seatbelt blunt injury: report of a case.

    Science.gov (United States)

    Sugimoto, Takaki; Omura, Atsushi; Kitade, Takashi; Takahashi, Hideyuki; Koyama, Takashi; Kurisu, Sigeru

    2007-01-01

    A 66-year-old man, who was a passenger in a car involved in a low-speed head-on motor vehicle accident, was rushed to our hospital. His abdomen was tender and distended. An enhanced computed tomography scan showed a massive retroperitoneal hematoma, and its three-dimensional imaging revealed an active leak of the contrast medium from the aortic bifurcation. He went into shock, and was immediately transferred to the operating theater. Through a median laparotomy, a ruptured site measuring 5 mm in diameter was found at the aortic bifurcation and it was closed with sutures under a proximal aortic control. The other organs showed no evidence of injury. Because of the remarkable edema of the bowel, mesentery, and retroperitoneum, the abdomen was temporarily closed with a mesh sheet to prevent the occurrence of abdominal compartment syndrome. A delayed closure was then successfully performed 4 days later, and he was discharged with no residual sequelae 17 days after the initial operation.

  5. The Potential Role of Kallistatin in the Development of Abdominal Aortic Aneurysm

    OpenAIRE

    Jiaze Li; Smriti Murali Krishna; Jonathan Golledge

    2016-01-01

    Abdominal aortic aneurysm (AAA) is a vascular condition that causes permanent dilation of the abdominal aorta, which can lead to death due to aortic rupture. The only treatment for AAA is surgical repair, and there is no current drug treatment for AAA. Aortic inflammation, vascular smooth muscle cell apoptosis, angiogenesis, oxidative stress and vascular remodeling are implicated in AAA pathogenesis. Kallistatin is a serine proteinase inhibitor, which has been shown to have a variety of funct...

  6. Critical ventriculo-peritoneal shunt failure due to peritoneal tuberculosis: Case report and diagnostic suggestions for abdominal pseudocyst

    Directory of Open Access Journals (Sweden)

    Hajime Takase

    2014-01-01

    Full Text Available Background: Tuberculous peritonitis (TBP is a well-known complication of ventriculo-peritoneal (VP shunt treatment for hydrocephalus resulting from tuberculous meningitis (TBM. However, a case of hydrocephalus unrelated to TBM resulting from VP shunt malfunction due to TBP has not been reported. Case Description: A 21-year-old male presented with nausea, abdominal pain, and headache. VP and cysto-peritoneal (CP shunts had been inserted to treat hydrocephalus due to a suprasellar arachnoid cyst, replaced the VP and removed the CP in his childhood. Computed tomography demonstrated acute hydrocephalus and an abdominal pseudocyst surrounding the distal end of the peritoneal tube. Initial laboratory data showed elevated white blood cell count and C-reactive protein level, but no causative pathogen was identified. External drainage of cerebrospinal fluid (CSF and of the fluid in the peritoneal cyst was established, and empirical antibiotic therapy was initiated. Bacterial cultures eventually revealed Mycobacterium tuberculosis infection, and TBP was diagnosed. The patient responded well to antituberculosis (anti-TB agents and insertion of a ventriculo-pleural shunt. Conclusion: This case highlights the possibility of CSF shunt failure and concomitant neurological sequelae from TB infection even when the pathogen has not invaded the central nervous system, as in TBM. Moreover, TBP is rare in developed countries and therefore may be misdiagnosed because of nonspecific clinical features and low sensitivity of common TB screening methods.

  7. Influencia de la geometría de aneurismas de aorta abdominal en la dinámica del flujo sanguíneo y en su riesgo de ruptura // Influence of abdominal aortic aneurysms geometry in the blood flow dynamics and in its rupture risk.

    Directory of Open Access Journals (Sweden)

    G. Vilalta

    2009-05-01

    Full Text Available La ruptura de aneurisma de aorta abdominal (AAA representa un evento clínico muy importante,con una tasa de mortalidad relativamente elevada. En un esfuerzo por aumentar la comprensiónsobre este complejo fenómeno, en el presente trabajo se estudia la influencia de la geometría delos aneurismas de aorta abdominal en el riesgo de ruptura. Para esto se ha utilizado un modelogeométrico realista, obtenido por la transformación de imágenes 2D de tomografía computarizada(CT, sometido a un flujo pulsátil fisiológicamente realista, con el objetivo de evaluar e identificarlas regiones donde ocurren las principales perturbaciones en los patrones de flujo, cómo éstamodifica los campos de velocidades y de tensiones hemodinámicas en el interior del sacoaneurismático, así como la influencia de los diferentes factores biomécanicos relacionados con lageometría que caracterizan el aneurisma. Se presenta una explicación de las modificaciones de lasestructuras vorticales y de la distribución de tensiones durante el ciclo cardíaco. Igualmente sedetermina un indicador numérico (Parámetro de Severidad que integra los 3 factoresbiomecánicos geométricos y que permite evaluar el riesgo de ruptura del aneurisma para un estadode desarrollo determinado. Los resultados confirman que la asimetría de los aneurismas de aortaabdominal es uno de los principales factores que influyen en su ruptura.Palabras claves: AAA, asimetría, riesgo de ruptura, factores biomecánicos.__________________________________________________________________________AbstractThe rupture of abdominal aortic aneurysm (AAA represents an important clinical event, with arelatively high mortality rate. In an effort to increase understanding about this complexphenomenon, this paper studies the influence of abdominal aortic aneurysms geometry on the riskof rupture. Patient specific AAA model, created by 2D reconstruction of computed tomographyimage, was used to identify regions of

  8. Decreased Risk of Ventilator-Associated Pneumonia in Sepsis Due to Intra-Abdominal Infection.

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    François Philippart

    Full Text Available Experimental studies suggest that intra-abdominal infection (IAI induces biological alterations that may affect the risk of lung infection.To investigate the potential effect of IAI at ICU admission on the subsequent occurrence of ventilator-associated pneumonia (VAP.We used data entered into the French prospective multicenter Outcomerea database in 1997-2011. Consecutive patients who had severe sepsis and/or septic shock at ICU admission and required mechanical ventilation for more than 3 days were included. Patients with acute pancreatitis were not included.Of 2623 database patients meeting the inclusion criteria, 290 (11.1% had IAI and 2333 (88.9% had other infections. The IAI group had fewer patients with VAP (56 [19.3%] vs. 806 [34.5%], P<0.01 and longer time to VAP (5.0 vs.10.5 days; P<0.01. After adjustment on independent risk factors for VAP and previous antimicrobial use, IAI was associated with a decreased risk of VAP (hazard ratio, 0.62; 95% confidence interval, 0.46-0.83; P<0.0017. The pathogens responsible for VAP were not different between the groups with and without IAI (Pseudomonas aeruginosa, 345 [42.8%] and 24 [42.8%]; Enterobacteriaceae, 264 [32.8%] and 19 [34.0%]; and Staphylococcus aureus, 215 [26.7%] and 17 [30.4%], respectively. Crude ICU mortality was not different between the groups with and without IAI (81 [27.9%] and 747 [32.0%], P = 0.16.In our observational study of mechanically ventilated ICU patients with severe sepsis and/or septic shock, VAP occurred less often and later in the group with IAIs compared to the group with infections at other sites.

  9. 正常胰腺及腹主动脉MSCT强化峰值和达峰时间与个体因素的相关性研究%Correlation of Peak Value and Peak Time of Normal Pancreas and Abdominal Aorta on Enhanced MSCT with the Individual Factors

    Institute of Scientific and Technical Information of China (English)

    郭静; 黄小华; 董国礼; 张喜荣; 张小明; 敬宗林

    2012-01-01

    目的:探讨正常胰腺及腹主动脉的强化峰值(PV)和达峰时间(PT)与年龄、性别及体质指数(BMI)的相关性,优化不同个体胰腺多期MSCT扫描时间窗的选择.方法:符合标准的62例患者分别进行MSCT胰腺灌注成像,并按年龄、性别及BMI分组,测量胰腺及腹主动脉的PV及PT值并按组别进行统计学分析.结果:①年龄组:44岁(包括44岁)以下组,正常胰腺PV值、PT值及腹主动脉PV值、PT值分别为(111.10±3.17)HU、(38.33±1.39)s、(343.22±17.65)HU、(31.08±1.41)s; 45-59岁组,其参数值分别为(110.53±2.60)HU、(37.15±1.42)s、(357.88±12.29)HU、(30.62±1.43)s; 60岁(包括60岁)以上组,其参数值分别为(116.67±4.27)HU、(36.92±1.95)s、(355.96±22.94)HU、(30.75±1.59)s.②性别组:男性组,正常胰腺PV值、PT值及腹主动脉PV值、PT值分别为(111.31±2.05)HU、(37.89±1.05)s、(341.28±9.19)HU、(30.83±0.96)s;女性组,其参数值分别为(113.92±4.10)HU、(36.53±1.52)s、(384.90±25.68)HU、(30.80±1.91)s.③BMI组:BMI值为22以下(包括22)组,正常胰腺PV值、PT值及腹主动脉PV值、PT值分别为(113.49±2.57)HU、(38.29±1.20)s、(371.89±12.88)HU、(31.31±1.17)s; BMI值为22以上组,其参数值分别为(109.94±2.56)HU、(36.63±1.28)s、(325.82±12.67)HU、(30.19± 1.27)s.统计结果显示,腹主动脉PV值与BMI值有统计学意义(P<0.05),且呈负相关,其余各参数与年龄、性别及BMI值均无相关性.结论:除腹主动脉PV值随BMI值的增加逐渐降低外,其它参数受个体因素的影响小或不受影响.%Purpose: To explore the correlation between the peak value (PV) and peak time (PT) of normal pancreas and abdominal aorta, and age, gender and the body mass index (BMI), and to optimize the choice of multi-phase CT scanning time window. Methods: Sixty-two patients, who had been undertaken multi-slices spiral CT perfusion imaging, were randomly chosen according to the inclusive criteria of normal pancreas and

  10. A case of cardiac tamponade due to an isolated abscess in the ascending aorta of a pregnant woman with a history of intravenous substance abuse.

    Science.gov (United States)

    Shattuck, Brandy; Livingstone, John

    2017-06-01

    We describe the case of a 23-year-old white female, 10-12 weeks pregnant, with a history of intravenous drug use and a recently diagnosed pneumonia, who was found deceased in her bed after a night of sleep. Although postmortem serum toxicology tested positive for alprazolam, tetrahydrocannabinol, and morphine, the ultimate cause of death was determined to be cardiac tamponade secondary to an isolated abscess in the ascending aorta. The patient had several risk factors for aortic rupture and cardiac tamponade including intravenous drug use, pneumonia, and pregnancy. However, an autopsy of the patient showed an isolated abscess of the ascending aorta without evidence of infective endocarditis, coronary artery rupture, aortic aneurysm, or aortic dissection making this an unusual case of cardiac tamponade. The aim of this case report is to encourage providers to obtain a tissue culture of any aortic abscesses so that the organisms involved can be identified. The identification of such organisms may help guide antimicrobial treatment in similar presentations in the future.

  11. Medical image of the week: abdominal compartment syndrome due to massive upper gastrointestinal hemorrhage

    Directory of Open Access Journals (Sweden)

    Truong VN

    2014-11-01

    Full Text Available No abstract available. Article truncated after 150 words. A 29 year old woman with history of a Whipple procedure for pancreatic cancer and nonalcoholic steatohepatitis cirrhosis presented with a massive upper gastrointestinal bleeding (UGIB likely from esophageal varices and developed hemorrhagic shock. Emergent upper endoscopy could not be performed due to hemodynamic instability. Therefore, a Minnesota Tube was placed emergently for balloon tamponade of the bleeding. A transjugular intrahepatic portosystemic shunt was also placed emergently to decrease bleeding by reducing portal pressure. By this time, the patient had received 4 liters of normal saline, 14 units of packed red blood cells, 6 units of platelets, and 4 units of fresh frozen plasma. The Minnesota tube did control the bleeding somewhat, however, there was continued bloody drainage from the stomach port of the Minnesota tube. The patient’s abdomen became remarkably distended and was dull to percussion throughout. A CT scan of the abdomen and pelvis revealed severe dilatation of ...

  12. Tratamiento endovascular de urgencia con endoprótesis de aneurisma roto disecado de aorta torácica: A propósito de un caso Emergency endovascular treatment with endoprosthesis of ruptured dissected aneurysm of thoracic aorta: Report of one case

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    José Lugo

    2007-12-01

    Full Text Available Los aneurismas de aorta torácica son menos comunes que los aneurismas de aorta abdominal y pueden encontrarse en aorta ascendente, arco aórtico, aorta descendente o en una combinación de estos segmentos. De estos aneurismas el 30% al 40% se originan en la aorta torácica descendente. En los aneurismas de aorta torácica existe una debilidad estructural de la pared de la aorta, que conlleva una dilatación arterial progresiva con eventual ruptura o disección. Aproximadamente, 50% de los aneurismas de aorta torácica son ateroscleróticos y ocurren como resultado de remodelado arterial y dilatación o a raíz de un metabolismo anormal del colágeno. La mayoría de los aneurismas de aorta torácica se descubren por casualidad durante la evaluación de otros problemas médicos. La meta del tratamiento de los aneurismas de aorta torácica, es prevenir la muerte debido a su ruptura. El riesgo de ruptura de los no tratados oscila entre 46% a 74% y la tasa de mortalidad por su ruptura es extremadamente alta. Los aneurismas de gran tamaño, en especial aquellos mayores de 6 cm, son más susceptibles de rupturas que los aneurismas de menor tamaño. El tratamiento endovascular, inicialmente desarrollado para los aneurismas de aorta abdominal, se introdujo en 1992 como una alternativa menos invasiva al tratamiento de cirugía abierta para los aneurismas de la aorta torácica descendente. En la actualidad, el injerto de stent endovascular en la aorta descendente o endoprótesis, recibe mayor atención como alternativa al reparo quirúrgico de los aneurismas de aorta torácica.Thoracic aortic aneurysms are less common than abdominal aortic aneurysms and can be found in ascending aorta, aortic arch, descending aorta or in a combination of these segments. 30% to 40% of these aneurysms are originated in thoracic descending aorta. In thoracic aortic aneurysms there exists a structural wall weakness that leads to a progressive arterial dilation with eventual

  13. Fatores envolvidos na migração das endopróteses em pacientes submetidos ao tratamento endovascular do aneurisma da aorta abdominal Factors involved in the migration of endoprosthesis in patients undergoing endovascular aneurysm repair

    Directory of Open Access Journals (Sweden)

    Marcelo José de Almeida

    2010-06-01

    Full Text Available A migração da endoprótese é complicação do tratamento endovascular definida como deslocamento da ancoragem inicial. Para avaliação da migração, verifica-se a posição da endoprótese em relação a determinada região anatômica. Considerando o aneurisma da aorta abdominal infrarrenal, a área proximal de referência consiste na origem da artéria renal mais baixa e, na região distal, situa-se nas artérias ilíacas internas. Os pacientes deverão ser monitorizados por longos períodos, a fim de serem identificadas migrações, visto que estas ocorrem normalmente após 2 anos de implante. Para evitar migrações, forças mecânicas que propiciam fixação, determinadas por características dos dispositivos e incorporação da endoprótese, devem predominar sobre forças gravitacionais e hemodinâmicas que tendem a arrastar a prótese no sentido caudal. Angulação, extensão e diâmetro do colo, além da medida transversa do saco aneurismático, são importantes aspectos morfológicos do aneurisma relacionados à migração. Com relação à técnica, não se recomenda implante de endopróteses com sobredimensionamento excessivo (> 30%, por provocar dilatação do colo do aneurisma, além de dobras e vazamentos proximais que também contribuem para a migração. Por outro lado, endopróteses com mecanismos adicionais de fixação (ganchos, farpas e fixação suprarrenal parecem apresentar menos migrações. O processo de incorporação das endopróteses ocorre parcialmente e parece não ser suficiente para impedir migrações tardias. Nesse sentido, estudos experimentais com endopróteses de maior porosidade e uso de substâncias que permitam maior fibroplasia e aderência da prótese à artéria vêm sendo realizados e parecem ser promissores. Esses aspectos serão discutidos nesta revisão.Migration of the endoprosthesis is defined as the misplacement of its initial fixation. To assess the migration, the position of the

  14. Tratamento endovascular do aneurisma da aorta abdominal infrarrenal em pacientes com anatomia favorável para o procedimento: experiência inicial em um serviço universitário Endovascular treatment of infrarenal abdominal aortic aneurysm in patients with favorable anatomy for the repair: initial experience in a university hospital

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    José Manoel da Silva Silvestre

    2011-03-01

    Full Text Available CONTEXTO: Desde sua introdução, em 1991, o reparo endovascular do aneurisma da aorta abdominal infrarrenal tem se tornado uma alternativa atraente para o tratamento dessa doença. Avaliar nossos resultados iniciais quanto à segurança e eficácia dessa técnica nos levou à realização deste estudo. OBJETIVOS: Analisar a mortalidade perioperatória, a sobrevida tardia, as reoperações, as taxas de perviedade e o comportamento do saco aneurismático em pacientes com anatomia favorável para a realização do procedimento. MÉTODOS: Trata-se de um estudo longitudinal, observacional e retrospectivo realizado entre outubro de 2004 e janeiro de 2009 com 41 pacientes que foram submetidos à correção endovascular do aneurisma de aorta abdominal infrarrenal por apresentarem anatomia favorável para o procedimento. Foram analisados os achados dos exames diagnósticos, o tratamento e o seguimento em todos os pacientes. RESULTADOS: Foram implantadas, com sucesso, 31 (75,6% próteses bifurcadas e 10 (24,5% monoilíacas, de 5 diferentes marcas. O diâmetro médio dos aneurismas fusiformes era de 62 mm. A mortalidade perioperatória foi de 4,8% e a sobrevida tardia, 90,2%. Durante o acompanhamento médio de 30 meses, 2 (4,8% pacientes necessitaram de reintervenção, um por migração da endoprótese e outro por vazamento tipo II. Dois (4,8% pacientes apresentaram oclusão de ramo da prótese. Oito (19,5% vazamentos foram diagnosticados e não houve nenhuma rotura dos aneurismas. CONCLUSÃO: Apesar do pequeno número de pacientes, os resultados observados parecem justificar a realização do procedimento endovascular nos pacientes com anatomia favorável.BACKGROUND: Since its introduction in 1991, endovascular repair of infrarenal aortic aneurysms has become an attractive option to treat this disease. The evaluation of our initial results about safety and efficacy of this technique has led us to carry out this study. OBJECTIVES: To analyze

  15. Abdominal Wall Abscess due to Acute Perforated Sigmoid Diverticulitis: A Case Report with MDCT and US Findings

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    Rafailidis Vasileios

    2013-01-01

    Full Text Available Perforation of the inflamed diverticula is a common diverticulitis complication. It usually leads to the formation of a local abscess. In some rare cases, the inflammatory process may spread towards extra-abdominal sites like the anterior or posterior abdominal wall or the thigh and form an abscess in these sites. We present the case of a 73-year-old man with a history of pain at the lower left quadrant of the abdomen for 20 days and a visible mass in this site. Ultrasonography and computed tomography revealed this mass to be an abscess of the abdominal wall which had been formed by the spread of ruptured sigmoid diverticulitis by continuity of tissue through the lower left abdominal wall. Local drainage of the abscess was performed and the patient was discharged after alleviation of symptoms and an uneventful course. We also discuss causes of abdominal wall abscesses along with the possible pathways by which an intra-abdominal abscess could spread outside the abdominal cavity.

  16. 超声检测股动脉、腹主动脉及颈动脉粥样硬化与冠状动脉粥样硬化的相关性%Ultrasound study on correlation between atherosclerosis of femoral artery, abdominal aorta and carotid artery and coronary atherosclerosis

    Institute of Scientific and Technical Information of China (English)

    孙建群; 刘颖

    2012-01-01

    目的:探讨股动脉、腹主动脉及颈动脉粥样硬化与冠状动脉粥样硬化的相关性.方法:采用高频超声测量109例行冠状动脉造影术后1周的患者股动脉、腹主动脉及颈动脉的内-中膜厚度(IMT)、斑块积分及斑块数目.结果:股动脉、腹主动脉及颈动脉粥样硬化与冠状动脉粥样硬化呈正相关(P<0.01、P<0.05);股动脉斑块预测冠状动脉粥样硬化的灵敏度为89%,特异度为77%,准确度84%;腹主动脉斑块预测冠状动脉粥样硬化的灵敏度为73%,特异度为72%,准确度72%;颈动脉斑块预测冠状动脉粥样硬化的灵敏度为83%,特异度为79%,准确度82%.结论:超声检查股动脉、腹主动脉及颈动脉IMT及斑块可间接预测不同程度的冠状动脉粥样硬化;股动脉的灵敏度与准确度较腹主动脉更好.%AIM; To explore the correlation between atherosclerosis of femoral artery, abdominal aorta and carotid artery and coronary atherosclerosis using ultrasound. METHODS; The film thickness within (IMT, intima-media thickness) , patch integral and plaque numbers of the femoral artery, abdominal aorta and carotid artery were measured by ultrasound in 109 patients 1 week after coronary angiography. RESULTS: Atherosclerosis of the femoral artery, abdominal aorta and carotid artery were positively correlated with coronary atherosclerosis (P <0. 01, P <0. 05) . Sensitivity of the femoral artery plaque and coronary atherosclerosis was 88. 6% and specificity was 76. 9%. Sensitivity of abdominal aorta plaque and coronary atherosclerosis was 72. 9% and specificity was 71. 8%. Sensitivity of carotid artery plaque and coronary atherosclerosis was 82. 9% and specificity was 79. 5%. CONCLUSION; Ultrasonic imaging and detection of the femoral artery, abdominal aorta and carotid artery IMT and plaque can indirectly predict the different degrees of coronary atherosclerosis.

  17. Associação entre aneurismas de aorta abdominal infrarrenal e doença renal policística autossômica dominante: relato de caso Association between infrarenal abdominal aortic aneurysm and autosomal dominant polycystic kidney disease: a case report

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    Milton Alves das Neves Junior

    2009-06-01

    Full Text Available A doença renal policística dominante é uma das doenças renais hereditárias mais comuns, podendo apresentar manifestações extrarrenais vasculares de importância clínica, como aneurismas intracranianos, aneurismas aórticos e dissecções arteriais. Relatamos o caso de um paciente masculino, com 66 anos de idade, renal crônico não-dialítico por doença renal policística dominante, com aneurisma de aorta abdominal infrarrenal assintomático, diagnosticado por ultrassonografia de rotina e operado eletivamente com sucesso. A doença renal policística dominante é uma síndrome genética, associada aos genes PDK1 e PDK2 no cromossomo 16. A expressão desses genes na parede dos vasos leva ao seu enfraquecimento, favorecendo a formação de aneurismas. A produção de metaloproteinases pelos túbulos renais também estaria relacionada às doenças vasculares desses pacientes. Tais doenças se apresentam como importantes fatores de mortalidade precoce e morbidade dos portadores de doença renal policística dominante e, como usualmente são assintomáticas, justifica-se o uso de propedêutica armada e tratamento precoce.Autosomal dominant polycystic kidney disease (ADPKD is one of the most common hereditary renal diseases, which may present important clinical extrarenal vascular manifestations, such as intracranial and aortic aneurysms and artery dissections. We report the case of a 66-year-old male chronic renal out-of-dialysis patient, with dominant polycystic kidney disease, presenting an asymptomatic infrarenal abdominal aortic aneurysm diagnosed by routine ultrasonography, submitted to successful elective surgery. ADPKD is a genetic syndrome, associated with PDK1 and PDK2 genes on chromosome 16. The expression of these genes in the vessel walls leads to vessel wall weakening, favoring aneurysm formation. In addition, metalloproteinase production by kidney tubules could be related to vascular diseases in ADPKD patients. These are

  18. Evaluación del impacto de las técnicas de control del daño en el tratamiento de los pacientes con aneurisma roto de la aorta abdominal. Hospital Universitario San Vicente de Paúl, Medellín, Colombia, enero de 2000 a octubre de 2007

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    John Fernando García V.

    2008-11-01

    Full Text Available La mortalidad quirúrgica atribuible al aneurisma de la aorta abdominal (AAA roto oscila entre 40 y 70% según los diversos informes de la literatura; la principal causa de ello es la falla orgánica múltiple (FOM, la que a su vez corresponde, en un porcentaje importante de casos, al complejo de hipertensión abdominal/síndrome del compartimento abdominal (HTA/SCA. A principios de la década de los años 90 aparecieron algunos artículos informando que los pacientes tratados con laparostomía, con o sin empaquetamiento, cursaban sin HTA/SCA, y presentaban tasas de supervivencia mejores que las de aquellos a quienes se les cerraba primariamente el abdomen, luego de la corrección de un AAA roto. Decidimos tratar a la mayoría de los pacientes con laparostomía y empaquetamiento abdominal, con el fin de disminuir la mortalidad previa global del servicio, la cual había sido del 81,8% en 44 pacientes (corregida de 79,3%. Se exceptúan 6 pacientes a quienes se les hizo cierre primario de la pared abdominal al momento de corregir su AAA roto. Se obtuvo una tasa global de mortalidad a 30 días del 55,9% y corregida del 45,5%. Con lo anterior se puede concluir que a los pacientes con AAA roto, dada su gravedad, se les deben ofrecer técnicas similares a las utilizadas en el control del daño en el trauma, como la laparostomía y el empaquetamiento abdominal con el fin de que tengan la mejor oportunidad de sobrevivir.

  19. Imaging anatomical study of abdominal aorta terminal blocking in vitro assisting in standard cardiopulmonary resuscitation%体外腹主动脉末端阻断辅助标准心肺复苏的影像解剖研究

    Institute of Scientific and Technical Information of China (English)

    钟涛; 张旻海; 菅洪健; 武钢

    2015-01-01

    Objective To supply imaging anatomical basis for abdominal aorta blocking assisting in standard cardiopulmonary resuscitation to improve coronary perfusion pressure. Methods CT images of 75 patients, 41 males and 34 females, were collected. The bellybutton was used as the landmark, and indexes as follows were measured:①The vertebral level of the bellybutton midpoint; ②The relationship between abdominal aorta termination and bellybutton midpoint;③The relationship among the vertical tracks of abdominal artery, lumbar vertebrae,and inferior vena cava. Results The markers for the end of abdominal artery,lumbar vertebrae and navel roughly overlapped at the human median line:①The navel midpoint was located between 40.31 mm above and 32.82 mm below the inferior border of L4;②The end of the abdominal artery was located between 35 mm above and 35 mm below the bellybutton midpoint; ③The end of abdominal artery was located slightly to the left of the lumbar spine, and inferior vena cava was located to right of the lumbar spine at the transverse section of the body at the level of the end of the abdominal artery. Conclusions According to the imaging study, navel can be adopted as the landmark for blocking in vitro the end of the abdominal aorta, assisting in the standard cardiopulmonary resuscitation. It could improve the hemodynamic indexes, ensure blood supply of the critical organs such as brain and heart, and improve coronary perfusion pressure with high success rate.%目的:为体外腹主动脉末端阻断辅助标准心肺复苏(CPR)提供影像解剖学基础。方法75名患者的CT影像解剖图中,以脐为标志点,主要观测:①脐中点水平面对应椎体的位置;②腹主动脉末端与脐中点的关系;③腹主动脉下段、下腔静脉下段与腰椎的相对位置关系。结果腹主动脉末端、腰椎与脐标志点基本重叠于人体正中线位置:①脐中点位于腰4椎体下缘以上40.31mm,以下32.82 mm

  20. NO donors-relaxation is impaired in aorta from hypertensive rats due to a reduced involvement of K(+) channels and sarcoplasmic reticulum Ca(2+)-ATPase.

    Science.gov (United States)

    Bonaventura, Daniella; de Lima, Renata Galvão; da Silva, Roberto Santana; Bendhack, Lusiane Maria

    2011-10-24

    To examine the vasodilatation induce by the NO donors, [Ru(terpy)(bdq)NO](3+) (TERPY) and sodium nitroprusside (SNP), and to compare their effects in aortic rings from hypertensive 2K-1C and normotensive 2K rats. Vascular reactivity was performed in aortic rings pre-contracted with phenylephrine (Phe 100nM). We have analyzed the maximal relaxation (Emax) and potency (pD(2)) of NO donors. Potency of SNP was greater than TERPY in both arterial groups. The vasodilatation induced by TERPY was greater in 2K than in 2K-1C, and it was inhibited by sGC inhibitor ODQ in 2K and in 2K-1C aortic rings. ODQ did not alter the efficacy to SNP, but it reduced its potency in 2K and 2K-1C. The blockade of K(+) channels reduced the potency of TERPY only in aortic rings of 2K. On the other hand, the potency of SNP was reduced in both 2K and 2K-1C. The combination of ODQ and TEA reduced the relaxation induced by TERPY and SNP in 2K and reduced the efficacy to SNP in 2K-1C aortic rings but it had no additional effect on the TERPY relaxation in 2K-1C aortas. The production of cGMP induced by TERPY was greater than that produced by SNP, which was similarly increased in 2K and 2K-1C. Sarcoplasmic reticulum Ca-ATPase inhibition only impaired the relaxation induced by SNP in 2K aortic rings. Taken together, our results provide evidences that in this model of hypertension, impaired K(+) channels activation by TERPY and SERCA activation by SNP may contribute to decreased vasodilatation. Copyright © 2011 Elsevier Inc. All rights reserved.

  1. [Abdominal aortic aneurysm treated by endovascular surgery: a case report].

    Science.gov (United States)

    Alconero-Camarero, Ana Rosa; Cobo-Sánchez, José Luis; Casaus-Pérez, María; García-Campo, María Elena; García-Zarrabeitia, María José; Calvo-Diez, Marta; Mirones-Valdeolivas, Luz Elena

    2008-01-01

    An aneurysm is an abnormal dilation or irreversible convex of a portion of an artery. The most common site of aneurysms is the abdominal aorta and their appearance is often due to degeneration of the arterial wall, associated with atherosclerosis and favored by risk factors such as smoking and hypertension, among others. Left untreated, aneurysm of the abdominal aorta usually leads to rupture. Treatment is surgical, consisting of the introduction of a prosthesis, composed basically of a stent and an introducer, into the aorta. We report the case of a person diagnosed with abdominal aortic aneurysm in a routine examination who was admitted for ambulatory surgical treatment. We designed a nursing care plan, following Virginia Henderson's conceptual model. The care plan was divided into 2 parts, a first preoperative phase and a second postimplantation or monitoring phase. The care plan contained the principal nursing diagnoses, based on the taxonomies of the North American Nursing Diagnosis Association (NANDA), nursing interventions classification (NIC) and nursing outcomes classifications (NOC), and collaboration problems/potential complications. The patient was discharged to home after contact was made with his reference nurse in the primary health center, since during the hospital phase, some NOC indicators remained unresolved.

  2. [Management of seat-belt aorta in severe polytrauma: a review].

    Science.gov (United States)

    Hornez, E; Bourgouin, S; Baudoin, Y; Prunet, B; Monchal, T; Schlienger, G; Meyrat, L; Thouard, H

    2011-07-01

    Blunt trauma of the abdominal aorta is rare. Secondary to high-energy trauma, it is observed mainly in association with complex lesions. Evaluation of injury to the aorta must be a priority due to the risk of life-threatening massive hemorrhage. The clinical presentation can be quite obvious but also variable and often misleading. If in doubt, a systematic injected whole body scan is essential to diagnose aortic lesions. Hemorrhage or ischemia dictates emergency laparotomy. Opening the retroperitoneum increases the risk of infection if there is an associated gastrointestinal tract injury and may contraindicate use of arterial prostheses. Endovascular treatment can be proposed for less symptomatic lesions, including intimal dissection. Stents can be inserted via a femoral approach. In the event of juxtarenal dissection, there is a risk of renal artery thrombosis. Endovascular treatment is currently not recommended. This treatment can be delayed for a few days if necessary. Morbidity is low and long-term results are good.

  3. Redo thoracic endovascular aortic repair due to endoleak with celiac artery snorkeling.

    Science.gov (United States)

    Planer, David; Bliagos, Dimitrios; Gray, William A

    2011-10-01

    Reintervention due to endoleak of aortic endograft repair is often challenging. Herein, we report endovascular endoleak repair in a patient with previous thoracic and abdominal endovascular grafts with extensive coverage of the aorta. The present technique included snorkeling of the celiac trunk to preserve antegrade flow in the celiac artery and to maintain future options for reintervention.

  4. Effects of "Kanli Granule" on Skeletal Muscle Apoptosis in Rats with Chronic Heart Failure Induced by Constriction of Abdominal Aorta%坎离颗粒对腹主动脉缩窄致慢性心衰大鼠骨骼肌细胞凋亡的影响

    Institute of Scientific and Technical Information of China (English)

    姚成增; 蒋梅先; 阮小芬; 腾名子

    2013-01-01

    目的:观察中药坎离颗粒对腹主动脉缩窄致慢性心衰大鼠骨骼肌细胞凋亡的影响.方法:以腹主动脉缩窄致慢性心衰大鼠为研究对象,对其细胞凋亡基因Bax、Bcl-2的蛋白表达进行观察,采用TUNEL检测凋亡细胞;并分别以中药坎离颗粒生药高(13.5 g/kg、)、中(6.75g/kg)、低(3.375g/kg)剂量及培哚普利(0.36 mg/kg)每日1次灌胃,3周1疗程,每疗程后停药1周,共干预8个疗程.结果:慢性心衰大鼠存在骨骼肌细胞凋亡增多的现象;培哚普利、坎离颗粒预防给药能改善上述病理变化,并观察到坎离颗粒改善心衰时骨骼肌细胞凋亡呈现明显的剂量依赖关系.结论:坎离颗粒在改善腹主动脉缩窄致慢性心衰大鼠心功能的同时还能改善其细胞凋亡,对骨骼肌功能的改善可能起有益作用.%To investigate the effects of "Kanli Granule" on the skeletal muscle apoptosis in rats with chronic heart failure (CHF) induced by constriction of abdominal aorta. Methods; The CHF rat model was established by ligating the abdominal aorta. The CHF rats were fed intragastrically with "Kanli Granule" (13. 5,6. 75, 3. 375 g/kg) and perindopril once a day for 32 weeks. The protein expressions of Bax and Bcl-2 genes were observed, and the apoptosis was detected by TUNEL. Results; The skeletal muscle apoptosis of the CHF rats was increased. Preventive therapy with "Kanli Granule" or perindopril could improve the skeletal muscle apoptosis of the CHF rats, and " Kanli Granule" had a clear dose-dependent relationship in improving the skeletal muscle apoptosis of CHF rats. Conclusion: "Kanli Granule" can improve the skeletal muscle apoptosis in rats with CHF induced by constriction of abdominal aorta.

  5. Experimental study on enhanced ultrasonography of normal abdominal aorta using self-made perfluorocarbon ultrasound contrast agent in rabbits%自制氟碳声学造影剂对正常兔腹主动脉造影的实验研究

    Institute of Scientific and Technical Information of China (English)

    马娜; 任卫东; 杨欣

    2006-01-01

    目的观察自制氟碳声学造影剂对正常兔腹主动脉造影效果及不同造影剂注入方式造影的时间-强度曲线变化.方法经兔耳缘静脉注入0.5 mL/kg自制造影剂,常规成像观察实时造影过程,触发成像模式定量分析团注和推注法(0.1 mL/s)造影的时间-强度曲线变化.结果造影后腹主动脉灰阶及多普勒信号显著增强.团注法同推注方式比较,峰值强度显著增高,但曲线下降斜率快,平均通过时间短(P<0.001);而推注方式可显著延长造影剂平均通过时间(P<0.001).结论自制氟碳声学造影剂显著增强血流显像,根据不同检查目的选择合适的造影剂注入方式,对提高造影效果有重要价值.%[Objective ] To observe the effect of enhanced ultrasonography on normal rabbit abdominal aorta using self-made perfluorocarbon ultrasound contrast agent and the time-intensity curve changes by different injection methods. [Methods] Self-made contrast agent was injected via rabbit ear vein at a dose of 0.5 mL/kg, real-time abdominal aorta enhancement was observed by conventional imaging, and changes of time-intensity curves were quantitatively analyzed using triggered imaging by bolus injection and infusion (0.1 mL/s). [Results] Gray-scale and Doppler signal of abdominal aorta were significantly enhanced by contrast agent. Peak intensity and descending slope were much increased by bolus compared with by infusion, but mean transit time was reduced (P <0.001); while mean transit time was longer using infusion (P <0.001). [Conclusion] Self-made perfluorocarbon ultrasound contrast agent can significantly enhance blood flow display,it is importance to choice ideal injection method according to checking aim to improve the effect of enhanced ultrasonography.

  6. Coarctation of the Aorta

    Science.gov (United States)

    ... of the aorta (aneurysm) Aortic rupture or tear (dissection) Premature coronary artery disease — narrowing of the blood ... have a higher risk of aortic rupture, aortic dissection or other complications during pregnancy and delivery. Doctors ...

  7. The intestinal tract as the major source of interleukin 6 production during abdominal aortic clamping and hind limb ischaemia-reperfusion injury O trato intestinal como a principal fonte na producao de interleucina 6 durante clampeamento da aorta abdominal e lesão de isquemia/rererfusão de membros inferiores

    Directory of Open Access Journals (Sweden)

    Márcio Benedito Palma Pimenta

    2007-01-01

    Full Text Available PURPOSE: The aim of this study was to investigate whether the hind limbs or intestinal tract is the most important initiator of the inflammatory response secondary aortic clamping and hind limb ischemia/reperfusion injury. METHODS: Blood samples of Wistar rats obtained from posterior cava vein, portal vein, and heart cavity during either laparotomy (control group, n=8 or laparotomy + 2 h of aortic clamping and bilateral hind limb ischemia (ischemia group, n=8, or 2 h after ischemia and 2 h of reperfusion (ischemia-reperfusion group, n=8 were assayed for interleukin 6 (IL-6 and C-reactive protein (CRP. RESULTS: Serum IL-6 at the heart (223.6±197.9 [10-832] pg/mL was higher (pOBJETIVO: Investigar qual o principal mediador da resposta inflamatória na lesao de isquemia/reperfusão após clampeamento da aorta abdominal e isquemia dos membros inferiores: o intestine ou as extremidades inferiores. MÉTODOS: amostra de sangue de ratos Wistar coletados da cava posterior, porta e cavidade cardíaca during tanto laparotomia (grupo controle n=8 ou laparotomia + 2 horas de clampeamento aórtico e isquemia bilateral de membros posteriores (grupo isquemia n=8, ou 2 h de isquemia seguido por 2 horas de reperfusão (grupo isquemia/reperfusão n=8, onde foram dosados interleucina 6 e proteína C-reativa. RESULTADOS: Il-6 no coração (223.6±197.9 [10-832] pg/mL foi maior (p<0.001 tanto na veia porta (133.08±108.52 [4-372] pg/mL quanto na veia cava posterior (127.58±109.15 [8-388] pg/mL. PCR não foi significativamente diferente entre os grupos. CONCLUSÃO: o trato intestinal foi responsável pela resposta inflamatória secundária a lesão de isquemia/reperfusão.

  8. Effect of potassium iodate and potassium iodide on the SR-B1 protein expression of abdominal aorta in rats%碘酸钾和碘化钾对大鼠腹主动脉SR-B1蛋白表达的影响

    Institute of Scientific and Technical Information of China (English)

    曹晓晓; 徐菁; 谷云有; 王海燕; 李秀维; 王建强; 刘列钧

    2013-01-01

    目的 观察不同剂量的碘酸钾和碘化钾对大鼠腹主动脉SR-B1蛋白表达的影响.方法 根据喂养碘剂和剂量不同将Wistar大鼠随机分为适碘组(KI、KIO3),10倍高碘组(10KI、10KIO3)、50倍高碘组(50KI、50KIO3),100倍高碘组(100KI、100KIO3).喂养半年后,利用免疫蛋白印迹分析(Western-blot)检测大鼠腹主动脉中SR-B1蛋白表达水平.结果 大鼠腹主动脉重量无组间统计学差异(P>0.05);大鼠动脉SR-B1蛋白水平在适碘组之间无差异(P>0.05),而在高剂量的碘酸钾组中,SR-B1蛋白水平均低于等剂量的碘化钾组(P<0.05);SR-B1的蛋白表达水平随着碘酸钾喂养剂量的增加而下降,但在不同剂量碘化钾组中无明显变化趋势.结论 与碘化钾相比,高剂量的碘酸钾抑制了大鼠动脉SR-B1蛋白表达水平.%Objective To observe the effect of potassium iodate and potassium iodide on the SR - Bl protein expression of abdominal aorta in rats. Methods The SPF wistar rats were randomly divided into 8 groups, normal iodide groups ( KI, KIO3), 10 fold iodide groups (10KI, 10KIO3), 50 fold iodide groups (50KI, 50KIO3) and 100 fold iodide groups (100KI , 100KIO3). After 6 months treatment, the SR - Bl protein levels in abdominal aorta were determined by western - blot analysis. Results The weights of rat abdominal aorta showed no statistically significant change among 8 groups ( P >0. 05); The SR - Bl protein expression displayed no remarkable difference between the group of KI and KIO3( P >0.05). But the protein level of SR - Bl in high dose groups of potassium iodate (10KIO3, 50KIO3, and 100KIO3) were higher than those in isodose groups of potassium iodide (10KI, 50KI and 100KI) ( P <0. 05); The SR - Bl protein level decreased with the increase of potassium iodate feeding dosage, but there was no apparent trend among the groups of potassium iodide. Conclusion Compared with potassium iodide, high dose potassium iodate can depress the SR - Bl protein

  9. Bipedicled transverse abdominal flap for coverage of exposed iliac crest due to post traumatic tissue loss in left inguinal region

    Directory of Open Access Journals (Sweden)

    Narendra G. Naik

    2016-03-01

    Full Text Available It is a surgical challenge for any plastic surgeon to choose the type of flap in the case of large inguinal canal tissue loss with exposed crest of ilium. Most repair methods provide inadequate closure of the defect for the large tissue loss over the inguinal region with exposure of the iliac crest. There are very few cases reported in the literature about transverse bipedicled abdominal flap for tissue defect over the inguinal region with exposure of the iliac crest bone and upper part of the thigh. In this case, by taking advantage of the large, loose, and lax nature of the abdominal skin, systematic primary closure of the donor as well as recipient site has been successfully achieved. [Int J Res Med Sci 2016; 4(3.000: 963-965

  10. The Study of Relationship between Inferior Phrenic Artery Originated from Abdominal Aorta and Celiac Trunk by Using Multi-Slice Helical CT%起源于腹主动脉的膈下动脉与腹腔干关系的多层螺旋CT研究

    Institute of Scientific and Technical Information of China (English)

    宫凤玲; 于鹏; 张惠英; 李盖; 赵鹤亮; 孙凤涛

    2011-01-01

    Purpose To explore whether there are some rules in the relationship between inferior phrenic artery (IPA) originated from the abdominal aorta and the celiac trunk. Materials and Methods The origin of IPA in 200 patients (174 with abdomen scan and 26 with chest-abdomen scan) who underwent two-phase enhanced CT scan at Philips 256-slice helical CT were respectively observed. The relationship of the orifice position between IPA originated from the abdominal aorta and the celiac trunk was analysed. Results RIPA was shown in 200 cases with total 201 branches. LIPA was shown in 198 cases with total 203 branches. 2 cases of LIPA were not shown. Bilateral IPA originated from a common stem was seen in 48 of 200 cases (24%). RIPA originated from the celiac trunk in 70/201 cases(34.8%) , from the aorta in 82/201 cases(40.8%), from the right renal artery in 37/201cases (18.4%), from the right accessory renal artery in 4/201cases (2.0%) and from the lefi gastric artery in 8/201 cases (4%). LIPA originated from the celiac trunk in 113/203 cases (55.7%), from the aorta in 77/203 cases (37.g%), from the left gastric artery in 11/203 cases(5.4%) and from the spleen artery in 2/203 cases (1.0%). There are some rules in the relationship between the origin of IPA originated from the abdominal aorta (135cases) and the celiac trunk: ① 98.3% of RIPA located in the 9-12 o'clock position relative to the wall of the aorta. LIPA and IPA which originated from a common stem located in the 12-3 o'clock position relative to the wall of aorta ; ② 80.0% of IPA had orifice located 10mm upper or lower of the orifice of the celiac trunk and the remaining located 10mm lower than the orifice of the celiac trunk.③ 63.8% of RIPA had the orifice located under the orifice of the celiac trunk. 43.4% of LIPA and 54.2% of IPA which originated from a common stem located upper than the orifice of the celiac trunk. ④ 86.8% of IPA had the orifice located under the orifice

  11. Hybrid Treatment of Acute Abdominal Aortic Thrombosis Presenting with Paraplegia.

    Science.gov (United States)

    Azzarone, Matteo; De Troia, Alessandro; Iazzolino, Luigi; Nabulsi, Bilal; Tecchio, Tiziano

    2016-05-01

    Acute thrombotic or embolic occlusion of the abdominal aorta is a rare vascular emergency associated with high morbidity and mortality rates. Classically, the clinical presentation is a severe peripheral ischemia with bilateral leg pain as the predominant feature. Aortic occlusion presenting as an isolated acute onset of paraplegia due to spinal cord ischemia is very rare and requires improved awareness to prevent adverse outcomes associated with delayed diagnosis. We report the case of a 54-year-old man who presented with sudden paraplegia due to the thrombotic occlusion of the infrarenal aorta involving the first segment of the common iliac arteries on both sides; emergent transperitoneal aorto iliac thrombectomy combined with the endovascular iliac kissing-stent technique were performed achieving perioperative complete regression of the symptoms.

  12. Posterior ''Nutcracker'' phenomenon in a patient with abdominal aortic aneurysm

    Energy Technology Data Exchange (ETDEWEB)

    Puig, Stefan [Department of Radiology, University of Vienna, Waehringer Guertel 18-20, 1090 Vienna (Austria); Department of Emergency Medicine, University of Vienna, Waehringer Guertel 18-20, 1090 Vienna (Austria); Stuehlinger, Hermann Georg; Domanovits, Hans [Department of Emergency Medicine, University of Vienna, Waehringer Guertel 18-20, 1090 Vienna (Austria); Staudenherz, Anton [Department of Emergency Medicine, University of Vienna, Waehringer Guertel 18-20, 1090 Vienna (Austria); Department of Nuclear Medicine, University of Vienna, Waehringer Guertel 18-20, 1090 Vienna (Austria); Zebenholzer, Karin [Department of Emergency Medicine, University of Vienna, Waehringer Guertel 18-20, 1090 Vienna (Austria); Department of Neurology, University of Vienna, Waehringer Guertel 18-20, 1090 Vienna (Austria); Rebhandl, Winfried [Department of Surgery, University of Vienna, Waehringer Guertel 18-20, 1090 Vienna (Austria); Prokop, Mathias [Department of Radiology, University of Vienna, Waehringer Guertel 18-20, 1090 Vienna (Austria)

    2002-07-01

    We report on a posterior ''nutcracker'' phenomenon due to an abdominal aortic aneurysm in a patient with a retro-aortic left renal vein. A 71-year-old man with a known abdominal aortic aneurysm presented in the emergency room with mild hematuria and flank pain. Computed tomography angiography revealed an aortic aneurysm, which compressed the left renal vein between the aorta and the vertebral column. Compression of the left renal vein, due to the aorta with consecutive congestion and hematuria as well as flank pain, was previously described as nutcracker phenomenon. In case of a retro-aortic left renal vein, increase of the aortic diameter can lead to compression of the renal vein and furthermore to the classical signs and symptoms of the ''nutcracker'' phenomenon, even though the aneurysm is not ruptured or there are no aorto-caval or aorto-left renal vein fistulas. (orig.)

  13. Growth patterns of abdominal atherosclerotic calcified deposits from lumbar lateral X-rays

    DEFF Research Database (Denmark)

    Erleben, Lene Lillemark; Ganz, Melanie; Barascuk, Natasha

    2010-01-01

    The aim of this study is to investigate new methods for describing the progression of atherosclerosis based on novel information of the growth patterns of individual abdominal aortic calcifications (AACs) over time. Lateral X-ray images were used due to their low cost, fast examination time, and ...... in the aorta, on average. The growth patterns of AACs may give new insights into the progression of atherosclerosis. The downstream asymmetry in the growth patterns indicates variability in microscopic environments around the AACs....

  14. Renal infarction due to spontaneous dissection of the renal artery: an unusual cause of non-visceral type abdominal pain.

    Science.gov (United States)

    Kang, James H-E; Kang, Jin-Yong; Morgan, Robert

    2013-09-18

    A 44-year-old man presented with very severe right upper quadrant pain of sudden onset. This was exacerbated by movement but unaffected by food or defaecation. It was continuous-day and night -but resolved over a 1-week period. The physical examination was normal at presentation, by which time the pain had resolved. His white cell count, alanine transaminase and C reactive protein were elevated but normalised after 10 days. An abdominal CT showed low density lesions in the right kidney consistent with segmental infarcts. CT angiogram showed a dissection of the right renal artery. The patient remained asymptomatic and normotensive when reviewed 1 month later.

  15. [Inflammatory abdominal aortic aneurysm].

    Science.gov (United States)

    Ziaja, K; Sedlak, L; Urbanek, T; Kostyra, J; Ludyga, T

    2000-01-01

    The reported incidence of inflammatory abdominal aortic aneurysm (IAAA) is from 2% to 14% of patients with abdominal aortic aneurysm and the etiology of this disease is still discussed--according to the literature several pathogenic theories have been proposed. From 1992 to 1997 32 patients with IAAA were operated on. The patients were mostly symptomatic--abdominal pain was present in 68.75% cases, back pain in 31.25%, fever in 12.5% and weight loss in 6.25% of the operated patients. In all the patients ultrasound examination was performed, in 4 patients CT and in 3 cases urography. All the patients were operated on and characteristic signs of inflammatory abdominal aortic aneurysm like: thickened aortic wall, perianeurysmal infiltration or retroperitoneal fibrosis with involvement of retroperitoneal structures were found. In all cases surgery was performed using transperitoneal approach; in three cases intraoperatively contiguous abdominal organs were injured, which was connected with their involvement into periaortic inflammation. In 4 cases clamping of the aorta was done at the level of the diaphragmatic hiatus. 3 patients (9.37%) died (one patient with ruptured abdominal aortic aneurysm). Authors present diagnostic procedures and the differences in the surgical tactic, emphasizing the necessity of the surgical therapy in patients with inflammatory abdominal aortic aneurysm.

  16. The Inhibitory Effect of Astilbin on the Arteriosclerosis of Murine Thoracic Aorta Transplant

    Institute of Scientific and Technical Information of China (English)

    Jinping ZHAO; Ping LI; Yunfeng ZHANG; Xianguo WANG; Qilin AO; Sihai GAO

    2009-01-01

    The inhibitory effect of astilbin on transplant arteriosclerosis in murine model of thoracic aorta transplantation was examined.Model of rat thoracic aorta transplantation was established.Ninety rats were divided into three groups.In isograft group,the thoracic aorta of Brown Norway (BN) rat was anastomosed with the abdominal aorta of another BN rat.In allograft group,the thoracic aorta of BN rat was anastomosed with the abdominal aorta of Lewis rat.In astilbin group,the rats receiving allo-transplantation were given astiibin 5 mg/kg per day for a time of 28 days.The donor thoracic aorta and the recipient abdominal aorta were anastomosed by means of a polyethylene cannula (inner diameter:1.5 mm,length:3 mm length).The grafts were histologically examined for structural changes.The areas of arterial lumen and endatrium were calculated.Our results showed that,in the allograft group,28 days after aliografting,conspicuous proliferation of smooth muscles and infiltration with a great number of inflammatory cells were found in the tunica intima and tunica media.Astilbin significantly inhibited the proliferation of smooth muscles and ameliorated the infiltration of inflammatory cells thereyby prevent against the development of transplant arteriosclerosis.It is concluded that asltilbin can effectively prevent the development of arteriosclerosis in allotrausplant by inhibiting the proliferation of smooth muscles and inhibit the proliferation of smooth muscles in tunica of intima and media and reducing infiltration of the inflammatory cells.

  17. Coarctation of the Aorta

    Science.gov (United States)

    ... of any of these risk factors or a family history of congenital heart disease. Complications Untreated coarctation of the aorta frequently leads to complications. Some complications may be a result of long-standing high blood pressure caused by the aortic coarctation. Complications are also possible ...

  18. Post trauma abdominal cocoon.

    Science.gov (United States)

    Kaur, Supreet; Doley, Rudra Prasad; Chabbhra, Mohinish; Kapoor, Rajeev; Wig, Jaidev

    2015-01-01

    Abdominal cocoon or sclerosing peritonitis refers to a rare cause of intestinal obstruction due to formation of a membrane encasing the bowel. We report a case of abdominal cocoon post blunt trauma abdomen. The patient presented with a history of subacute intestinal obstruction and a mobile abdomen lump. Abdominal cocoon was diagnosed on computed tomography. He underwent adhesiolysis with excision of membrane.

  19. Meningitis due to Enterobacter aerogenes subsequent to resection of an acoustic neuroma and abdominal fat graft to the mastoid

    Directory of Open Access Journals (Sweden)

    Fida A. Khan

    2004-10-01

    Full Text Available Meningitis is an uncommon complication of neurosurgical procedures, with an incidence of 1.1% to 2.5%. Although unusual, the frequency of nosocomial Gram-negative meningitis appears to be increasing. Gram-negative meningitis has been documented following disruption of the dura-arachnoid barrier secondary to trauma or surgery. The association of Gram-negative bacillary meningitis with neurosurgical procedures was first reported in the 1940's. Wolff et al. described the association between Enterobacter species and post-neurosurgical infection. More recently, risk factors for nosocomial Enterobacter meningitis have been characterized by Parodi et al. Adipose graft, as an independent risk factor has not yet been reported. A patient with acoustic neuroma resection, who developed bacterial meningitis from an abdominal fat pad graft to a mastoidectomy bed is described. A brief overview was made of post-neurosurgical Gram-negative meningitis.

  20. Meningitis due to Enterobacter aerogenes subsequent to resection of an acoustic neuroma and abdominal fat graft to the mastoid

    Directory of Open Access Journals (Sweden)

    Fida A. Khan

    Full Text Available Meningitis is an uncommon complication of neurosurgical procedures, with an incidence of 1.1% to 2.5%. Although unusual, the frequency of nosocomial Gram-negative meningitis appears to be increasing. Gram-negative meningitis has been documented following disruption of the dura-arachnoid barrier secondary to trauma or surgery. The association of Gram-negative bacillary meningitis with neurosurgical procedures was first reported in the 1940's. Wolff et al. described the association between Enterobacter species and post-neurosurgical infection. More recently, risk factors for nosocomial Enterobacter meningitis have been characterized by Parodi et al. Adipose graft, as an independent risk factor has not yet been reported. A patient with acoustic neuroma resection, who developed bacterial meningitis from an abdominal fat pad graft to a mastoidectomy bed is described. A brief overview was made of post-neurosurgical Gram-negative meningitis.

  1. Ranking of magnetic resonance tomography of the infrarenal abdominal aorta aneurysms. Comparison with sonography, computed tomography, and angiography. Stellenwert der Kernspintomographie in der Diagnostik der infrarenalen Bauchaortenaneurysmen. Vergleich mit Sonographie, Computertomographie und Angiographie

    Energy Technology Data Exchange (ETDEWEB)

    Rieber, A.; Wrazidlo, W.; Brambs, H.J. (Heidelberg Univ. (Germany, F.R.). Radiologische Klinik); Allenberg, J.R. (Heidelberg Univ. (Germany, F.R.). Chirurgische Universitaetsklinik)

    15 patients with asymptomatic abdominal aortic aneurysms were evaluated with magnetic resonance imaging. The results were compared to the sonographic findings in 12, the computed tomographic in 14 and the angiographic findings in 14 cases. 14 patients were operated and the diagnostic results were verified. The advantage of MRI in comparison with the other diagnostic methods is the visualization of an infrarenal segment on the coronal images, which can be anastomized with the vascular prothesis. The evidence of this segment is important to know for the vascular surgeon to plan the operation technique. The disadvantage of MRI ist that thrombotic material and arterosclerotic plaques were bad or not visualized. We try to estimate, which importance the MRI will get in further times in the preoperative diagnosis of abdominal aortic aneurysms. (orig.).

  2. Ventral Abdominal Hernia

    Directory of Open Access Journals (Sweden)

    Georgi Tchernev

    2017-08-01

    Full Text Available A 63-year-old Caucasian female patient presented with redness of the both foot and lower legs, as well as edema of the left lower leg, accompanied by subjective complaints of burning. Fever was not reported. Well-circumscribed oval shaped tumor formation was revealed also on the abdominal wall, with hyperpigmented and depigmented areas on its ulcerated surface, measuring approximately 10/10cm in diameter, with soft-elastic texture on palpation.  The lesion occurred in 2011, according to the patient’s history. No subjective complaints were reported in association. The performed ultrasonography revealed intestinal loops in the hernial sac, without incarceration. The diagnosis of ventral abdominal hernia without mechanical ileus was made. The patient was referred for planned surgical procedure, because of her refusal on this stage.The clinical manifestation of the tumor formation on the abdominal wall, required wide spectrum of differential diagnosis, including aneurysm of the abdominal aorta, abdominal tumor, subcutaneous tumor or metastasis or hernia. In the presented cases, the abdominal wall mass was a sporadic clinical finding in the framework of the total-body skin examination in patient with erysipelas. The lack of subjective symptoms, as well as the reported history for hysterectomy and previously abscessus were not enough indicative symptoms for the correct diagnosis. The diagnosis of non-complicated hernia was made via ultrasonography, while the clinical differentiation between hernia and other life-threatening conditions as aneurysms or tumor was not possible.

  3. Segmental and age differences in the elastin network, collagen, and smooth muscle phenotype in the tunica media of the porcine aorta.

    Science.gov (United States)

    Tonar, Zbyněk; Kubíková, Tereza; Prior, Claudia; Demjén, Erna; Liška, Václav; Králíčková, Milena; Witter, Kirsti

    2015-09-01

    The porcine aorta is often used in studies on morphology, pathology, transplantation surgery, vascular and endovascular surgery, and biomechanics of the large arteries. Using quantitative histology and stereology, we estimated the area fraction of elastin, collagen, alpha-smooth muscle actin, vimentin, and desmin within the tunica media in 123 tissue samples collected from five segments (thoracic ascending aorta; aortic arch; thoracic descending aorta; suprarenal abdominal aorta; and infrarenal abdominal aorta) of porcine aortae from growing domestic pigs (n=25), ranging in age from 0 to 230 days. The descending thoracic aorta had the greatest elastin fraction, which decreased proximally toward the aortic arch as well as distally toward the abdominal aorta. Abdominal aortic segments had the highest fraction of actin, desmin, and vimentin positivity and all of these vascular smooth muscle markers were lower in the thoracic aortic segments. No quantitative differences were found when comparing the suprarenal abdominal segments with the infrarenal abdominal segments. The area fraction of actin within the media was comparable in all age groups and it was proportional to the postnatal growth. Thicker aortic segments had more elastin and collagen with fewer contractile cells. The collagen fraction decreased from ascending aorta and aortic arch toward the descending aorta. By revealing the variability of the quantitative composition of the porcine aorta, the results are suitable for planning experiments with the porcine aorta as a model, i.e. power test analyses and estimating the number of samples necessary to achieving a desirable level of precision. The complete primary morphometric data, in the form of continuous variables, are made publicly available for biomechanical modeling of site-dependent distensibility and compliance of the porcine aorta.

  4. Tuberculosis abdominal Abdominal tuberculosis

    OpenAIRE

    Rubio, T.; M. T. Gaztelu; Calvo, A.; M. Repiso; H. Sarasíbar; F. Jiménez Bermejo; A. Martínez Echeverría

    2005-01-01

    La tuberculosis abdominal cursa con un cuadro inespecífico, con difícil diagnóstico diferencial respecto a otras entidades de similar semiología. Presentamos el caso de un varón que ingresa por presentar dolor abdominal, pérdida progresiva y notoria de peso corporal y fiebre de dos meses de evolución. El cultivo de la biopsia de colon mostró presencia de bacilo de Koch.Abdominal tuberculosis develops according to a non-specific clinical picture, with a difficult differential diagnosis with re...

  5. Role of Dryk1A-ASF-CaMKⅡδ signaling pathway in EGCG preventing myocardial hypertrophy in rats with coarctation of abdominal aorta%Dyrk1A-ASF-CaMKⅡδ信号通路在EGCG预防腹主动脉缩窄大鼠心肌肥厚中的作用

    Institute of Scientific and Technical Information of China (English)

    陆晓晨; 姚健; 盛红专; 顾青青; 朱健华

    2012-01-01

    Objective To investigate the role and underlying mechanism of epigallocatechin gallate( EGCG) in preventing myocardial hypertrophy in rats with abdominal aortic constrictioa Methods Thirty SD rats were equally randomized into three groups of A (coarctation of suprarenal abdominal aorta) ,B(coarctation of suprarenal abdominal aorta and fed with EGCG 100 mg · kg-1· d-1) and C(sham operated). The ratio of left ventricular weight to body weight(LVW/BW) was calculated for judging the degree of myocardial hypertrophy. The protein expressions of dual-specificity tyrosine phosphorylated and regulated kinase lA(DyrklA) and alternative splicing factor(ASF) were detected by Western blot, and the mRNA expression of calmodulin-dependent protein kinase Ⅱδ (CaMK Ⅱδ) was measured by RT-PCR. Results Compared with group C,the ratio of LVW/BW, protein expression of DyrklA and mRNA expressions of CaMKⅡδ A and B were significantly increased, while the protein expression of ASF and mRNA expression of CaMK US C were decreased in group A(P<0. 05) , which were all obviously reversed in group B(P<0. 05). Conclusion EGCG can prevent myocardial hypertrophy in rats with abdominal aortic constriction via inhibiting Dryk1A-ASF-CaMKⅡδ signaling pathways.%目的 探讨表没食子儿茶素没食子酸酯(EGCG)对腹主动脉缩窄大鼠心肌肥厚的影响及可能机制.方法 30只SD大鼠随机均分为腹主动脉缩窄组(A组)、腹主动脉缩窄+EGCG组(B组)和假手术组(C组).4周后,计算左室重量/体重(LVW/BW)比值以判断大鼠心肌肥厚程度,Western blot法检测双特异性酪氨酸磷酸化调控激酶1A(Dyrk1A)和可变剪接因子(ASF)蛋白表达,RT-PCR法检测钙调素依赖蛋白激酶Ⅱδ(CaMKⅡδ)mRNA表达.结果 与C组相比,A组大鼠LVW/BW升高,心肌中Dyrk1A蛋白及CaMKⅡδA、B亚型mRNA表达增加,ASF蛋白及CaMKⅡδC亚型mRNA表达下降(P<0.05);而B组能明显逆转A组上述指标的变化(P<0.05).结论 EGCG

  6. Coarctation of the aorta

    Science.gov (United States)

    ... Saunders; 2015:chap 62. Read More Abdominal aortic aneurysm Aortic dissection Endocarditis Heart failure - overview High blood pressure Magnetic resonance angiography Pediatric heart surgery Stable angina Stroke Turner syndrome Patient ...

  7. Mitochondrial-dependent apoptosis in experimental rodent abdominal aortic aneurysms.

    Science.gov (United States)

    Sinha, Indranil; Sinha-Hikim, Amiya P; Hannawa, Kevin K; Henke, Peter K; Eagleton, Matthew J; Stanley, James C; Upchurch, Gilbert R

    2005-10-01

    While extrinsic mechanisms of apoptosis in abdominal aortic aneurysms (AAAs) are recognized, this project hypothesizes that an intrinsic, mitochondrial-dependent, mechanism of apoptosis also contributes to experimental AAA formation. Rat aortas were perfused with either saline or elastase (N = 5 per group) and harvested 7 days postperfusion. The aortas were placed in gluteraldehyde for subsequent transmission electron microscopy, Bouin's solution for TUNEL, or paraformaldehyde for immunohistochemical staining for caspase-9, caspase-3, and Bid. Abdominal aortic diameters increased 168 +/- 25% (mean +/- SEM) after elastase perfusion. compared with 30 +/- 5% after saline perfusion (P < .001). Apoptosis of aortic smooth muscle cells, macrophages, and neutrophils was evidenced by transmission electron microscopy and TUNEL in the elastase-perfused aneurysmal aortas. Quantitative analysis of the apoptotic cells revealed a significant (P < .01) increase in the number of total apoptotic cells in the elastase-perfused aortas (12 +/- 3 cells per high-power field), compared with that of saline-infused controls (1.3 +/- 0.2). Caspase-9, the key initiator in the mitochondrial-dependent apoptotic pathway, stained positively in only elastase-perfused aortas. Bid staining was not detected in either the elastase-perfused aortas or the saline controls. Apoptosis is evident in multiple cell lines in elastase-perfused aneurysmal aortas, but rarely observed in control aortas. Caspase-9, the key initiator of intrinsic apoptosis, was documented only in elastase-perfused aortas. These results suggest that mitochondrial-dependent apoptosis is associated with abdominal aortic aneurysm formation.

  8. Involvement of the aorta in brucellosis: the forgotten, life-threatening complication. A systematic review.

    Science.gov (United States)

    Cascio, Antonio; De Caridi, Giovanni; Lentini, Salvatore; Benedetto, Filippo; Stilo, Francesco; Passari, Gabriele; Iaria, Chiara; Spinelli, Francesco; Pappas, Georgios

    2012-10-01

    Human brucellosis is a disease of protean manifestations, and has been implicated in complications and focal disease in many human organ systems. However, little is collectively known about the background, the course, the clinical characteristics, the diagnostic issues raised, and the short- and long-term therapeutic approaches in patients with aortic involvement as a complication of brucellosis. With the aim to glean from the literature useful information to better understand and manage this complication, a computerized search without language restriction was conducted using PubMed and SCOPUS. An article was considered eligible for inclusion in the systematic review if it reported data on patients with involvement of the aorta due to a Brucella infection. The epidemiologic and clinical characteristics of 44 cases of brucellar aortic involvement found through the systematic review of the literature were analyzed together with those of two new cases that we treated in the recent past. This complication involved the ascending thoracic aorta in 18 cases (in 16 of them as a consequence of brucellar endocarditis), and the descending thoracic aorta or the abdominal aorta in the remaining 30 cases. In the latter it was associated with spondylodiscitis of the lumbar spine in 13 cases. History of or symptoms indicative of brucellosis were not universally present. Brucellar aortic involvement represents a possibly underdiagnosed and underreported complication with major morbidity and mortality potential. Experience with novel invasive therapeutic approaches remains limited. Early suspicion through detailed history and diagnosis, aided by advances in aortic imaging, would allow for better planning of therapeutic interventions.

  9. Nursing assistance during endovascular reconstruction using balloon occlusion of the abdominal aorta for patients with severe pelvic trauma and vascular injury%严重骨盆外伤合并血管损伤应用腹主动脉球囊阻断技术的护理配合

    Institute of Scientific and Technical Information of China (English)

    钱维明; 杜丽丽; 项海燕

    2011-01-01

    This paper summarizes the experience of nursing assistance during endovascular reconstruction using balloon occlusion of the abdominal aorta for patients with severe pelvic trauma and vascular injury in traffic accidents. Measures of nursing assistance included preoperative preparation,maintaining vascular access,monitoring urine volume,bilateral dorsalis pedis arterial pulses and the change of blood pressure during the operation. Postoperative nursing focused on effective compression on femoral artery after withdrawal of catheter,observation of urine volume,and local hematoma and skin temperature of lower extremities. The four patients got through the perioperative period safely and were discharged with recovery.%总结了4例因车祸致严重骨盆外伤合并血管损伤的急诊患者应用腹主动脉球囊阻断技术的护理配合经验.护理配合重点包括:完善术前准备,术中确保动静脉通路畅通,准确观察尿量,密切观察双侧足背动脉的搏动,监测血压的变化,穿刺侧肢体拔管后予有效压迫,观察尿量、局部血肿及肢体皮温.4例患者均安全度过围手术期,痊愈出院.

  10. Influence of small volume resuscitation with different fluids on cardiac function and hemodynamics of abdominal aorta in septic shock rats%超声多普勒评估小容量复苏时感染性休克大鼠心功能及腹主动脉血流的变化

    Institute of Scientific and Technical Information of China (English)

    罗晨芳; 刘德昭; 陈景晖; 庞红宇; 黑子清

    2012-01-01

    Objective To investigate Influence of different fluids small -volume resuscitation on cardiac function and hemodynamics of abdominal aorta in septic shock rats. Methods 30 SD rats weighting 180 ~ 250 g were divided randomly into 5 groups ( n = 6 ) : Group N ( LPS negative control group) , Group E(LPS + 4 mL/kg physiologic saline) , Group HSS(LPS + 4 mL/kg Hypertonic saline solution) , Group HES ( LPS + 4 ml/kg Hydroxyethyl Starch) , Group HSH ( LPS + 4 mL/kg Hypertonic Sodium Chloride Hydroxyethyl Starch). Resuscitation were administrated 30 min after LPS injected. Doppler ultrasound examination of heart and abdominal aorta were measured at five time points: pre - injection of LPS, 30min post - injection of LPS, l0min post resuscitation, 30min post resuscitation , 60min post resuscitation. Then rats were executed and hearts were taken out. Heart pathological examination was observed under light microscope. Results ①On the early stage of sepsis, septic septic shock rats'heart systolic function increased first and then decreased obviously (P <0. 01) , LVDd decreased significantly, heart rate increased and blood pressure dereased. while these indexes were obviously recovered in resuscitation group, especially Group HSH; ② septic shock rats'abdominal aorta blood flow rate( BFR) became slower in systolic and diastolic phase, resistent index( RI) increased significantly(P < 0. 01) . While BFR rised and RI descended in resuscitation group, especially Group HSH; ③ There were no significant pathological change between these five group. Conclusion Septic shock rats cardiac function depressed, blood volume decreased, the abdominal aorta BFR descended, RI increased. Small - volume resuscitation could improve cardiac function, increased blood volume and BFR, lowered RI. The use of HSH succeed to ameliorate the deleterious hemodynamic responses associated with endotoxemia in rat.%目的 探讨不同液体早期小容量复苏对大鼠感染性休克引起的心功能和

  11. Tenascin C protects aorta from acute dissection in mice

    Science.gov (United States)

    Kimura, Taizo; Shiraishi, Kozoh; Furusho, Aya; Ito, Sohei; Hirakata, Saki; Nishida, Norifumi; Yoshimura, Koichi; Imanaka-Yoshida, Kyoko; Yoshida, Toshimichi; Ikeda, Yasuhiro; Miyamoto, Takanobu; Ueno, Takafumi; Hamano, Kimikazu; Hiroe, Michiaki; Aonuma, Kazutaka; Matsuzaki, Masunori; Imaizumi, Tsutomu; Aoki, Hiroki

    2014-02-01

    Acute aortic dissection (AAD) is caused by the disruption of intimomedial layer of the aortic walls, which is immediately life-threatening. Although recent studies indicate the importance of proinflammatory response in pathogenesis of AAD, the mechanism to keep the destructive inflammatory response in check is unknown. Here, we report that induction of tenascin-C (TNC) is a stress-evoked protective mechanism against the acute hemodynamic and humoral stress in aorta. Periaortic application of CaCl2 caused stiffening of abdominal aorta, which augmented the hemodynamic stress and TNC induction in suprarenal aorta by angiotensin II infusion. Deletion of Tnc gene rendered mice susceptible to AAD development upon the aortic stress, which was accompanied by impaired TGFβ signaling, insufficient induction of extracellular matrix proteins and exaggerated proinflammatory response. Thus, TNC works as a stress-evoked molecular damper to maintain the aortic integrity under the acute stress.

  12. Reconstrução da aorta com conduto de pericárdio bovino corrugado

    Directory of Open Access Journals (Sweden)

    Claudio A. Salles

    1998-04-01

    éticas, proporciona um conduto circular, que facilita a realização da anastomose, mantém a forma tubular mesmo quando fletido e evita o acotovelamento. O pericárdio é muito macio, fácil de ser manipulado, suturado e coapta muito bem nas linhas de sutura, resultando uma anastomose hemostática. O seguimento de 9 anos demonstrou um desempenho satisfatório deste substituto vascular biológico, não ocorrendo casos de fibrose, calcificação ou dilatação aneurismática.From October 1989 to May 1997, 40 patients with aortic dissection, aortic aneurysm, aortic coarctation or aorto-iliac occlusive disease, underwent reconstruction of their aorta using crimped bovine pericardial conduits processed in glutaraldehyde. Total reconstruction of ascending thoracic aorta and aortic valve with reimplantation of coronary arteries was performed in 9 patients, single ascending thoracic aorta in 6, descending thoracic aorta in 2, aortic arch in 1, thoracoabdominal aorta in 1 and the abdominal aorta was reconstructed in 21, also including patients undergoing aortoiliac or aortofemoral bypass. Hospital mortality was 20% (8 patients and causes of death were low cardiac output, recurrence of aortic dissection, multiple organ failure and bleeding. Total follow-up was 128.4 patient-years with a mean follow-up of 4 years per patient. Late complications related to the conduit were observed in 4 patients, including a limb obstruction in 1 patient subjected to aorto-femoral bypass and infection in 3, resulting in pseudoaneurysm. All of them underwent reoperations, corresponding to an incidence of 3.1% ± 1.6% per patient-year. There were 5 late deaths and the causes were sudden death, coronary artery disease, pneumonia, septicemia, and metabolic complications of diabetes and renal failure, corresponding to an incidence of 3.9% ± 1.7% per patient-year. The 9-year actuarial survival was 61.5% ± 9.2%, including the surgical mortality, and the 9-year actuarial freedom from conduit failure due to primary

  13. Facts about Coarctation of the Aorta

    Science.gov (United States)

    ... Websites Information For... Media Policy Makers Facts about Coarctation of the Aorta Recommend on Facebook Tweet Share ... the body, is narrower than usual. What is Coarctation of the Aorta? Coarctation of the aorta is ...

  14. Post trauma abdominal cocoon

    Directory of Open Access Journals (Sweden)

    Supreet Kaur

    2015-01-01

    Full Text Available Abdominal cocoon or sclerosing peritonitis refers to a rare cause of intestinal obstruction due to formation of a membrane encasing the bowel. We report a case of abdominal cocoon post blunt trauma abdomen. The patient presented with a history of subacute intestinal obstruction and a mobile abdomen lump. Abdominal cocoon was diagnosed on computed tomography. He underwent adhesiolysis with excision of membrane.

  15. Neurofibromatosis type 1-associated hypertension secondary to coarctation of the thoracic aorta

    Science.gov (United States)

    Mavani, Gaurang; Kesar, Vivek; Devita, Maria V.; Rosenstock, Jordan L.; Michelis, Michael F.; Schwimmer, Joshua A.

    2014-01-01

    Neurofibromatosis type 1 (NF-1), also known as von Recklinghausen's disease, is an autosomal dominant genetic disorder. NF-I vasculopathy has been used to describe various vascular malformations associated with NF-1. Secondary hypertension related to NF-1 vasculopathy has been reported because of renal artery stenosis, coarctation of the abdominal aorta and other vascular lesions; however, coarctation of the thoracic aorta has seldom been reported. We report the first case, to our knowledge, of isolated coarctation of thoracic aorta in a pregnant female with NF-1. Healthcare providers caring for patients with NF-1 should be aware of associated vascular complications. PMID:25852916

  16. Abdominal aortic aneurysms : clinical insights and outcome after endovascular repair

    NARCIS (Netherlands)

    Zandvoort, H.J.A.

    2013-01-01

    Abdominal aortic aneurysm (AAA) is a focal dilatation of the abdominal aorta. The pathophysiology of AAA is a complex multifactorial process and much is still unknown. Histologic and biochemical analysis of AAA wall characteristics can contribute to a better insight in AAA pathophysiology. To make t

  17. Acute abdominal aortic thrombosis following the Heimlich maneuver.

    Science.gov (United States)

    Ayerdi, Juan; Gupta, Sushil K; Sampson, Lawrence N; Deshmukh, Narayan

    2002-04-01

    Complications from the Heimlich maneuver are relatively infrequent. Two fatal cases of abdominal aortic thrombosis have been reported following this technique. We report on the first patient that suffered an acute thrombosis of the abdominal aorta and survived. Prompt recognition of this complication provides the only hope of survival from this rare and catastrophic complication.

  18. 腹主动脉阻断术后合并脓毒症大鼠肾脏损伤TNF-α的变化%Changes of TNF-αin rats underwent kidney injury complicated with metastasizing septicemia infection after abdominal aorta clamping

    Institute of Scientific and Technical Information of China (English)

    朱睿瑶; 尹述洲; 张迪; 夏文芳; 邹捍东; 周青山

    2014-01-01

    目的:观察大鼠腹主动脉阻断缺血再灌注术后合并脓毒症时肾脏组织病理学改变及肾脏组织中肿瘤坏死因子-α( TNF-α)的变化。方法 SPF级 Wistar大鼠32只随机分为4组:假手术组(A组),腹主动脉阻断组(B 组),脓毒症组(C 组)及腹主动脉阻断合并脓毒症组( D组)。所有动物于再灌注后8 h处死。4%多聚甲醛灌注固定后取肾脏,采用 HE染色光镜下对各组肾脏进行组织形态学对比观察,免疫组化法检测肾脏组织中 TNF -α的表达。结果 HE染色显示 A组无明显病理改变,B 组可见轻度损伤,C 组较 B 组病理改变严重,D组最为严重。TNF -α表达平均总面积 A、B、C、D 组依次递增,与 A 组比较,B、C、D 组均显著增加(P均<0.05),但 B组与 C组无显著性差异(P>0.05);TNF-α表达平均积分光密度 A、B、D、C组依次递增,各组间有显著性差异(P均<0.05)。结论腹主动脉阻断术后合并脓毒症时急性肾损伤最为严重,TNF-α作为一种至关重要的前炎性因子发挥了重要作用;免疫紊乱和肾脏再灌注无复流,对肾脏 TNF -α表达造成了复杂的影响。%Objective It is to observe the pathmorphological changes of kidney tissues and the expression of TNF -α in kidney tissues of rats with ischemic reperfusion injury complicated with sepsis after abdominal aorta champing( AAC). Meth-ods Thirty-two Wistar rats of SPF were randomly divided into four groups:control group( group A),abdominal aorta cham-ping group( group B),sepsis group( group C),and abdominal aorta champing complicated with sepsis group( group D). All animals were killed 8 hours after the reperfusion. The pathomorphological changes in Kidney tissues were observed with HE method,and the TNF-α expression was detection by immunohistochemistty methods. Results There was no obviously patho-logical changes in group A,and was slight pathological changes

  19. Coarctation of the aorta and renal artery stenosis in tuberous sclerosis

    Energy Technology Data Exchange (ETDEWEB)

    Flynn, P.M.; Robinson, M.B.; Stapleton, F.B.; Roy, S. III; Koh, G.; Tonkin, I.L.D.

    1984-07-01

    Among neurocutaneous disorders, coarctation of the abdominal aorta and renal artery stenosis have traditionally been associated with neurofibromatosis. We report a 5-year-old girl who was discovered to have bilateral renal artery stenosis, coarctation of the abdominal aorta, renal cysts and typical skin lesions of tuberous clerosis during the evaluation of asymptomatic hypertension. Renal vascular hypertension has not been reported previously in tuberous sclerosis. We conclude that the tuberous sclerosis complex should be expanded to include vascular malformations and the hypertension should not be assumed to be secondary to renal hamartomata or cysts in patients with tuberous sclerosis.

  20. Surgical treatment of penetrating atherosclerotic ulcer of the descending aorta

    Directory of Open Access Journals (Sweden)

    Kovačević Pavle

    2013-01-01

    Full Text Available Introduction. The term “penetrating atherosclerotic ulcer” (PAU of the aorta describes the condition in which ulceration of an aortic atherosclerotic lesion penetrates the internal elastic lamina into media. PAU is a high-risk lesion due to its deleterious effects on the integrity of aortic wall, with potentially fatal outcome. Case report. A patient with intensive, sharp chest pain irradiating to the back but with no signs of myocardial ischemia on an electrocardiogram was referred to our hospital. Transthoracic echocardiography showed no pathological changes of the ascending aorta. However, multislice computed tomography (CT showed an aortic ulcer with varying degree of the subadventitial hemorrhage in the region of the thoracic aorta at the level of Th 8-9. Due to imminent rupture of the penetrating aortic ulcer, the patient was promptly prepared for surgery. A 15 cm long subadventitial hematoma was found intraoperatively in the right posterolateral aspect of the descending aorta, 5 cm above the diaphragm and 7 cm below the origin of the left subclavial artery. The affected segment of the aorta was resected, followed by an inlay aortic reconstruction with a Dacron tube graft of 24 mm. Control CT revealed satisfactory reconstruction of the descending aorta. Conclusion. PAU is a rare, but potentially fatal disease. Open surgery in patients with PAU is an effective treatment strategy, although endovascular treatment options are emerging.

  1. Atherosclerotic Human Aorta

    Directory of Open Access Journals (Sweden)

    Igor A. Sobenin

    2011-01-01

    Full Text Available We have evaluated the binding of sialylated and desialylated lipoproteins to collagen isolated from the proteoglycan and musculoelastic layers of intima and media of uninvolved human aorta and atherosclerotic lesions. Comparing various collagen preparations from the uninvolved intima-media, the binding of sialylated apoB-containing lipoproteins was best to collagen from the intimal PG-rich layer. Binding of sialylated apoB-containing lipoproteins to collagen from this layer of fatty streak and fibroatheroma was 1.4- and 3.1-fold lower, respectively, in comparison with normal intima. Desialylated VLDL versus sialylated one exhibited a greater binding (1.4- to 3.0-fold to all the collagen preparations examined. Desialylated IDL and LDL showed a higher binding than sialylated ones when collagen from the intimal layers of fibroatheroma was used. Binding of desialylated HDL to collagen from the intimal PG-rich layer of normal tissue, initial lesion, and fatty streak was 1.2- to 2.0-fold higher compared with sialylated HDL.

  2. Correção endovascular de aneurisma de aorta abdominal e artéria ilíaca comum esquerda em paciente com hemofilia C grave Endovascular repair of abdominal aortic aneurysm and left common iliac artery in a patient with severe hemophilia C

    Directory of Open Access Journals (Sweden)

    Sergio Quilici Belczak

    2012-03-01

    Full Text Available A deficiência do fator XI, também conhecida como hemofilia C, é uma doença hematológica hereditária rara, que se manifesta clinicamente com hemorragia persistente após cirurgias, traumas, menorragias e extrações dentárias. Neste artigo, relatou-se a correção endovascular de um paciente com aneurisma de aorta e de artéria ilíaca comum esquerda em um paciente portador de deficiência major do fator XI (atividade do fator XI inferior a 20%. O procedimento foi realizado com sucesso, com o manuseio do distúrbio da coagulação por meio da infusão de plasma fresco no pré-operatório imediato e no pós-operatório, e controle laboratorial da coagulação do paciente.Factor XI deficiency, also known as hemophilia C, is a rare hereditary blood disease that manifests with persistent bleeding after surgery, trauma, menorrhagia, and dental extractions. This article reports an endovascular repair of a patient diagnosed with an aortic and left common iliac aneurysm, with severe factor XI deficiency (factor XI activity below 20%. The procedure was successfully performed with management of the coagulation disorder by preoperative and postoperative infusion of plasma and laboratory control of the coagulation.

  3. Different Anti-Contractile Function and Nitric Oxide Production of Thoracic and Abdominal Perivascular Adipose Tissues.

    Science.gov (United States)

    Victorio, Jamaira A; Fontes, Milene T; Rossoni, Luciana V; Davel, Ana P

    2016-01-01

    Divergent phenotypes between the perivascular adipose tissue (PVAT) surrounding the abdominal and the thoracic aorta might be implicated in regional aortic differences, such as susceptibility to atherosclerosis. Although PVAT of the thoracic aorta exhibits anti-contractile function, the role of PVAT in the regulation of the vascular tone of the abdominal aorta is not well defined. In the present study, we compared the anti-contractile function, nitric oxide (NO) availability, and reactive oxygen species (ROS) formation in PVAT and vessel walls of abdominal and thoracic aorta. Abdominal and thoracic aortic tissue from male Wistar rats were used to perform functional and molecular experiments. PVAT reduced the contraction evoked by phenylephrine in the absence and presence of endothelium in the thoracic aorta, whereas this anti-contractile effect was not observed in the abdominal aorta. Abdominal PVAT exhibited a reduction in endothelial NO synthase (eNOS) expression compared with thoracic PVAT, without differences in eNOS expression in the vessel walls. In agreement with this result, NO production evaluated in situ using 4,5-diaminofluorescein was less pronounced in abdominal compared with thoracic aortic PVAT, whereas no significant difference was observed for endothelial NO production. Moreover, NOS inhibition with L-NAME enhanced the phenylephrine-induced contraction in endothelial-denuded rings with PVAT from thoracic but not abdominal aorta. ROS formation and lipid peroxidation products evaluated through the quantification of hydroethidine fluorescence and 4-hydroxynonenal adducts, respectively, were similar between PVAT and vessel walls from the abdominal and thoracic aorta. Extracellular superoxide dismutase (SOD) expression was similar between the vessel walls and PVAT of the abdominal and thoracic aorta. However, Mn-SOD levels were reduced, while CuZn-SOD levels were increased in abdominal PVAT compared with thoracic aortic PVAT. In conclusion, our results

  4. Distensión abdominal y edemas por quiste del cordón espermático Abdomina distention and edema due to spermatic cord cyst

    Directory of Open Access Journals (Sweden)

    Guillermo A. Keller

    2006-04-01

    Full Text Available La distensión abdominal es un síntoma común, siendo en general la presentación inicial de enfermedades sistémicas o desórdenes gastrointestinales. Otras causas son infrecuentes. Los quistes del cordón espermático son poco frecuentes, pero aún más su ubicación intraabdominal, su tamaño habitual es insuficiente para producir distensión. El paciente presentado en este caso es un varón con criptorquidia bilateral admitido por distensión abdominal, interpretada inicialmente como síndrome ascítico edematoso. La ecografía interpretó la distensión como ascitis tabicada, y la tomografía computada como debida a un gran quiste. En la exploración quirúrgica se diagnosticó un quiste gigante del cordón espermático de ubicación abdominal.Abdominal distention is a frequent symptom, being often the initial presentation of systemic diseases or gastrointestinal disorders. Other causes are uncommon. Spermatic cord cysts are infrequent, abdominal location is even rarer, and the size of the cysts is usually not enough to produce abdominal distention. In our case a man with bilateral cryptorchidism was admitted with abdominal distention and edema of the lower extremities initially interpreted as ascitic-edematous syndrome. Ultrasonography interpreted abdominal distention as septate ascites, computed tomography as a giant cyst. Exploratory surgery showed a giant spermatic cord cyst in the left spermatic cord.

  5. Hematoma da aorta ascendente Intramural hematoma of the ascending aorta

    Directory of Open Access Journals (Sweden)

    Noedir Antônio G. Stolf

    2006-12-01

    Full Text Available É relatado o caso de um paciente do sexo masculino com idade de 71 anos, dando entrada no pronto-atendimento com palidez cutaneomucosa, acompanhada de hipertensão arterial sistêmica e dor torácica. Na investigação diagnóstica não foi evidenciada alteração compatível com isquemia miocárdica aguda. A radiografia de tórax evidenciava alargamento importante do mediastino. Ao ecocardiograma, a aorta ascendente media 47 mm, no nível do tronco pulmonar. Um dia após o eco, o paciente foi submetido a exame de ressonância magnética (RNM, quando se evidenciou aorta ascendente de 62 mm, sem evidenciar fluxo em falsa luz ou "flap" intimal, mas mostrando hematoma intramural da aorta ascendente, estendendo-se da raiz da aorta até um terço proximal do arco aórtico. Procedeu-se a correção cirúrgica, sendo realizada substituição da aorta ascendente e parte do arco aórtico (hemiarco, com preservação da valva aórtica pela suspensão das comissuras. Paciente evolui bem sem intercorrência, recebendo alta no nono dia de pós-operatório. Enfatizamos nesse relato de caso a semelhança do quadro clínico do hematoma intramural da aorta com o quadro de dissecção da aorta, a importância de se estabelecer diagnóstico correto e o melhor tratamento.It is reported the case of a 71 year old male patient admitted to the emergency service pale and with systemic arterial hypertension and thoracic pain. In the diagnostic investigation, there was no evidence of compatible with acute myocardial ischemia. The thorax x-ray showed important enlargement of the mediastinum. In the echocardiogram the ascending aorta measured 47mm, at the level of the pulmonary artery. One day after the echo, submitted to exam of magnetic resonance (RNM, the ascending aorta had a diameter of 62mm, without false lumen flow or intimal "flap", but showing intramural hematoma envolving the ascending aorta and the proximal portion of the aorta. It was submitted to the surgical

  6. Dr Murray's case of ligation of the abdominal aorta - Somerset ...

    African Journals Online (AJOL)

    1991-04-06

    Apr 6, 1991 ... from the umbilicus to the lower ribs, and downwards to a couple of inches ... much pain in the tumour at present, but says it is often excruciatingly ..... Heart. 2nd ed. (power JR, ed.) Dublin: Fannin, 1850: 123-126. 4. Laidler PW ...

  7. Aneurisma de aorta abdominal y fistula aorto-cava

    Directory of Open Access Journals (Sweden)

    Juan Jose Gonzalez Soler

    2012-03-01

    Full Text Available Paciente de 67 años de edad que acude al servicio de urgencias por dolor dorsolumbar intenso de 4 horas de evolu-ción. Se trata de un paciente con hipoacusia neurosensorial severa que dificulta la anamnesis. Se desconocen factores de riesgo cardiovascular por no constar seguimiento médico habitual.

  8. THE COURSE OF DISSECTING ANEURYSM OF THE AORTA

    Directory of Open Access Journals (Sweden)

    N. A. Kosheleva

    2016-01-01

    Full Text Available Research objective. To define features of a course of dissecting aortic aneurysm now.Materials and methods. 11 clinical records of the patients with the established diagnosis of dissecting aortic aneurysm who have come to Regional clinical hospital of Saratov for 2015 are analysed.Results. Along with traditional risk factors, such as the male, existence of arterial hypertension are revealed also additional risk factors, in particular, regular heavy lifting. Gender features in localization of dissecting aortic aneurysm are defined: at men more often of dissecting aortic aneurysm of an aorta is localized in the abdominal aorta, at women in the thoracic region.Conclusions. Additional risk factor of stratification of dissecting aortic aneurysm in the thoracic region at women is the systematic raising of weights.

  9. Chronic abdominal pain after ventral hernia due to mesh migration and erosion into the sigmoid colon from a distant site: a case report and review of literature.

    Science.gov (United States)

    Millas, S G; Mesar, T; Patel, R J

    2015-10-01

    Hernia repair is one of the most commonly performed procedures in general surgery. Use of mesh has been shown to decrease the overall recurrence rate. Mesh implantation, however, carries its own risks and complications. We report a case of a 41-year-old female who presented with nonspecific, chronic lower abdominal pain after ventral hernia repair with mesh implantation. The chronic pain was found to be the consequence of mesh migration and erosion into the sigmoid colon from a previous supraumbilical hernia repair. Hernia repair, use of mesh, and chronic abdominal pain are discussed.

  10. Endovascular management of lap belt-related abdominal aortic injury in a 9-year-old child.

    Science.gov (United States)

    Papazoglou, Konstantinos O; Karkos, Christos D; Kalogirou, Thomas E; Giagtzidis, Ioakeim T

    2015-02-01

    Blunt abdominal aortic trauma is a rare occurrence in children with only a few patients having been reported in the literature. Most such cases have been described in the context of lap belt injuries. We report a 9-year-old boy who suffered lap belt trauma to the abdomen during a high-speed road traffic accident resulting to the well-recognized pattern of blunt abdominal injury, that is, the triad of intestinal perforation, fractures of the lumbar spine, and abdominal aortic injury. The latter presented with lower limb ischemia due to dissection of the infrarenal aorta and right common iliac artery. Revascularization was achieved by endovascular means using 2 self-expanding stents in the infrarenal aorta and the right common iliac artery. This case is one of the few reports of lap belt-related acute traumatic abdominal aortic dissection in a young child and highlights the feasibility of endovascular management in the pediatric population. Copyright © 2015 Elsevier Inc. All rights reserved.

  11. A rare but potentially lethal case of tuberculous aortic aneurysm presenting with repeated attacks of abdominal pain.

    Science.gov (United States)

    Hung, Yao-Min; Chang, Yun-Te; Wang, Jyh-Seng; Wang, Paul Yung-Pou; Wann, Shue-Ren

    2015-01-01

    Tuberculous aortic aneurysm is an extremely rare disease with a high mortality rate. The clinical features of this condition are highly variable, ranging from asymptomatic with or without constitutional symptoms, abdominal pain to frank rupture, bleeding and shock. We herein report the case of a 56-year-old man with a large tuberculous mycotic aneurysm in the abdominal aorta with an initial presentation of repeated attacks of abdominal pain lasting for several months. Due to the vague nature of the initial symptoms, tuberculous aortic aneurysms may take several months to diagnose. This case highlights the importance of having a high index of suspicion and providing timely surgery for this rare but potentially lethal disease.

  12. Epidermal growth factor receptor inhibitor protects against abdominal aortic aneurysm in a mouse model.

    Science.gov (United States)

    Obama, Takashi; Tsuji, Toshiyuki; Kobayashi, Tomonori; Fukuda, Yamato; Takayanagi, Takehiko; Taro, Yoshinori; Kawai, Tatsuo; Forrester, Steven J; Elliott, Katherine J; Choi, Eric; Daugherty, Alan; Rizzo, Victor; Eguchi, Satoru

    2015-05-01

    Angiotensin II (Ang II) has been implicated in the development of abdominal aortic aneurysm (AAA). In vascular smooth muscle cells (VSMC), Ang II activates epidermal growth factor receptor (EGFR) mediating growth promotion. We hypothesized that inhibition of EGFR prevents Ang II-dependent AAA. C57BL/6 mice were co-treated with Ang II and β-aminopropionitrile (BAPN) to induce AAA with or without treatment with EGFR inhibitor, erlotinib. Without erlotinib, 64.3% of mice were dead due to aortic rupture. All surviving mice had AAA associated with EGFR activation. Erlotinib-treated mice did not die and developed far fewer AAA. The maximum diameters of abdominal aortas were significantly shorter with erlotinib treatment. In contrast, both erlotinib-treated and non-treated mice developed hypertension. The erlotinib treatment of abdominal aorta was associated with lack of EGFR activation, endoplasmic reticulum (ER) stress, oxidative stress, interleukin-6 induction and matrix deposition. EGFR activation in AAA was also observed in humans. In conclusion, EGFR inhibition appears to protect mice from AAA formation induced by Ang II plus BAPN. The mechanism seems to involve suppression of vascular EGFR and ER stress.

  13. Cardiovascular syphilis complicated by Lower thoracic and upper abdominal aneurysm – A rare case report

    Directory of Open Access Journals (Sweden)

    K Gayathri

    2016-01-01

    Full Text Available A 50-year-old male presented with left lower abdominal pain, visible pulsation below xiphoid process, and tenderness in the left iliac fossa for the past 10 days. Chest X-ray revealed blunting of left cardiophrenic angle. Echocardiogram revealed descending thoracic aortic pseudoaneurysm. Contrast-enhanced computed tomography of the chest and abdomen revealed dissecting aneurysm of lower thoracic and upper abdominal aorta. Thoracoabdominal aortogram revealed erosion of D12 vertebra and infected aneurysm of adjacent thoracoabdominal aorta. Serum venereal disease research laboratory assay was positive in 1:4 dilution Treponema pallidum hemagglutination assay was positive. The patient was treated with Injection procaine penicillin for 20 days undercover of steroids. Cerebrospinal fluid analysis was normal. Aortic aneurysm repair with reconstruction was done. Histopathology was in favor of syphilitic etiology. This case is being presented as descending thoracic and upper abdominal aortic aneurysm due to syphilis complicated by dissection and erosion of vertebral body is rare and has not been reported nowadays to the best of our knowledge.

  14. Coarctation of the Aorta (For Teens)

    Science.gov (United States)

    ... Loss Surgery? A Week of Healthy Breakfasts Shyness Coarctation of the Aorta KidsHealth > For Teens > Coarctation of ... of Yourself en español Estrechamiento aórtico What Is Coarctation of the Aorta? The aorta (pronounced: ay-OR- ...

  15. Activities of the Oxazolidinones Linezolid and Eperezolid in Experimental Intra-Abdominal Abscess Due to Enterococcus faecalis or Vancomycin-Resistant Enterococcus faecium

    OpenAIRE

    1999-01-01

    The in vivo effectiveness of oxazolidinones eperezolid (U-100592) and linezolid (U-100766) against one strain each of Enterococcus faecalis and vancomycin-resistant Enterococcus faecium was examined in a rat model of intra-abdominal abscess. MICs of both drugs were 2 μg/ml for each strain. At doses of 25 mg/kg of body weight twice daily intravenously or orally, linezolid produced small but statistically significant reductions in abscess bacterial density for E. faecalis. The reduction in viab...

  16. The Potential Role of Kallistatin in the Development of Abdominal Aortic Aneurysm.

    Science.gov (United States)

    Li, Jiaze; Krishna, Smriti Murali; Golledge, Jonathan

    2016-08-11

    Abdominal aortic aneurysm (AAA) is a vascular condition that causes permanent dilation of the abdominal aorta, which can lead to death due to aortic rupture. The only treatment for AAA is surgical repair, and there is no current drug treatment for AAA. Aortic inflammation, vascular smooth muscle cell apoptosis, angiogenesis, oxidative stress and vascular remodeling are implicated in AAA pathogenesis. Kallistatin is a serine proteinase inhibitor, which has been shown to have a variety of functions, potentially relevant in AAA pathogenesis. Kallistatin has been reported to have inhibitory effects on tumor necrosis factor alpha (TNF-α) signaling induced oxidative stress and apoptosis. Kallistatin also inhibits vascular endothelial growth factor (VEGF) and Wnt canonical signaling, which promote inflammation, angiogenesis, and vascular remodeling in various pre-clinical experimental models. This review explores the potential protective role of kallistatin in AAA pathogenesis.

  17. The Potential Role of Kallistatin in the Development of Abdominal Aortic Aneurysm

    Directory of Open Access Journals (Sweden)

    Jiaze Li

    2016-08-01

    Full Text Available Abdominal aortic aneurysm (AAA is a vascular condition that causes permanent dilation of the abdominal aorta, which can lead to death due to aortic rupture. The only treatment for AAA is surgical repair, and there is no current drug treatment for AAA. Aortic inflammation, vascular smooth muscle cell apoptosis, angiogenesis, oxidative stress and vascular remodeling are implicated in AAA pathogenesis. Kallistatin is a serine proteinase inhibitor, which has been shown to have a variety of functions, potentially relevant in AAA pathogenesis. Kallistatin has been reported to have inhibitory effects on tumor necrosis factor alpha (TNF-α signaling induced oxidative stress and apoptosis. Kallistatin also inhibits vascular endothelial growth factor (VEGF and Wnt canonical signaling, which promote inflammation, angiogenesis, and vascular remodeling in various pre-clinical experimental models. This review explores the potential protective role of kallistatin in AAA pathogenesis.

  18. Medical image of the week: atherosclerotic aneurysm of aortic arch and descecnding thoracic aorta

    Directory of Open Access Journals (Sweden)

    Parasram M

    2016-02-01

    Full Text Available No abstract available. Article truncated after 150 words. A 94-year-old Spanish-speaking woman presented to the hospital with intermittent episodes of dyspnea and abdominal pain for one week. Her past medical history was notable for 30 pack-year smoking history and hypertension, which was reportedly controlled with medical therapy. Physical exam showed trace peripheral edema bilaterally, intact peripheral pulses, and a mild abdominal bruit. Work up at the emergency department revealed a non-ST elevation myocardial infarction with troponin T of 0.34 ng/mL but no ST-wave abnormality on electrocardiography. Chest x-ray displayed an incidental thoracic aneurysm (Figure 1. Chest computed tomography with contrast demonstrated a continuous aneurysm of the aortic arch and descending thoracic aorta with diameters measuring 6.8 cm and 6 cm, respectively (Figure 2A and 2B. Eccentric thrombi are noted in the aortic arch and the descending aorta. Interestingly, the distal descending thoracic aorta curves as it transitions to the abdominal aorta, which is evidence of a tortuous descending ...

  19. Abdominal pain

    Science.gov (United States)

    Stomach pain; Pain - abdomen; Belly ache; Abdominal cramps; Bellyache; Stomachache ... Almost everyone has pain in the abdomen at some point. Most of the time, it is not serious. How bad your pain is does not always reflect the seriousness ...

  20. Abdominal actinomycosis.

    Science.gov (United States)

    Wagenlehner, F M E; Mohren, B; Naber, K G; Männl, H F K

    2003-08-01

    Intra-abdominal and extraperitoneal actinomycosis are rare infections, caused by different Actinomyces species. However, they have been diagnosed more frequently in the last ten years. We report three cases of abdominal actinomycosis and a literature review of the last eight years. All three patients were diagnosed by means of histopathologic examination only. In one case, an intrauterine device (IUD) was associated with the infection. Therapy consisted of surgical resection of the inflammatory, infected tissue, and long-term antibiotic therapy. All patients are free of recurrence. Abdominal actinomycosis should be included in the differential diagnosis of an abdominal pathology of insidious onset, especially when an IUD is in place. Even when infection had spread extensively, combined operative and antibiotic therapy cured most of the cases.

  1. Modification of an endovascular stent graft for abdominal aortic aneurysm

    Science.gov (United States)

    Moloye, Olajompo Busola

    Endovascular surgery is currently used to treat abdominal aortic aneurysms (AAA). A stent graft is deployed to exclude blood flow from the aneurysm sac. It is an effective procedure used in preventing aneurysm rupture, with reduced patient morbidity and mortality compared to open surgical repair. Migration and leakage around the device ("endoleak") due to poor sealing of the stent graft to the aorta have raised concerns about the long-term durability of endovascular repair. A preliminary study of cell migration and proliferation is presented as a prelude to a more extensive in vivo testing. A method to enhance the biological seal between the stent graft and the aorta is proposed to eliminate this problem. This can be achieved by impregnating the stent graft with 50/50 poly (DL-lactide co glycolic acid) (PLGA) and growth factors such as basic fibroblast growth factor (bFGF) or connective tissue growth factor (CTGF), at the proximal and distal ends. It is hypothesized that as PLGA degrades it will release the growth factors that will promote proliferation and migration of aortic smooth muscle cells to the coated site, leading to a natural seal between the aorta and the stent graft. In addition, growth factor release should promote smooth muscle cell (SMC) contraction that will help keep the stent graft in place at the proximal and distal ends. It is shown that a statistically significant effect of increased cell proliferation and migration is observed for CTGF release. Less of an effect is noted for bFGF or just the PLGA. The effect is estimated to be large enough to be clinically significant in a future animal study. The long term goal of this study is to reduce migration encounter after graft deployment and to reduce secondary interventions of EVAR especially for older patients who are unfit for open surgical treatment.

  2. Aortocaval fistula complicating abdominal aortic aneurysm: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Jeong, Bong Gak; Kim, Hyun; Kang, Si Won [College of Medicine, The Catholic Univ. of Korea, Seoul (Korea, Republic of); Kim, Man Deuk [College of Medicine, Pochon CHA Univ., Pochon (Korea, Republic of)

    2002-01-01

    Aortocaval fistula is rare complication arising from an abdominal aortic aneurysm. A typical feature observed during the arterial phase of contrast-enhanced CT scanning in such patients is simultaneous enhancement of the dilated inferior vena cava and aorta. Awareness of the specific radiologic features of aortocaval fistula may facilitate diagnosis when the condition is unsuspected clinically. We report a case of aortocaval fistula secondary to abdominal aortic aneurysm, and review the previous literature.

  3. Experimental unsteady flow study in a patient-specific abdominal aortic aneurysm model

    Science.gov (United States)

    Stamatopoulos, Ch.; Mathioulakis, D. S.; Papaharilaou, Y.; Katsamouris, A.

    2011-06-01

    The velocity field in a patient-specific abdominal aneurysm model including the aorto-iliac bifurcation was measured by 2D PIV. Phase-averaged velocities obtained in 14 planes reveal details of the flow evolution during a cycle. The aneurysm expanding asymmetrically toward the anterior side of the aorta causes the generation of a vortex at its entrance, covering the entire aneurysm bulge progressively before flow peak. The fluid entering the aneurysm impinges on the left side of its distal end, following the axis of the upstream aorta segment, causing an increased flow rate in the left (compared to the right) common iliac artery. High shear stresses appear at the aneurysm inlet and outlet as well as along the posterior wall, varying proportionally to the flow rate. At the same regions, elevated flow disturbances are observed, being intensified at flow peak and during the deceleration phase. Low shear stresses are present in the recirculation region, being two orders of magnitude smaller than the previous ones. At flow peak and during the deceleration phase, a clockwise swirling motion (viewed from the inlet) is present in the aneurysm due to the out of plane curvature of the aorta.

  4. Activities of the oxazolidinones linezolid and eperezolid in experimental intra-abdominal abscess due to Enterococcus faecalis or vancomycin-resistant Enterococcus faecium.

    Science.gov (United States)

    Schülin, T; Thauvin-Eliopoulos, C; Moellering, R C; Eliopoulos, G M

    1999-12-01

    The in vivo effectiveness of oxazolidinones eperezolid (U-100592) and linezolid (U-100766) against one strain each of Enterococcus faecalis and vancomycin-resistant Enterococcus faecium was examined in a rat model of intra-abdominal abscess. MICs of both drugs were 2 microg/ml for each strain. At doses of 25 mg/kg of body weight twice daily intravenously or orally, linezolid produced small but statistically significant reductions in abscess bacterial density for E. faecalis. The reduction in viable cells observed would not likely be clinically relevant. Eperezolid was ineffective at this dose. At a dosage of 100 mg/kg/day, linezolid treatment led to an approximately 100-fold reduction in viable cells per gram of abscess. Against E. faecium infections, intravenous eperezolid and oral linezolid were effective, reducing densities approximately 2 log(10) CFU/g. Both oxazolidinones demonstrated activity against enterococci in this model. However, results were modest with the dosing regimens employed.

  5. Microsurgical Bypass Training Rat Model, Part 1: Technical Nuances of Exposure of the Aorta and Iliac Arteries.

    Science.gov (United States)

    Tayebi Meybodi, Ali; Lawton, Michael T; Mokhtari, Pooneh; Yousef, Sonia; Gandhi, Sirin; Benet, Arnau

    2017-06-21

    Animal models using rodents are frequently used for practicing microvascular anastomosis-an essential technique in cerebrovascular surgery. However, safely and efficiently exposing rat's target vessels is technically difficult. Such difficulty may lead to excessive hemorrhage and shorten animal survival. This limits the ability to perform multiple anastomoses on a single animal and may increase the overall training time and costs. We report our model for microsurgical bypass training in rodents in 2 consecutive articles. In part 1, we describe the technical nuances for a safe and efficient exposure of the rat abdominal aorta and common iliac arteries (CIAs) for bypass. Over a 2-year period, 50 Sprague-Dawley rats underwent inhalant anesthesia for practicing microvascular anastomosis on the abdominal aorta and CIAs. Lessons learned regarding the technical nuances of vessel exposure were recorded. Several technical nuances were important for avoiding intraoperative bleeding and preventing animal demise while preparing an adequate length of vessels for bypass. The most relevant technical nuances include (1) generous subcutaneous dissection; (2) use of cotton swabs for the blunt dissection of the retroperitoneal fat; (3) combination of sharp and blunt dissection to isolate the aorta and iliac arteries from the accompanying veins; (4) proper control of the posterior branches of the aorta; and (5) efficient division and mobilization of the left renal pedicle. Applying the aforementioned technical nuances enables safe and efficient preparation of the rat abdominal aorta and CIAs for microvascular anastomosis. Copyright © 2017 Elsevier Inc. All rights reserved.

  6. Therapeutic Prospect of Adipose-Derived Stromal Cells for the Treatment of Abdominal Aortic Aneurysm

    NARCIS (Netherlands)

    Parvizi, Mojtaba; Harmsen, Martin C.

    2015-01-01

    Aneurysm refers to the dilation of the vessel wall for more than 50%. Abdominal aortic aneurysm (AAA) refers to the dilation and weakening of all three layers of the abdominal aorta, which mostly occur infrarenally. The population aged above 50 years is at risk of AAA development, while a familiar

  7. Therapeutic Prospect of Adipose-Derived Stromal Cells for the Treatment of Abdominal Aortic Aneurysm

    NARCIS (Netherlands)

    Parvizi, Mojtaba; Harmsen, Martin C.

    2015-01-01

    Aneurysm refers to the dilation of the vessel wall for more than 50%. Abdominal aortic aneurysm (AAA) refers to the dilation and weakening of all three layers of the abdominal aorta, which mostly occur infrarenally. The population aged above 50 years is at risk of AAA development, while a familiar h

  8. 缬沙坦涂层支架置入兔腹主动脉对血管内膜胶原沉积及AT2受体表达的影响%Influence of valsartan-eluting stent implantation into rabbit abdominal aorta on collagen deposition and AT2 receptor expression

    Institute of Scientific and Technical Information of China (English)

    李贵华; 王雷; 贾三庆; 赵林; 姚道阔; 丁荣晶; 任文林

    2008-01-01

    BACKGROUND:Clinical trials have shown that oral administration of valsartan can decrease in-stent restenosis after stent implantation.But whether valsartan used locally also has the sanle effect and the possible mechanism should be validated.OBJECTIVE:To observe the effect of valsartan-eluting stents on collagen deposition in neointima and AT2 receptor expression after implanting valsartan-eluting stents into rabbit abdominal orta.DESIGN:Randomized and controlled animal experiment.SETTING:Beijing Friendship Hospital.MATERIALS:The experiment was performed at the Laboratory of Beijing Friendship Hospital between October 2004 and March 2006.Fifteen New Zealand white rabbits,irrespective of gender,weighing 2.75-3.25 kg were selected(Animal Laboratory of Beijing Friendship Hospital).The rabbits were adaptively fed for one week.All the operations of rabbits during the experiment were accorded with animal ethical standards.Valsartan powder was presented as a gift by Novartis.China;Reagent of MASSON was provided by Department of Pathology of Beijing Friendship Hospital;1%picrosirius solution was provided by the Department of Pathology of China-Japan Friendship Hospital:Mice-anti-rabbit monoclonal AT2 antibody was product of Santa Cruz Biotechnology (USA);Envision reagent was purphased from Dako;primers were synthesized by SBS Genetech(SBS).METHODS:①The animals were randomized into bare-metal stent group,carrier-eluting stent group and valsartan-eluting stent group with 5 animals in each group.All rabbits were implanted with corresponding types of above-mentioned stents into abdominal aortas down below renal artery.②Quantitative angiography before,immediately after and 3 months after stent implantation were performed to compare vascular diameters of the aortas.③Three months Iater,the rabbits were executed after anaesthesia.The vessels with stents were processed with HE staining.Indices of the vascular neointimal formation,I.e. iBrier and external elastic membrane

  9. Abdominal Sepsis.

    Science.gov (United States)

    De Waele, Jan J

    2016-08-01

    Abdominal infections are an important challenge for the intensive care physician. In an era of increasing antimicrobial resistance, selecting the appropriate regimen is important and, with new drugs coming to the market, correct use is important more than ever before and abdominal infections are an excellent target for antimicrobial stewardship programs. Biomarkers may be helpful, but their exact role in managing abdominal infections remains incompletely understood. Source control also remains an ongoing conundrum, and evidence is increasing that its importance supersedes the impact of antibiotic therapy. New strategies such as open abdomen management may offer added benefit in severely ill patients, but more data are needed to identify its exact role. The role of fungi and the need for antifungal coverage, on the other hand, have been investigated extensively in recent years, but at this point, it remains unclear who requires empirical as well as directed therapy.

  10. Improving the efficiency of abdominal aortic aneurysm wall stress computations.

    Science.gov (United States)

    Zelaya, Jaime E; Goenezen, Sevan; Dargon, Phong T; Azarbal, Amir-Farzin; Rugonyi, Sandra

    2014-01-01

    An abdominal aortic aneurysm is a pathological dilation of the abdominal aorta, which carries a high mortality rate if ruptured. The most commonly used surrogate marker of rupture risk is the maximal transverse diameter of the aneurysm. More recent studies suggest that wall stress from models of patient-specific aneurysm geometries extracted, for instance, from computed tomography images may be a more accurate predictor of rupture risk and an important factor in AAA size progression. However, quantification of wall stress is typically computationally intensive and time-consuming, mainly due to the nonlinear mechanical behavior of the abdominal aortic aneurysm walls. These difficulties have limited the potential of computational models in clinical practice. To facilitate computation of wall stresses, we propose to use a linear approach that ensures equilibrium of wall stresses in the aneurysms. This proposed linear model approach is easy to implement and eliminates the burden of nonlinear computations. To assess the accuracy of our proposed approach to compute wall stresses, results from idealized and patient-specific model simulations were compared to those obtained using conventional approaches and to those of a hypothetical, reference abdominal aortic aneurysm model. For the reference model, wall mechanical properties and the initial unloaded and unstressed configuration were assumed to be known, and the resulting wall stresses were used as reference for comparison. Our proposed linear approach accurately approximates wall stresses for varying model geometries and wall material properties. Our findings suggest that the proposed linear approach could be used as an effective, efficient, easy-to-use clinical tool to estimate patient-specific wall stresses.

  11. Familial Abdominal Aortic Aneurysm : Clinical Features and Genetics

    NARCIS (Netherlands)

    K.M. van de Luijtgaarden (Koen)

    2016-01-01

    markdownabstractAbstract Cardiovascular disease is the most important cause of death in the world and encompasses occlusive as well as aneurysmal disease. The most common aneurysm in humans is the abdominal aortic aneurysm (AAA). The question is why the aorta dilates in aneurysmal disease and

  12. Familial Abdominal Aortic Aneurysm : Clinical Features and Genetics

    NARCIS (Netherlands)

    K.M. van de Luijtgaarden (Koen)

    2016-01-01

    markdownabstractAbstract Cardiovascular disease is the most important cause of death in the world and encompasses occlusive as well as aneurysmal disease. The most common aneurysm in humans is the abdominal aortic aneurysm (AAA). The question is why the aorta dilates in aneurysmal disease and occ

  13. Penetrating abdominal trauma

    African Journals Online (AJOL)

    Enrique

    inal trauma (PAT) in our area, and to try to identify a pattern of organ-specific injury ... laparotomy due to persistent abdominal pain, after a period of observation of about .... in the ini- tial assessment who turned out to be free of visceral injuries.

  14. Mice aorta loop grafting: A new model which separate vascular rejection and neointimal formation in chronic rejection

    Institute of Scientific and Technical Information of China (English)

    陈勇; 窦科峰; 何勇; 孙凯

    2003-01-01

    Objective: To study the cause and mechanism of transplantation vasculopathy which characterized by accelerated graft arteriosclerosis (AGA), we established a mouse aorta graft model. Methods: A segment of thoracic aortas of B10.A (2R) mice were transplanted to C57BL/10 mice abdominal aorta by end to side anastomoses. The different time point collected grafts were analyzed by morphological, histochemical and electro microscopic methods. Results: Rejection was manifested as a concentric progressive destruction of the smooth muscle cells. In contrast, the endothelial inflammation and subsequent neointimal proliferation characteristic of AGA was localized to the regions of turbulent flow, i.e. the junction of the graft with the recipient aorta. Conclusion: This model separates the processes of rejection and neointimal formation which usually manifested together in the lesion of AGA, elucidate that different mechanisms control vascular rejection and neointimal formation in chronic rejection.

  15. Application of two multi-dimensional analytical methods to histological study of the aorta in dietary atherosclerosis of the rabbit.

    Science.gov (United States)

    Richard, J L; Martin, C; Desecure, J P; Jacotot, B

    1980-01-01

    Multivariate analysis (principal component analysis, discriminant analysis) have been applied to the histological data of arterial lesions in experimental atherosclerosis of the rabbit. We carried out a comparative study of: 1. the lesion observed at three levels of the aortas; origin of the aorta, thoracic aorta and abdominal aorta, and 2. the lesions according to the type of fat ingested during the experimental period. Five edible fats were studied: butter, olive oil, arachid oil, rapeseed oil rich in erucic acid, and rapeseed oil poor in erucic acid (Primor). This study re-affirms the possible importance of the above mentioned methods in evaluation by histology of lesions induced in the arteries by the different hyperlipidic regimens. Indeed these methods are complementary and enable the introduction of statistical methods in the quantitative evaluation of morphological lesions.

  16. Non-contrast-enhanced renal and abdominal MR angiography using velocity-selective inversion preparation.

    Science.gov (United States)

    Shin, Taehoon; Worters, Pauline W; Hu, Bob S; Nishimura, Dwight G

    2013-05-01

    Non-contrast-enhanced MR angiography is a promising alternative to the established contrast-enhanced approach as it reduces patient discomfort and examination costs and avoids the risk of nephrogenic systemic fibrosis. Inflow-sensitive slab-selective inversion recovery imaging has been used with great promise, particularly for abdominal applications, but has limited craniocaudal coverage due to inflow time constraints. In this work, a new non-contrast-enhanced MR angiography method using velocity-selective inversion preparation is developed and applied to renal and abdominal angiography. Based on the excitation k-space formalism and Shinnar-Le-Roux transform, a velocity-selective excitation pulse is designed that inverts stationary tissues and venous blood while preserving inferiorly flowing arterial blood. As the magnetization of the arterial blood in the abdominal aorta and iliac arteries is well preserved during the magnetization preparation, artery visualization over a large abdominal field of view is achievable with an inversion delay time that is chosen for optimal background suppression. Healthy volunteer tests demonstrate that the proposed method significantly increases the extent of visible arteries compared with the slab-selective approach, covering renal arteries through iliac arteries over a craniocaudal field of view of 340 mm. Copyright © 2012 Wiley Periodicals, Inc.

  17. Endovascular treatment of penetrating ulcers of the paraceliac aorta using fenestrated endografts.

    Science.gov (United States)

    Gargiulo, Mauro; Gallitto, Enrico; Freyrie, Antonio; Stella, Andrea

    2014-04-01

    Penetrating atherosclerotic ulcers (PAUs) are usually focal aortic lesions found in patients with significant comorbidities. They are ideal targets for an endovascular approach if localized in the descending thoracic or infrarenal aorta, but when an origin in the visceral vessels is involved, a standard endovascular approach might not be feasible or effective. We report 2 cases of endovascular treatment of PAUs involving the paraceliac abdominal aorta, using a custom-made tube fenestrated endograft with 4 fenestrations for the abdominal visceral vessels (i.e., celiac-trunk, superior mesenteric artery, and renal arteries). There were no intra- or perioperative complications. At 1 year of follow-up, patients were asymptomatic and computed tomography angiography revealed total lesion exclusion and patency of the visceral vessels. The use of a fenestrated endograft is a safe and effective option to treat paraceliac PAUs.

  18. Characterization of human aortic elastase found in patients with abdominal aortic aneurysms.

    Science.gov (United States)

    Cohen, J R; Mandell, C; Wise, L

    1987-10-01

    Recent evidence indicates that the homeostatic balance between elastase and antiprotease activity is altered in the infrarenal aorta of those patients with different types of aortic pathologic findings. The specific properties of elastase found in the aorta of patients with abdominal aortic aneurysms (AAA) are discussed herein. Activity of elastase extracted from ten pooled AAA specimens was observed when incubated with several inhibitors: 13.2 per cent for phenyl-suphonyl flouride (PSF); 43.3 per cent for ethylenediaminetetraacetic acid (EDTA); 77.7 per cent for pepstatin; 137.0 per cent for leupeptin, and 24.0 per cent for alpha-1-antitrypsin. Irreversible inhibition by PSF indicates that the elastase is a serine protease. The elastase is most likely not a metallo enzyme, since it had no absolute requirement for divalent cations as indicated by only partial inhibition by EDTA. Elastase activity is most likely not due to cathepsins B or D, since cathepsins are active in an acid pH and selectively inhibited by leupeptin and pepstatin. The pH curve revealed a maximum activity at pH 8.2 and elastase activity was significantly inhibited by alpha-1-antitrypsin in a dose response manner determining functional elastase activity. These data indicate that the elastase in the aorta of patients with an AAA has the exact properties of the serine elastase found in the smooth muscle cells of the aorta in rats. These results also confirm the critical role of alpha-1-antitrypsin in determining functional elastase activity. Smooth muscle cell regulation of elastin metabolism may be important in determining why some patients have AAA and others have occlusive aortic disease develop.

  19. Micromanaging Abdominal Aortic Aneurysms

    Directory of Open Access Journals (Sweden)

    Lars Maegdefessel

    2013-07-01

    Full Text Available The contribution of abdominal aortic aneurysm (AAA disease to human morbidity and mortality has increased in the aging, industrialized world. In response, extraordinary efforts have been launched to determine the molecular and pathophysiological characteristics of the diseased aorta. This work aims to develop novel diagnostic and therapeutic strategies to limit AAA expansion and, ultimately, rupture. Contributions from multiple research groups have uncovered a complex transcriptional and post-transcriptional regulatory milieu, which is believed to be essential for maintaining aortic vascular homeostasis. Recently, novel small noncoding RNAs, called microRNAs, have been identified as important transcriptional and post-transcriptional inhibitors of gene expression. MicroRNAs are thought to “fine tune” the translational output of their target messenger RNAs (mRNAs by promoting mRNA degradation or inhibiting translation. With the discovery that microRNAs act as powerful regulators in the context of a wide variety of diseases, it is only logical that microRNAs be thoroughly explored as potential therapeutic entities. This current review summarizes interesting findings regarding the intriguing roles and benefits of microRNA expression modulation during AAA initiation and propagation. These studies utilize disease-relevant murine models, as well as human tissue from patients undergoing surgical aortic aneurysm repair. Furthermore, we critically examine future therapeutic strategies with regard to their clinical and translational feasibility.

  20. Novel Treatment Approach to Ascending Aorta Pseudoaneurysms: A Case Report

    Directory of Open Access Journals (Sweden)

    Seyed Ebrahim Kassaian

    2017-06-01

    Full Text Available The pseudoaneurysm of the aorta is rarely due to trauma and infection but usually is a late complication of previous surgical procedures like coronary artery bypass graft surgery. We describe a 65-year-old woman with the pseudoaneurysm of the ascending aorta due to coronary artery bypass graft surgery. It was revealed in coronary artery angiography after nonspecific symptoms. It was confirmed by multidetector computed tomographic angiography. The patient refused open cardiac surgery, so we decided to use an atrial septal defect occluder device in off-label way to seal the pseudoaneurysm orifice. In a hybrid operating room setting, the procedure was done successfully and patient’s hospitalization course was eventless. In multidetector computed tomographic angiography after 3 months, the device was in the appropriate position without endoleak and in the yearly visit the patient was asymptomatic and healthy.

  1. Diagnosis of a perforating aneurysm of the aorta as late complication of patch aortoplasty by central venous DSA

    Energy Technology Data Exchange (ETDEWEB)

    Zitzmann, A.; Kreuzer, E.; Huber, R.M.; Kenn, R.W.; Pfeifer, K.J.

    1988-06-01

    11 years after patch aortoplasty due to coarctation of the aorta a 33 year-old-patient experienced two spontaneous haemoptyses. A centralvenous digital subtraction angiography demonstrated a large aneurysm of the proximal descending aorta penetrating the left upper lobe of the lung. The successful emergency surgical treatment consisted of implantation of a dacron-prothesis.

  2. Surgical treatment of penetrating atherosclerotic ulcer of the descending aorta

    OpenAIRE

    Kovačević Pavle; Velicki Lazar; Popović Dušan; Ivanović Vladimir; Mojašević Renata

    2013-01-01

    Introduction. The term “penetrating atherosclerotic ulcer” (PAU) of the aorta describes the condition in which ulceration of an aortic atherosclerotic lesion penetrates the internal elastic lamina into media. PAU is a high-risk lesion due to its deleterious effects on the integrity of aortic wall, with potentially fatal outcome. Case report. A patient with intensive, sharp chest pain irradiating to the back but with no signs of myocardial ischemia on an electrocardiogram was referred to...

  3. Hemodynamics of patient-specific aorta-pulmonary shunt configurations

    OpenAIRE

    Pekkan, Kerem; Pişkin, Senol; Altın, H. Fırat; Yıldız, Okan; Bakır, İhsan

    2017-01-01

    Optimal hemodynamics in aorta-pulmonary shunt reconstruction is essential for improved post-operative recovery of the newborn congenital heart disease patient. However, prior to in vivo execution, the prediction of post-operative hemodynamics is extremely challenging due to the interplay of multiple confounding physiological factors. It is hypothesized that the post-operative performance of the surgical shunt can be predicted through computational blood flow simulations that consider patient ...

  4. Verminous Arteritis Due to Crassicauda sp. in Cuvier's Beaked Whales (Ziphius Cavirostris).

    Science.gov (United States)

    Díaz-Delgado, J; Fernández, A; Xuriach, A; Sierra, E; Bernaldo de Quirós, Y; Mompeo, B; Pérez, L; Andrada, M; Marigo, J; Catão-Dias, J L; Groch, K R; Edwards, J F; Arbelo, M

    2016-11-01

    The vascular system of Cuvier's beaked whales (CBW) (Ziphius cavirostris; family Ziphiidae), an extremely deep, prolonged-diving cetacean, is increasingly receiving anatomic and physiologic study due to possible anthropogenic interactions; however, vascular pathology rarely has been reported in this species. Thirteen CBW stranded in the Canary Islands from June 2008 to June 2014 were autopsied. A careful dissection of the thoracic and abdominal vasculature was performed on these animals. All had moderate to severe and extensive chronic fibrosing arteritis with aneurysms, hemorrhages, and thrombosis primarily involving the mesenteric and gastroepiploic arteries and the thoracic and abdominal aorta. Microscopically, the lesions varied from subacute subintimal hemorrhages and severe neutrophilic, eosinophilic, and histiocytic dissecting arteritis with intralesional nematode larvae to marked, chronic, fibrosing arteritis with thickening and distortion of the vascular wall with calcification and occasional cartilage metaplasia. In addition, adult nematodes in renal arteries and veins, renal parenchyma and/or ureter were identified morphologically as Crassicauda sp. Nucleic acid sequenced from renal nematodes from 2 animals yielded closest nucleotide identity to C. magna The pathogenesis is proposed to involve a host response to larval migration from the intestine to the kidney through the mesenteric arteries, abdominal aorta, and renal arteries. Severe consequences for such lesions are possible and could vary from reduced vascular compliance to chronic renal disease and predisposition to the development of disseminated intravascular coagulation and multiorgan failure. Severe chronic arteritis in CBW is associated with renal parasitism by Crassicauda spp.

  5. Self-expandable nitinol stent placement in homocysteinemic porcine aorta

    Directory of Open Access Journals (Sweden)

    Luís Henrique Gil França

    2008-01-01

    Full Text Available PURPOSE: To compare aortic intimal thickening of normal and hyperhomocysteinemic pigs (induced with a methionine-rich diet following placement of a self-expanding nitinol stent. METHODS: Eighteen Macau pigs were used. They were older than eight weeks in age and had an average weight of 30 kg. Pigs were randomly divided into two groups. The first, Group C (control, was fed a regular diet, and the second group, Group M, was fed a methionine-rich diet for 30 days to induce hyperhomocysteinemia. The self-expandable nitinol stents were 25mm in length and 8 mm in diameter after expansion. Blood samples were collected to measure total cholesterol, triglycerides, HDL and homocysteine concentrations. All animals were subjected to angiography. Thirty days after the procedure, the animals were sacrificed, and the abdominal aorta was removed for histological and digital morphometry analysis. RESULTS: Under microscopic evaluation, the intima was significantly thicker in Group C than in Group M. When groups were compared by digital morphometric analysis, intimal thickening of the vessel wall was higher in Group C than in Group M. There was no significant change in total cholesterol, triglycerides or HDL concentrations in either group. In group C the levels of plasma homocysteine ranged from 14,40 to 16,73µmol/l; in Group M, plasma homocysteine levels ranged from 17.47 to 59.80 µmol/l after 30 days of a methionine-rich diet. CONCLUSION: Compared to normal pigs, less intimal hyperplasia was observed in the abdominal aortas of hyperhomocysteinemic pigs thirty days after the insertion of a self-expandable nitinol stent.

  6. [Abdominal multi-organ transplantation in dogs].

    Science.gov (United States)

    Kumagae, T

    1988-07-01

    Abdominal multi-organ transplantation including the liver, gallbladder, spleen, pancreas, kidneys, adrenal glands and gastrointestinal tract was attempted in 8 dogs. Each experiment was discontinued when the recipient deteriorated. Immersion hypothermia was introduced in both the donor and recipient until the esophageal temperature reached 27-30 degrees C. Whole abdominal organs of the donor were removed in an en-bloc fashion at 20 degrees C of the graft temperature after additional cooling by ice slush scattering into the abdominal cavity. Transplantation was carried out orthotopically in the following sequence: (1) the proximal aorta, (2) suprahepatic vena cava, (3) distal aorta, (4) infrahepatic vena cava. The alimentary tract was reconstructed by gastro-gastrostomy and colo-colostomy. The ureters were implanted in the bladder. Cold ischemic time of the graft was about 40 minutes. Heparin was not used throughout the procedure. Five out of eight dogs were alive for more than 24 hours and two of them survived for 60 hours with good recovery. No immunosuppressant was given. Though the result in the present study was far from satisfaction, the experiment may provide a possibility of a new experimental model for transplantation, especially regarding pathophysiology and interrelationship of the transplanted complex organs.

  7. Human Aorta Is a Passive Pump

    Science.gov (United States)

    Pahlevan, Niema; Gharib, Morteza

    2012-11-01

    Impedance pump is a simple valveless pumping mechanism that operates based on the principles of wave propagation and reflection. It has been shown in a zebrafish that a similar mechanism is responsible for the pumping action in the embryonic heart during early stages before valve formation. Recent studies suggest that the cardiovascular system is designed to take advantage of wave propagation and reflection phenomena in the arterial network. Our aim in this study was to examine if the human aorta is a passive pump working like an impedance pump. A hydraulic model with different compliant models of artificial aorta was used for series of in-vitro experiments. The hydraulic model includes a piston pump that generates the waves. Our result indicates that wave propagation and reflection can create pumping mechanism in a compliant aorta. Similar to an impedance pump, the net flow and the flow direction depends on the frequency of the waves, compliance of the aorta, and the piston stroke.

  8. Mechanical characterization of human aortas from pressurization testing and a paradigm shift for circumferential residual stress.

    Science.gov (United States)

    Labrosse, Michel R; Gerson, Eleanor R; Veinot, John P; Beller, Carsten J

    2013-01-01

    Material properties needed for accurate stress analysis of the human aorta are still incompletely known, especially as many reports have ignored the presence of residual stresses in the aortic wall. To contribute new material regarding these issues, we carried out measurements and pressurization testing on ascending, thoracic and abdominal aortic samples from 24 human subjects aged 38-77 years, and evaluated the opening angle describing the circumferential residual stress level present in the aorta. We determined material constants for the aorta by gender, anatomic location and age group, according to a simple phenomenological constitutive model. The unpressurized aortic radius positively correlated with age, and the circumferential and longitudinal stretch ratios under systemic pressure negatively correlated with age, confirming the known enlargement and stiffening of the aorta with aging. The opening angle was measured to range from a minimum of 89° to above 360° for extreme cases. For given aortic dimensions and material properties, analysis of the in vivo circumferential and longitudinal mural stress distributions indicated a profound influence of the opening angle. For instance, in the thoracic aorta of males aged 38-66, opening angles in the range of 0° to 80° (resp. 60°) may equalize the gradient of in vivo circumferential (resp. longitudinal) stress between the inner and outer layers of the aorta, as commonly expected; however, opening angles above 160° (resp. 120°) may cause the gradient of circumferential (resp. longitudinal) stress to reverse and increase compared to the case without residual stress, putting the maximum stresses toward the adventitia instead of the intima. Even though the analysis of the aortic wall excluded possible longitudinal residual stresses as well as material inhomogeneities, such as constitutive differences between the intimal, medial and adventitial layers, the experimental data reported herein are important to aortic

  9. Calcification of thoracic aorta - solar eclipse sign.

    Science.gov (United States)

    Dhoble, Abhijeet; Puttarajappa, Chethan

    2008-08-29

    Calcification of thoracic aorta is very common in old people, especially ones with hypertension. This can sometime be visible on plain chest radiograph. We present a case of a male patient who had extensive deposition of calcium in the thoracic aorta. The relationship between aortic calcification and coronary atherosclerosis remains contentious. Computed tomography of the thorax can display this calcification which appears like 'solar eclipse'.

  10. Physicians' Abdominal Auscultation

    DEFF Research Database (Denmark)

    John, Gade; Peter, Kruse; Andersen, Ole Trier

    1998-01-01

    Background: Abdominal auscultation has an important position in the physical examination of the abdomen. Little is known about rater agreement. The aim of this study was to describe rater agreement and thus, indirectly, the value of the examination. Methods: In a semi-virtual setup 12 recordings...... of the intestinal sounds from 8 patients with acute abdominal pain and 4 healthy volunteers were presented to 100 physicians. The physicians were asked to characterize the intestinal sounds as normal or pathologic. Fisher's exact test was used for comparison between groups of physicians. Results: Overall, 72......% of the answers with regard to healthy volunteers concluded that the sounds were normal (equalling agreement), whereas 64% of answers with regard to intestinal obstruction concluded that the sounds were pathologic (but agreement was higher due to agreement on wrong diagnosis in one case). Bowel sounds from...

  11. A case of abdominal aortic thrombosis associated with the nephrotic syndrome

    Directory of Open Access Journals (Sweden)

    Jannet Labidi

    2017-01-01

    Full Text Available Thromboembolic disease is an important and frequent complication in patients with the nephrotic syndrome (NS, and the consequences are often severe. Usually, the venous system is affected. Arterial thrombosis has rarely been reported and occurs mainly in children. We report the case of a 27-year-old man with a history of NS due to focal and segmental glomerulosclerosis resistant to steroids and cyclosporine, admitted for bilateral pain in the calves. Aortogram revealed a suspended thrombus in the abdominal aorta just below the origin of the renal arteries with embolism into the left tibioperoneal trunk and the right anterior tibial artery. Endarterectomy was performed followed by systemic heparinization with a good outcome. Arterial thrombosis is rare and must be prevented.

  12. Severe diffuse hypoplasia of the aorta associated with multiple vascular abnormalities.

    Science.gov (United States)

    Grebeldinger, Slobodan P; Balj, Svetlana S; Adic, Oto

    2011-06-01

    Hypoplasia of the thoracic and abdominal aorta is an extremely rare vascular pathology. The most common clinical manifestation is severe uncontrolled hypertension in adolescents and young adults. Medical treatment alone can decrease blood pressure, but often very high doses of antihypertensive drugs are needed. When hypertension is refractory to the antihypertensive medications, surgical revascularization is considered as the treatment of choice. We report the case of a severe and diffuse hypoplasia of the aorta, beginning with the aortic isthmus, to the aortic bifurcation, associated with an aberrant celiac trunk and superior mesenteric artery, and with other multiple vascular abnormalities. Unlikely, the only manifestation of this extensive vascular malformation was medicamentously controllable hypertension. To our knowledge, this severe vascular anomaly, with such a minimal clinical manifestation, has not been previously described in the English literature.

  13. Abdominal aortic thrombosis in association with an attempted Heimlich maneuver.

    Science.gov (United States)

    Roehm, E F; Twiest, M W; Williams, R C

    1983-03-04

    We report herein a case of an incorrectly applied Heimlich maneuver--to the best of our knowledge, the first reported fatal complication associated with a Heimlich maneuver, acute thrombosis of an abdominal aortic aneurysm, and the distal aorta. While the Heimlich maneuver is effective for the relief of foreign body-induced upper airway obstruction, increased efforts should be directed toward instructing the public in correctly recognizing and optimally treating airway obstruction.

  14. Estimation of prenatal aorta intima-media thickness from ultrasound examination

    Science.gov (United States)

    Veronese, E.; Tarroni, G.; Visentin, S.; Cosmi, E.; Linguraru, M. G.; Grisan, E.

    2014-10-01

    Prenatal events such as intrauterine growth restriction and increased cardiovascular risk in later life have been shown to be associated with an increased intima-media thickness (aIMT) of the abdominal aorta in the fetus. In order to assess and manage atherosclerosis and cardiovascular disease risk in adults and children, in recent years the measurement of abdominal and carotid artery thickness has gained a growing appeal. Nevertheless, no computer aided method has been proposed for the analysis of prenatal vessels from ultrasound data, yet. To date, these measurements are being performed manually on ultrasound fetal images by skilled practitioners. The aim of the presented study is to introduce an automatic algorithm that identifies abdominal aorta and estimates its diameter and aIMT from routine third trimester ultrasonographic fetal data. The algorithm locates the aorta, then segments it and, by modeling the arterial wall longitudinal sections by means of a gaussian mixture, derives a set of measures of the aorta diameter (aDiam) and of the intima-media thickness (aIMT). After estimating the cardiac cycle, the mean diameter and the aIMT at the end-diastole phase are computed. Considering the aIMT value for each subject, the correlation between automatic and manual end-diastolic aIMT measurements is 0.91 in a range of values 0.44-1.10 mm, corresponding to both normal and pathological conditions. The automatic system yields a mean relative error of 19%, that is similar to the intra-observer variability (14%) and much lower that the inter-observer variability (42%). The correlation between manual and automatic measurements and the small error confirm the ability of the proposed system to reliably estimate aIMT values in prenatal ultrasound sequences, reducing measurement variability and suggesting that it can be used for an automatic assessment of aIMT. Preliminary results have been presented in E Veronese, E Cosmi, S Visentin, E Grisan: 'Semiautomatic estimation

  15. Pseudoprominent aorta: Radiographic findings and CT correlation

    Energy Technology Data Exchange (ETDEWEB)

    Brown, K.T.; Shepard, J.A.O.; Stewart, W.J.

    1985-05-01

    The presence of a persistent left-sided superior vena cava (LSVC) in the absence of a right-sided superior vena cava (RSVC) may be suspected on a posteroanterior (PA) chest radiograph because of a prominent-appearing ascending aorta, which results from the absence of the RSVC. In the absence of an RSVC, the right upper lobe abuts and outlines the course of the ascending aorta, allowing better demonstration of its profile. This report describes a patient with this finding on a PA chest radiograph. Computed tomographic correlation is presented.

  16. Digital subtraction angiography of the thoracic aorta

    Energy Technology Data Exchange (ETDEWEB)

    Grossman, L.B.; Buonocore, E.; Modic, M.T.; Meaney, T.F.

    1984-02-01

    Forty-three patients with acquired and congenital abnormalities of the thoracic aorta were studied using digital subtraction angiography (DSA) after an intravenous bolus injection of 40 ml of contrast material. Abnormalities studied included coarctation, pseudocoarctation, Marfan syndrome, cervical aorta, double aortic arch, aneurysm, dissection, and tumor. Twenty-four patients also had conventional angiography. DSA was accurate in 95% of cases; in the other 5%, involving patients with acute type I dissection, the coronary arteries could not be seen. The authors concluded that in 92% of their patients, DSA could have replaced the standard aortogram.

  17. Mycotic aneurysm rupture of the descending aorta

    Energy Technology Data Exchange (ETDEWEB)

    Gufler, H.; Buitrago-Tellez, C.H.; Nesbitt, E.; Hauenstein, K.H. [Department of Radiology, Albert-Ludwigs-Universitaet, Freiburg (Germany)

    1998-03-01

    A 69-year-old diabetic male with salmonella bacteremia developed hypovolemic shock and swelling of the neck. A CT examination revealed massive mediastinal hemorrhage extending into the neck soft tissues caused by false aneurysm rupture of the descending thoracic aorta. Aortography showed continuous extravasation from a large leak at the medial side of the descending thoracic aorta. Although surgical intervention was immediately performed, the patient died 3 weeks later from multiple-organ failure. In this report, CT and angiographic findings of mycotic aneurysm rupture are presented and a review is given. (orig.) With 2 figs., 11 refs.

  18. Hybrid Endovascular Aorta Repair with Simultaneous Supra-aortic Branch or Iliac Branch Revascularization

    Institute of Scientific and Technical Information of China (English)

    Yue-hong Zheng; Nim Choi; Hong-ru Deng; CU Kouk; Kun Yu; Furtado Rui

    2009-01-01

    Objective To describe a hybrid endovascular procedure for aorta repair with different kinds of bypass followed by concomitant placement of stent graft in the aorta.Methods From June 2007 to May 2008,5 consecutive patients who presented with aortic aneurysm or dissection were treated with a new hybrid aorta repair technique.Complete surgical rerouting of supra-aortic vessels was simultaneously created by endovascular repair of aortic arch aneurysm with stent graft.Hybrid left carotid-subclavian bypass with stent graft deployment covering the ostium of the left subclavian artery was performed in a Debakey type Ⅲ aortic dissection case.The supra-aortic branch was revascularized in 2 cases from ascending aorta to bilateral common carotid arteries using a 16-8 mm bifurcated graft,then total aortic arch and descending artery was occluded with stent-graft.The left carotid artery to the left subclavian artery bypass was created in 1 case,followed by stent-graft deployment.Two cases of infrarenal abdominal aortic aneurysm underwent left external iliac artery to left internal iliac artery bypass by a retroperineal route,then hybrid procedure was performed with bifurcated stent-graft.All stent grafts were deployed via a retrograde femoral artery approach in 5 patients.Results Technical success with complete aneurysmal exclusion was achieved in all patients.There was no incidence of endoleak.During a follow-up period of 2 to 10 months,documented perioperative neurologic events did not occur in all patients.One patient suffered from adult respiratory distress syndrome.After received tracheostomy,he recovered later.There was one death resulting from a postoperative myocardial infarction.Conclusion Hybrid arch repair provides an alternative therapy to patients otherwise considered prohibitively high risk for traditional open arch and thoracoabdominal aorta repair.

  19. [Abdominal pregnancy care. Case report].

    Science.gov (United States)

    Morales Hernández, Sara; Díaz Velázquez, Mary Flor; Puello Tamara, Edgardo; Morales Hernández, Jorge; Basavilvazo Rodríguez, Maria Antonia; Cruz Cruz, Polita del Rocío; Hernández Valencia, Marcelino

    2008-10-01

    Abdominal pregnancies are the implantation of gestation in some of the abdominal structures. This kind of pregnancies represents sevenfold maternal death risk than tubarian ectopic pregnancies, and 90-fold death risk than normal ones. Previous cases have erroneously reported as abscess in Douglas punch, and frequently result in obitus or postnatal deaths. We report a case of a patient with 27 years old, and diagnosis of 25.2 weeks of pregnancy, prior placenta and anhidramnios, referred due to difficult in uterine contour delimitation, easy palpation of fetal parts, cephalic pole in left hypochondrious and presence of mass in hypogastria, no delimitations, pain with mobilization, no transvaginal bleed and fetal movements. Interruption of pregnancy is decided by virtue of severe oligohidramnios, retardation in fetal intrabdominal growth, and recurrent maternal abdominal pain. Surgical intervention was carried out for resolution of the obstetrical event, in which was found ectopic abdominal pregnancy with bed placental in right uterine horn that corresponded to a pregnancy of 30 weeks of gestation. Abdominal pregnancy is still a challenge for obstetrics due to its diagnosis and treatment. Early diagnosis is oriented to prevent an intrabdominal hemorrhage that is the main maternal cause of mortality.

  20. Correção cirúrgica de aneurismas da aorta torácica por técnica de exclusão Surgical correction of aneurysms of the thoracic aorta using the aneurysmal exclusion technique

    Directory of Open Access Journals (Sweden)

    Bayard Gontijo Filho

    1988-04-01

    Full Text Available São apresentados 14 pacientes portadores de aneurisma da aorta torácica (4 do arco aórtico e 10 da aorta descendente, com importantes complicações pré-operatórias, que foram submetidos a correção cirúrgica através de técnica de exclusão da área aneurismática. Esta exclusão foi realizada através de um desvio extra-anatômico entre a aorta ascendente e a aorta abdominal, associado a ligadura da aorta, acima e abaixo do aneurisma. Em 5 pacientes, esta ligadura foi realizada com uso de suturas mecânicas (stapler. Houve 6 (42,8% óbitos no período pós-operatório, quase todos relacionados a grave condição clínica pré-operatória, em pacientes portadores de discussão aórtica aguda (tipo B. Dos 8 pacientes sobreviventes, 7 encontram-se em controle clínico por período de 6 meses a 4 anos, com boa evolução. Todos demonstraram redução progressiva do aneurisma, após a cirurgia, tendo, em alguns casos, ocorrido desaparecimento completo do mesmo.The authors report their experience with 14 patients who underwent correction of aneurysms of the aortic arch and descending thoracic aorta, utilizing a technique based on aortic exclusion. The approach was accomplished with an ascending abdominal aortic by-pass, and the aneurysm was isolated with a ligature of the aorta above and below it. In 5 patients, this ligature was done with staplers. Six patients died in the immediate post-operative period, mainly from preoperative clinical condition related to acute aortic dissection of the descending thoracic aorta. Severn patients have been followed from 6 months to 4 years and all of them showed a progressive reduction of the aneurysmal sac.

  1. Thoracic aorta stent grafting through transapical access.

    NARCIS (Netherlands)

    Saouti, N.; Vos, J.A.; Heuvel, D. van de; Morshuis, W.J.; Heijmen, R.H.

    2015-01-01

    BACKGROUND: To describe the transapical approach for thoracic endovascular aortic repair (TEVAR). METHODS: Three patients, 2 elective and 1 emergent, with thoracic aorta aneurysm are described with vascular or direct aortic inaccessible access, who underwent TEVAR through transapical access. The tec

  2. Platelet affinity for burro aorta collagen

    Energy Technology Data Exchange (ETDEWEB)

    Schneider, M.D.

    1977-10-01

    Despite ingenious concepts, there are no unequivocal clues as to what, when, and how some undefined biochemical factor(s) or constituent(s) that localizes in the arterial wall can precipitate a thromboatheromatous lesion or arterial disease. The present study focused on the extraction, partial purification, and characterization of a collagen-active platelet stimulator from the aortas of aged burros. The aggregator moiety in the aorta extracts invariably had a higher affinity for platelets in citrated platelet-rich plasma of human beings than for platelets of homologous burros. The platelet-aggregating factor(s) in the aorta extract was retained by incubation with ..cap alpha..-chymotrypsin. Platelet-aggregating activity was rapidly abolished after incubation with collagenase, as determined by platelet-aggregometry tests. Evidence based on light microscope and polysaccharide histochemical reactions indicates a probability that the intracellular amorphous matrix (PAS-positive) and filamentous components (PTAH-positive) expelled from smooth muscle cells disrupted during homogenization of the aorta may be a principal source of a precursor collagen species which is a potent inducer of platelet aggregation.

  3. [Ascending aorta-supraceliac++ aorta bypass. Correction of a case of atypical coarctation in the adult].

    Science.gov (United States)

    Vaquero, F; Zorita, A; Samos, R F; Vázquez, J G; Ortega, J M; Morán, C F

    1993-01-01

    A case of atypic coarctation at the aortic arch in an adult patient is described. Coarctation was surgically treated by a retrosternal bypass from the ascendant aorta to the supra-celiac aorta. After a short prelude the clinical case is summarized. Furthermore, the etiopathogenic features of the disease, the different diagnostic methods and the multiple surgical procedures are discussed. Finally, we briefly review the literature.

  4. Surgical or endovascular therapy of abdominal penetrating aortic ulcers and their natural history: a systematic review.

    Science.gov (United States)

    Georgiadis, George S; Antoniou, George A; Georgakarakos, Efstratios I; Nikolopoulos, Evagelos S; Papanas, Nikolaos; Trellopoulos, George; Iatrou, Christos; Papadopoulou, Maria Z; Lazarides, Miltos K

    2013-10-01

    Little is known regarding the outcomes of endovascular and surgical treatment of penetrating ulcers in the abdominal aorta. The potential benefit of conservative management of asymptomatic disease is also debatable. A systematic review of the literature was undertaken to investigate these issues.

  5. Validation and application of intravascular ultrasound in endovascular treatment of abdominal aortic aneurysm

    NARCIS (Netherlands)

    J.A. van Essen (Anthonie)

    2000-01-01

    textabstractAn abdominal aortic aneurysm (AAA) is a localized and permanent dilatation of the aorta that presents a clear danger for the patient because of the risk of rupture. The chance of rupture increases with the size of the aneurysm. Mortality after rupture is high: 60-70% of patients with

  6. Validation and application of intravascular ultrasound in endovascular treatment of abdominal aortic aneurysm

    NARCIS (Netherlands)

    J.A. van Essen (Anthonie)

    2000-01-01

    textabstractAn abdominal aortic aneurysm (AAA) is a localized and permanent dilatation of the aorta that presents a clear danger for the patient because of the risk of rupture. The chance of rupture increases with the size of the aneurysm. Mortality after rupture is high: 60-70% of patients with a r

  7. Intramural hemorrhage of the thoracic aorta - imaging features and differential diagnosis; Das intramurale Haematom der thorakalen Aorta: Bildgebende Diagnostik und Differentialdiagnose

    Energy Technology Data Exchange (ETDEWEB)

    Sommer, T. [Bonn Univ. (Germany) Radiologische Klinik; Abu-Ramadan, D. [Bonn Univ. (Germany). Klinik fuer Herz- und Gefaesschirurgie; Busch, M. [Bonn Univ. (Germany) Radiologische Klinik; Bierhoff, E. [Bonn Univ. (Germany). Pathologische Inst.; Kreft, B. [Bonn Univ. (Germany) Radiologische Klinik; Kuhl, C. [Bonn Univ. (Germany) Radiologische Klinik; Lutterbey, G. [Bonn Univ. (Germany) Radiologische Klinik; Keller, E. [Bonn Univ. (Germany) Radiologische Klinik; Schild, H. [Bonn Univ. (Germany) Radiologische Klinik

    1996-09-01

    Purpose: Aortic wall thickening due to intramural hemorrhage may be the only sign of aortic dissection. The aim of this study was to evaluate the incidence, imaging features and differential diagnoses of intramural hemorrhage (IMH) of the thoracic aorta. Methods: 98 patients with clinically suspected aortic dissection were investigated via Spiral-CT and MRT. Diagnosis of IMH based on the presence of smooth crescentic or concentric wall thickening over a longer segment of the thoracic aorta without flow visualization and without compression or distortion of the aortic lumen. Results: 69 patients had classic aortic dissections and 7 patients were diagnosed to have IMH of the thoracic aorta. One patient with IMH of the ascending aorta died of aortic rupture and subsequent pericardial tamponade 12 hours after onset of symptoms. In one patient with IMH of the descending aorta on initial examination, there was a progression of overt aortic dissection at follow-up after three weeks. In two patients with IMH of the descending aorta, wall thickening decreased in size at follow-up (10-15 weeks), whereas in one patient it remained unchanged. Conclusion: IMH of the aorta should be considered a precursor of aortic dissection. At follow-up IMH may decrease in size, rupture or progress to overt aortic dissection. (orig.) [Deutsch] Ziel: Eine aortale Wandverdichtung als Ausdruck eines intramuralen Haematoms kann die einzige Manifestation einer Aortendissektion sein. Ziel dieser Arbeit war die Evaluierung der Inzidenz, bildgebenden Aspekte und Differentialdiagnosen dieses in der deutschsprachigen Literatur wenig bekannten Krankheitsbildes. Methode: 98 Patienten mit klinischem Verdacht auf eine Aortendissektion wurden MR- und computertomographisch untersucht. Kriterium fuer das Vorliegen eines intramuralen Haematoms war der Nachweis einer laengerstreckigen aortalen Wandverdickung ohne Flussnachweis sowie ohne Konfigurationsaenderung des aortalen Lumens. Ergebnisse: 69 Patienten

  8. Age-associated pro-inflammatory adaptations of the mouse thoracic aorta.

    Science.gov (United States)

    Hemmeryckx, Bianca; Hoylaerts, Marc F; Deloose, Eveline; Van Hove, Cor E; Fransen, Paul; Bult, Hidde; Lijnen, H Roger

    2013-10-01

    Arterial ageing may be associated with a reduction in vasodilation due to increased reactive oxygen species (ROS) production, whereas endothelial cell activation induces procoagulant changes. However, little is known on the effect of ageing on expression of anticoagulant endothelial markers such as endothelial protein C receptor (EPCR). To study age-associated alterations in smooth muscle cell (SMC) and endothelial cell (EC) structure and function, the aorta was isolated from 10-week- and 12- and 24-month-old C57BL/6J mice and analysed for its expression of genes involved in senescence, oxidative stress production, coagulation and matrix remodelling. In addition, vasorelaxation experiments were performed using 10-week- and 24-month-old thoracic aortic ring segments in organ chamber baths. The media thickness of the thoracic aorta progressively increased with age, associated with hypertrophy of vascular SMCs. Basal nitric oxide production and sensitivity to acetylcholine-mediated vasodilation in thoracic aorta rings was reduced with age, whereas no significant differences in ROS production could be demonstrated. Gene expression of tissue factor, EPCR and von Willebrand factor was not affected by ageing of the aorta, whereas that of thrombomodulin was mildly reduced and that of xanthine dehydrogenase, NADPH oxidase 4, tumour necrosis factor-α and vascular cell adhesion molecule-1 significantly enhanced. In conclusion, a reduction in endothelial cell-mediated vasodilation in aged thoracic aortas of C57BL/6J mice was accompanied by a shift towards a pro-inflammatory state of the endothelium.

  9. Polydimethylsiloxane embedded mouse aorta ex vivo perfusion model: proof-of-concept study focusing on atherosclerosis.

    Science.gov (United States)

    Wang, Xueya; Wolf, Marc P; Keel, Rahel Bänziger; Lehner, Roman; Hunziker, Patrick R

    2012-07-01

    Existing mouse artery ex vivo perfusion models have utilized arteries such as carotid, uterine, and mesenteric arteries, but not the aorta. However, the aorta is the principal vessel analyzed for atherosclerosis studies in vivo. We have devised a mouse aorta ex vivo perfusion model that can bridge this gap. Aortas from apoE((-/-)) mice are embedded in a transparent, gas-permeable, and elastic polymer matrix [polydimethylsiloxane (PDMS)] and artificially perfused with cell culture medium under cell culture conditions. After 24 h of artificial ex vivo perfusion, no evidence of cellular apoptosis is detected. Utilizing a standard confocal microscope, it is possible to image specific receptor targeting of cells in atherosclerotic plaques during 24 h. Imaging motion artifacts are minimal due to the polymer matrix embedding. Re-embedding of the aorta enables tissue sectioning and immuno-histochemical analysis. The ex vivo data are validated by comparison with in vivo experiments. This model can save animal lives via production of multiple endpoints in a single experiment, is easy to apply, and enables straightforward comparability with pre-existing atherosclerosis in vivo data. It is suited to investigate atherosclerotic disease in particular and vascular biology in general.

  10. 'Aorta-in-aorta' sign on chest radiograph representing enlarged left superior intercostal and hemiazygos veins

    Energy Technology Data Exchange (ETDEWEB)

    Sung, Yon Mi; Lee, Kyung Soo; Kim, Tae Sung [School of Medicine, Sungkyunkwan Univ., Seoul (Korea, Republic of)

    2002-06-01

    We recently encountered a patient with membranous obstruction of the inferior vena cava in whom the left superior intercostal and hemiazygos veins were dilated. At chest radiography, the dilation simulated the presence of a second aortic knob and descending thoracic aorta lateral to the originals, and an 'aorta-in-aorta' appearance was thus created.

  11. Non-infectious Pseudoaneurysm of Ascending Aorta Following Redo-Aortic Valve Replacement

    Directory of Open Access Journals (Sweden)

    Nozari Younes

    2009-05-01

    Full Text Available A 46 year old man had been undergone Aortic valve replacement (AVR due to mechanical aortic valve endocarditis two month ago. He was referred to Imam Khomeini hospital because of dyspnea since two weeks ago. Echocardiography showed the false aneurysm, with an area of flow beyond the lumen of the aorta. This patient underwent reoperation, the previously implanted aortic valve was removed, meticulous debridement was performed in aortic valve annulus and adjacent part of the ascending aorta, and aortic valve and root replacement were performed.

  12. Massive Gastrointestinal Bleed as Presentation for Previously Undiagnosed Coarctation of Aorta.

    Science.gov (United States)

    Neubrand, Tara; Mistry, Rakesh; Lefort, Roxanna

    2016-04-01

    Coarctation of the aorta is a common congenital heart lesion with a known complication of collateral vessel formation if left untreated. To alert pediatric emergency physicians of a rare and life-threatening presentation of previously undiagnosed congenital heart disease in the adolescent. We discuss the case of a 15-year-old boy who presented with hypertension and massive upper GI bleed due to aortoenteric fistula formation associated with undiagnosed coarctation of the aorta. There are no other reports of a similar presentation in the literature.

  13. Thoracic aorta aneurysm open repair in heart transplant recipient; the anesthesiologist′s perspective

    Directory of Open Access Journals (Sweden)

    Fabrizio Monaco

    2016-01-01

    Full Text Available Many years following transplantation, heart transplant recipients may require noncardiac major surgeries. Anesthesia in such patients may be challenging due to physiological and pharmacological problems regarding allograft denervation and difficult immunosuppressive management. Massive hemorrhage, hypoperfusion, renal, respiratory failure, and infections are some of the most frequent complications related to thoracic aorta aneurysm repair. Understanding how to optimize hemodynamic and infectious risks may have a substantial impact on the outcome. This case report aims at discussing risk stratification and anesthetic management of a 54-year-old heart transplant female recipient, affected by Marfan syndrome, undergoing thoracic aorta aneurysm repair.

  14. [Anesthetic management of a patient with aortocaval fistula caused by rupture of a huge abdominal aortic aneurysm into the inferior vena cava].

    Science.gov (United States)

    Tanaka, Motonari; Kawashima, Akira; Kuremoto, Yoshito; Tanada, Kazuko

    2013-12-01

    Aortocaval fistula is a rare complication of ruptured abdominal aortic aneurysm. We report anesthetic management of a patient with aortocaval fistula caused by rupture of a huge abdominal aortic aneurysm into the inferior vena cava. A 51-year-old man who had complained of low back pain and general fatigue was referred to our hospital because of his liver damage. Aortocaval fistula due to rupture of a huge abdominal aortic aneurysm was diagnosed from physical examination, enhanced computed tomography and color Doppler ultrasonography. Anesthesia was induced with propofol and rocuronium, and was maintained with sevoflurane and remifentanil. After induction of anesthesia, the central venous pressure and cardiac index showed remarkably high values because of arteriovenous shunt. When the aneurysm was incised after the clamping of the abdominal aorta, massive venous bleeding occurred from the fistula and caused severe hypotension. Blood pressure recovered by digital compression of the bleeding point and the use of an autotransfusion device. After the repair of the aortocaval fistula, the hemodynamics became stable. The patient had a high output but a good cardiac function in preoperative examination. Therefore anesthesia was managed successfully without worsening high-output heart failure.

  15. Dissecting aneurysm of arch and descending thoracic aorta presenting as a left sided hemorrhagic pleural effusion

    Directory of Open Access Journals (Sweden)

    Shamim Shelley

    2010-01-01

    Full Text Available The most common cause of massive hemorrhagic effusion is malignancy. Herein we present a case of dissecting aneurysm of descending thoracic aorta presenting initially with shortness of breath due to left sided massive pleural effusion. Effusion was hemorrhagic in nature with high hematocrit value. CT scan of thorax with CT angiogram was done and that revealed the diagnosis.

  16. Coarctatio aortae: 40 års opfølgning efter kirurgisk korrektion - sekundaerpublikation

    DEFF Research Database (Denmark)

    Høimyr, Hilde; Pedersen, Thais A L; Christensen, Thomas D;

    2009-01-01

    Coarctation of the aorta (CoA) was previously considered cured after surgical repair. Among 229 patients operated for CoA in Aarhus between 1965 and 1985, 14 died at surgery and 35 died during 20-40 years of follow-up, mainly due to cardiovascular disease. The mortality among CoA patients was 4...

  17. Abdominal radiation - discharge

    Science.gov (United States)

    Radiation - abdomen - discharge; Cancer - abdominal radiation; Lymphoma - abdominal radiation ... When you have radiation treatment for cancer, your body goes through changes. About 2 weeks after radiation treatment starts, you might notice changes ...

  18. Abdominal and Pelvic CT

    Medline Plus

    Full Text Available ... accurate. In emergency cases, it can reveal internal injuries and bleeding quickly enough to help save lives. ... kidney and bladder stones. abdominal aortic aneurysms (AAA), injuries to abdominal organs such as the spleen, liver, ...

  19. Abdominal and Pelvic CT

    Medline Plus

    Full Text Available ... accurate. In emergency cases, it can reveal internal injuries and bleeding quickly enough to help save lives. ... kidney and bladder stones. abdominal aortic aneurysms (AAA), injuries to abdominal organs such as the spleen, liver, ...

  20. Aorta Structural Alterations in Term Neonates: The Role of Birth and Maternal Characteristics

    Directory of Open Access Journals (Sweden)

    Marco Matteo Ciccone

    2013-01-01

    Full Text Available Aim. To evaluate the influence of selected maternal and neonatal characteristics on aorta walls in term, appropriately grown-for-gestational age newborns. Methods. Age, parity, previous abortions, weight, height, body mass index before and after delivery, smoking, and history of hypertension, of diabetes, of cardiovascular diseases, and of dyslipidemia were all assessed in seventy mothers. They delivered 34 males and 36 females healthy term newborns who underwent ultrasound evaluation of the anteroposterior infrarenal abdominal aorta diameter (APAO, biochemical profile (glucose, insulin, total cholesterol, HDL and LDL cholesterol, triglycerides, fibrinogen, and D-dimers homeostasis model assessment [HOMAIR]index, and biometric parameters. Results. APAO was related to newborn length (r=+0.36; P=0.001, head circumference (r=+0.37; P=0.001, gestational age (r=+0.40, P=0.0005, HOMA index (r=+0.24; P=0.04, and D-dimers (r=+0.33, P=0.004. Smoke influenced APAO values (odds ratio: 1.80; confidence interval 95%: 1.05–3.30, as well as diabetes during pregnancy (r=+0.42, P=0.0002. Maternal height influenced neonatal APAO (r=+0.47, P=0.00003. Multiple regression analysis outlined neonatal D-dimers as still significantly related to neonatal APAO values. Conclusions. Many maternal and neonatal characteristics could influence aorta structures. Neonatal D-dimers are independently related to APAO.

  1. [Ascending aorta replacement late after aortic valve replacement].

    Science.gov (United States)

    Hayashi, Yasunari; Ito, Toshiaki; Maekawa, Atsuo; Sawaki, Sadanari; Fujii, Genyo; Hoshino, Satoshi; Tokoro, Masayoshi; Yanagisawa, Junji

    2013-07-01

    Replacement of the asceding aorta is indicated in patients undergoing aortic valve replacement( AVR), if the diameter of the ascending aorta is greater than 5.0 cm. If the diameter of the asceding aorta is from 4.0 to 5.0 cm, it was arguable whether replacement of the ascending aorta should be performed. Nine patients who underwent reoperative ascending aorta replacement after AVR were reviewed retrospectively. Reoperation on the asending aorta replacement was performed 11.8±7.2 years (range 1y5m~23y3m) after AVR. Mean patient age was 69.9±6.3 (range 60~81). In 2 cases, reoperations were performed early year after AVR. Although ascending aorta was dilated at the 1st operation, replacement wasn't performed for the age and minimally invasive cardiac surgery (MICS). In 3 cases, reoperations were performed more than 10 years later. On these cases, ascending aorta aneurysm and dissection occurred with no pain and were pointed out by computed tomography(CT) or ultrasonic cardiogram(UCG). We think that patients with dilatation of the ascending aorta should undergo AVR and aorta replacement at the 1st operation regardness of age. It is important that patients who underwent AVR should undergo a regular checkup on the ascending aorta.

  2. Long-term results after repair of ruptured and non-ruptured abdominal aortic aneurysm

    Directory of Open Access Journals (Sweden)

    Kuzmanović Ilija B.

    2004-01-01

    Full Text Available INTRODUCTION Abdominal aortic aneurysm can be repaired by elective procedure while asymptomatic, or immediately when it is complicated - mostly due to rupture. Treating abdominal aneurysm electively, before it becomes urgent, has medical and economical reason. Today, the first month mortality after elective operations of the abdominal aorta aneurysm is less than 3%; on the other hand, significant mortality (25%-70% has been recorded in patients operated immediately because of rupture of the abdominal aneurysm. In addition, the costs of elective surgical treatment are significantly lower. OBJECTIVE The objective of this study is to compare long-term survival of patients that underwent elective or immediate repair of abdominal aortic aneurysm (due to rupture, and to find out the factors influencing the long-term survival of these patients. MATERIAL AND METHODS Through retrospective review of prospectively collected data of the Institute for Cardiovascular Diseases of Clinical Center of Serbia, Belgrade, 56 patients that had elective surgery and 35 patients that underwent urgent operation due to rupture of abdominal aneurysm were followed up. Only the patients that survived 30 postoperative days were included in this review, and were followed up (ranging from 2 to 126 months. Electively operated patients were followed during 58.82 months on the average (range 7 to 122, and urgently operated were followed over 52.26 months (range 2 to 126. There was no significant difference of the length of postoperative follow-up between these two groups. RESULTS During this period, out of electively operated and immediately operated patients, 27 and 22 cases died, respectively. There was no significant difference (p>0,05a of long-term survival between these two groups. Obesity and early postoperative complications significantly decreased long-term survival of both electively and immediately operated patients. Graft infection, ventral hernia, aneurysm of

  3. Abdominal wall fat pad biopsy

    Science.gov (United States)

    Amyloidosis - abdominal wall fat pad biopsy; Abdominal wall biopsy; Biopsy - abdominal wall fat pad ... method of taking an abdominal wall fat pad biopsy . The health care provider cleans the skin on ...

  4. Flow topology in patient-specific abdominal aortic aneurysms during rest and exercise

    Science.gov (United States)

    Arzani, Amirhossein; Shadden, Shawn

    2012-11-01

    Abdominal aortic aneurysm (AAA) is a permanent, localized widening of the abdominal aorta. Flow in AAA is dominated by recirculation, transitional turbulence and low wall shear stress. Image-based CFD has recently enabled high resolution flow data in patient-specific AAA. This study aims to characterize transport in different AAAs, and understand flow topology changes from rest to exercise, which has been a hypothesized therapy due to potential acute changes in flow. Velocity data in 6 patients with different AAA morphology were obtained using image-based CFD under rest and exercise conditions. Finite-time Lyapunov exponent (FTLE) fields were computed from integration of the velocity data to identify dominant Lagrangian coherent structures. The flow topology was compared between rest and exercise conditions. For all patients, the systolic inflow jet resulted in coherent vortex formation. The evolution of this vortex varied greatly between patients and was a major determinant of transport inside the AAA during diastole. During exercise, previously observed stagnant regions were either replaced with undisturbed flow, regions of uniform high mixing, or persisted relatively unchanged. A mix norm measure provided a quantitative assessment of mixing. This work was supported by the National Institutes of Health, grant number 5R21HL108272.

  5. The preventive effect of fish oil on abdominal aortic aneurysm development.

    Science.gov (United States)

    Kugo, Hirona; Zaima, Nobuhiro; Mouri, Youhei; Tanaka, Hiroki; Yanagimoto, Kenichi; Urano, Tetsumei; Unno, Naoki; Moriyama, Tatsuya

    2016-06-01

    Abdominal aortic aneurysm (AAA) is a vascular disease involving gradual dilation of the abdominal aorta and high rupture-related mortality rates. AAA is histologically characterized by oxidative stress, chronic inflammation, and extracellular matrix degradation in the vascular wall. We previously demonstrated that aortic hypoperfusion could cause the vascular inflammation and AAA formation. However, the preventive method for hypoperfusion-induced AAA remains unknown. In this study, we evaluated the effect of fish oil on AAA development using a hypoperfusion-induced AAA animal model. Dilation of the abdominal aorta in the fish oil administration group was smaller than in the control group. Collagen destruction and oxidative stress were suppressed in the fish oil administration group than in the control group. These results suggested that fish oil could prevent the development of AAA induced by hypoperfusion.

  6. Ovariectomy Increases the Participation of Hyperpolarizing Mechanisms in the Relaxation of Rat Aorta

    Science.gov (United States)

    Sagredo, Ana; del Campo, Lara; Martorell, Aina; Navarro, Rocío; Martín, María C.; Blanco-Rivero, Javier; Ferrer, Mercedes

    2013-01-01

    This study examines the downstream NO release pathway and the contribution of different vasodilator mediators in the acetylcholine-induced response in rat aorta 5-months after the loss of ovarian function. Aortic segments from ovariectomized and control female Sprague-Dawley rats were used to measure: the levels of superoxide anion, the superoxide dismutases (SODs) activity, the cGMP formation, the cGMP-dependent protein kinase (PKG) activity and the involvement of NO, cGMP, hydrogen peroxide and hyperpolarizing mechanisms in the ACh-induced relaxation. The results showed that ovariectomy did not alter ACh-induced relaxation; incubation with L-NAME, a NO synthase inhibitor, decreased the ACh-induced response to a lesser extent in aorta from ovariectomized than from control rats, while ODQ, a guanylate cyclase inhibitor, decreased that response to a similar extent; the blockade of hyperpolarizing mechanisms, by precontracting arteries with KCl, decreased the ACh-induced response to a greater extent in aortas from ovariectomized than those from control rats; catalase, that decomposes hydrogen peroxide, decreased the ACh-induced response only in aorta from ovariectomized rats. In addition, ovariectomy increased superoxide anion levels and SODs activity, decreased cGMP formation and increased PKG activity. Despite the increased superoxide anion and decreased cGMP in aorta from ovariectomized rats, ACh-induced relaxation is maintained by the existence of hyperpolarizing mechanisms in which hydrogen peroxide participates. The greater contribution of hydrogen peroxide in ACh-induced relaxation is due to increased SOD activity, in an attempt to compensate for increased superoxide anion formation. Increased PKG activity could represent a redundant mechanism to ensure vasodilator function in the aorta of ovariectomized rats. PMID:24058477

  7. Ovariectomy increases the participation of hyperpolarizing mechanisms in the relaxation of rat aorta.

    Directory of Open Access Journals (Sweden)

    Ana Sagredo

    Full Text Available This study examines the downstream NO release pathway and the contribution of different vasodilator mediators in the acetylcholine-induced response in rat aorta 5-months after the loss of ovarian function. Aortic segments from ovariectomized and control female Sprague-Dawley rats were used to measure: the levels of superoxide anion, the superoxide dismutases (SODs activity, the cGMP formation, the cGMP-dependent protein kinase (PKG activity and the involvement of NO, cGMP, hydrogen peroxide and hyperpolarizing mechanisms in the ACh-induced relaxation. The results showed that ovariectomy did not alter ACh-induced relaxation; incubation with L-NAME, a NO synthase inhibitor, decreased the ACh-induced response to a lesser extent in aorta from ovariectomized than from control rats, while ODQ, a guanylate cyclase inhibitor, decreased that response to a similar extent; the blockade of hyperpolarizing mechanisms, by precontracting arteries with KCl, decreased the ACh-induced response to a greater extent in aortas from ovariectomized than those from control rats; catalase, that decomposes hydrogen peroxide, decreased the ACh-induced response only in aorta from ovariectomized rats. In addition, ovariectomy increased superoxide anion levels and SODs activity, decreased cGMP formation and increased PKG activity. Despite the increased superoxide anion and decreased cGMP in aorta from ovariectomized rats, ACh-induced relaxation is maintained by the existence of hyperpolarizing mechanisms in which hydrogen peroxide participates. The greater contribution of hydrogen peroxide in ACh-induced relaxation is due to increased SOD activity, in an attempt to compensate for increased superoxide anion formation. Increased PKG activity could represent a redundant mechanism to ensure vasodilator function in the aorta of ovariectomized rats.

  8. Fourier transform infrared spectroscopy to quantify collagen and elastin in an in vitro model of extracellular matrix degradation in aorta.

    Science.gov (United States)

    Cheheltani, Rabee; McGoverin, Cushla M; Rao, Jayashree; Vorp, David A; Kiani, Mohammad F; Pleshko, Nancy

    2014-06-21

    Extracellular matrix (ECM) is a key component and regulator of many biological tissues including aorta. Several aortic pathologies are associated with significant changes in the composition of the matrix, especially in the content, quality and type of aortic structural proteins, collagen and elastin. The purpose of this study was to develop an infrared spectroscopic methodology that is comparable to biochemical assays to quantify collagen and elastin in aorta. Enzymatically degraded porcine aorta samples were used as a model of ECM degradation in abdominal aortic aneurysm (AAA). After enzymatic treatment, Fourier transform infrared (FTIR) spectra of the aortic tissue were acquired by an infrared fiber optic probe (IFOP) and FTIR imaging spectroscopy (FT-IRIS). Collagen and elastin content were quantified biochemically and partial least squares (PLS) models were developed to predict collagen and elastin content in aorta based on FTIR spectra. PLS models developed from FT-IRIS spectra were able to predict elastin and collagen content of the samples with strong correlations (RMSE of validation = 8.4% and 11.1% of the range respectively), and IFOP spectra were successfully used to predict elastin content (RMSE = 11.3% of the range). The PLS regression coefficients from the FT-IRIS models were used to map collagen and elastin in tissue sections of degraded porcine aortic tissue as well as a human AAA biopsy tissue, creating a similar map of each component compared to histology. These results support further application of FTIR spectroscopic techniques for evaluation of AAA tissues.

  9. Acute intramural hematoma of ascending aorta. CT findings and clinical outcome

    Energy Technology Data Exchange (ETDEWEB)

    Yamaguchi, Toshio; Sakuyama, Keiko; Hiekata, Tomizou; Yamanaka, Ikuo [St. Marianna Univ., Kanagawa (Japan). Yokohama Seibu Hospital; Kuroki, Kazunori; Ohyama, Yukio; Ishikawa, Tohru; Kawada, Tadanori; Akashi, Katsuya

    1997-12-01

    The purpose of this study was to describe the CT findings and clinical outcomes of nineteen patients with acute intramural hematoma (IMH) of the ascending aorta. Six patients underwent surgery on the emergency basis (3 patients) due to cardiac tamponade (n=2) and dilated aorta (n=1), and on the elective basis (3 patients) due to patent and enlarging false lumen. Among the 13 patients with medical management, four patients died from complications of IMH during the follow-up period (2 days-2.5 years). Transition to aortic dissection or enlargement of an intimal tear was noted in 5 patients (31%) in 1 to 6 weeks after onset. Three patients died of causes not related to IMH. Six patients had been alive 2 to 9 years after onset. Retrospective review revealed 10 patients (53%) as possible surgical candidates, and the other 9 patients as medically treated patients in the long-term follow-up. The surgical group showed cardiac tamponade or shock in 6 patients on admission and had pericardial effusion in all the patients on the initial CT scan. In the patients with acute IMH of the ascending aorta, surgery should be considered for severe clinical symptoms, pericardial effusion and large size of the ascending aorta (more than 4 cm) on CT scan, and for converting to a typical type A aortic dissection. CT scan had a major role in making an early diagnosis, in depicting a dangerous sign, and in monitoring its progression or resolution of IMH. (author)

  10. Abdominal epilepsy in chronic recurrent abdominal pain

    Directory of Open Access Journals (Sweden)

    V Y Kshirsagar

    2012-01-01

    Full Text Available Background: Abdominal epilepsy (AE is an uncommon cause for chronic recurrent abdominal pain in children and adults. It is characterized by paroxysmal episode of abdominal pain, diverse abdominal complaints, definite electroencephalogram (EEG abnormalities and favorable response to the introduction of anti-epileptic drugs (AED. We studied 150 children with chronic recurrent abdominal pain and after exclusion of more common etiologies for the presenting complaints; workup proceeded with an EEG. We found 111 (74% children with an abnormal EEG and 39 (26% children with normal EEG. All children were subjected to AED (Oxcarbazepine and 139 (92% children responded to AED out of which 111 (74% children had an abnormal EEG and 27 (18% had a normal EEG. On further follow-up the patients were symptom free, which helped us to confirm the clinical diagnosis. Context: Recurrent chronic abdominal pain is a common problem encountered by pediatricians. Variety of investigations are done to come to a diagnosis but a cause is rarely found. In such children diagnosis of AE should be considered and an EEG will confirm the diagnosis and treated with AED. Aims: To find the incidence of AE in children presenting with chronic recurrent abdominal pain and to correlate EEG findings and their clinical response to empirical AEDs in both cases and control. Settings and Design: Krishna Institute of Medical Sciences University, Karad, Maharashtra, India. Prospective analytical study. Materials and Methods: A total of 150 children with chronic recurrent abdominal pain were studied by investigations to rule out common causes of abdominal pain and an EEG. All children were then started with AED oxycarbamezepine and their response to the treatment was noted. Results: 111 (74% of the total 150 children showed a positive EEG change suggestive of epileptogenic activity and of which 75 (67.56% were females and 36 (32.43% were male, majority of children were in the age of group of 9

  11. [Abdominal ischemia and lesions of the pancreas].

    Science.gov (United States)

    Myshanych, T V; Moskal', O M; Arkhiĭ, E Ĭ; Sozoniuk, O V

    2014-01-01

    The analysis of the results of 50 patients with diseases of coronary heart disease (25 pers.) And chronic pancreatitis (25 people) are submitted. Along with the standard test from these patients underwent Doppler-ultrasonography of abdominal aorta and its visceral branches. Conclusions: A characteristic feature of Doppler indices in AIC is to reduce Vps and Ved, and PI BbA, increase Vps, Ved, IR and PI after exercise in chBA, chC and BbA. At patients with CP with IHD feature is the increase in Ved and IR in the chC, and Ved and PI in BbA under act of loading Bleed a feature at CP with IHD must be taken into account for optimization of treatment of IHD at CP.

  12. [Takayasu's disease disclosed by isolated involvement of the ascending aorta].

    Science.gov (United States)

    Marcaggi, X; Courant, N; Soubrier, M; Kemeny, J L; Camilleri, L; Lusson, J R; Cassagnes, J

    1992-03-01

    The authors report the histological discovery of a case of Takayasu syndrome affecting the ascending aorta. This involvement appearing to concern only the aorta, with no symptomatic complaints nor any laboratory abnormalities indicative of an inflammatory syndrome, corticosteroids were not prescribed. Management consisted of biennial monitoring by transthoracic and transesophageal ultrasonography of the aorta and the supra-aortic main vessels together with monitoring of laboratory parameters.

  13. Abdominal Decompression in Children

    Directory of Open Access Journals (Sweden)

    J. Chiaka Ejike

    2012-01-01

    Full Text Available Abdominal compartment syndrome (ACS increases the risk for mortality in critically ill children. It occurs in association with a wide variety of medical and surgical diagnoses. Management of ACS involves recognizing the development of intra-abdominal hypertension (IAH by intra-abdominal pressure (IAP monitoring, treating the underlying cause, and preventing progression to ACS by lowering IAP. When ACS is already present, supporting dysfunctional organs and decreasing IAP to prevent new organ involvement become an additional focus of therapy. Medical management strategies to achieve these goals should be employed but when medical management fails, timely abdominal decompression is essential to reduce the risk of mortality. A literature review was performed to understand the role and outcomes of abdominal decompression among children with ACS. Abdominal decompression appears to have a positive effect on patient survival. However, prospective randomized studies are needed to fully understand the indications and impact of these therapies on survival in children.

  14. In-situ laser fenestration of endovascular stent-graft in abdominal aortic aneurysm repair (EVAR)

    Science.gov (United States)

    Micheletti, Filippo; Pini, Roberto; Piazza, Roberta; Ferrari, Vincenzo; Condino, Sara; Rossi, Francesca

    2017-02-01

    Endovascular abdominal aortic aneurysms repair (EVAR) involves the minimally invasive implantation of a stent-graft within the aorta to exclude the aneurysm from the circulation thus preventing its rupture. The feasibility of such operation is highly dependent on the aorta morphology and in general the presence of one/both renal arteries emerging from the aneurysm is the absolute limit for the implantation of a standard stent-graft. Consequently, classical intervention methods involve the implantation of a custom-made graft with fenestrations, leading to extremely complicated surgeries with high risks for the patient and high costs. Recent techniques introduced the use of standard grafts (i.e. without fenestrations) in association with mechanical in-situ fenestration, but this procedure is limited principally by the brittleness and low stability of the environment, in addition to the difficulty of controlling the guidance of the endovascular tools due to the temporarily block of the blood flow. In this work we propose an innovative EVAR strategy, which involves in-situ fenestration with a fiber guided laser tool, controlled via an electromagnetic navigation system. The fiber is sensorized to be tracked by means of the driving system and, using a 3D model of the patient anatomy, the surgeon can drive the fiber to the aneurysm, where the stent has been previously released, to realize the proper fenestration(s). The design and construction of the catheter laser tool will be presented, togheter with preliminary fenestration tests on graft-materials, including the effects due to the presence of blood and tissues.

  15. Abdominal Compartment Syndrome

    OpenAIRE

    Ovchinnikov V.А.; Sokolov V.А.

    2013-01-01

    We considered one of the most complicated problems of surgery and intensive care — abdominal compartment syndrome. It is a severe, and in some cases lethal complication developing in major injuries and pathology of abdominal cavity and retroperitoneal space, as well as in extra-abdominal pathology. In addition, compartment syndrome can be the complication of a number of surgical procedures accompanied primarily by laparotomy wound closure with tissue tension. We demonstrated the classificatio...

  16. Abdominal Compartment Syndrome

    Directory of Open Access Journals (Sweden)

    Pınar Zeyneloğlu

    2015-04-01

    Full Text Available Intraabdominal hypertension and Abdominal compartment syndrome are causes of morbidity and mortality in critical care patients. Timely diagnosis and treatment may improve organ functions. Intra-abdominal pressure monitoring is vital during evaluation of the patients and in the management algorithms. The incidence, definition and risk factors, clinical presentation, diagnosis and management of intraabdominal hypertension and Abdominal compartment syndrome were reviewed here.

  17. AORTA: Adding Organizational Reasoning to Agents

    DEFF Research Database (Denmark)

    Jensen, Andreas Schmidt; Dignum, Virginia

    2014-01-01

    the expected behavior of the agents. Agents need to be able to reason about the regulations, so that they can act within the expected boundaries and work towards the objectives of the organization. This extended abstract introduces AORTA, a component that can be integrated into agents’ reasoning mechanism......, allowing them to reason about (and act upon) regulations specified by an organizational model using simple reasoning rules. The added value is that the organizational model is independent of that of the agents, and that the approach is not tied to a specific organizational model....

  18. Tratamento de aneurismas da parte torácica da aorta pela introdução de "stents" sob visão endoscópica

    Directory of Open Access Journals (Sweden)

    José Honório PALMA

    1998-01-01

    Full Text Available Tratamento de paciente com dois aneurismas saculares da aorta descendente, utilizando dois "stents" distintos, manufaturados sob medida tanto em comprimento quanto em diâmetro. Inseridos sob visão endoscópica com aparelho da marca "Olimpus" esterilizado com óxido de etileno, através de abertura na croça da aorta. O procedimento foi realizado por esternotomia mediana, com circulação extracorpórea, em hipotermia profunda e parada circulatória total. A manipulação endoscópica da aorta descendente, sem sangue, permitiu a identificação dos dois aneurismas, assim como a visão dos ramos principais da aorta e a inserção com expansão , na posição exata, dos dois "stents". A evolução pós- operatória foi satisfatória, sendo que este procedimento, inédito, abre uma nova perspectiva no tratamento dos aneurismas torácicos, toracoabdominais e abdominais.This is a case report of a patient with two saccular aneurysms in the thoracic descending aorta. Treatment consisted of the positioning, through an opening in the aortic arch under deep hipothermia and total circulatory arrest, of two auto expandable stents, guided an Olympus endoscope. The bloodless field made possible the identification of the main thoracic and abdominal aortic branches facilitating the positioning and expansion of both stents. Immediate postoperative recovery was excellent. This is a previously unreported way of placing stents and could open a new perspective in the treatment of thoraco, abdominal and thoracic abdominal aortic aneurysms.

  19. [Pathobiological determinants of atherosclerosis in youths: data from a macromorphometric and histomorphometric investigation of the aorta and coronary arteries].

    Science.gov (United States)

    Lesauskaite, Vaiva; Stalioraityte, Elena; Tanganelli, Piero; Epistolato, Maria Carmela

    2004-01-01

    We present a review of data from epidemiological and morphological studies carried out in Kaunas of atherosclerosis in youths. Since 1985, Kaunas has been a Collaborating Center involved with the World Health Organization and International Society and Federation of Cardiology studying the pathobiological determinants of atherosclerosis in youth. During the pilot study (1985-1987), we estimated the prevalence and extent of atherosclerotic lesions in the aorta and coronary arteries correlated to various risk factors in Kaunas residents aged 5 to 44 years. Within the framework of this international study, we compared histomorphometric characteristics of arteries collected from trauma victims aged 5 to 34 years in Budapest (Hungary), Heidelberg (Germany), Kaunas (Lithuania), Yaounde (Cameroon), and Mexico City (Mexico). These data revealed that males from countries with a high mortality from ischemic heart disease (Hungary, Lithuania, Germany) tended to have thicker intima in the thoracic and abdominal aorta and left anterior descending coronary artery than did males from countries with low mortality from ischemic heart disease (Mexico, Cameroon). We detected an increased mean intimal thickness of the abdominal aorta in male smokers aged 25-34 years. Males with hypertension aged 15-24 and 25-34 years had a thicker intima in the aorta and left anterior descending coronary artery than normotensive males. The morphological and epidemiological studies of atherosclerosis in youths carried out in Kaunas demonstrated that aortic and coronary atherosclerotic lesions appeared as early as childhood and advanced until the lesions become clinically apparent in adulthood. Histomorphometric findings support the postulate that increased intimal thickness can be considered a structural determinant of atherogenesis. These data draw attention to the means for the primary prevention of atherosclerosis in youth.

  20. TAVR Through Heavily Calcified Aorta Following Atheroma Retrieval With the "Elevator" Technique.

    Science.gov (United States)

    Senguttuvan, N Boopathy; Ellozy, Sharif; Tejani, Furqan; Kovacic, Jason; Kini, Annapoorna S; Sharma, Samin K; Dangas, George D

    2015-10-01

    An 86-year-old Caucasian female with severe symptomatic, inoperable aortic stenosis was accepted for high-risk transfemoral transcatheter aortic valve replacement (TAVR) approach due to severe calcification of the aorta. During initial passage of a 22 Fr sheath, there was dislodgment with proximal migration of a circumferential tunnel of calcium from the infrarenal aorta. A novel "elevator" technique was used to secure and retrieve the dislodged aorta en bloc back to its original infrarenal aortic position and allow in situ fixation with stenting. A new TAVR system was then successfully placed through the stent and a 23 mm Edwards Sapien valve (Edwards Lifesciences) was implanted as planned. In case of calcification protruding into the lumen of the aorta and limiting the passage of the large valve delivery system sheath, the obstruction can be managed by stenting the calcification against the luminal wall under fluoroscopic and intravascular-ultrasound guidance, allowing successful passage of the valve delivery system. The elevator technique allows axial transportation of any calcified vascular fragments, should they become dislodged.

  1. Increased apoptosis and decreased density of medial smooth muscle cells in human abdominal aortic aneurysms

    Institute of Scientific and Technical Information of China (English)

    ZHANG Jian张健; Jan Schmidt; Eduard Ryschich; Hardy Schumacher; Jens R Allenberg

    2003-01-01

    Objective To determine the increase of apoptosis and the decrease of smooth muscle cells (SMCs) density in human abdominal aortic aneurysms (AAA). Methods In situ terminal transferase-mediated dUTP nick end labeling (TUNEL) was employed to detect apoptosis of SMCs in patients with AAA (n=25) and normal abdominal aortae (n=10). Positive cells were identified by specific cell marker in combination with immunohistochemistry. Meanwhile SMC counting was performed by anti-α-actin immunohistostaining to compare the SMC density. Results TUNEL staining revealed that there was significantly increased apoptosis in AAAs (average 8.6%) compared with normal abdominal aortae (average 0.95%, P<0.01). Double staining showed that most of these cells were SMCs. Counting of α-actin positive SMCs revealed that medial SMC density of AAAs (37.5±7.6 SMCs /HPF) was reduced by 79.1% in comparison with that of normal abdominal aortae (179.2±16.1 SMCs /HPF, P<0.01). Conclusions Significantly increased SMCs of AAA bear apoptotic markers initiating cell death. Elevated apoptosis may result in a decreased density of SMCs in AAA, which may profoundly influence the development of AAA.

  2. Mode B ultrasonography and abdominal Doppler in crab-eating-foxes ( Cerdocyon thous

    Directory of Open Access Journals (Sweden)

    Alanna S.L. Silva

    2014-12-01

    Full Text Available Abstract: Annually hundreds of crab-eating foxes (Cerdocyon thous are referred to rehabilitation centers and zoos in Brazil. The ultrasonographic study of wildlife species is an important tool for a non-invasive and accurate anatomical description and provides important information for wildlife veterinary care. The aim of the present study was to determine the characteristics of the main abdominal organs as well as the vascular indexes of the abdominal aorta and renal arteries of crab-eating foxes (Cerdocyon thous using mode B ultrasonography and Doppler ultrasonography, respectively. Ultrasonographic features of the main abdominal organs were described and slight differences were noticed between ultrasound imaging of abdominal organs of crab-eating foxes and other species. The bladder presented wall thickness of 12±0.01mm, with three defined layers. Both, the right and left kidneys presented corticomedullary ratio of 1:1 and similarly to the adrenals and the liver, they were homogeneous and hypoechoic compared to the spleen. The spleen was homogeneous and hyperechoic compared to the kidneys. The stomach presented 3 to 5 peristaltic movements per minute, wall thickness of 39±0.05mm and lumen and mucosa with hyperechoic and hypoechoic features, respectively. Small and large intestines presented 2 to 3 peristaltic movements per minute, wall thickness of 34±0.03mm and three defined layers with hyperechogenic (submucosa and serosa and hypoechogenic (muscular features. Ovaries of the female crab-eating fox were hypoechoic compared to the spleen and with heterogeneous parenchyma due to the presence of 2x2mm ovarian follicles. Prostates of the six males were regular and with a well defined boundary, with a homogeneous and hyperechoic parenchyma compared to the spleen. Vascular indexes of the abdominal aorta (PSV: 25.60±0.32cm/s; EDV: 6.96±1.68cm/s; PI: 1.15±0.07 e RI: 0.73±0.07 and right (PSV: 23.08±3.34cm/s; EDV: 9.33±2.36cm/s; PI: 1.01±0

  3. Intra-Abdominal Hypertension and Abdominal Compartment Syndrome after Abdominal Wall Reconstruction: Quaternary Syndromes?

    Science.gov (United States)

    Kirkpatrick, A W; Nickerson, D; Roberts, D J; Rosen, M J; McBeth, P B; Petro, C C; Berrevoet, Frederik; Sugrue, M; Xiao, Jimmy; Ball, C G

    2017-06-01

    Reconstruction with reconstitution of the container function of the abdominal compartment is increasingly being performed in patients with massive ventral hernia previously deemed inoperable. This situation places patients at great risk of severe intra-abdominal hypertension and abdominal compartment syndrome if organ failure ensues. Intra-abdominal hypertension and especially abdominal compartment syndrome may be devastating systemic complications with systematic and progressive organ failure and death. We thus reviewed the pathophysiology and reported clinical experiences with abnormalities of intra-abdominal pressure in the context of abdominal wall reconstruction. Bibliographic databases (1950-2015), websites, textbooks, and the bibliographies of previously recovered articles for reports or data relating to intra-abdominal pressure, intra-abdominal hypertension, and the abdominal compartment syndrome in relation to ventral, incisional, or abdominal hernia repair or abdominal wall reconstruction. Surgeons should thus consider and carefully measure intra-abdominal pressure and its resultant effects on respiratory parameters and function during abdominal wall reconstruction. The intra-abdominal pressure post-operatively will be a result of the new intra-peritoneal volume and the abdominal wall compliance. Strategies surgeons may utilize to ameliorate intra-abdominal pressure rise after abdominal wall reconstruction including temporizing paralysis of the musculature either temporarily or semi-permanently, pre-operative progressive pneumoperitoneum, permanently removing visceral contents, or surgically releasing the musculature to increase the abdominal container volume. In patients without complicating shock and inflammation, and in whom the abdominal wall anatomy has been so functionally adapted to maximize compliance, intra-abdominal hypertension may be transient and tolerable. Intra-abdominal hypertension/abdominal compartment syndrome in the specific setting of

  4. 口服莫西沙星致过敏伴腹痛和阴道出血%Allergy complicated with abdominal pain and colporrhagia due to oral moxifloxacin

    Institute of Scientific and Technical Information of China (English)

    姚丹林; 牟红梅

    2015-01-01

    1例45岁女性患者因急性支气管炎自行口服莫西沙星0.4 g。约5 min 后,患者出现周身瘙痒、全身皮肤发红、颜面水肿、声音嘶哑、呕吐、腹痛、腹泻;约25 min 后出现视物模糊、神志恍惚。遂静脉注射甲泼尼龙120 mg,快速静脉滴注0.9%氯化钠注射液1000 ml,但患者腹痛无缓解,服药后1 h 出现阴道出血。腹部超声检查未见明显异常。给予哌替啶100 mg 肌内注射,约30 min 后患者腹痛减轻,口服莫西沙星24 h 后阴道出血停止。患者1个月前有相同发病及诊治经历。%A 45 year-old woman with acute bronchitis took moxifloxacin 0. 4 g orally by herself. She developed pruritus and rubefaction on the whole body,edema in the face,hoarseness,vomiting,abdominal pain,and diarrhea 5 minutes after taking the medicine. About 25 minutes later,she developed clouded vision and became unconscious. She was given an intravenous injection of methylprednisolone 120 mg,and rapid intravenous drip of 0. 9% sodium chloride injection 1 000 ml. But the abdominal pain did not alleviate. She developed colporrhagia one hour after taking the medicine. The result of abdominal ultrasound examination showed no obvious abnormity. Then she was given an intramuscular injection of meperidine 100 mg. About 30 minutes later,her abdominal pain was relieved. Twenty-four hours after receiving moxifloxacin,her colporrhagia was stopped. The patient had a similar experience of morbidity,diagnosis and therapy one month ago.

  5. The clinical application of multi-slice spiral CT angiography in abdominal aortic disease

    Institute of Scientific and Technical Information of China (English)

    2005-01-01

    Objective: To evaluate the clinical application of multi-slice spiral CT angiography(MSCTA) in the assessment of abdominal aortic disease. Methods: Fifty-four patients underwent multi-slice spiral CT angiography of abdomen. Contrast agent (Omnipaque 300 I g/L) 1.5 ml/kg was injected and the injection rate was 3 ml/s. The delay time was determined by bolus tracking technique,Tll level abdominal aorta was set as the target vessel and the threshold was 180-200 Hu, slice width was 3 mm and with a pitch of 4-6.Original data were transferred to working-station to perform functional reconstruction. Results: Ten cases were normal, twenty-eight cases were abdominal aortic aneurysms, five abdominal aortic dissecting aneurysms (Debakay type Ⅲ ) and eleven aortic sclerosis. SSD showed the body of aneurysm and the relationship between aneurysm and adjacent blood vessel, MIP better displayed calcification of blood vessel wall and condition of the stent, MPR demonstrated true and false lumen, rupture site of abdominal aorta intima and mural thrombus. Conclusion: MSCTA axial and reconstruction image can show the extent of abdominal aortic disease and the relationship with adjacent blood vessels. It is a safe, simple and non-invasive examination method.

  6. Recurrent Abdominal Pain

    Science.gov (United States)

    Banez, Gerard A.; Gallagher, Heather M.

    2006-01-01

    The purpose of this article is to provide an empirically informed but clinically oriented overview of behavioral treatment of recurrent abdominal pain. The epidemiology and scope of recurrent abdominal pain are presented. Referral process and procedures are discussed, and standardized approaches to assessment are summarized. Treatment protocols…

  7. [Abdominal pregnancy, institutional experience].

    Science.gov (United States)

    Bonfante Ramírez, E; Bolaños Ancona, R; Simón Pereyra, L; Juárez García, L; García-Benitez, C Q

    1998-07-01

    Abdominal pregnancy is a rare entity, which has been classified as primary or secondary by Studiford criteria. A retrospective study, between January 1989 and December 1994, realized at Instituto Nacional de Perinatología, found 35,080 pregnancies, from which 149 happened to be ectopic, and 6 of them were abdominal. All patients belonged to a low income society class, age between 24 and 35 years, and average of gestations in 2.6. Gestational age varied from 15 weeks to 32.2 weeks having only one delivery at term with satisfactory postnatal evolution. One patient had a recurrent abdominal pregnancy, with genital Tb as a conditional factor. Time of hospitalization varied from 4 to 5 days, and no further patient complications were reported. Fetal loss was estimated in 83.4%. Abdominal pregnancy is often the sequence of a tubarian ectopic pregnancy an when present, it has a very high maternal mortality reported in world literature, not found in this study. The stated frequency of abdominal pregnancy is from 1 of each 3372, up to 1 in every 10,200 deliveries, reporting in the study 1 abdominal pregnancy in 5846 deliveries. The study had two characteristic entities one, the recurrence and two, the delivery at term of one newborn. Abdominal pregnancy accounts for 4% of all ectopic pregnancies. Clinical findings in abdominal pregnancies are pain, transvaginal bleeding and amenorrea, being the cardinal signs of ectopic pregnancy.

  8. Ascending Aorta to Hepatic and Mesenteric Artery Bypassing, in Patients with Chronic Mesenteric Ischemia and Extensive Aortic Disease-A Case Report and Review of the Literature.

    Science.gov (United States)

    Barr, James; Kokotsakis, John; Tsipas, Pantelis; Papapavlou, Prodromos; Velissarios, Konstantinos; Kratimenos, Theodoros; Athanasiou, Thanos

    2017-02-01

    Chronic mesenteric ischemia (CMI) is a rare disorder caused by severe stenosis of the mesenteric arterial supply that results in postprandial pain and weight loss. Treatment options are surgical or endovascular. Surgical bypass can be performed in an antegrade fashion from the supraceliac abdominal aorta (AA) or the distal descending thoracic aorta or in a retrograde fashion from the infrarenal aorta or the common iliac artery. However, in some patients with disease of the descending thoracic aorta or the AA, another site for the proximal anastomosis needs to be found. In this article, we report the case of a 69-year-old man with a thoracoabdominal aortic aneurysm and CMI in whom we performed bypass grafts to the hepatic and superior mesenteric arteries using the ascending aorta as the site for the proximal anastomoses via a median sternolaparotomy. In addition, we performed a literature review of all similar cases and provide an analysis of this technique and an assessment of the success rates.

  9. Abdominal hernias: Radiological features

    Science.gov (United States)

    Lassandro, Francesco; Iasiello, Francesca; Pizza, Nunzia Luisa; Valente, Tullio; Stefano, Maria Luisa Mangoni di Santo; Grassi, Roberto; Muto, Roberto

    2011-01-01

    Abdominal wall hernias are common diseases of the abdomen with a global incidence approximately 4%-5%. They are distinguished in external, diaphragmatic and internal hernias on the basis of their localisation. Groin hernias are the most common with a prevalence of 75%, followed by femoral (15%) and umbilical (8%). There is a higher prevalence in males (M:F, 8:1). Diagnosis is usually made on physical examination. However, clinical diagnosis may be difficult, especially in patients with obesity, pain or abdominal wall scarring. In these cases, abdominal imaging may be the first clue to the correct diagnosis and to confirm suspected complications. Different imaging modalities are used: conventional radiographs or barium studies, ultrasonography and Computed Tomography. Imaging modalities can aid in the differential diagnosis of palpable abdominal wall masses and can help to define hernial contents such as fatty tissue, bowel, other organs or fluid. This work focuses on the main radiological findings of abdominal herniations. PMID:21860678

  10. Traumatic abdominal hernia complicated by necrotizing fasciitis.

    Science.gov (United States)

    Martínez-Pérez, Aleix; Garrigós-Ortega, Gonzalo; Gómez-Abril, Segundo Ángel; Martí-Martínez, Eva; Torres-Sánchez, Teresa

    2014-11-01

    Necrotizing fasciitis is a critical illness involving skin and soft tissues, which may develop after blunt abdominal trauma causing abdominal wall hernia and representing a great challenge for physicians. A 52-year-old man was brought to the emergency department after a road accident, presenting blunt abdominal trauma with a large non-reducible mass in the lower-right abdomen. A first, CT showed abdominal hernia without signs of complication. Three hours after ICU admission, he developed hemodynamic instability. Therefore, a new CT scan was requested, showing signs of hernia complication. He was moved to the operating room where a complete transversal section of an ileal loop was identified. Five hours after surgery, he presented a new episode of hemodynamic instability with signs of skin and soft tissue infection. Due to the high clinical suspicion of necrotizing fasciitis development, wide debridement was performed. Following traumatic abdominal wall hernia (TAWH), patients can present unsuspected injuries in abdominal organs. Helical CT can be falsely negative in the early moments, leading to misdiagnosis. Necrotizing fasciitis is a potentially fatal infection and, consequently, resuscitation measures, wide-spectrum antibiotics, and early surgical debridement are required. This type of fasciitis can develop after blunt abdominal trauma following wall hernia without skin disruption.

  11. [Early detection of abdominal aortic aneurysm in risk population].

    Science.gov (United States)

    Enríquez-Vega, María Elizabeth; Solorio-Rosete, Hugo Francisco; Cossío-Zazueta, Alfonso; Bizueto-Rosas, Héctor; Cruz-Castillo, Juan Ernesto; Iturburu-Enríquez, Alessandra

    2015-01-01

    Introducción: aneurisma es el incremento del diámetro de una arteria > 50 %; los más frecuentes son los aneurismas de la aorta abdominal (AAA). La ecografía abdominal es el estudio de escrutinio para su diagnóstico. La detección oportuna del AAA en población de riesgo disminuye la morbimortalidad. El objetivo fue estimar la frecuencia de AAA en pacientes mayores de 65 años.Métodos: Se realizó un estudio transversal entre junio y octubre del 2012 en pacientes de ambos sexos mayores de 65 años que cubrieron los criterios de selección. Se les practicó ultrasonidoDoppler dúplex y se midió el diámetro anteroposterior de la aorta abdominal infrarrenal, se definió como AAA a una aorta abdominal con un diámetro mayor a 3 cm. Se empleó estadística descriptiva y regresión logística para factores de riesgo.Resultados: se incluyeron 144 pacientes, edad media (72.7 ± 6.7), el 95.1 % sexo masculino. El 13 % continuaban fumando. En 127 el diámetro de la aorta fue normal. Se detectaron 10 pacientes con AAA, todos del sexo masculino, el diámetro de los aneurismas identificados variaron de 3.2 a 7.11 cm, el diámetro promedio de 3 - 4 cm (n = 5). Solo el tabaquismo activo fue un factor predictivo significativo para AAA.Conclusión: Se demostró frecuencia significativa de AAA no detectada en masculinos mayores de 65 años, el tabaquismo fue el factor de riesgo más importante.

  12. Dynamic Morphology of the Aorta. Pre- and postoperative imaging

    NARCIS (Netherlands)

    van Prehn, J.

    2009-01-01

    With endovascular treatment of the aorta a folded covered stentgraft is introduced in the aorta via the femoral arteries. Adequate pre-operative planning is necessary to allow for proper stentgraft sizing. Stentgrafts should be adequately oversized to ensure good apposition to the aortic wall and pr

  13. Coil embolization of an anastomotic leak after ascending aorta replacement

    DEFF Research Database (Denmark)

    Nørgaard, Anders; Andersen, Lars Ib; Haahr, P.E.

    2008-01-01

    Surgical treatment of diseases of the thoracic aorta (aneurysms, dissections, and ruptures) may be associated with serious postoperative complications. Endovascular repair of thoracic aorta pathology is less invasive and offers a therapeutic alternative in high-surgical-risk patients, particularly...... accepted--embolization with endovascular coils--successfully resulting in occlusion of the leakage....

  14. Management of the atherosclerotic ascending aorta with endoaortic occlusion.

    Science.gov (United States)

    Liddicoat, J R; Doty, J R; Stuart, R S

    1998-04-01

    Application of an external cross-clamp to an atherosclerotic ascending aorta increases the risk of an embolic event and traumatic injury of the aorta. Currently, there are limited management options in these patients when the clinical situation requires cardiac arrest during an operation. We present our approach to these patients using the Heartport Endoaortic Clamp (Heartport, Redwood City, CA).

  15. Stent migration during transcatheter management of coarctation of aorta.

    Science.gov (United States)

    Kannan, Bhava R J; Srinivasan, Muthusamy

    2012-02-15

    A 13-year-old girl underwent endovascular stent placement for coarctation of aorta. The fully expanded stent migrated to ascending aorta which could be stabilized, recrimped, and repositioned with a 20-mm goose neck snare. Postdilatation was performed from the left brachial route resulting in a good outcome.

  16. Gastrointestinal causes of abdominal pain.

    Science.gov (United States)

    Marsicano, Elizabeth; Vuong, Giao Michael; Prather, Charlene M

    2014-09-01

    Gastrointestinal causes of abdominal pain are numerous. These causes are reviewed in brief here, divided into 2 categories: acute abdominal pain and chronic abdominal pain. They are further subcategorized by location of pain as it pertains to the abdomen.

  17. Clinical Study on Abdominal Acupuncture plus Herbal Medicine for Chronic Pelvic Pain Due to Qi Stagnation and Blood Stasis%腹针配合中药治疗气滞血瘀型慢性盆腔痛的临床研究

    Institute of Scientific and Technical Information of China (English)

    宋玉娟; 张殿全; 苏丹萍

    2015-01-01

    Objective To observe the clinical efficacy of abdominal acupuncture plus herbal medicine in treating chronic pelvic pain due to qi stagnation and blood stasis after pelvic inflammatory diseases.Method Sixty patients with chronic pelvic pain due to qi stagnation and blood stasis after pelvic inflammatory diseases were randomized into a treatment group and a control group, 30 in each group. The treatment group was intervened by abdominal acupuncture plus herbal medicine, while the control group was by herbal medicine alone. After 3 menstrual cycles, the Visual Analogue Scale (VAS) for abdominal pain and McCormack scale were observed.Result After intervention, the abdominal VAS score and McCormack score were changed significantly in both groups (P<0.01,P<0.05). After intervention, there were significant differences in comparing the VAS score and McCormack score between the two groups (P<0.01).Conclusion Abdominal acupuncture plus herbal medicine can reduce chronic pelvic pain due to qi stagnation and blood stasis after pelvic inflammatory diseases.%目的:观察腹针配合中药治疗盆腔炎性疾病后气滞血瘀型慢性盆腔痛的临床疗效。方法将60例盆腔炎性疾病后气滞血瘀型慢性盆腔痛患者随机分为治疗组和对照组,每组30例。治疗组采用腹针配合中药治疗,对照组采用单纯中药治疗。治疗3个月经周期后,观察两组治疗前后腹痛VAS评分及McCormack量表评分变化。结果两组治疗后腹痛VAS评分及McCormack量表评分与同组治疗前比较,差异均具有统计学意义(P<0.01,P<0.05)。治疗组治疗后腹痛VAS评分及McCormack量表评分与对照组比较,差异均具有统计学意义(P<0.01)。结论腹针配合中药能够减轻盆腔炎性疾病后气滞血瘀型慢性盆腔痛。

  18. Decreased mortality of abdominal aortic aneurysms in a peripheral county

    DEFF Research Database (Denmark)

    Lindholt, Jes Sanddal; Henneberg, E W; Fasting, H

    1995-01-01

    To analyse the effect on the mortality associated with abdominal aortic aneurysms, due to the establishment of a decentralised vascular surgical unit in the county of Viborg.......To analyse the effect on the mortality associated with abdominal aortic aneurysms, due to the establishment of a decentralised vascular surgical unit in the county of Viborg....

  19. Effects of ovariohysterectomy on intra-abdominal pressure and abdominal perfusion pressure in cats.

    Science.gov (United States)

    Bosch, L; Rivera del Álamo, M M; Andaluz, A; Monreal, L; Torrente, C; García-Arnas, F; Fresno, L

    2012-12-15

    Intra-abdominal pressure (IAP) and abdominal perfusion pressure (APP) have shown clinical relevance in monitoring critically ill human beings submitted to abdominal surgery. Only a few studies have been performed in veterinary medicine. The aim of this study was to assess how pregnancy and abdominal surgery may affect IAP and APP in healthy cats. For this purpose, pregnant (n=10) and non-pregnant (n=11) queens undergoing elective spaying, and tomcats (n=20, used as controls) presented for neutering by scrotal orchidectomy were included in the study. IAP, mean arterial blood pressure (MAP), APP, heart rate and rectal temperature (RT) were determined before, immediately after, and four hours after surgery. IAP increased significantly immediately after abdominal surgery in both female groups when compared with baseline (PPregnancy did not seem to affect IAP in this population of cats, possibly due to subjects being in early stages of pregnancy.

  20. Comparison of arterial stiffness and microcirculatory changes following abdominal aortic aneurysm grafting.

    LENUS (Irish Health Repository)

    Moloney, M A

    2010-11-11

    BACKGOUND: Abdominal aortic aneurysm (AAA) surgery provides a unique opportunity to study the impact of arterial stiffness on central haemodynamics, reflected in augmentation index (AI). The aneurysmal aorta is significantly stiffer than undilated age-matched aorta. AIM: We investigated whether replacement of an aneurysmal aorta with a compliant graft would result in a decrease in AI, which would thus decrease myocardial workload parameters. METHODS: Patients undergoing elective open or endovascular AAA repair were assessed with applanation tonometry and laser fluximetry pre-operatively, immediately and long-term post-operatively. RESULTS: Replacement of a small segment of abnormal conduit vessel resulted in improvements in AI, demonstrating that arterial stiffness can be surgically manipulated. CONCLUSIONS: These results reflect a decreased myocardial workload post-aortic grafting. This decrease in AI is important from a risk factor management perspective, and arterial stiffness should become a further recognised and screened for risk factor in patients with known aneurysmal disease.

  1. Comparison of arterial stiffness and microcirculatory changes following abdominal aortic aneurysm grafting.

    LENUS (Irish Health Repository)

    Moloney, M A

    2012-02-01

    BACKGOUND: Abdominal aortic aneurysm (AAA) surgery provides a unique opportunity to study the impact of arterial stiffness on central haemodynamics, reflected in augmentation index (AI). The aneurysmal aorta is significantly stiffer than undilated age-matched aorta. AIM: We investigated whether replacement of an aneurysmal aorta with a compliant graft would result in a decrease in AI, which would thus decrease myocardial workload parameters. METHODS: Patients undergoing elective open or endovascular AAA repair were assessed with applanation tonometry and laser fluximetry pre-operatively, immediately and long-term post-operatively. RESULTS: Replacement of a small segment of abnormal conduit vessel resulted in improvements in AI, demonstrating that arterial stiffness can be surgically manipulated. CONCLUSIONS: These results reflect a decreased myocardial workload post-aortic grafting. This decrease in AI is important from a risk factor management perspective, and arterial stiffness should become a further recognised and screened for risk factor in patients with known aneurysmal disease.

  2. Levosimendan in a neonate with severe coarctation of aorta and low cardiac output syndrome

    Directory of Open Access Journals (Sweden)

    Yann Olivier Boegli

    2013-01-01

    Full Text Available We report successful use of levosimendan after failed balloon angioplasty in a critically ill neonate with coarctation of aorta (CoA and severe low cardiac output syndrome (LCOS. Treatment with levosimendan improved left heart function, and decreased lactate and brain natriuretic peptide levels. To our knowledge, this is the first report on the safe and successful use of levosimendan in the management of LCOS due to severe CoA in a neonate awaiting surgical repair.

  3. Blunt traumatic aortic injuries of the ascending aorta and aortic arch: a clinical multicentre study.

    Science.gov (United States)

    Mosquera, Victor X; Marini, Milagros; Muñiz, Javier; Gulias, Daniel; Asorey-Veiga, Vanesa; Adrio-Nazar, Belen; Herrera, José M; Pradas-Montilla, Gonzalo; Cuenca, José J

    2013-09-01

    To report the clinical and radiological characteristics, management and outcomes of traumatic ascending aorta and aortic arch injuries. Historic cohort multicentre study including 17 major trauma patients with traumatic aortic injury from January 2000 to January 2011. The most common mechanism of blunt trauma was motor-vehicle crash (47%) followed by motorcycle crash (41%). Patients sustaining traumatic ascending aorta or aortic arch injuries presented a high proportion of myocardial contusion (41%); moderate or greater aortic valve regurgitation (12%); haemopericardium (35%); severe head injuries (65%) and spinal cord injury (23%). The 58.8% of the patients presented a high degree aortic injury (types III and IV). Expected in-hospital mortality was over 50% as defined by mean TRISS 59.7 (SD 38.6) and mean ISS 48.2 (SD 21.6) on admission. Observed in-hospital mortality was 53%. The cause of death was directly related to the ATAI in 45% of cases, head and abdominal injuries being the cause of death in the remaining 55% cases. Long-term survival was 46% at 1 year, 39% at 5 years, and 19% at 10 years. Traumatic aortic injuries of the ascending aorta/arch should be considered in any major thoracic trauma patient presenting cardiac tamponade, aortic valve regurgitation and/or myocardial contusion. These aortic injuries are also associated with a high incidence of neurological injuries, which can be just as lethal as the aortic injury, so treatment priorities should be modulated on an individual basis. Copyright © 2012 Elsevier Ltd. All rights reserved.

  4. Novel aspects of the pathogenesis of aneurysms of the abdominal aorta in humans

    DEFF Research Database (Denmark)

    Michel, Jean-Baptiste; Martin-Ventura, José-Luis; Egido, Jesus

    2011-01-01

    and the adventitial response in the development of human AAA. The intraluminal thrombus exerts its pathogenic effect through platelet activation, fibrin formation, binding of plasminogen and its activators, and trapping of erythrocytes and neutrophils, leading to oxidative and proteolytic injury of the arterial wall...... into diagnostic and therapeutic applications....

  5. Calcificacion de aorta abdominal de pacientes en hemodialisis en una unidad renal

    National Research Council Canada - National Science Library

    Valderrama, Luis A; Guerrero, Luis Fernando; Bolivar, Guillermo

    2012-01-01

    ...). Los pacientes en hemodialisis presentan mayor riesgo de mortalidad cardiovascular y factores como la edad, enfermedades asociadas y algunas alteraciones metabolicas incrementan el riesgo de calcificaciones vasculares. Palabras clave...

  6. Congenital Abdominal Wall Defects

    DEFF Research Database (Denmark)

    Risby, Kirsten; Jakobsen, Marianne Skytte; Qvist, Niels

    2016-01-01

    complications were seen in five (15%) children: four had detachment of the mesh and one patient developed abdominal compartment syndrome. Mesh related clinical infection was observed in five children. In hospital mortality occurred in four cases (2 gastroschisis and 2 omphalocele) and was not procedure......OBJECTIVE: To evaluate the clinical utility of GORE® DUALMESH (GDM) in the staged closure of large congenital abdominal wall defects. MATERIALS AND METHODS: Data of patients with congenital abdominal wall defects managed with GDM was analyzed for outcome regarding complete fascial closure; mesh...

  7. Abdominal wall endometriosis.

    Science.gov (United States)

    Upadhyaya, P; Karak, A K; Sinha, A K; Kumar, B; Karki, S; Agarwal, C S

    2010-01-01

    Endometriosis of abdominal wall scar following operation on uterus and tubes is extremely rare. The late onset of symptoms after surgery is the usual cause of misdiagnosis. Scar endometriosis is a rare disease which is difficult to diagnose and should always be considered as a differential diagnosis of painful abdominal masses in women. The diagnosis is made only after excision and histopathology of the lesion. Preoperative differentials include hernia, lipoma, suture granuloma or abscess. Hence an awareness of the entity avoids delay in diagnosis, helps clinicians to a more tailored treatment and also avoids unnecessary referrals. We report a case of abdominal endometriosis. The definitive diagnosis of which was established by histopathological studies.

  8. Paradoxical Hypertension after Successful Cheatham Platinum Stent Implantation in an Adolescent with Coarctation of the Aorta

    Science.gov (United States)

    Tan, Yin Ling; Chih, Wan-Ling; Wang, Jou-Kou; Chen, Chun-An

    2016-01-01

    Stent implantation using a Cheatham Platinum (CP) stent for coarctation of the aorta (CoA) is a promising treatment alternative to traditional surgical repair. However, there are no earlier reports in the literature focusing on use of this stent in a Taiwanese patient. Herein we report a 16-year-old boy with CoA presenting with heart murmur and exercise intolerance who underwent successful CP stent placement. However, severe hypertension with arterial blood pressure increasing to 207/104 mmHg occurred four hours after stent implantation. There was no abdominal pain, nausea or vomiting. The patient’s hypertension was controlled by intravenous nitroglycerin infusion, followed by an oral antihypertensitve agent for the following 7 days. Experience from this case highlighted the usefulness of CP stent implantation for native CoA, and the importance of early recognition and management of paradoxical hypertension after CoA stenting. PMID:27899866

  9. Surgical thoracic sympathectomy induces structural and biomechanical remodeling of the thoracic aorta in a porcine model.

    Science.gov (United States)

    Angouras, Dimitrios C; Dosios, Theodosios J; Dimitriou, Constantinos A; Chamogeorgakis, Themistocles P; Rokkas, Chris K; Manos, Themistoklis A; Sokolis, Dimitrios P

    2012-01-01

    Sympathetic innervation exerts marked effects on vascular smooth muscle cells, including a short-term homeostatic (vasoconstrictor) and a direct trophic action promoting differentiation. However, the role of sympathetic nervous system in long-term structural and functional modulation of the aortic wall is yet undefined. Six Landrace pigs underwent bilateral thoracic sympathectomy from the stellate to T8 ganglion, whereas 10 pigs underwent sham operation. Animals were sacrificed 3 mo postoperatively. Histometrical examination was performed on specimens from the thoracic (TA) and abdominal aorta (AA) utilizing an image-processing system. A uniaxial tensile tester was utilized for biomechanical evaluation; parameters of extensibility, strength, and stiffness of aortic tissue were calculated. Structural aortic remodeling of sympathectomized animals was observed, including increased inner aortic diameter in TA (15.3 ± 0.4 versus 10.4 ± 0.2 mm, P sympathectomy, TA was equally extensible but manifested augmented strength (1344 ± 73 versus 1071 ± 52 kPa, P = 0.004) and stiffness (6738 ± 478 versus 5026 ± 273 kPa, P = 0.003), in accordance with extracellular matrix protein accumulation in that region. Differences in the AA were non-significant. Chronic thoracic sympathetic denervation causes significant structural and biomechanical remodeling of the thoracic aorta. Possible clinical implications for patients undergoing thoracic sympathectomy or chronically treated with sympathetic blockers require further investigation. Copyright © 2012 Elsevier Inc. All rights reserved.

  10. CT diagnosis of inflammatory abdominal aneurysms. Computertomographische Diagnostik des inflammatorischen Bauchaortenaneurysmas

    Energy Technology Data Exchange (ETDEWEB)

    Koch, J.A. (Inst. fuer Diagnostische Radiologie, Duesseldorf Univ. (Germany)); Gruetzner, G. (Inst. fuer Diagnostische Radiologie, Duesseldorf Univ. (Germany)); Jungblut, R.M. (Inst. fuer Diagnostische Radiologie, Duesseldorf Univ. (Germany)); Kniemeyer, H.W. (Abt. fuer Gefaesschirurgie und Nierentransplantation, Duesseldorf Univ. (Germany)); Moedder, U. (Inst. fuer Diagnostische Radiologie, Duesseldorf Univ. (Germany))

    1994-07-01

    Amongst 1599 patients undergoing surgery for abdominal aortic aneurysm, there were 89 patients (5,6%) who showed typical features of inflammatory aneurysms of the abdominal aorta (IAAA). 37 of the 89 patients had been examined preoperatively by CT. In 73% of the cases (27/37) a correct diagnosis had been made. Localisation, width and extent of the IAAA was correctly diagnosed in all patients. Involvement of the renal arteries by the inflammatory process, the extent of thrombus and of mural calcification were accurately shown. The inflammatory tissues were typically ventral and lateral to the aorta. Frequently, there were adhesions to neighbouring structures. Aortic rupture, aortic dissection and retroperitoneal lymphoma may produce similar CT appearances; nevertheless, CT remains at present the method of choice for the diagnosis of IAAA because of its high sensitivity. (orig.)

  11. Primary stenting in the treatment of focal atherosclerotic abdominal aortic stenoses

    Energy Technology Data Exchange (ETDEWEB)

    Poncyljusz, W.; Falkowski, A.; Garncarek, J.; Karasek, M.; England, S.; Zawierucha, D

    2006-08-15

    Aim: To evaluate the results of primary stent placement in focal atherosclerotic aortic stenoses using balloon expandable stents. Materials and methods: Twenty-six primary balloon expandable stent placements in the abdominal aorta were performed and reviewed. All the aortic stenoses were atherosclerotic. Patients were followed up by ankle/brachial pressure indices (ABPI) and Doppler ultrasound (US) at 24 h after procedure and at 12 and 24 months. Follow-up angiograms were performed at 12 months. Results: Twenty-six stents in 26 patients were placed in the infrarenal aorta. All procedures were technically successful and immediate clinical success was obtained. The mean ABPI significantly improved from 0.52 {+-} 0.10 to 0.94 {+-} 0.09 within 24 h after procedure, and remained at 0.90 {+-} 0.12 between 12 and 24 months follow-up (mean 18 months). There was full haemodynamic success at hospital discharge and at 12 and 24 months after the procedure. Clinical success at 12 and 24 months (mean 18 months) was defined as an improvement in the Fontaine classification by at least one class compared with the pre-procedure class and was shown to be 100%. Conclusion: In summary, we report that primary stenting is a safe and effective alternative to surgery in cases of symptomatic stenosis of the infrarenal abdominal aorta. The excellent intermediate term results suggested that we would recommend primary stenting as the treatment of choice for focal atherosclerotic stenoses of the infrarenal aorta in selected patients.

  12. COARCTATION OF AORTA AND TAKAYASU ARTERITIS FOR LSCS: ANAESTHESIA MANAGEMENT

    Directory of Open Access Journals (Sweden)

    Rashmi

    2015-10-01

    Full Text Available Coarctation of aorta is a congenital disorder with 5-10% incidence. It occurs in about 1 in 10,000 births .It may remain asymptomatic till adulthood. During pregnancy, early gestational hypertension is the presenting sign. Difference in blood pressure in upper and lower limb is a characteristic finding of coarctation of aorta. Association of bicuspid aortic valve and ventricular septal defect is seen in 50% patients of coarctation. Major cardiovascular complications are infrequent but continue to be a source of concern for patients with coarctation who become pregnant. Coarctation of aorta commonly located at the junction of the arch of aorta and proximal descending aorta at the level of ductal structure, may be diagnosed for the first time during pregnancy. Dilatation and dissection of the aorta can lead to increased maternal mortality; significant stenosis is a contraindication to pregnancy. However, successful pregnancies have been reported in women with uncorrected coarctation if preconception risk stratification is done. Here is a case of LSCS with coarctation of aorta and Takayasu arteritis done successfully under epidural anaesthesia.

  13. Abdominal tuberculosis: Imaging features

    Energy Technology Data Exchange (ETDEWEB)

    Pereira, Jose M. [Department of Radiology, Hospital de S. Joao, Porto (Portugal)]. E-mail: jmpjesus@yahoo.com; Madureira, Antonio J. [Department of Radiology, Hospital de S. Joao, Porto (Portugal); Vieira, Alberto [Department of Radiology, Hospital de S. Joao, Porto (Portugal); Ramos, Isabel [Department of Radiology, Hospital de S. Joao, Porto (Portugal)

    2005-08-01

    Radiological findings of abdominal tuberculosis can mimic those of many different diseases. A high level of suspicion is required, especially in high-risk population. In this article, we will describe barium studies, ultrasound (US) and computed tomography (CT) findings of abdominal tuberculosis (TB), with emphasis in the latest. We will illustrate CT findings that can help in the diagnosis of abdominal tuberculosis and describe imaging features that differentiate it from other inflammatory and neoplastic diseases, particularly lymphoma and Crohn's disease. As tuberculosis can affect any organ in the abdomen, emphasis is placed to ileocecal involvement, lymphadenopathy, peritonitis and solid organ disease (liver, spleen and pancreas). A positive culture or hystologic analysis of biopsy is still required in many patients for definitive diagnosis. Learning objectives:1.To review the relevant pathophysiology of abdominal tuberculosis. 2.Illustrate CT findings that can help in the diagnosis.

  14. [The abdominal catastrophe].

    Science.gov (United States)

    Seiler, Christian A

    2011-08-01

    Patients with an abdominal catastrophe are in urgent need of early, interdisciplinary medical help. The treatment plan should be based on medical priorities and clear leadership. First priority should be given to achieve optimal oxygenation of blood and stabilization of circulation during all treatment-phases. The sicker the patient, the less invasive the (surgical) treatment should to be, which means "damage control only". This short article describes 7 important, pragmatic rules that will help to increase the survival of a patient with an abdominal catastrophe. Preexisting morbidity and risk factors must be included in the overall risk-evaluation for every therapeutic intervention. The challenge in patients with an abdominal catastrophe is to carefully balance the therapeutic stress and the existing resistance of the individual patient. The best way to avoid abdominal disaster, however, is its prevention.

  15. Abdominal and Pelvic CT

    Medline Plus

    Full Text Available ... contrast materials and a metallic taste in your mouth that lasts for at most a minute or ... can diagnose many causes of abdominal pain or injury from trauma with very high accuracy, enabling faster ...

  16. Abdominal x-ray

    Science.gov (United States)

    ... are, or may be, pregnant. Alternative Names Abdominal film; X-ray - abdomen; Flat plate; KUB x-ray ... Assistant Studies, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington, Seattle, WA. Also ...

  17. Abdominal and Pelvic CT

    Medline Plus

    Full Text Available ... often used to determine the cause of unexplained pain. CT scanning is fast, painless, noninvasive and accurate. ... help diagnose the cause of abdominal or pelvic pain and diseases of the internal organs, small bowel ...

  18. Abdominal and Pelvic CT

    Medline Plus

    Full Text Available ... is done because a potential abnormality needs further evaluation with additional views or a special imaging technique. ... GI) contrast exams and ultrasound are preferred for evaluation of acute abdominal conditions in babies, such as ...

  19. Abdominal ultrasound (image)

    Science.gov (United States)

    Abdominal ultrasound is a scanning technique used to image the interior of the abdomen. Like the X-ray, MRI, ... it has its place as a diagnostic tool. Ultrasound scans use high frequency sound waves to produce ...

  20. Abdominal exploration - slideshow

    Science.gov (United States)

    ... ency/presentations/100049.htm Abdominal exploration - series—Normal anatomy To use the ... Overview The abdomen contains many vital organs: the stomach, the small intestine (jejunum and ileum), the large ...

  1. Abdominal and Pelvic CT

    Medline Plus

    Full Text Available ... is done because a potential abnormality needs further evaluation with additional views or a special imaging technique. ... GI) contrast exams and ultrasound are preferred for evaluation of acute abdominal conditions in babies, such as ...

  2. Linear abdominal trauma.

    Science.gov (United States)

    Danto, L A; Wolfman, E F

    1976-03-01

    Three cases of blunt abdominal trauma are presented to exemplify the mechanism of trauma and the problems of diagnosis associated with any linear blow to the abdomen. The mechanisms of visceral injury are reviewed, and special attention is directed to the abdominal wall injury that can be present in these patients. This injury has special implications in directing the operative approach and repair. An unusual aortic occlusion is described which is peculiar to this type of injury.

  3. Successful Percutaneous Coronary Intervention through a Severely Bent Artificial Ascending Aorta Using the DIO Thrombus Aspiration Catheter

    Directory of Open Access Journals (Sweden)

    Akinori Fujikake

    2016-01-01

    Full Text Available A 66-year-old man was admitted to our institute because of chest pain. He had undergone replacement of the ascending aorta due to aortic dissection 9 years previously. We made a diagnosis of acute coronary syndrome, and coronary artery angiography was performed. Although the right coronary artery was successfully cannulated, a severe bend of the artificial aorta made it very difficult to advance the catheter into the left coronary artery. Ultimately, a DIO thrombus aspiration catheter was used to enter the left coronary artery, and a stent was implanted successfully. The DIO catheter is very useful when the selection of a guiding catheter is complicated, such as in the case of severe vessel tortuosity or a bend of the ascending aorta.

  4. Unusual presenting of acute aortic dissection due to penetrating atheromatous ulcer.

    Science.gov (United States)

    Atas, Halil; Durmus, Erdal; Sunbul, Murat; Birkan, Yasar; Ozben, Beste

    2014-07-01

    Penetrating atheromatous ulcer (PAU) is an atherosclerotic ulcer penetrating the internal elastic lamina of the aortic wall causing a hematoma within the media layer of aorta. They are commonly located in the descending aorta of the elderly and hypertensive patients. They may rarely be complicated by aortic dissection. We report a relative young normotensive patient presenting with acute aortic dissection due to PAU located in the ascending aorta.

  5. Comparative study of abdominal and thoracic aortic aneurysms: their pathogenesis and a gingival fibroblasts-based ex vivo treatment.

    Science.gov (United States)

    Cherifi, Hafida; Gogly, Bruno; Loison-Robert, Ludwig-Stanislas; Couty, Ludovic; Ferré, François Côme; Nassif, Ali; Lafont, Antoine; Fournier, Benjamin Pj

    2015-01-01

    Aortic aneurysms (AAs) consist of slow proteolysis and loss of both collagen and elastin matrix in the aorta wall, leading to wall dilation, weakening and rupture in well-advanced lesions. This can occur in both abdominal aorta (Abdominal Aortic Aneurysm: AAA) and thoracic aorta (Thoracic Aortic Aneurysm: TAA). To date, no non-surgical therapy has been proposed to slow or stop AA progression. Previously published preclinical studies from our team using an aneurysm rabbit model showed a promising concept for treatment of AAs with gingival fibroblast (GFs) which are readily available cells. In this study, we investigated the possible tissue repair of human AAAs and TAAs using ex vivo models co-cultured with GFs. Histological analysis showed that TAA and AAA are two distinct pathologies. Both lesions presented destruction of the aorta wall, highly evidenced in AAA samples. The results have confirmed the presence of the bacterial Porphyromonas gingivalis (Pg) protein in all AAA samples, but not in TAA samples, indicating the possible role of an infectious factor in the developing and progression of AAA lesions compared to TAA. The co-culture of GFs with AA lesions shows increased expression of TIMP-1, the inhibitor of the aneurysm severity marker MMP-9. Our study indicates that GFs might ameliorate aorta wall reestablishment in both AA types by their regenerative and immunomodulatory capacities. It also demonstrates the possible infectious cause of AAA compared with TAA that may explain their different behavior.

  6. [Endovascular repair for coarctation of the aorta in an adult].

    Science.gov (United States)

    Hayashi, Jun; Abe, Kazuo; Hata, Masaki; Nagano, Naoko; Hamasaki, Azumi; Suzuki, Kenji

    2013-09-01

    A 27-year-old woman with Turner's syndrome who underwent successful endovascular treatment for coarctation of the aorta is presented. She was admitted to our hospital complaining of upper extremity hypertension. Computed tomography revealed discrete stenosis of the proximal descending aorta and developed collateral circulation. After endovascular repair with a balloon expandable stent, her transcoarctation gradient fell from 44 mmHg preoperatively to less than 10 mmHg. She was discharged with no complications on the 7th postoperative day. Coarctation of the aorta in an adult patient could be safely and effectively managed by endovascular treatment.

  7. Tratamento das lesões de aorta nos traumatismos torácicos fechados Management of aortic lesions in blunt chest trauma

    Directory of Open Access Journals (Sweden)

    Boulanger Mioto Neto

    2005-09-01

    Full Text Available OBJETIVO: Rever a casuística, etiologia, lesões associadas, tipos de tratamento e evolução das lesões da aorta por trauma torácico fechado. MÉTODOS: Estudo retrospectivo em prontuário dos pacientes atendidos no Pronto-Socorro do Hospital das Clínicas da Universidade de São Paulo e tratados pelo Grupo de Cirurgia Vascular de janeiro de 2001 a junho de 2004. Foram analisados 10 pacientes, todos do sexo masculino, sendo sete com técnica endovascular e três com técnica operatória aberta. RESULTADOS: Quanto à localização, foram observadas oito lesões da aorta descendente junto ao istmo, uma lesão da aorta descendente na transição tóraco-abdominal e uma dissecção traumática da aorta. O intervalo de tempo para o tratamento cirúrgico foi, em média, de 10,62 ± 3,45 horas para os que receberam tratamento endoluminal e 28 ± 32,39 para os operados de forma convencional. Já o período de internação total variou de 9 a 180 dias (média de 23,33 ± 6,66 dias para os tratados com endoprótese e 42,55 ± 52,7 para os operados de forma convencional. Foram utilizadas uma endoprótese Excluder®, uma Apolo® e cinco Talent®. Dos pacientes operados, dois utilizaram bomba átrio femoral. Ocorreram dois óbitos, um entre os operados de forma convencional e um entre os operados com endopróteses. CONCLUSÕES: As lesões da aorta em casos de trauma torácico fechado são pouco freqüentes e geralmente associadas a um grande número de lesões associadas. O diagnóstico precoce e preciso é fundamental para a evolução do paciente. A correção com endopróteses nos pacientes estáveis do ponto de vista hemodinâmico apresenta-se como solução eficaz.OBJECTIVE: To review the population, etiology, associated injuries, types of treatment, and evolution of aortic injuries due to blunt chest trauma. METHODS: Retrospective study of medical charts of patients admitted to the Emergency Department at Hospital das Clínicas of Universidade de S

  8. Redo mitral valve replacement through a right mini-thoracotomy with an unclamped aorta.

    Science.gov (United States)

    Botta, Luca; Fratto, Pasquale; Cannata, Aldo; Bruschi, Giuseppe; Merlanti, Bruno; Brignani, Christian; Bosi, Mauro; Martinelli, Luigi

    2014-08-14

    Redo cardiac surgery represents a clinical challenge due to a higher rate of perioperative morbidity and mortality. Mitral valve (MV) re operations can particularly be demanding in patients with patent coronary grafts, previous aortic valve replacement, calcified aorta or complications following a previous operation (abscesses, leaks or thrombosis). In this article we describe our technique to manage complex mitral reoperations using a minimally invasive approach, moderate hypothermia and avoiding aortic cross-clamping. Minimally invasive procedures with an unclamped aorta have the potential to combine the benefits of less invasive access and continuous myocardial perfusion. The advantage of a right mini-thoracotomy is the avoidance of sternal re-entry and limited dissection of adhesions, reducing the risk of cardiac structures or patent graft injury. Moderate hypothermia and continuous blood perfusion can guarantee adequate myocardial protection particularly in the case of patent grafts, decreasing the dangers of an incomplete or imperfect aortic clamping at mild hypothermia and potential lesions due to demanding clamp placing. Complex MV reoperations can be safely and effectively performed through a smaller right thoracotomy in the fourth intercostal space with an unclamped aorta.

  9. Abdominal Wall Desmoid during Pregnancy: Diagnostic Challenges

    Directory of Open Access Journals (Sweden)

    Johnny Awwad

    2013-01-01

    Full Text Available Background. Desmoids are benign tumors, with local invasive features and no metastatic potential, which have rarely been described to be pregnancy associated. Case. We described the rapid growth of an anterior abdominal wall mass in a 40-year-old pregnant woman. Due to its close proximity to the enlarged uterus, it was misdiagnosed to be a uterine leiomyoma by ultrasound examination. Final tissue diagnosis and radical resection were done at the time of abdominal delivery. Conclusion. Due to the diagnostic limitations of imaging techniques, desmoids should always be considered when the following manifestations are observed in combination: progressive growth of a solitary abdominal wall mass during pregnancy and well-delineated smooth tumor margins demonstrated by imaging techniques. This case emphasizes the importance of entertaining uncommon medical conditions in the differential diagnosis of seemingly common clinical manifestations.

  10. A rare case of febrile abdominal pain revealing Horton's disease.

    Science.gov (United States)

    Chaudet, Arnaud; Goujon, Jean-Michel; Ghazali, Aiham Daniel

    2017-07-08

    Horton's disease is a systemic inflammatory vasculitis, usually found in persons over 50years old. It affects medium and large-sized arteries stemming from the external carotid, especially the superficial temporal arteries. It can affect extracranial large vessels but only rarely the aorta. Diagnosis of aortitis is difficult and its incidence is probably underestimated. A 68-year-old Caucasian woman consulted in an emergency department for febrile abdominal pain with inflammatory syndrome. Abdomen was soft with right-side flank sensitivity. A contrast-enhanced CT scan showed aortitis from the descending aorta to the iliac arteries without complication. Because of age, clinical presentation and aortitis, Horton disease was suspected. The temporal artery biopsy showed a histological aspect of degenerative endarteritis with intimal thickening and luminal stenosis. High-dose corticosteroid therapy was introduced which improved clinical conditions and resulted in the amendment of the pain. In the present case, this patient had Horton's disease, based on 3 criteria of The American College of Rheumatology (age, temporal artery abnormalities and inflammatory syndrome) associated with aortitis. However, aortitis is a rare complication of Horton disease and is a major cause of mortality inasmuch as it can be complicated by aneurysm and dissection. It is unusual to diagnose Horton's disease from aortitis symptoms without complications. The aorta represents the most severe localization of Horton's disease. It should not be ignored in etiological hypotheses regarding febrile abdominal pain in the elderly. Corticosteroids should be started rapidly at high doses and temporal artery biopsy should be planned. Copyright © 2017. Published by Elsevier Inc.

  11. Helical computed tomography in the assessment of abdominal aortic pathology

    Energy Technology Data Exchange (ETDEWEB)

    Vicaretti, M.; Young, N.; Jenkins, J.; Fletcher, J. [Westmead Hospital, Westmead, NSW (Australia)

    1997-05-01

    A pilot study was undertaken to evaluate the role of helical computed tomography in the assessment of abdominal aortic pathology. A total of 17 patients underwent intra-arterial digital subtraction angiography (IADSA) and helical computed tomography, with eight patients undergoing subsequent operative intervention. A comparison of radiological findings between IADSA and helical computed tomography (CT) was made and, where applicable, a comparison was made with operative findings. Pathology included abdominal aortic aneurysm (AAA) (n=12), thoraco abdominal aneurysm (n=2) and dissection (n=1), graft distension following AAA repair (n=1) and plaque haemorrhage in the distal aorta following percutaneous transluminal angioplasty (PTA) of the iliac artery (n=1). Planned operative management as based on pre-operative helical CT imaging findings, in particular with reference to the type of graft used (straight or bifurcated) was not changed at operation. Our findings on helical CT in regards to AAA, thoraco-abdominal aneurysm and dissection correlated well with angiography and surgery findings. (authors). 26 refs., 2 tabs., 5 figs.

  12. Magnetic resonance imaging of congenital abnormalities of the thoracic aorta

    Energy Technology Data Exchange (ETDEWEB)

    Soler, R.; Rodriguez, E.; Requejo, I.; Fernandez, R. [Department of Radiology, Hospital Juan Canalejo, La Coruma (Spain); Raposo, I. [Department of Pediatric Cardiology, Hospital Juan Canalejo, La Coruna (Spain)

    1998-05-01

    This article outlines the ability of MR imaging in the detection and presurgical evaluation of congenital abnormalities of the thoracic aorta (CATA). Congenital abnormalities of the thoracic aorta may be found incidentally on chest radiographs in patients without symptoms, or it can be associated with clinical findings which are very variable depending on the association with congenital cardiac malformations or vascular ring. When CATA is suspected as the cause of anomalies in the mediastinum in asymptomatic patients, confirmation of the abnormality should be by MR imaging allowing precise evaluation of the thoracic aorta and origin of the principal arteries. When CATA is considered because clinical findings indicate coarctation of the aorta, vascular ring or associated cardiac disorder, evaluation with ultrasound can be complemented by MR, which in most cases will replace the diagnostic catheterization. (orig.) With 12 figs., 24 refs.

  13. Active axial stress in mouse aorta.

    Science.gov (United States)

    Agianniotis, A; Rachev, A; Stergiopulos, N

    2012-07-26

    The study verifies the development of active axial stress in the wall of mouse aorta over a range of physiological loads when the smooth muscle cells are stimulated to contract. The results obtained show that the active axial stress is virtually independent of the magnitude of pressure, but depends predominately on the longitudinal stretch ratio. The dependence is non-monotonic and is similar to the active stress-stretch dependence in the circumferential direction reported in the literature. The expression for the active axial stress fitted to the experimental data shows that the maximum active stress is developed at longitudinal stretch ratio 1.81, and 1.56 is the longitudinal stretch ratio below which the stimulation does not generate active stress. The study shows that the magnitude of active axial stress is smaller than the active circumferential stress. There is need for more experimental investigations on the active response of different types of arteries from different species and pathological conditions. The results of these studies can promote building of refined constrictive models in vascular rheology. Copyright © 2012 Elsevier Ltd. All rights reserved.

  14. Calcification of thoracic aorta – solar eclipse sign

    Science.gov (United States)

    Dhoble, Abhijeet; Puttarajappa, Chethan

    2008-01-01

    Background Calcification of thoracic aorta is very common in old people, especially ones with hypertension. This can sometime be visible on plain chest radiograph. Case Presentation We present a case of a male patient who had extensive deposition of calcium in the thoracic aorta. Conclusion The relationship between aortic calcification and coronary atherosclerosis remains contentious. Computed tomography of the thorax can display this calcification which appears like 'solar eclipse'. PMID:18759981

  15. Endovascular management of recurrent adult coarctation of the aorta.

    Science.gov (United States)

    Kpodonu, Jacques; Ramaiah, Venkatesh G; Rodriguez-Lopez, Julio A; Diethrich, Edward B

    2010-11-01

    Traditional open surgical repair has proven to be an effective treatment for the management of primary and recurrent coarctation of the thoracic aorta. Potential complications at short-term and long-term follow-up have included recurrent coarctation, hypertension, premature coronary artery disease, cerebrovascular disease, and anastomotic pseudoaneurysm. Endovascular repair of recurrent coarctation of the thoracic aorta offers a less invasive treatment approach in potential high-risk surgical patients.

  16. Abdominal emergencies in pediatrics.

    Science.gov (United States)

    Coca Robinot, D; Liébana de Rojas, C; Aguirre Pascual, E

    2016-05-01

    Abdominal symptoms are among the most common reasons for pediatric emergency department visits, and abdominal pain is the most frequently reported symptom. Thorough history taking and physical examination can often reach the correct diagnosis. Knowing the abdominal conditions that are most common in each age group can help radiologists narrow the differential diagnosis. When imaging tests are indicated, ultrasonography is usually the first-line technique, enabling the diagnosis or adding relevant information with the well-known advantages of this technique. Nowadays, plain-film X-ray studies are reserved for cases in which perforation, bowel obstruction, or foreign body ingestion is suspected. It is also important to remember that abdominal pain can also occur secondary to basal pneumonia. CT is reserved for specific indications and in individual cases, for example, in patients with high clinical suspicion of abdominal disease and inconclusive findings at ultrasonography. We review some of the most common conditions in pediatric emergencies, the different imaging tests indicated in each case, and the imaging signs in each condition.

  17. 3-D segmentation and quantitative analysis of inner and outer walls of thrombotic abdominal aortic aneurysms

    Science.gov (United States)

    Lee, Kyungmoo; Yin, Yin; Wahle, Andreas; Olszewski, Mark E.; Sonka, Milan

    2008-03-01

    An abdominal aortic aneurysm (AAA) is an area of a localized widening of the abdominal aorta, with a frequent presence of thrombus. A ruptured aneurysm can cause death due to severe internal bleeding. AAA thrombus segmentation and quantitative analysis are of paramount importance for diagnosis, risk assessment, and determination of treatment options. Until now, only a small number of methods for thrombus segmentation and analysis have been presented in the literature, either requiring substantial user interaction or exhibiting insufficient performance. We report a novel method offering minimal user interaction and high accuracy. Our thrombus segmentation method is composed of an initial automated luminal surface segmentation, followed by a cost function-based optimal segmentation of the inner and outer surfaces of the aortic wall. The approach utilizes the power and flexibility of the optimal triangle mesh-based 3-D graph search method, in which cost functions for thrombus inner and outer surfaces are based on gradient magnitudes. Sometimes local failures caused by image ambiguity occur, in which case several control points are used to guide the computer segmentation without the need to trace borders manually. Our method was tested in 9 MDCT image datasets (951 image slices). With the exception of a case in which the thrombus was highly eccentric, visually acceptable aortic lumen and thrombus segmentation results were achieved. No user interaction was used in 3 out of 8 datasets, and 7.80 +/- 2.71 mouse clicks per case / 0.083 +/- 0.035 mouse clicks per image slice were required in the remaining 5 datasets.

  18. Pancreatic and biliary drainage for the treatment of bile leakage and severe intra-abdominal infection after pancreatiduodenectomy due to severe trauma%急诊胰十二指肠切除术后并发胆胰漏的处理

    Institute of Scientific and Technical Information of China (English)

    朱耀明

    2012-01-01

    目的 探讨因腹部外伤行急诊胰十二指肠切除术( pancreaticoduodenectomy,PD)后胆胰漏的发生及并发严重腹腔感染需再次手术时的处理策略.方法 回顾分析10年来因腹部外伤而急诊行PD手术病人共35例,术后发生胆胰漏12例,发生率为34.3%.经保守治疗、调整腹腔引流管或穿刺引流后治愈3例,另9例发生严重腹腔感染,再次手术行腹腔清洗和置管引流.结果 再手术者中8例未行胆胰管支撑引流,其中6例术后胆胰漏之积液区未有效局限,腹腔感染持续并加重,3例并发腹腔出血;均行第3次手术,于胰管和(或)胆管内置管外引流,感染区留置双套管术后冲洗腹腔并负压引流;6例均存活,6个月后行决定性手术.结论 胰十二指肠外伤行PD术后胆胰漏发生率高,再次手术时行胰管和(或)胆管内置支撑管外引流,可迅速有效地控制腹腔感染,降低死亡率.%Objective The objective of this study was to investigate the incidence and the operation strategy of biliary and pancreatic leakage and related severe intra-abdominal infection after pancre-aticoduodenectomy (PD) due to abdominal trauma. Methods A total of 35 patients who underwent e-mergent PD in our department due to severe abdominal trauma during past ten years were retrospectively analyzed. Results Postoperative biliary and pancreatic leakages developed in 12 cases with an incidence of 34.3 %, in which 3 patients were cured by non-operating treatment, including peritoneal drainage tube,and other 9 patients had severe abdominal infectious complications and needed re-operation. In these patients who required re-operations without biliary and pancreatic drainage, bile and pancreatic secreting fluid were not limited effectively, resulting in severe intraperitoneal infection in 6 cases, in which 3 patients needed to be re-operated for the third time due to a massive bleeding. Other 6 patients were treated with effectively drainage by

  19. Adult thoracic and abdominal aortic

    Directory of Open Access Journals (Sweden)

    Randa O. Kaddah

    2016-06-01

    Conclusion: Aortic COA could be found in any segment of the aorta. Proper identification of the anatomical details and pressure gradient studies are important factors affecting the plan of management.

  20. Metabolic and hemodynamic effects of saline infusion to maintain volemia on temporary abdominal aortic occlusion

    Directory of Open Access Journals (Sweden)

    Fábio Ferreira Amorim

    2002-10-01

    Full Text Available OBJECTIVE: To analyze hemodynamic and metabolic effects of saline solution infusion in the maintenance of blood volume in ischemia-reperfusion syndrome during temporary abdominal aortic occlusion in dogs. METHODS: We studied 20 dogs divided into 2 groups: the ischemia-reperfusion group (IRG, n=10 and the ischemia-reperfusion group with saline solution infusion aiming at maintaining mean pulmonary arterial wedge pressure between 10 and 20 mmHg (IRG-SS, n=10. All animals were anesthetized with sodium thiopental and maintained on spontaneous ventilation. Occlusion of the supraceliac aorta was obtained with inflation of a Fogarty catheter inserted through the femoral artery. After 60 minutes of ischemia, the balloon was deflated, and the animals were observed for another 60 minutes of reperfusion. RESULTS: IRG-SS dogs did not have hemodynamic instability after aortic unclamping, and the mean systemic blood pressure and heart rate were maintained. However, acidosis worsened, which was documented by a greater reduction of arterial pH that occurred especially due to the absence of a respiratory response to metabolic acidosis that was greater with the adoption of this procedure. CONCLUSION: Saline solution infusion to maintain blood volume avoided hemodynamic instability after aortic unclamping. This procedure, however, caused worsening in metabolic acidosis in this experimental model.

  1. Through-Plane Movement at Multiple Aortic Levels on Dynamic Computed Tomography Angiography Is Limited in Patients With an Abdominal Aortic Aneurysm

    NARCIS (Netherlands)

    de Jonge, Jeroen C; Zandvoort, Herman J A; Vonken, Evert-Jan P A; Moll, Frans L; van Herwaarden, JA

    2015-01-01

    PURPOSE: To analyze the movement of the aorta in the craniocaudal direction (through-plane movement) during the cardiac cycle at several levels to determine any potential impact on endovascular aneurysm repair (EVAR) of abdominal aortic aneurysm (AAA). METHODS: For this study, 30 patients (median ag

  2. Abnormal Wave Reflections and Left Ventricular Hypertrophy Late After Coarctation of the Aorta Repair

    Science.gov (United States)

    Quail, Michael A.; Short, Rebekah; Pandya, Bejal; Steeden, Jennifer A.; Khushnood, Abbas; Taylor, Andrew M.; Segers, Patrick

    2017-01-01

    Patients with repaired coarctation of the aorta are thought to have increased afterload due to abnormalities in vessel structure and function. We have developed a novel cardiovascular magnetic resonance protocol that allows assessment of central hemodynamics, including central aortic systolic blood pressure, resistance, total arterial compliance, pulse wave velocity, and wave reflections. The main study aims were to (1) characterize group differences in central aortic systolic blood pressure and peripheral systolic blood pressure, (2) comprehensively evaluate afterload (including wave reflections) in the 2 groups, and (3) identify possible biomarkers among covariates associated with elevated left ventricular mass (LVM). Fifty adult patients with repaired coarctation and 25 age- and sex-matched controls were recruited. Ascending aorta area and flow waveforms were obtained using a high temporal-resolution spiral phase-contrast cardiovascular magnetic resonance flow sequence. These data were used to derive central hemodynamics and to perform wave intensity analysis noninvasively. Covariates associated with LVM were assessed using multivariable linear regression analysis. There were no significant group differences (P≥0.1) in brachial systolic, mean, or diastolic BP. However central aortic systolic blood pressure was significantly higher in patients compared with controls (113 versus 107 mm Hg, P=0.002). Patients had reduced total arterial compliance, increased pulse wave velocity, and larger backward compression waves compared with controls. LVM index was significantly higher in patients than controls (72 versus 59 g/m2, Pcoarctation of the aorta repair, including abnormal wave reflections that are associated with elevated LVM. PMID:28115510

  3. Unusual Differential Diagnosis of Upper Abdominal Pain

    Directory of Open Access Journals (Sweden)

    Lanthaler Monika

    2009-01-01

    The peculiarity of this case is the rarity of toothpick ingestion and gastric perforation in a young and healthy white Caucasian followed by development of a liver abscess after primary uneventful endoscopic removal. In light of this case, gastric perforation due to ingested foreign bodies such as toothpicks can be considered a rare cause of upper abdominal pain.

  4. ADVANCED ABDOMINAL PREGNANCY: THREE CASES WITH A ...

    African Journals Online (AJOL)

    least 6 cm above the plane of the brim. The foetal .... history of abdominal pains, i.e. 'spurious labour' probably due to the ... a combination of several features; from a study of these, a high index of ... Foetal parts overlie the maternal spine in a lateral view. 4. ... provided the X-ray examination excludes foetal abnor- malities' ...

  5. Abdominal paracentesis and thoracocentesis.

    Science.gov (United States)

    Lee, Ser Yee; Pormento, James G; Koong, Heng Nung

    2009-04-01

    Abdominal paracentesis and thoracocentesis are common bedside procedures with diagnostic, therapeutic and palliative roles. We describe a useful and familiar a useful and familiar technique with the use of a multiple lumen catheter commonly used for central venous line insertion for drainage of ascites or moderate to large pleural effusions. The use of a multiple lumen catheter allows easier and more rapid aspiration of fluid with a smaller probability of the side holes being blocked as compared to the standard needle or single catheter methods. This is particularly useful in situations where the dedicated commercial kits for thoracocentesis and abdominal paracentesis are not readily available.

  6. Childhood abdominal cystic lymphangioma

    Energy Technology Data Exchange (ETDEWEB)

    Konen, Osnat; Rathaus, Valeria; Shapiro, Myra [Department of Diagnostic Imaging, Meir General Hospital, Sapir Medical Centre, Kfar Saba (Israel); Dlugy, Elena [Department of Paediatric Surgery, Schneider Medical Centre, Sackler School of Medicine, Tel-Aviv University (Israel); Freud, Enrique [Department of Paediatric Surgery, Sapir Medical Centre, Sackler School of Medicine, Tel-Aviv University (Israel); Kessler, Ada [Department of Diagnostic Imaging, Sourasky Medical Centre, Tel-Aviv (Israel); Horev, Gadi [Department of Diagnostic Imaging, Schneider Medical Centre, Tel-Aviv (Israel)

    2002-02-01

    Background: Abdominal lymphangioma is a rare benign congenital malformation of the mesenteric and/or retroperitoneal lymphatics. Clinical presentation is variable and may be misleading; therefore, complex imaging studies are necessary in the evaluation of this condition. US and CT have a major role in the correct preoperative diagnosis and provide important information regarding location, size, adjacent organ involvement, and expected complications. Objective: To evaluate the clinical and imaging findings of seven children with proven abdominal cystic lymphangioma. Materials and methods: Clinical and imaging files of seven children with pathologically proven abdominal lymphangioma, from three university hospitals, were retrospectively evaluated. Patient's ages ranged from 1 day to 6 years (mean, 2.2 years). Symptoms and signs included evidence of inflammation, abnormal prenatal US findings, chronic abdominal pain, haemorrhage following trauma, clinical signs of intestinal obstruction, and abdominal distension with lower extremities lymphoedema. Plain films of five patients, US of six patients and CT of five patients were reviewed. Sequential imaging examinations were available in two cases. Results: Abdominal plain films showed displacement of bowel loops by a soft tissue mass in five of six patients, two of them with dilatation of small bowel loops. US revealed an abdominal multiloculated septated cystic mass in five of six cases and a single pelvic cyst in one which changed in appearance over 2 months. Ascites was present in three cases. CT demonstrated a septated cystic mass of variable sizes in all available five cases. Sequential US and CT examinations in two patients showed progressive enlargement of the masses, increase of fluid echogenicity, and thickening of walls or septa in both cases, with multiplication of septa in one case. At surgery, mesenteric lymphangioma was found in five patients and retroperitoneal lymphangioma in the other two

  7. [Abdominal actinomycosis with IUD].

    Science.gov (United States)

    Kamprath, S; Merker, A; Kühne-Heid, R; Schneider, A

    1997-01-01

    We report a case of abdominal actinomycosis in a 54 year old woman using an intrauterine device for a period of 8 years. The most important finding was a tuboovarialabscess at the left pelvic side with involvement of the serosa of the jejunum, ileum, sigma, and omentum majus. Intraoperative exploration showed a solid retroperitoneal infiltration between the pelvic side wall and sigma. Another infiltration was found on the left side of the abdominal wall. The diagnosis was confirmed by histopathological examination and the patient was treated by a combination of Aminopenicillin and Metronidazol. After a period of three months we observed a complete regression of the clinical and the MRI findings.

  8. Morphological Evidence of Telocytes in Mice Aorta

    Institute of Scientific and Technical Information of China (English)

    Hong-Qi Zhang; Shan-Shan Lu; Ting Xu; Yan-Ling Feng; Hua Li; Jun-Bo Ge

    2015-01-01

    Background:Telocytes (TCs) are a novel type of interstitial cells,which have been recently described in a large variety of cavitary and noncavitary organs.TCs have small cell bodies,and remarkably thin,long,and moniliform prolongations called telopodes (Tps).Until now,TCs have been found in various loose connective tissues surrounding the arterioles,venules,and capillaries,but as a histological cellular component,whether TCs exist in large arteries remains unexplored.Methods:TCs were identified by transmission electron microscope in the aortic arch of male C57BL/6 mice.Results:TCs in aortic arch had small cell bodies (length:6.06-13.02 μm; width:1.05-4.25 μm) with characteristics of specific long (7.74-39.05 μm),thin,and moniliform Tps; TCs distributed in the whole connective tissue layer of tunica adventitia:TCs in the innermost layer of tunica adventitia,located at the juncture between media and adventitia,with their long axes oriented parallel to the outer elastic membrane; and TCs in outer layers oftunica adventitia,were embedded among transverse and longitudinal oriented collagen fibers,forming a highly complex three-dimensional meshwork.Moreover,desmosomes were observed,serving as pathways connecting neighboring Tps.In addition,vesicles shed from the surface of TCs into the extracellular matrix,participating in some biological processes.Conclusions:TCs in aorta arch are a newly recognized complement distinct from other interstitial cells in large arteries,such as fibroblasts.And further biologically functional correlations need to be elucidated.

  9. Intramural aortic hematomas; Intramurale Haematome der Aorta

    Energy Technology Data Exchange (ETDEWEB)

    Raab, B.W.; Vosshenrich, R.; Fischer, U.; Funke, M.; Grabbe, E. [Goettingen Univ. (Germany). Abt. fuer Roentgendiagnostik

    2001-08-01

    Intramural hematomas (IMH) are regarded as a hemorrhage into the aortic wall. In general a traumatic form can be differentiated from a spontaneous non-traumatic. There is a predisposition of IMH with arterial hypertension and mesoectodermal dysplastic syndromes. The diagnosis is established with the clinical presentation in combination with the findings of different imaging modalities. Acute and subacute discomfort associated with a tendency of collaps are considered as typical presenting complaints. A semicircular or concentric thickening of the aortic wall with the absence of blood flow or a dissection membran are typical findings in transesophageal echocardiography, computed tomography and magnetic resonance tomography. From a differential diagnostic point of view a distinction from atherosclerotic wall changes, intraluminal thrombi and inflammatory aortic diseases is essential. The IMH is considered as an early presentation of aortic dissection, put into and treated according to the Stanford classification. In the course of natural history an IMH can disappear, rupture or progress into a classic aortic dissection. (orig.) [German] Das intramurale Haematom (IMH) ist eine Einblutung in die Aortenwand. Grundsaetzlich kann zwischen traumatischer Genese und einer atraumatischen spontanen Form unterschieden werden. Praedisponierend sind arterielle Hypertension und mesoektodermale Dysplasiesyndrome. Die Diagnose ergibt sich aus der Klinik und den Befunden in den bildgebenden Verfahren. Zu den klinischen Symptomen zaehlen akut oder subakut auftretende Schmerzen, assoziiert mit einer Kollapsneigung. Typische Befunde in der transoesophagealen Echokardiographie, der Computer- oder der Magnetresonanztomographie sind eine halbmondfoermige oder konzentrische Wandverdickung der Aorta ohne Nachweis von Blutfluss oder einer Dissektionsmembran mit Dichtewerten bzw. Signalintensitaeten in Abhaengigkeit vom Alter der Einblutung. Differenzialdiagnostisch ist eine Abgrenzung

  10. Morphological Evidence of Telocytes in Mice Aorta

    Directory of Open Access Journals (Sweden)

    Hong-Qi Zhang

    2015-01-01

    Full Text Available Background: Telocytes (TCs are a novel type of interstitial cells, which have been recently described in a large variety of cavitary and noncavitary organs. TCs have small cell bodies, and remarkably thin, long, and moniliform prolongations called telopodes (Tps. Until now, TCs have been found in various loose connective tissues surrounding the arterioles, venules, and capillaries, but as a histological cellular component, whether TCs exist in large arteries remains unexplored. Methods: TCs were identified by transmission electron microscope in the aortic arch of male C57BL/6 mice. Results: TCs in aortic arch had small cell bodies (length: 6.06-13.02 μm; width: 1.05-4.25 μm with characteristics of specific long (7.74-39.05 μm, thin, and moniliform Tps; TCs distributed in the whole connective tissue layer of tunica adventitia: TCs in the innermost layer of tunica adventitia, located at the juncture between media and adventitia, with their long axes oriented parallel to the outer elastic membrane; and TCs in outer layers of tunica adventitia, were embedded among transverse and longitudinal oriented collagen fibers, forming a highly complex three-dimensional meshwork. Moreover, desmosomes were observed, serving as pathways connecting neighboring Tps. In addition, vesicles shed from the surface of TCs into the extracellular matrix, participating in some biological processes. Conclusions: TCs in aorta arch are a newly recognized complement distinct from other interstitial cells in large arteries, such as fibroblasts. And further biologically functional correlations need to be elucidated.

  11. Onze anos de experiência com emprego do anel intraluminal para tratamento das doenças da aorta

    Directory of Open Access Journals (Sweden)

    BERNARDES Rodrigo de Castro

    1999-01-01

    Full Text Available O tratamento cirúrgico das doenças da aorta é geralmente acompanhado de altas taxas de morbimortalidade. O paciente que tem média de idade avançada geralmente é apresentado ao cirurgião em estado grave, com má condição nutricional, muitas vezes com alterações em vários órgãos e sistemas causados pela própria doença aguda. A correção convencional exige técnicas coadjuvantes complexas e agressivas como a circulação extracorpórea prolongada, hipotermia profunda, parada circulatória total além de prolongados tempos de pinçamento de aorta. Na tentativa de reduzir a agressão cirúrgica no paciente já intensamente debilitado pela própria doença, desenvolvemos, em 1988, um anel intraluminal (1, 2 que tem medidas projetadas e experimentadas para facilitar a sua manipulação e anastomose, proporcionando uma diminuição acentuada no tempo de operação, tempo de CEC, tempo de pinçamento de aorta, excluindo muitas vezes a circulação extracorpórea e a hipotermia, obtendo uma anastomose fácil, rápida, segura e hemostática. Entre março de 1988 e janeiro de 1999, 432 pacientes foram submetidos a tratamento cirúrgico de dissecções ou aneurismas da aorta em nosso Serviço. Em 328 pacientes empregamos o anel intraluminal como técnica de anastomose. Usamos 489 anéis. Cento e vinte e cinco pacientes eram portadores de dissecção aguda de aorta do tipo A, 29 eram portadores de dissecção aguda de aorta do tipo B, 81 de aneurisma de aorta ascendente, 8 de aneurisma de arco aórtico, 28 pacientes eram portadores de aneurisma de aorta torácica descendente, 17 eram portadores de aneurisma toracoabdominal e 40 pacientes de aneurisma de aorta abdominal infra-renal. A mortalidade global foi de 13,41%. O seguimento ambulatorial destes pacientes variou de 11 anos a 25 dias. A curva actuarial de sobrevivência em 11 anos mostra 67,3%. Em nenhum caso observamos as complicações descritas na literatura, como embolia, formação de

  12. 灸法对肠易激综合征慢性内脏痛镇痛效应的研究与展望%Moxibustion therapy for chronic abdominal pain due to irritable bowel syndrome

    Institute of Scientific and Technical Information of China (English)

    包春辉; 吴焕淦; 黄任佳; 王硕硕; 周志刚; 胡智海; 赵继梦; 王思瑶; 谭琳蓥; 刘世敏

    2015-01-01

    BACKGROUND:Chronic visceral pain is one of major complaints of irritable bowel syndrome which seriously affects patient’s quality of life. Recent researches have shown that moxibustion therapy has positive effects on aleviating chronic visceral pain in irritable bowel syndrome patients. OBJECTIVE: To study the clinical utility of moxibustion in coping with chronic visceral pain of irritable bowel syndrome patients, and shed light on the theoretical basis of moxibustion analgesia, thereby to give insights into the further research and application on moxibustion. METHODS: With the key words of “moxibustion, irritable bowel syndrome, visceral pain, abdominal pain” in Chinese and in English, respectively, a computer-based search was performed in CNKI, VIP, Wanfang and PubMed databases for articles published from January 1990 to October 2014. After the initial screening, the remained articles went through further selection and categorization. RESULTS AND CONCLUSION:The result shows promising results of moxibustion on relieving chronic visceral pain for both two subtypes of irritable bowel syndrome patients, diarrhea type and constipation type. Moxibustion may exert an analgesic effect on chronic visceral pain in irritable bowel syndrome patients through regulation of visceral hypersensitivity, gastrointestinal motility disorders, brain-gut axis and neuroendocrine system disorders, immune dysfunction and low-grade inflammation in the gut, psychological abnormalities, and alteration of intestinal flora. However, to fuly understand the analgesia effect of moxibustion and elucidate its mechanism, more standardized randomized controled trials employing advanced scientific techniques and equipments wil stil be needed in the future.%背景:慢性内脏痛是肠易激综合征患者最主要的临床表现之一,患者的生活质量受到严重影响。近年研究表明,灸法对肠易激综合征患者慢性内脏痛的治疗取得了一定

  13. Abdominal lift for laparoscopic cholecystectomy.

    Science.gov (United States)

    Gurusamy, Kurinchi Selvan; Koti, Rahul; Davidson, Brian R

    2013-08-31

    pneumoperitoneum group). There was no significant difference in the proportion of people discharged as laparoscopic cholecystectomy day-patients (two trials; 15/31 (weighted proportion 48.5%) versus 9/31 (29%); RR 1.67; 95% CI 0.85 to 3.26). Abdominal wall lift with or without pneumoperitoneum does not seem to offer an advantage over pneumoperitoneum in any of the patient-oriented outcomes for laparoscopic cholecystectomy in people with low anaesthetic risk. Hence it cannot be recommended routinely. The safety of abdominal wall lift is yet to be established. More research on the topic is needed because of the risk of bias in the included trials and because of the risk of type I and type II random errors due to the few participants included in the trials. Future trials should include people at higher anaesthetic risk. Furthermore, such trials should include blinded assessment of outcomes.

  14. Systemic lupus erythematosus : abdominal radiologic findings

    Energy Technology Data Exchange (ETDEWEB)

    Oh, Jae Cheon; Cho, On Koo; Lee, Yong Joo; Bae, Jae Ik; Kim, Yong Soo; Rhim, Hyun Chul; Ko, Byung Hee [Hanyang Univ. College of Medicine, Seoul (Korea, Republic of)

    1999-06-01

    Systemic lupus erythematosus(SLE) is a systemic disease of unknown etiology. Its main pathology is vasculitis and serositis, due to deposition of the immune complex or antibodies. Most findings are nonspecific ; abdominal manifestations include enteritis, hepatomegaly, pancreatic enlargement, serositis, lymphadenopathy, splenomegaly, nephritis, interstitial cystitis, and thrombophlebitis. We described radiologic findings of various organ involvement of SLE; digestive system, serosa, reticuloendothelial system, urinary system, and venous system. Diagnosis of SLE was done according to the criteria of American Rheumatism Association. Understanding of the variable imaging findings in SLE may be helpful for the early detection of abdominal involvement and complications.

  15. Proximal aortic stent-graft displacement with type I endoleak due to Heimlich maneuver.

    Science.gov (United States)

    Lin, Peter H; Bush, Ruth L; Lumsden, Alan B

    2003-08-01

    The Heimlich maneuver has saved countless lives by relieving foreign body obstruction from the respiratory tract. Complications related to this life-saving technique, particularly involving the abdominal aorta, are extremely rare. We report the case of a patient who underwent successful endovascular abdominal aortic aneurysm (AAA) repair, with AAA reduction at postoperative surveillance. Endograft displacement after performance of the Heimlich maneuver resulted in a proximal type I endoleak. This case underscores both the potential for aortic trauma from the Heimlich maneuver and the risk for clinical failure as a result of abdominal compression after successful endovascular AAA repair.

  16. Adult abdominal hernias.

    LENUS (Irish Health Repository)

    Murphy, Kevin P

    2014-06-01

    Educational Objectives and Key Points. 1. Given that abdominal hernias are a frequent imaging finding, radiologists not only are required to interpret the appearances of abdominal hernias but also should be comfortable with identifying associated complications and postrepair findings. 2. CT is the imaging modality of choice for the assessment of a known adult abdominal hernia in both elective and acute circumstances because of rapid acquisition, capability of multiplanar reconstruction, good spatial resolution, and anatomic depiction with excellent sensitivity for most complications. 3. Ultrasound is useful for adult groin assessment and is the imaging modality of choice for pediatric abdominal wall hernia assessment, whereas MRI is beneficial when there is reasonable concern that a patient\\'s symptoms could be attributable to a hernia or a musculoskeletal source. 4. Fluoroscopic herniography is a sensitive radiologic investigation for patients with groin pain in whom a hernia is suspected but in whom a hernia cannot be identified at physical examination. 5. The diagnosis of an internal hernia not only is a challenging clinical diagnosis but also can be difficult to diagnose with imaging: Closed-loop small-bowel obstruction and abnormally located bowel loops relative to normally located small bowel or colon should prompt assessment for an internal hernia.

  17. Abdominal and Pelvic CT

    Medline Plus

    Full Text Available ... as ulcerative colitis or Crohn's disease , pancreatitis or liver cirrhosis. cancers of the liver, kidneys, pancreas, ovaries and bladder as well as ... injuries to abdominal organs such as the spleen, liver, kidneys or other internal organs in cases of ...

  18. Abdominal and Pelvic CT

    Medline Plus

    Full Text Available ... to help diagnose the cause of abdominal or pelvic pain and diseases of the internal organs, small bowel and colon, such as: infections such as appendicitis , pyelonephritis or infected fluid collections, also known as abscesses. inflammatory bowel disease such as ulcerative colitis or Crohn's ...

  19. Abdominal wall hernias: imaging with spiral CT

    Energy Technology Data Exchange (ETDEWEB)

    Stabile Ianora, A.A.; Midiri, M.; Vinci, R.; Rotondo, A.; Angelelli, G. [Department of Radiology, Bari University Hospital (Italy)

    2000-06-01

    Computed tomography is an accurate method of identifying the various types of abdominal wall hernias, especially if they are clinically occult, and of distinguishing them from other diseases such as hematomas, abscesses and neoplasia. In this study we examined the CT images of 94 patients affected by abdominal wall hernias observed over a period of 6 years. Computed tomography clearly demonstrates the anatomical site of the hernial sac, the content and any occlusive bowel complications due to incarceration or strangulation. Clinical diagnosis of external hernias is particularly difficult in obese patients or in those with laparotic scars. In these cases abdominal imaging is essential for a correct preoperative diagnosis and to determine the most effective treatment. (orig.)

  20. Abdominal Wall Endometrioma. Report of Two Cases

    Directory of Open Access Journals (Sweden)

    Tahiluma Santana Pedraza

    2014-08-01

    Full Text Available Abdominal wall endometrioma is a condition rarely seen by surgeons. It represents a diagnostic challenge due to its similarity with other tumors. This entity occurs in fertile women and often appears two to five years after gynecological and obstetric surgical procedures. It must be considered when dealing with a cyclically painful nodule located in a laparotomy scar. The diagnosis is established by histological examination; most imaging tests determine the characteristics of the lesion, concomitant lesions and the intra-abdominal origin or location in the abdominal wall. The cases of two patients treated at the General Surgery Department of the María Eugenia González Comprehensive Diagnostic Center in the Capital District, Venezuela, are presented. Wide excision of the tissue and histological examination were performed, confirming the diagnosis. The postoperative course was uneventful. This case is presented given the rarity of this condition.

  1. Right thoracotomy approach for repair of recurrent or complex coarctation of the aorta using an extra-anatomic ascending aorta to descending aorta bypass graft off-pump.

    Science.gov (United States)

    Tabry, Imad F; Zachariah, Zachariah P

    2013-01-01

    A previously described but rarely used surgical technique for the repair of complex or recurrent coarctation of the aorta through a right thoracotomy approach is presented in detail. It has the advantages of being simple and avoiding left chest re-entry, median sternotomy and cardiopulmonary bypass altogether.

  2. Children's (Pediatric) Abdominal Ultrasound Imaging

    Medline Plus

    Full Text Available ... are the limitations of Abdominal Ultrasound Imaging? What is Abdominal Ultrasound Imaging? Ultrasound is safe and painless, ... through the blood vessels. top of page How is the procedure performed? For most ultrasound exams, you ...

  3. Children's (Pediatric) Abdominal Ultrasound Imaging

    Medline Plus

    Full Text Available ... particularly valuable for evaluating abdominal, pelvic or scrotal pain in children. Preparation will depend on the type ... help a physician determine the source of abdominal pain, such as gallstones, kidney stones, abscesses or an ...

  4. Children's (Pediatric) Abdominal Ultrasound Imaging

    Medline Plus

    Full Text Available ... or kidneys. top of page What are some common uses of the procedure? Abdominal ultrasound imaging is ... Except for traumatic injury, appendicitis is the most common reason for emergency abdominal surgery. Ultrasound imaging can ...

  5. Screening for Abdominal Aortic Aneurysm

    Science.gov (United States)

    Understanding Task Force Recommendations Screening for Abdominal Aortic Aneurysm The U.S. Preventive Services Task Force (Task Force) has issued a final recommendation statement on Screening for Abdominal Aortic Aneurysm. This final ...

  6. Abdominal aortic aneurysm repair - open

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/007392.htm Abdominal aortic aneurysm repair - open To use the sharing features on this page, please enable JavaScript. Open abdominal aortic aneurysm repair is surgery to fix a widened part ...

  7. Elastic fibers and collagen distribution in human aorta

    Science.gov (United States)

    Vieira-Damiani, G.; Ferro, D. P.; Adam, R. L.; de Thomaz, A. A.; Pelegati, V.; Cesar, C. L.; Metze, K.

    2011-03-01

    Elastic and collagen fibers are essential components of the aorta, the remodeling of these structures is accompanied with aging in various diseases and life-threatening events. While the elastic fibers confer resilience to major blood vessels collagen confers resistance to the same. Elastic fibers are easily visualized in the fluorescent light when stained with hematoxylin eosin. Second Harmonic Generation (SHG) is a non linear signal that occurs only in molecules without inversion symmetry and is particularly strong in the collagen fibers arranged in triple helices. The aim of this paper is to describe the distribution of collagen in the thickness of the thoracic aorta, and to demonstrate the distribution of between elastic fibers. The images were acquired in a multifoton microscopy and both signals, Two-phtoton excitaded fluorescence (TPEF) and SHG, were excited by a Ti:Sapphire laser. We used a band pass filter to filter the SHG signal from the TPEF signal. The thickness of the aorta varies 2-3 mm, and the image was composed of the juxtaposition of images of 220 x 220 microns. We acquired images of a histological slide of the thoracic aorta stained with picrosirius red (specific for collagen) at a wavelength of 670nm SHG subsequently acquired images with the same region and observed that the images are overlapping. Therefore, the following images were acquired by confocal microscopy (fluorescence of eosin for visualization of elastic fibers) and for collagen SHG. After reconstruction of the images, we observed the distribution of collagen along the aorta.

  8. Increased RhoA translocation in aorta of diabetic rats

    Institute of Scientific and Technical Information of China (English)

    Jiping TANG; Ikuyo KUSAKA; Amber R MASSEY; Shadon ROLLINS; John H ZHANG

    2006-01-01

    Aim: To analyze RhoA expression and activation in the aorta of diabetic rats. Methods: Male SD rats (n=70) were divided into 2 groups: the diabetic group and the control group. Diabetes was induced by intravenous injection of streptozotocin (55 mg/kg). The Rats were studied 3 weeks after the induction of diabetes. Western blotting was used to measure the expression and activation of Rho. Results: Heart rate was measured 24 h/d; it decreased by 58±13 beats/min in the diabetic rats. Isometric tension showed that the contraction of diabetic aorta was significantly reduced compared with that of control aorta when stimulated by KCl and serotonin. The relaxation of the diabetic aorta was reduced when stimulated by acetylcholine. An enhanced RhoA translocation in the aortic tissues of diabetic rats was determined by a 90% increase in membrane-bound RhoA, indicating that the activation of RhoA is markedly increased in the diabetic aorta. Conclusion: Our data suggest that upregulated RhoA could be involved in the vascular dysfunction of diabetic rats.

  9. Percutaneous drainage of abdominal abcess

    Energy Technology Data Exchange (ETDEWEB)

    Men, Sueleyman E-mail: suleyman.men@deu.edu.tr; Akhan, Okan; Koeroglu, Mert

    2002-09-01

    The mortality in undrained abdominal abscesses is high with a mortality rate ranging between 45 and 100%. The outcome in abdominal abscesses, however, has improved due to advances in image guided percutaneous interventional techniques. The main indications for the catheter drainage include treatment or palliation of sepsis associated with an infected fluid collection, and alleviation of the symptoms that may be caused by fluid collections by virtue of their size, like pancreatic pseudocele or lymphocele. The single liver abscesses may be drained with ultrasound guidance only, whereas the multiple abscesses usually require computed tomography (CT) guidance and placement of multiple catheters. The pancreatic abscesses are generally drained routinely and urgently. Non-infected pancreatic pseudocysts may be simply observed unless they are symptomatic or cause problems such as pain or obstruction of the biliary or the gastrointestinal tract. Percutaneous routes that have been described to drain pelvic abscesses include transrectal or transvaginal approach with sonographic guidance, a transgluteal, paracoccygeal-infragluteal, or perineal approach through the greater sciatic foramen with CT guidance. Both the renal and the perirenal abscesses are amenable to percutaneous drainage. Percutaneous drainage provides an effective and safe alternative to more invasive surgical drainage in most patients with psoas abscesses as well.

  10. Abdominal closed trauma in children. Trauma abdominal cerrado en el niño.

    Directory of Open Access Journals (Sweden)

    Rogelio Rodríguez Castillo

    Full Text Available Blunt abdominal trauma constitutes 90% approximately of the abdominal injuries in children. Due to the augmented size of the child trunk in relation to their extremities, the abdominal lesions are extremely frequents. The abdominal trauma is present in 20-30% of the patients with serious trauma. It's the second cause of death for accidents after the cranial traumatism in the pediatric patient. We presented the Good Clinical Practices Guideline for Blunt Abdominal Trauma, approved by consensus in the 2nd National Good Clinical Practices Workshop in Pediatric Surgery (Manzanillo, Cuba, September 31 - October 3, 2002.

    El trauma abdominal cerrado constituye aproximadamente el 90 % de los traumatismos abdominales en niños. Debido al tamaño aumentado del tronco del niño en relación con sus extremidades las lesiones abdominales son extremadamente frecuentes. El trauma abdominal está presente en el 20-30 % de los pacientes con trauma grave. Es la segunda causa de muerte por accidentes, después del traumatismo craneal, en el paciente pediátrico. Se presenta la Guía de Buenas Prácticas Clínicas para trauma abdominal cerrado, aprobada por consenso en el 2º Taller Nacional de Buenas Prácticas Clínicas en Cirugía Pediátrica (Manzanillo, 31 de septiembre al 3 de octubre del 2002.

  11. Análisis del comportamiento mecánico en una sección de la aorta // Mechanical behavior analysis in an aorta section

    Directory of Open Access Journals (Sweden)

    A. González-Martin

    2009-05-01

    achieved results and the ones obtained by otherauthors. That is due to the different methods used by different authors and the difficulty in theexperimentation in humans. It was only possible to establish critical areas where some illnesses arepresented.Key words: aorta, simulation, finite elements (EF, hiperelásticity

  12. A subpopulation of large granular von Willebrand Ag negative and CD105 positive endothelial cells, isolated from abdominal aortic aneurysms, overexpress ICAM-1 and Fas antigen.

    Science.gov (United States)

    Páez, Araceli; Archundia, Abel; Méndez Cruz, René; Rodríguez, Emma; López Marure, Rebeca; Masso, Felipe; Aceves, José Luis; Flores, Leopoldo; Montaño, Luis F

    2002-01-01

    The aim of this work was to determine whether there is a pre-established basal condition of the endothelial cells isolated from aortic abdominal aneurysm that might augment immune effector mechanisms and thus provide us an insight into the possible causes of aneurysm rupture. Endothelial cells isolated from saccular aortic aneurysm fragments were analyzed by cytofluorometry for the expression of different immune response-related molecules. Our results showed that there is a subpopulation of granule-rich, CD105 positive and von Willebrand antigen negative endothelial cells that have an enhanced basal expression of ICAM-1, and Fas antigen, but, interestingly, no apoptotic bodies were detected. Control endothelial cells derived from healthy areas of the same abdominal aortas did not show such enhanced expression. We conclude that in the endothelium that lines abdominal aorta aneurysms there is, at least, one endothelial cell subpopulation with an apparent inhibition of programmed cell death and in a proinflammatory activation status.

  13. Optimal control applied to a thoraco-abdominal CPR model.

    Science.gov (United States)

    Jung, Eunok; Lenhart, Suzanne; Protopopescu, Vladimir; Babbs, Charles

    2008-06-01

    The techniques of optimal control are applied to a validated blood circulation model of cardiopulmonary resuscitation (CPR), consisting of a system of seven difference equations. In this system, the non-homogeneous forcing terms are chest and abdominal pressures acting as the 'controls'. We seek to maximize the blood flow, as measured by the pressure difference between the thoracic aorta and the right atrium. By applying optimal control methods, we characterize the optimal waveforms for external chest and abdominal compression during cardiac arrest and CPR in terms of the solutions of the circulation model and of the corresponding adjoint system. Numerical results are given for various scenarios. The optimal waveforms confirm the previously discovered positive effects of active decompression and interposed abdominal compression. These waveforms can be implemented with manual (Lifestick-like) and mechanical (vest-like) devices to achieve levels of blood flow substantially higher than those provided by standard CPR, a technique which, despite its long history, is far from optimal.

  14. Endometrioma de parede abdominal

    Directory of Open Access Journals (Sweden)

    Italo Accetta

    Full Text Available OBJETIVO: Relatar a experiência dos autores com as manifestações clínicas e o tratamento cirúrgico em pacientes com endometrioma de parede abdominal. MÉTODOS: Análise retrospectiva das pacientes operadas por endometrioma de parede abdominal, dando ênfase aos dados relativos à idade, sintomas, cesariana prévia, relação dos sintomas com o ciclo menstrual, exames físicos e complementares, tratamento cirúrgico, evolução pós-operatória e resultado histopatológico dos espécimes. RESULTADOS: Foram operadas 14 pacientes no período estudado, com idade entre 28 e 40 anos. A presença de massa e dor local que piorava durante a menstruação foram as queixas principais. Ultrassonografia e tomografia computadorizada foram exames importantes em localizar precisamente a doença. O tratamento cirúrgico foi exérese ampla da tumoração e dos tecidos comprometidos. As pacientes evoluíram satisfatoriamente e o histopatológico confirmou a suspeita de endometrioma de parede abdominal em todos os casos. CONCLUSÃO: Foi nítida a relação entre cesariana prévia e endometrioma de parede abdominal e estudos ultrassonográficos e tomográficos auxiliaram a planejar a abordagem cirúrgica permitindo a exérese da tumoração e de todos os tecidos adjacentes comprometidos.

  15. Ruptured abdominal aortic aneurysm.

    Science.gov (United States)

    Sachs, T; Schermerhorn, M

    2010-06-01

    Ruptured abdominal aortic aneurysm (AAA) continues to be one of the most lethal vascular pathologies we encounter. Its management demands prompt and efficient evaluation and repair. Open repair has traditionally been the mainstay of treatment. However, the introduction of endovascular techniques has altered the treatment algorithm for ruptured AAA in most major medical centers. We present recent literature and techniques for ruptured AAA and its surgical management.

  16. Zinc Prevents Abdominal Aortic Aneurysm Formation by Induction of A20-Mediated Suppression of NF-κB Pathway.

    Directory of Open Access Journals (Sweden)

    Ya-Wei Yan

    Full Text Available Chronic inflammation and degradation of elastin are the main processes in the development of abdominal aortic aneurysm (AAA. Recent studies show that zinc has an anti-inflammatory effect. Based on these, zinc may render effective therapy for the treatment of the AAA. Currently, we want to investigate the effects of zinc on AAA progression and its related molecular mechanism. Rat AAA models were induced by periaortic application of CaCl2. AAA rats were treated by daily intraperitoneal injection of ZnSO4 or vehicle alone. The aorta segments were collected at 4 weeks after surgery. The primary rat aortic vascular smooth muscle cells (VSMCs were stimulated with TNF-α alone or with ZnSO4 for 3 weeks. The results showed that zinc supplementation significantly suppressed the CaCl2-induced expansion of the abdominal aortic diameter, as well as a preservation of medial elastin fibers in the aortas. Zinc supplementation also obviously attenuated infiltration of the macrophages and lymphocytes in the aortas. In addition, zinc reduced MMP-2 and MMP-9 production in the aortas. Most importantly, zinc treatment significantly induced A20 expression, along with inhibition of the NF-κB canonical signaling pathway in vitro in VSMCs and in vivo in rat AAA. This study demonstrated, for the first time, that zinc supplementation could prevent the development of rat experimental AAA by induction of A20-mediated inhibition of the NF-κB canonical signaling pathway.

  17. Zinc Prevents Abdominal Aortic Aneurysm Formation by Induction of A20-Mediated Suppression of NF-κB Pathway.

    Science.gov (United States)

    Yan, Ya-Wei; Fan, Jun; Bai, Shu-Ling; Hou, Wei-Jian; Li, Xiang; Tong, Hao

    2016-01-01

    Chronic inflammation and degradation of elastin are the main processes in the development of abdominal aortic aneurysm (AAA). Recent studies show that zinc has an anti-inflammatory effect. Based on these, zinc may render effective therapy for the treatment of the AAA. Currently, we want to investigate the effects of zinc on AAA progression and its related molecular mechanism. Rat AAA models were induced by periaortic application of CaCl2. AAA rats were treated by daily intraperitoneal injection of ZnSO4 or vehicle alone. The aorta segments were collected at 4 weeks after surgery. The primary rat aortic vascular smooth muscle cells (VSMCs) were stimulated with TNF-α alone or with ZnSO4 for 3 weeks. The results showed that zinc supplementation significantly suppressed the CaCl2-induced expansion of the abdominal aortic diameter, as well as a preservation of medial elastin fibers in the aortas. Zinc supplementation also obviously attenuated infiltration of the macrophages and lymphocytes in the aortas. In addition, zinc reduced MMP-2 and MMP-9 production in the aortas. Most importantly, zinc treatment significantly induced A20 expression, along with inhibition of the NF-κB canonical signaling pathway in vitro in VSMCs and in vivo in rat AAA. This study demonstrated, for the first time, that zinc supplementation could prevent the development of rat experimental AAA by induction of A20-mediated inhibition of the NF-κB canonical signaling pathway.

  18. Abdominal aspergillosis: CT findings

    Energy Technology Data Exchange (ETDEWEB)

    Yeom, Suk Keu, E-mail: pagoda20@hanmail.net [Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 388-1, Poongnap2-dong, Songpa-gu, Seoul, 138-736 (Korea, Republic of); Kim, Hye Jin, E-mail: kimhyejin@amc.seoul.kr [Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 388-1, Poongnap2-dong, Songpa-gu, Seoul, 138-736 (Korea, Republic of); Byun, Jae Ho, E-mail: jhbyun@amc.seoul.kr [Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 388-1, Poongnap2-dong, Songpa-gu, Seoul, 138-736 (Korea, Republic of); Kim, Ah Young, E-mail: aykim@amc.seoul.kr [Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 388-1, Poongnap2-dong, Songpa-gu, Seoul, 138-736 (Korea, Republic of); Lee, Moon-Gyu, E-mail: mglee@amc.seoul.kr [Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 388-1, Poongnap2-dong, Songpa-gu, Seoul, 138-736 (Korea, Republic of); Ha, Hyun Kwon, E-mail: hkha@amc.seoul.kr [Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 388-1, Poongnap2-dong, Songpa-gu, Seoul, 138-736 (Korea, Republic of)

    2011-03-15

    Objective: In order to retrospectively evaluate the CT findings of abdominal aspergillosis in immunocompromised patients. Materials and methods: CT scans were reviewed with regard to the sites, number, morphologic appearance, attenuation, and the contrast enhancement patterns of the lesions in six patients (5 women, 1 man; mean age, 43.4 years; range, 23-59 years) with pathologically proved abdominal aspergillosis by two gastrointestinal radiologists in consensus. Medical records were also reviewed to determine each patient's clinical status and outcome. Results: All patients were immunocompromised state: 4 patients received immunosuppressive therapy for solid organ transplantation and 2 patients received chemotherapy for acute myeloid leukemia. Aspergillosis involved blood vessels (n = 3), liver (n = 2), spleen (n = 2), gastrointestinal tract (n = 2), native kidney (n = 1), transplanted kidney (n = 1), peritoneum (n = 1), and retroperitoneum (n = 1). CT demonstrated solid organ or bowel infarction or perforation secondary to vascular thrombosis or pseudoaneurysm, multiple low-attenuating lesions of solid organs presenting as abscesses, concentric bowel wall thickening mimicking typhlitis, or diffuse or nodular infiltration of the peritoneum and retroperitoneum. Conclusion: Familiarity with findings commonly presenting as angioinvasive features or abscesses on CT, may facilitate the diagnosis of rare and fatal abdominal aspergillosis.

  19. Demonstration of coarctation of the aorta by magnetic resonance imaging

    Energy Technology Data Exchange (ETDEWEB)

    Amparo, E.; Higgins, C.B.; Shafton, E.P.

    1984-12-01

    The physical findings in coarctation of the aorta are sufficiently characteristic to allow a reasonably accurate clinical diagnosis. The preoperative evaluation has been accomplished by catheterization, aortography, intravenous digital subtraction angiography, computed tomography (CT), and two-dimensional (2D) echocardiography. The authors report a case of coarctation of the aorta clinically suspected in a 29-year-old man. Magnetic resonance imaging (MRI) was the initial preoperative imaging technique. In retrospect, it provided sufficient information for preoperative evaluation so that other imaging techniques would not have been required.

  20. The AORTA Architecture: Integrating Organizational Reasoning in Jason

    DEFF Research Database (Denmark)

    Jensen, Andreas Schmidt; Dignum, Virginia; Villadsen, Jørgen

    2014-01-01

    the expected behavior of the agents. Agents need to be able to reason about the regulations, so that they can act within the expected boundaries and work towards the objectives of the organization. In this paper, we describe the AORTA (Adding Organizational Reasoning to Agents) architecture for making agents...... organization-aware. It is designed such that it provides organizational reasoning capabilities to agents implemented in existing agent programming languages without being tied to a specific organizational model. We show how it can be integrated in the Jason agent programming language, and discuss how...... the agents can coordinate their organizational tasks using AORTA....

  1. Finite Element Implementation of a Structurally-Motivated Constitutive Relation for the Human Abdominal Aortic Wall with and without Aneurysms

    DEFF Research Database (Denmark)

    Enevoldsen, Marie Sand; Henneberg, Kaj-Åge; Lönn, L

    2011-01-01

    The structural integrity of the abdominal aorta is maintained by elastin, collagen, and vascular smooth muscle cells. Changes with age in the structure can lead to develop-ment of aneurysms. This paper presents initial work to capture these changes in a finite element model (FEM) of a structural......-ly-motivated anisotropic constitutive relation for the “four fiber family” arterial model. First a 2D implementation is used for benchmarking the FEM implementation to fitted biaxial stress-strain data obtained experimentally from four different groups of persons; 19-29 years, 30-60 years, 61-79 years and abdominal aortic...

  2. Quality of abdominal computed tomography angiography: hand versus mechanical intravenous contrast administration in children

    Energy Technology Data Exchange (ETDEWEB)

    Ayyala, Rama S.; Lee, Edward Y. [Boston Children' s Hospital and Harvard Medical School, Department of Radiology, Boston, MA (United States); Zurakowski, David [Boston Children' s Hospital and Harvard Medical School, Departments of Anesthesiology and Surgery, Boston, MA (United States)

    2015-11-15

    Abdominal CT angiography has been increasingly used for evaluation of various conditions related to abdominal vasculature in the pediatric population. However, no direct comparison has evaluated the quality of abdominal CT angiography in children using hand versus mechanical administration of intravenous (IV) contrast agent. To compare hand versus mechanical administration of IV contrast agent in the quality of abdominal CT angiography in the pediatric population. We retrospectively reviewed the electronic medical record to identify pediatric patients (≤18 years) who had abdominal CT angiography between August 2012 and August 2013. The information obtained includes: (1) type of administration of IV contrast agent (hand [group 1] versus mechanical [group 2]), (2) size (gauge) of IV catheter, (3) amount of contrast agent administered and (4) rate of contrast agent administration (ml/s). Two reviewers independently performed qualitative and quantitative evaluation of abdominal CT angiography image quality. Qualitative evaluation of abdominal CT angiography image quality was performed by visual assessment of the degree of contrast enhancement in the region of interest (ROI) based on a 4-point scale. Quantitative evaluation of each CT angiography examination was performed by measuring the Hounsfield unit (HU) using an ROI within the abdominal aorta at two levels (celiac axis and the inferior mesenteric artery) for each child. Analysis of variance (ANOVA) using the F-test was applied to compare contrast enhancement within the abdominal aorta at two levels (celiac axis and inferior mesenteric artery) between hand administration and mechanical administration of IV contrast methods with adjustment for age. We identified 46 pediatric patients (24 male, 22 female; mean age 7.3 ± 5.5 years; range 5 weeks to 18 years) with abdominal CT angiography performed during the study period. Of these patients, 16 (35%; 1.7 ± 2.2 years; range 5 weeks to 5 years) had hand

  3. Ruptura traumática de la aorta descendente torácica Traumatic ruptura of the descending thoracic aorta

    Directory of Open Access Journals (Sweden)

    Gabriel González Sosa

    2013-03-01

    Full Text Available Los traumatismos torácicos graves (TT, ya sean abiertos o cerrados, pueden ocurrir secundarios a lesiones por arma de fuego, arma blanca, accidentes de tránsito, caídas de altura o compresiones torácicas por aplastamientos, entre otros y se han transformado en una causa importante de morbilidad y mortalidad, pero son las lesiones vasculares directamente responsables de un 20 a un 25 % del total de las muertes, causadas por estos traumatismos. La mayoría de los afectados por estas lesiones son personas jóvenes previamente sanas, fundamentalmente del sexo masculino. Se presenta un caso clínico de un paciente de 38 años de edad, con antecedentes de salud previos, que durante una riña, sufrió una herida en la región posterior del hemitórax derecho, por debajo del borde inferior de la escápula, penetrante en la cavidad torácica, ocasionada por un objeto corto punzante de fabricación artesanal, cuyo pedazo quedó dentro de esta cavidad, lo cual provocó una lesión de alrededor de 3 cm de longitud, aproximadamente a nivel de la aorta descendente torácica. El paciente fue intervenido quirúrgicamente de manera urgente, y se logró suturar la lesión vascular con éxito, proceder que casi nunca es posible debido al alto índice de mortalidad de este tipo de lesiones, pues la mayoría de las personas fallecen antes de su llegada a un centro especializado de salud.Severe thoracic traumatisms, either open or close, may occur secondary to injuries caused by firearms, knifes, traffic accidents, falls from height or thoracic compression due to crushing, among others. They have become an important cause of mortality and morbidity but they are vascular injuries directly responsible for 20 to 25 % of the total number of deaths caused by this type of traumatism. Most of the injuries occurred in healthy young people, mainly men. This is the case of a 38 years-old patient with a history of health problems, who in a street fight, suffered an injury

  4. Endovascular covered stent treatment for descending aorta pseudoaneurysm following coarctation of the aorta repair in an infant.

    Science.gov (United States)

    Takawira, Farirai F; Sinyangwe, Greenwood; Mooloo, Rene

    2010-12-01

    The development of a pseudoaneurysm is a rare complication following repair of a coarctation of the aorta. Surgical management of pseudoaneurysms is associated with high morbidity and mortality. We describe the successful endovascular deployment of a covered stent in a sick infant with a descending aorta pseudoaneurysm, following the repair of an aortic coarctation. We highlight the challenges we encountered. Endovascular repair is a safe palliative alternative to re-do open surgery in unstable infants with large pseudoaneurysms following aortic coarctation repair. The role of endovascular stents as the final definitive therapy will remain limited by the deployable, small-size stents in small, growing children.

  5. [MDCT features and anatomic-pathological basis of the diseases in central thoracic-abdominal junctional region].

    Science.gov (United States)

    Ye, Yilan; Yang, Zhigang; Li, Hua; Deng, Wen; Li, Yuan; Guo, Yingkun

    2012-02-01

    This paper is to determine relationship between MDCT features and anatomic-pathology of the diseases in central thoracic-abdominal junctional region. 3 cadavers were cut transversely and another 3 vertically to observe the anatomy of thoracic-abdominal junctional zone. 93 patients with diseases in central thoracic-abdominal junctional zone were scanned with MDCT. The correlation between MDCT features of the diseases in central thoracic-abdominal junctional region and the anatomic-pathology of the diseases in this region was evaluated. On cadaver sections, central thoracic-abdominal junctional region was an area between anterior chest wall and dorsal spine in vertical direction. The region was separated into upper and lower sections by diaphragm. The upper section mainly contains heart and pericardium, while the lower contains broad ligament and left lobe of liver. The hiatus of diaphragm are vena caval foramen, esophageal foramen and aortic foramen in anterior-posterior turn. In the present study, 23 patients had portal hypertension, 18 had dissection of aorta, 8 got diseases in inferior vena cava, 9 had lymphoma, 12 got diseases in multiple vertebrae, 7 had lower thoracic esophageal carcinoma accompanied with metastasis in upper abdominal lymph nodes, 9 had carcinoma of abdominal esophagus and/or gastric cardia, 4 had esophageal hiatal hernia and 3 patients had neurogenic tumor in posterior mediastinum and/or superior spatium retroperitoneale. The MDCT features and distribution of the diseases in central thoracic-abdominal junctional region influence the anatomic-pathology characteristics in this region.

  6. Isolated Anomalous Origin of Left Pulmonary Artery From the Descending Aorta: An Embryologic Ambiguity.

    Science.gov (United States)

    Gnanappa, Ganesh Kumar; Laohachai, Karina; Orr, Yishay; Ayer, Julian

    2016-11-01

    Anomalous origin of a branch pulmonary artery from the aorta is a rare malformation, accounting for 0.12% of all congenital heart defects. Anomalous origin of the left pulmonary artery from the aorta (ALPA) constitutes a small proportion of these cases. ALPA has been reported to arise from the ascending aorta with various embryologic postulates. We report a case of isolated ALPA arising from the descending aorta in association with a patent ductus arteriosus, to emphasize its embryologic ambiguity.

  7. Segmentation of the thoracic aorta in noncontrast cardiac CT images.

    Science.gov (United States)

    Avila-Montes, Olga C; Kurkure, Uday; Nakazato, Ryo; Berman, Daniel S; Dey, Damini; Kakadiaris, Ioannis A

    2013-09-01

    Studies have shown that aortic calcification is associated with cardiovascular disease. In this study, a method for localization, centerline extraction, and segmentation of the thoracic aorta in noncontrast cardiac-computed tomography (CT) images, toward the detection of aortic calcification, is presented. The localization of the right coronary artery ostium slice is formulated as a regression problem whose input variables are obtained from simple intensity features computed from a pyramid representation of the slice. The localization, centerline extraction, and segmentation of the aorta are formulated as optimal path detection problems. Dynamic programming is applied in the Hough space for localizing key center points in the aorta which guide the centerline tracing using a fast marching-based minimal path extraction framework. The input volume is then resampled into a stack of 2-D cross-sectional planes orthogonal to the obtained centerline. Dynamic programming is again applied for the segmentation of the aorta in each slice of the resampled volume. The obtained segmentation is finally mapped back to its original volume space. The performance of the proposed method was assessed on cardiac noncontrast CT scans and promising results were obtained.

  8. Surgical exclusion of postsurgical pseudoaneurysm of the ascending aorta

    Directory of Open Access Journals (Sweden)

    Ramachandra Barik

    2014-01-01

    Full Text Available Pseudoaneurysm of ascending aorta after cardiac surgery is rare in children. We report a case of successful surgical exclusion of ascending aortic pseudoaneurysm in a 15-year-old boy. The neck of the aneurysm was in close proximity to the right coronary artery (RCA.

  9. Trauma to the Thoracic Aorta and the Great Vessels

    Energy Technology Data Exchange (ETDEWEB)

    Hong, Min Ji; Kim, Young Tong; Jou, Sung Shick; Kim, Sang Won; Shin, Hyeong Cheol; Kim, Il Young [Soonchunhyang University Cheonan Hospital, Cheonan (Korea, Republic of)

    2009-04-15

    Trauma to the thoracic aorta and the great vessels carries a high mortality rate. The survival rate can be improved if these patients are given prompt and appropriate treatment. Various types of vascular injury are caused by blunt, penetrating, iatrogenic trauma. This article reviews the multimodality imaging of traumatic injuries to the aortic and great vessels

  10. Mineralization of human aortas with coarctation: quantitative electron probe microanalysis

    Energy Technology Data Exchange (ETDEWEB)

    Krefting, E.R.; Roehrig, T.; Broecker, W.; Anyanwu, E.; Schlake, W.; Dittrich, H.; Hoehling, H.J.

    1982-01-01

    Aortas with coarctation (isthmus stenosis) are obviously an ideal model to investigate pressure dependent changes of the aorta, as one can compare the proximal region (high pressure) with the distal region (low pressure). 7 aortas of patients aged from 2 months to 54 years were investigated. The concentrations of Na, Mg, P, S, C1, K, and Ca were determined by electronprobe microanalysis. Ca and P are constituent parts of the developing mineral and are mainly discussed. The Ca/P ratio (by weight) is about 0.3 in the unmineralized and about 2 in the mineralized tissue. Mineralization is demonstrated by a parallel increase of Ca, P, and the Ca/P ratio. Enrichments of Ca and P are found above all in a subintimal band. Usually they occur proximally and distally, but are much more pronounced proximally. Even in the aorta of a 2 month old infant enrichments were found proximally, but not distally. Thus mineral deposits occur very early in regions of hypertension. The differences between the proximal and distal region may demonstrate the influence of blood pressure on vascular mineralization. The mineralization starts in small compartments, which increase in size and number in the process of mineralization. Mineralized regions could often be localized by cathodoluminescence. But to demonstrate and localize the initial mineral deposits and to quantify element contents, electronprobe microanalysis became indispensable.

  11. Xanthorrhizol induces endothelium-independent relaxation of rat thoracic aorta.

    Science.gov (United States)

    Campos, M G; Oropeza, M V; Villanueva, T; Aguilar, M I; Delgado, G; Ponce, H A

    2000-06-08

    Xanthorrhizol, a bisabolene isolated from the medicinal plant Iostephane heterophylla, was assayed on rat thoracic aorta rings to elucidate its effect and likely mechanism of action, by measuring changes of isometric tension. Xanthorrhizol (1, 3, 10, 30 and 100 microg/mL) significantly inhibited precontractions induced by KCI-; (60mM), noradrenaline (10(-6) M) or CaCl2 (1.0 mM). Increasing concentrations of external calcium antagonized the inhibitory effect on KCl-induced contractions. The vasorelaxing effect of xanthorrhizol was not affected by indomethacin (10 microM) or L-NAME (100 microM) in intact rat thoracic aorta rings precontracted by noradrenaline, which suggested that the effect was not mediated through either endothelium-derived prostacyclin (PGI2) or nitric oxide release from endothelial cells. Endothelium removal did not affect the relaxation induced by xanthorrhizol on rat thoracic aorta rings, discarding the participation of any substance released by the endothelium. Xanthorrhizol inhibitory effect was greater on KCI- and CaCl2-induced contractions than on those induced by noradrenaline. Xanthorrhizol inhibitory effect in rat thoracic aorta is likely explained for interference with calcium availability by inhibiting calcium influx through both voltage- and receptor-operated channels.

  12. Abdominal ultrasound-scanning versus non-contrast computed tomography as screening method for abdominal aortic aneurysm

    DEFF Research Database (Denmark)

    Liisberg, Mads; Diederichsen, Axel C.; Lindholt, Jes S.

    2017-01-01

    tested using paired t-test. Results: Due to logistics, 533 underwent both nCT and US. In four patients, aortae could not be visualized with US, and two of these had an AAA (>30 mm) as diagnosed by nCT. Using nCT 30 (5.7%, 95% CI: 4.2;7.5%) AAA were found. US failed to detect 9 of these, but diagnosed 3...

  13. EXPERIENCE ON SURGICAL MANAGEMENT OF RUPTURE OF ABDOMINAL AORTIC ANEURYSM

    Institute of Scientific and Technical Information of China (English)

    管珩; 郑月宏; 李拥军; 刘昌伟; 刘暴; 叶炜

    2003-01-01

    Objective. To describe our surgical experience on rupture of abdominal aortic aneurysm .Methods. Two cases of ruptured aortic aneurysms with severe complication were analyzed. Aorta re-construction procedures were performed using bifurcated e-PTFE grafts during emergency operation. Diag-nosis, preoperative resuscitation, emergency surgical intervention, and postoperative complications of thesepatients were summarized and discussed.Results. Rupture of aortic aneurysm in both patients presented as a huge retroperitoneum haematomaby computed tomography scan. They were successfully saved by prompt body fluid compensation, emer-gency procedure, intraoperative resuscitation, and postoperative intensive care.Conclusions. Correct diagnosis, prompt surgical management, immediate intraoperative proximal aortaclamping during procedure, and effective management of postoperative complications were the key pointsto successful treatment of ruptured aortic aneurysm.

  14. Abdominal aortic aneurysm and histological, clinical, radiological correlation.

    Science.gov (United States)

    Rodella, Luigi Fabrizio; Rezzani, Rita; Bonomini, Francesca; Peroni, Michele; Cocchi, Marco Angelo; Hirtler, Lena; Bonardelli, Stefano

    2016-04-01

    To date, the pathogenesis of abdominal aortic aneurism (AAA) still remains unclear. As such, the aim of this study was to evaluate changes of the aortic structure during AAA. We analysed the microscopic frame of vessels sections, starting from the primum movens leading to abnormal dilatation. AAA samples were collected and processed through various staining methods (Verhoeff-Van Gieson, Masson Goldner, Sirius Red). Subsequently, the vessel morphology and collagenic web of the tunica media and adventitia were determined and the amount of type I and type III collagen was measured. We also applied immune-histochemistry markers for CD34 and PGP 9.5 in order to identify vascular and nerve structures in the aorta. Immune-positivity quantification was used to calculate the percentage of the stained area. We found increasing deposition of type I collagen and reduced type III collagen in both tunica media and adventitia of AAA. The total amount of vasa vasorum, marked with CD34, and nerva vasorum, marked with PGP 9.5, was also higher in AAA samples. Cardiovascular risk factors (blood pressure, dyslipidemia, cigarette smoking) and radiological data (maximum aneurism diameter, intra-luminal thrombus, aortic wall calcification) increased these changes. These results suggest that the tunica adventitia may have a central role in the pathogenesis of AAA as clearly there are major changes characterized by rooted inflammatory infiltration. The presence of immune components could explain these modifications within the framework of the aorta.

  15. Abdominal aortic aneurysm surgery

    DEFF Research Database (Denmark)

    Gefke, K; Schroeder, T V; Thisted, B

    1994-01-01

    The goal of this study was to identify patients who need longer care in the ICU (more than 48 hours) following abdominal aortic aneurysm (AAA) surgery and to evaluate the influence of perioperative complications on short- and long-term survival and quality of life. AAA surgery was performed in 553......, 78% stated that their quality of life had improved or was unchanged after surgery and had resumed working. These data justify a therapeutically aggressive approach, including ICU therapy following AAA surgery, despite failure of one or more organ systems....

  16. Abdominal perfusion computed tomography.

    Science.gov (United States)

    Ogul, Hayri; Bayraktutan, Ummugulsum; Kizrak, Yesim; Pirimoglu, Berhan; Yuceler, Zeynep; Sagsoz, M Erdem; Yilmaz, Omer; Aydinli, Bulent; Ozturk, Gurkan; Kantarci, Mecit

    2013-02-01

    The purpose of this article is to provide an up to date review on the spectrum of applications of perfusion computed tomography (CT) in the abdomen. New imaging techniques have been developed with the objective of obtaining a structural and functional analysis of different organs. Recently, perfusion CT has aroused the interest of many researchers who are studying the applicability of imaging modalities in the evaluation of abdominal organs and diseases. Per-fusion CT enables fast, non-invasive imaging of the tumor vascular physiology. Moreover, it can act as an in vivo biomarker of tumor-related angiogenesis.

  17. Lower Abdominal Pain.

    Science.gov (United States)

    Carlberg, David J; Lee, Stephen D; Dubin, Jeffrey S

    2016-05-01

    Although most frequently presenting with lower abdominal pain, appendicitis, colitis, and diverticulitis can cause pain throughout the abdomen and can cause peritoneal and retroperitoneal symptoms. Evaluation and management of lower intestinal disease requires a nuanced approach by the emergency physician, sometimes requiring computed tomography, ultrasonography, MRI, layered imaging, shared decision making, serial examination, and/or close follow-up. Once a presumed or confirmed diagnosis is made, appropriate treatment is initiated, and may include surgery, antibiotics, and/or steroids. Appendicitis patients should be admitted. Diverticulitis and inflammatory bowel disease can frequently be managed on an outpatient basis, but may require admission and surgical consultation.

  18. Dolor abdominal recurrente .

    Directory of Open Access Journals (Sweden)

    Rodrigo De Vivero

    2009-11-01

    Full Text Available El dolor abdominal recurrente (DAR es un problema frecuente en la consulta médica y en la subespecialidad médica y quirúrgica. El DAR es frecuentemente funcional, es decir, sin una causa orgánica aparente. El diagnóstico diferencial debe incluir pérdida de peso, sangrado gastrointestinal, fiebre persistente, diarrea crónica y vómito importante. En este artículo se revisa el diagnóstico y tratamiento, pruebas diagnósticas y manejo farmacológico y ambiental.

  19. [Differential diagnosis of abdominal pain].

    Science.gov (United States)

    Frei, Pascal

    2015-09-02

    Despite the frequency of functional abdominal pain, potentially dangerous causes of abdominal pain need to be excluded. Medical history and clinical examination must focus on red flags and signs for imflammatory or malignant diseases. See the patient twice in the case of severe and acute abdominal pain if lab parameters or radiological examinations are normal. Avoid repeated and useless X-ray exposure whenever possible. In the case of subacute or chronic abdominal pain, lab tests such as fecal calprotectin, helicobacter stool antigen and serological tests for celiac disease are very useful. Elderly patients may show atypical or missing clinical signs. Take care of red herrings and be skeptical whether your initial diagnosis is really correct. Abdominal pain can frequently be an abdominal wall pain.

  20. Abdominal wall blocks in adults

    DEFF Research Database (Denmark)

    Børglum, Jens; Gögenür, Ismail; Bendtsen, Thomas F

    2016-01-01

    Purpose of review Abdominal wall blocks in adults have evolved much during the last decade; that is, particularly with the introduction of ultrasound-guided (USG) blocks. This review highlights recent advances of block techniques within this field and proposes directions for future research.......  Recent findings Ultrasound guidance is now considered the golden standard for abdominal wall blocks in adults, even though some landmark-based blocks are still being investigated. The efficiency of USG transversus abdominis plane blocks in relation to many surgical procedures involving the abdominal wall...... been introduced with success. Future research should also investigate the effect of specific abdominal wall blocks on neuroendocrine and inflammatory stress response after surgery.  Summary USG abdominal wall blocks in adults are commonplace techniques today. Most abdominal wall blocks are assigned...

  1. Pulsatile flow in the aorta of the LVAD supported heart studied using particle image velocimetry

    Science.gov (United States)

    Moyedi, Zahra

    Currently many patients die because of the end-stage heart failure, mainly due to the reduced number of donor heart transplant organs. Studies show that a permanent left ventricular assist device (LVAD), a battery driven pump which is surgically implanted, increased the survival rate of patients with end-stage heart failure and improved considerably their quality of life. The inlet conduit of the LVAD is attached to the left ventricle and the outflow conduit anastomosed to the ascending aorta. The purpose of LVAD support is to help a weakened heart to pump blood to the rest of the body. However LVAD can cause some alterations of the natural blood flow. When your blood comes in contact with something that isn't a natural part of your body blood clots can occur and disrupt blood flow. Aortic valve integrity is vital for optimal support of left ventricular assist LVAD. Due to the existence of high continuous transvalvular pressure on the aortic valve, the opening frequency of the valve is reduced. To prevent the development of aortic insufficiency, aortic valve closure during LVAD implantation has been performed. However, the closed aortic valve reduces wash out of the aortic root, which causes blood stagnation and potential thrombus formation. So for this reason, there is a need to minimize the risks of occurring blood clot, by having more knowledge about the flow structure in the aorta during LVAD use. The current study focuses on measuring the flow field in the aorta of the LVAD assisted heart with two different types of aortic valve (Flat and Finned) using the SDSU cardiac simulator. The pulsatile pump that mimics the natural pulsing action of the heart also added to the system. The flow field is visualized using Particle Image Velocimetry (PIV). Furthermore, The fluid mechanics of aorta has been studied when LVAD conduit attached to two different locations (proximal and distal to the aortic valve) with pump speeds of 8,000 to 10,000 revolutions per minute (RPM

  2. The novel phenylpropiophenone derivates induced relaxation of isolated rat aorta.

    Science.gov (United States)

    Ivković, B; Vladimirov, S; Novaković, R; Cupić, V; Heinle, H; Gojković-Bukarica, L

    2012-07-01

    Our aim was to define how different chemical properties of newly developed phenylpropiophenone derivates (PhPds) influenced their potency and efficacy to relax rat aorta. A contribution of ion channels in the PhPds and propafenone mechanism of vasodilatation was tested. PhPds were syntethysed by substitution in the benzyl moiety with -F, -CH3 or -CF3 groups on the ortho or para position. The vasodilatation by PhPds was examined on the rings of rat aorta precontracted with phenylephrine. In order to test involvement of voltage-gated Na+ and K+ channels and L-type Ca2+ channels in a mechanism of action of PhPds, we used their blockers: lidocaine, nifedipine and 4-aminopiridine, respectively. Aorta was more sensitive to 5-ortho-trifluoromethyl derivate than to propafenone and other PhPds. The 5-para-methyl derivate had lower potency and efficacy than propafenone and other PhPds. Lidocaine did not influenced relaxation induced by PhPds, but slightly inhibited the effect of propafenone. The 4-aminopiridine only inhibited relaxation induced by 5-para-methyl derivate. Nifedipine inhibited relaxation of the rat aorta induced by 5-ortho-trifluoromethyl derivate and by propafenone. Introduction of 5-ortho-trifluoromethyl and 5-para-methyl group in the benzyl moiety of propafenone molecule changed its potency, efficacy and mechanism of action in the rat aorta. The 4-aminopiridine- and nifedipine sensitive ion channels are involved in mechanism of action of 5-para-methyl and 5-ortho-trifluoromethyl derivate. The introduction of other tested groups in the benzyl moiety does not affect pharmacological properties of the PhPds in relation to propafenone.

  3. Abdominal cystic lymphangioma mimicking appendicitis.

    Science.gov (United States)

    Wake, Sarah; Abhyankar, Aruna; Hutton, Kim

    2013-06-01

    A cystic lymphangioma arising within the abdomen is a rare entity in children. It may present with an abdominal mass and symptoms of abdominal pain, vomiting, and anorexia. These nonspecific clinical symptoms are often attributed to more common acute pediatric conditions. In this report, we describe two pediatric cases of intra-abdominal cystic lymphangioma that were initially diagnosed and treated as appendicitis. True diagnosis was only achieved on surgical excision and pathological investigation of cystic material.

  4. Abdominal Cystic Lymphangioma Mimicking Appendicitis

    OpenAIRE

    Wake, Sarah; Abhyankar, Aruna; Hutton, Kim

    2013-01-01

    A cystic lymphangioma arising within the abdomen is a rare entity in children. It may present with an abdominal mass and symptoms of abdominal pain, vomiting, and anorexia. These nonspecific clinical symptoms are often attributed to more common acute pediatric conditions. In this report, we describe two pediatric cases of intra-abdominal cystic lymphangioma that were initially diagnosed and treated as appendicitis. True diagnosis was only achieved on surgical excision and pathological investi...

  5. Abdominal pregnancy- a case report.

    Science.gov (United States)

    Okafor, Ii; Ude, Ac; Aderibigbe, Aso; Amu, Oc; Udeh, Pe; Obianyo, Nen; Ani, Coc

    2011-01-01

    A case of abdominal pregnancy in a 39 year old female gravida 4, para 0(+3) is presented. Ultrasonography revealed a viable abdominal pregnancy at 15 weeks gestational age. She was initially managed conservatively. Surgical intervention became necessary at 20 weeks gestational age following Ultrasound detection of foetal demise. The maternal outcome was favourable. This case is presented to highlight the dilemma associated with diagnosis and management of abdominal pregnancy with a review of literature.

  6. Wall Shear Stress in Aorta with Coarctation and Post-Stenotic Dilatation - Scale Resolved Simulation of Pulsatile Blood Flow

    Science.gov (United States)

    Gardhagen, Roland; Karlsson, Matts

    2012-11-01

    Large eddy simulations of pulsating blood flow in an idealized model of a human aorta with a coarctation and a post-stenotic dilatation were conducted before and after treatment of the stenosis using Ansys Fluent. The aim was to study wall shear stress (WSS), which influences the function of endothelial cells, and turbulence, which may play a role in thrombus formation. Phase average values of WSS before the treatment revealed high shear in the stenosis at peak systole, as expected, but also at the end of the dilatation. In the dilatation backflow causes a negative peak. Diastolic WSS is characterized by low amplitude oscillations, which promotes atherogenesis. Also noticeable is the asymmetric pattern between the inner and outer sides of the vessel caused by the arch upstream of the stenosis. Thus, large spatial, temporal, and probably asymmetric WSS gradients in the already diseased region suggest increased risk for further endothelial dysfunction. This reflects a complex, partly turbulent, flow pattern that may disturb the blood flow in the abdominal aorta. After treatment of the stenosis, but not the dilatation, fluctuations of velocity and WSS were still found, thus harmful flow conditions still exist.

  7. Tratamento cirúrgico da dissecção da aorta Surgical treatment of the aortic dissection

    Directory of Open Access Journals (Sweden)

    Marcos Fassheber Berlinck

    1990-04-01

    Full Text Available Entre janeiro de 1979 e dezembro de 1989, foram realizadas 85 operações para o tratamento da dissecção da aorta, sendo 50 na fase aguda e 35 na fase crónica. A mortalidade imediata (hospitalar foi de 21,1% (18 pacientes, tendo como causa principal a síndrome de baixo débito cardíaco. Foi maior nos pacientes operados na fase aguda. Dentre quatro pacientes reoperados por recidiva ou dissecção em outro local, dois faleceram. Com relação à morbidade, uma paciente, reoperada por aneurisma tóraco-abdominal, apresentou paraplegia no período de pós-operatório. O seguimento tardio mostrou boa evolução dos 63 sobreviventes.Between January 1979 and December 1989, eighty five operations were performed to treat aortic dissection, including fifty in the acute phase, and thirty five in a chronic phase. The Hospital mortality was 21.1% (eighteen patients and low cardiac output was the major cause of death. The mortality was higher in the group of patients operated upon in the acute phase. Four patients were operated upon for redissection or dissection in other localization of the aorta, and all of them died. One patient developed paraplegy in the postoperative period. The late follow-up showed good evolution in the survivors group.

  8. Analysis of the strain and stress distribution in the wall of the developing and mature rat aorta.

    Science.gov (United States)

    Rachev, A; Greenwald, S E; Kane, T P; Moore, J E; Meister, J J

    1995-01-01

    The variation of wall stress distribution with age in the thoracic and abdominal aortas of normotensive rats was studied. Dimensions of the zero-stress configurations were measured at the ages of 4, 8, 12, 20, and 52 weeks. Using data from previously published inflation tests, the circumferential stress-strain relationship was obtained in each age group. The calculated stress distribution showed that the average circumferential stress remained practically constant after the age of 20 weeks. The circumferential stress at the innermost part of the arterial wall was greater than the stress at the outermost part, but the difference was maintained at a moderate level with adjustments in the zero-stress configuration. It is speculated that, after the age of 20 weeks, changes in arterial geometry and rheological properties tend to maintain a constant stress distribution under varying conditions of loading. This distribution was achieved by enhanced growth at the inner part of the media in comparison with the growth at its outer margins and suggests that during development and maturity, the growth of the aorta is modulated by circumferential stress.

  9. Children's (Pediatric) Abdominal Ultrasound Imaging

    Medline Plus

    Full Text Available ... through blood vessels. Ultrasound imaging is a noninvasive medical test that helps physicians diagnose and treat medical conditions. Children's (pediatric) abdominal ultrasound imaging produces pictures ...

  10. CFU-S(11) activity does not localize solely with the aorta in the aorta-gonad-mesonephros region

    NARCIS (Netherlands)

    M.F.T.R. de Bruijn (Marella); M.C. Peeters (Marian); T. Luteijn; P. Visser (Pim); N.A. Speck; E.A. Dzierzak (Elaine)

    2000-01-01

    textabstractThe aorta-gonad-mesonephros (AGM) region is a potent hematopoietic site in the midgestation mouse conceptus and first contains colony-forming units-spleen day 11 (CFU-S(11)) at embryonic day 10 (E10). Because CFU-S(11) activity is present in the AGM region b

  11. A case of abdominal aortic injury caused by a traffic accident.

    Science.gov (United States)

    Kutsukata, Noriyoshi; Mashiko, Kunihiro; Matsumoto, Hisashi; Hara, Yoshiaki; Sakamoto, Yuichiro; Takei, Kenkichi; Saito, Nobuyuki

    2008-12-01

    A 30-year-old man was injured when the large motorcycle he was riding crashed into a power pole. Upon arrival at our institution, the patient complained of abdominal pain; blood pressure at admission was 160/70 mmHg, and the heart rate was 112 bpm. Abdominal ultrasonography showed a small collection of fluid in Morrison's pouch. A chest X-ray film showed a right rib fracture. Multidetector computed tomography (MD-CT) revealed pleural effusion, a hepatic lesion, and a dissection of the abdominal aorta distal to the renal artery. Because of the complicated intraluminal injuries, the insertion of a stent graft was difficult. On the 34th day after injury, elective surgery was performed. Because dissection of the lumen was observed, the vessel was replaced with an artificial graft. Medial degeneration of the aorta wall was not observed upon pathological examination, and no degenerative disorders have occurred. The postoperative progress was favorable, and the patient was discharged from hospital.

  12. A case of lipoma of parietal peritoneum causing abdominal pain.

    Science.gov (United States)

    Bang, Chang Seok; Kim, Yeon Soo; Baik, Gwang Ho; Han, Sang Hak

    2014-06-01

    Lipomas are common benign tumors of mature adipose tissue, enclosed by thin fibrous capsules. They can occur on any part of the body; however, peritoneal lipoma is extremely rare. We encountered a case of a 75-year-old man presenting with intermittent abdominal pain, who had undergone right hemicolectomy due to colon cancer. Abdominal computerized tomography showed a well-defined heterogenous fatty mass measuring 4.5 × 3.5 cm in size, suggesting fat necrosis located in the abdominal wall. Laparotomy showed a very large soft mass of peritoneum. Pathologically, the tumor was diagnosed as lipoma containing fat necrosis located in parietal peritoneum not fixed to any organs, but with small bowel adhesion. Due to its rare etiologic origin and obscure cause of development, we report on a case of lipoma of parietal peritoneum causing abdominal pain.

  13. Chronic cadmium treatment promotes oxidative stress and endothelial damage in isolated rat aorta.

    Directory of Open Access Journals (Sweden)

    Camila C P Almenara

    Full Text Available Cadmium is a highly toxic metal that is present in phosphate fertilizers, and the incidence of cadmium poisoning in the general population has increased, mainly due to cigarette smoking. Once absorbed, cadmium accumulates in the tissues, causing harmful effects including high blood pressure, endothelial damage and oxidative stress. Oxidative stress is known to efficiently produce oxidized low-density lipoprotein and consequently atherosclerosis, mainly in the aorta. However, the mechanisms through which endothelial damage is induced by cadmium have not been elucidated. Thus, the aim of this study was to investigate the effects of this metal in the isolated aorta and the possible role of oxidative stress. Rats received 100 mg.L(-1 cadmium chloride (CdCl2 in the drinking water or distilled water alone for four weeks. The pressor effect of cadmium was followed throughout the exposure period by tail plethysmography. At the end of the fourth week, the blood cadmium content was established, and the vascular reactivity of the isolated aorta to phenylephrine, acetylcholine and sodium nitroprusside was analyzed in the context of endothelium denudation and incubation with L-NAME, apocynin, losartan, enalapril, superoxide dismutase (SOD or catalase. We observed an increased response to phenylephrine in cadmium-treated rats. This increase was abolished by catalase and SOD incubation. Apocynin treatment reduced the phenylephrine response in both treatment groups, but its effect was greater in cadmium-treated rats, and NOX2 expression was greater in the cadmium group. These results suggested that cadmium in blood concentrations similar to those found in occupationally exposed populations is able to stimulate NOX2 expression, contributing to oxidative stress and reducing NO bioavailability, despite enhanced eNOS expression. These findings suggest that cadmium exposure promotes endothelial damage that might contribute to inflammation, vascular injury and the

  14. Nontraumatic abdominal emergencies: acute abdominal pain: diagnostic strategies

    Energy Technology Data Exchange (ETDEWEB)

    Marincek, B. [Institute of Diagnostic Radiology, University Hospital Zurich, Raemistrasse 100, 8091 Zurich (Switzerland)

    2002-09-01

    Common causes of acute abdominal pain include appendicitis, cholecystitis, bowel obstruction, urinary colic, perforated peptic ulcer, pancreatitis, diverticulitis, and nonspecific, nonsurgical abdominal pain. The topographic classification of acute abdominal pain (pain in one of the four abdominal quadrants, diffuse abdominal pain, flank or epigastric pain) facilitates the choice of the imaging technique. The initial radiological evaluation often consists of plain abdominal radiography, despite significant diagnostic limitations. The traditional indications for plain films - bowel obstruction, pneumoperitoneum, and the search of ureteral calculi - are questioned by helical computed tomography (CT). Although ultrasonography (US) is in many centers the modality of choice for imaging the gallbladder and the pelvis in children and women of reproductive age, CT is considered to be one of the most valued tools for triaging patients with acute abdominal pain. CT is particularly beneficial in patients with marked obesity, unclear US findings, bowel obstruction, and multiple lesions. The introduction of multidetector row CT (MDCT) has further enhanced the utility of CT in imaging patients with acute abdominal pain. (orig.)

  15. Potential role of vascular smooth muscle cell-like progenitor cell therapy in the suppression of experimental abdominal aortic aneurysms.

    Science.gov (United States)

    Park, Hyung Sub; Choi, Geum Hee; Hahn, Soli; Yoo, Young Sun; Lee, Ji Youl; Lee, Taeseung

    2013-02-08

    Abdominal aortic aneurysms (AAA) are a growing problem worldwide, yet there is no known medical therapy. The pathogenesis involves degradation of the elastic lamina by two combined mechanisms: increased degradation of elastin by matrix metalloproteinases (MMP) and decreased formation of elastin due to apoptosis of vascular smooth muscle cells (VSMC). In this study, we set out to examine the potential role of stem cells in the attenuation of AAA formation by inhibition of these pathogenetic mechanisms. Muscle-derived stem cells from murine skeletal muscles were isolated and stimulated with PDGF-BB in vitro for differentiation to VSMC-like progenitor cells (VSMC-PC). These cells were implanted in to elastase-induced AAAs in rats. The cell therapy group had decreased rate of aneurysm formation compared to control, and MMP expression at the genetic, protein and enzymatic level were also significantly decreased. Furthermore, direct implantation of VSMC-PCs in the intima of harvested aortas was visualized under immunofluorescent staining, suggesting that these cells were responsible for the inhibition of MMPs and consequent attenuation of AAA formation. These results show a promising role of stem cell therapy for the treatment of AAAs, and with further studies, may be able to reach clinical significance.

  16. Effect of Low-Pressurized Perfusion with Different Concentration of Elastase on the Aneurysm Formation Rate in the Abdominal Aortic Aneurysm Model in Rabbits.

    Science.gov (United States)

    Nie, Maoxiao; Yan, Yunfeng; Li, Xinhe; Feng, Tingting; Zhao, Xin; Zhang, Mingduo; Zhao, Quanming

    2016-01-01

    Establishing an animal model of abdominal aortic aneurysm (AAA) is the key to study the pathogenesis and the pathophysiological features of AAAs. We investigated the effects of low-pressurized perfusion with different concentrations of elastase on aneurysm formation rate in the AAA model. Fifty male New Zealand white rabbits were randomly divided into A, B, C, D, and E groups. 10 μL of normal saline was perfused into the abdominal aorta in group A and 1 U/mL, 10 U/mL, 100 U/mL, or 200 U/mL of elastase was, respectively, perfused for the other four groups. All the animals were perfused for 7 min. Doppler ultrasound examinations of the abdominal aorta were performed before surgery and on day 14 after surgery. The rabbits were sacrificed and the perfused segment of the abdominal aorta was observed visually and after staining. The aneurysm formation rate of group A, group B, group C, group D, and group E was, respectively, 0%, 0%, 33.3%, 102.5-146.8%, and 241.5-255.2%. The survival rate of five groups was 90%, 90%, 90%, 90%, and 40%, respectively. So, we concluded that low-pressurized perfusion with 100 U/mL of elastase can effectively establish AAAs in rabbits with a high aneurysm formation rate.

  17. Algumas características morfológicas segmentares da parede da aorta de galo doméstico (Gallus domesticus

    Directory of Open Access Journals (Sweden)

    Josiane Medeiros de Mello

    2003-01-01

    Full Text Available A estrutura segmentar da parede aórtica foi estudada em galo doméstico, em níveis torácico e abdominal, nas dimensões de microscopias óptica e eletrônica de varredura. Secções histológicas selecionadas foram submetidas a estudos histomorfométricos usando métodos de análises de imagens. As variáveis analisadas foram as espessuras das túnicas da parede aórtica em três segmentos investigados, compreendendo as porções ascendente torácica; descendente torácica e abdominal, bem como os diâmetros tubulares, em cada porção, e o número médio de lamelas elásticas na túnica média de cada segmento analisado. A parede aórtica do galo doméstico apresenta estrutura predominantemente elástica nas porções torácicas, cujo número relativo de lamelas elásticas decresce gradualmente para a parte abdominal da aorta, onde células musculares lisas predominam. Os diâmetros aórticos decrescem também gradualmente, e progressivamente, da porção torácica ascendente para a porção torácica descendente, e desta para a porção abdominal da aorta.

  18. High-resolution fluid-structure interaction simulations of flow through a bi-leaflet mechanical heart valve in an anatomic aorta.

    Science.gov (United States)

    Borazjani, Iman; Ge, Liang; Sotiropoulos, Fotis

    2010-02-01

    We have performed high-resolution fluid-structure interaction simulations of physiologic pulsatile flow through a bi-leaflet mechanical heart valve (BMHV) in an anatomically realistic aorta. The results are compared with numerical simulations of the flow through an identical BMHV implanted in a straight aorta. The comparisons show that although some of the salient features of the flow remain the same, the aorta geometry can have a major effect on both the flow patterns and the motion of the valve leaflets. For the studied configuration, for instance, the BMHV leaflets in the anatomic aorta open much faster and undergo a greater rebound during closing than the same valve in the straight axisymmetric aorta. Even though the characteristic triple-jet structure does emerge downstream of the leaflets for both cases, for the anatomic case the leaflet jets spread laterally and diffuse much faster than in the straight aorta due to the aortic curvature and complex shape of the anatomic sinus. Consequently the leaflet shear layers in the anatomic case remain laminar and organized for a larger portion of the accelerating phase as compared to the shear layers in the straight aorta, which begin to undergo laminar instabilities well before peak systole is reached. For both cases, however, the flow undergoes a very similar explosive transition to the small-scale, turbulent-like state just prior to reaching peak systole. The local maximum shear stress is used as a metric to characterize the mechanical environment experienced by blood cells. Pockets of high local maximum shear are found to be significantly more widespread in the anatomic aorta than in the straight aorta throughout the cardiac cycle. Pockets of high local maximum shear were located near the leaflets and in the aortic arc region. This work clearly demonstrates the importance of the aortic geometry on the flow phenomena in a BMHV and demonstrates the potential of our computational method to carry out image

  19. Abdominal Complications after Severe Burns

    Science.gov (United States)

    2009-05-01

    abdominal compartment syndrome, schemic bowel, biliary disease , peptic ulcer disease and astritis requiring laparotomy, small bowel obstruction, rimary fungal...complications in- luded trauma exploratory laparotomy, abdominal com- artment syndrome, ischemic bowel, biliary disease , peptic lcer disease and gastritis, large...because it was almost uniformly ssociated with serious lethal burns. This was in the period efore effective gastric acid control, explaining the high

  20. Videolaparoscopia no trauma abdominal

    Directory of Open Access Journals (Sweden)

    Átila Varela Velho

    Full Text Available A videolaparoscopia (VL vem contribuindo de forma crescente, para diagnóstico e terapêutica de várias afecções cirúrgicas abdominais, introduzindo profundas mudanças na cirurgia contemporânea. Esse avanço incorporou-se também às urgências traumáticas, fazendo parte da avaliação diagnóstica e, às vezes, da terapêutica do trauma abdominal. Os autores apresentam uma revisão concisa da literatura sobre a VL no trauma, atualizando o tema e discutindo os aspectos mais relevantes das indicações, limitações e complicações do método.

  1. Abdominal aortic aneurysms

    DEFF Research Database (Denmark)

    Lindholt, Jes Sanddal

    2010-01-01

    Although the number of elective operations for abdominal aortic aneurysms (AAA) is increasing, the sex- and age-standardised mortality rate of AAAs continues to rise, especially among men aged 65 years or more. The lethality of ruptured AAA continues to be 80-95%, compared with 5-7% by elective...... inhibit further AAA progression. All 4 existing RCTs point in the same direction, viz. in favour of screening of men aged 65 and above. We found that screening significantly reduced AAA-related mortality by 67% within the first five years (NNT = 352). Restriction of screening to men with previous...... year gained was 157 euro [1,170 DKK] and the cost per QALY at 178 euro [1,326 DKK]. In all, the ethical dilemma of the prophylactic operation, and the limited psychological side effects seem not to outweigh the benefits of screening. Conclusively, we found that offering men aged 65-73 years screening...

  2. Abdominal aortic surgery and renal anomalies

    Directory of Open Access Journals (Sweden)

    Ilić Nikola

    2011-01-01

    Full Text Available Introduction. Kidney anomalies present a challenge even for the most experienced vascular surgeon in the reconstruction of the aortoilliac segment. The most significant anomalies described in the surgery of the aortoilliac segment are a horse-shoe and ectopic kidney. Objective. The aim of this retrospective study was to analyze experience on 40 patients with renal anomalies, who underwent surgery of the aortoilliac segment and to determine attitudes on conventional surgical treatment. Methods. In the period from 1992 to 2009, at the Clinic for Vascular Surgery of the Clinical Centre of Belgrade we operated on 40 patients with renal anomalies and aortic disease (aneurysmatic and obstructive. The retrospective analysis involved standard epidemiological data of each patient (gender, age, risk factors for atherosclerosis, type of anomaly, type of aortic disease, presurgical parameter values of renal function, type of surgical approach (laparatomy or retroperitoneal approach, classification of the renal isthmus, reimplantation of renal arteries and perioperative morbidity and mortality. Results. Twenty patients were males In 30 (70% patients we diagnosed a horse-shoe kidney and in 10 (30% ectopic kidney. In the cases of ruptured aneurysm of the abdominal aorta the diagnosis was made by ultrasound findings. Pre-surgically, renal anomalies were confirmed in all patients, except in those with a ruptured aneurysm who underwent urgent surgery. In all patients we applied medial laparatomy, except in those with a thoracoabdominal aneurysm type IV, when the retroperitonal approach was necessary. On average the patients were under follow-up for 6.2 years (from 6 months to 17 years. Conclusion. Under our conditions, the so-called double clamp technique with the preservation of the kidney gave best results in the patients with renal anomalies and aortic disease.

  3. Traumatic Abdominal Wall Hernia After a Blunt Trauma: A Case Report

    Directory of Open Access Journals (Sweden)

    Ersin Dumlu

    2014-06-01

    Full Text Available Traumatic abdominal wall hernia is a rare result of blunt abdominal traumas in adults. Altough the detection of the injuries of the abdominal organs is the priority in blunt traumas, abdominal wall defect may also occur in these patients. These hernias can go undetected due to preservation of the skin overlying the hernia defect. Traumatic abdominal wall hernias can have high morbidity and mortality rates due to incarceration and perforation of tubular hollow organs, especially if there is any delay. The possibility of traumatic hernia should always be considered in cases with serious blunt trauma. Computed Tomography (CT scan examinations should be performed routinely due to their high diagnostic value if trumatic hernia is suspected. In this report, a traumatic abdominal wall hernia patient who was treated by surgery has been presented with the review of the current literature.

  4. Paradoxical emboli: demonstration using helical computed tomography of the pulmonary artery associated with abdominal computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Delalu, P.; Ferretti, G.R.; Bricault, I.; Ayanian, D.; Coulomb, M. [Service Central de Radiologie et Imagerie Medicale, CHU Grenoble (France)

    2000-02-01

    We report the case of a 60-year-old woman with a recent history of a cerebrovascular accident. Because of clinical suspicion of pulmonary embolism and negative Doppler ultrasound findings of the lower limbs, spiral computed tomography of the pulmonary artery was performed and demonstrated pulmonary emboli. We emphasize the role of computed tomography of the abdomen, performed 3 min after the thoracic acquisition, which showed an unsuspected thrombus within the abdominal aorta and the left renal artery with infarction of the left kidney. Paradoxical embolism was highly suspected on computed tomography data and confirmed by echocardiography which demonstrated a patent foramen ovale. (orig.)

  5. [Evaluation of the blood coagulation system after surgeries on abdominal aortic aneurysms].

    Science.gov (United States)

    Nikul'nikov, P I; Liksunov, O V; Ratushniuk, A V; Lugovs'koĭ, E V; Kolesnikova, I M; Lytvynova, L M; Kostiuchenko, O P; Chernyshenko, T M; Hornyts'ka, O V; Platonova, T M

    2012-09-01

    Basing on data of analysis of the hemostasis system state in the patients, suffering abdominal aorta aneurysm, a tendency for raising of postoperative soluble fibrin and D-dimer content in the blood plasm and reduction of these indices on the third day was noted. The abovementioned markers content depends on the aneurysm size, the fibrin deposits presence, the terms from clinical signs beginning to the certain therapy administration and anticoagulants application. Information about correlation between content of D-dimer and soluble fibrin in the treatment dynamics is important for determination of activation degree in the patients blood coagulation system and the thrombotic complications prognosis.

  6. The AORTA Reasoning Framework - Adding Organizational Reasoning to Agents

    DEFF Research Database (Denmark)

    Jensen, Andreas Schmidt

    is a practical component (founded in logic) that enriches intelligent agents with organizational reasoning capabilities. We take the agent’s perspective by devising a component that integrates with the agent’s usual reasoning capabilities in a non-intrusive way. This results in agents that are both organization...... a generic framework that allows different kinds of agents to reason about different kinds of organizations. We present our results in three main parts. In the first part, we present the theoretical foundations for the AORTA framework, which consists of semantics of norms, an organizational metamodel......, and the AORTA reasoning component. The reasoning component is characterized by being completely decoupled from the cognitive agent, by its automated reasoning about norms and organizational options, and by the reasoning rules specified by the designer to act upon norms and options. We specify the reasoning...

  7. Mycotic aneurysm of the thoracic aorta presenting as pneumonia

    Energy Technology Data Exchange (ETDEWEB)

    Mengozzi, E. [Dept. of Radiology, Maggiore Hospital, Bologna (Italy); Sartoni Galloni, S. [Dept. of Radiology, San Salvatore Hospital, Bologna (Italy); Giovannini, G. [Dept. of Paediatrics, Maggiore Hospital, Bologna (Italy); Bronzetti, G. [Dept. of Paediatric Cardiology, Sant' Orsola-Malpighi University Medical Centre, Bologna (Italy)

    2001-07-01

    Mycotic aneurysms of the thoracic aorta rarely occur in children. We report an unusual case of a mycotic aneurysm of the descending aorta in a 4-year-old boy presenting with respiratory tract infection, which was rapidly complicated by atelectasis of the left lung. The patient's mycotic aortic aneurysm was diagnosed by contrast-enhanced spiral CT, whereas conventional chest radiographs did not detect its presence. An unsuspected mild aortic coarctation was also diagnosed at the time of admission. This case demonstrates that an aortic aneurysm may clinically and radiologically manifest itself with respiratory tract infection and atelectasis and that contrast-enhanced spiral CT is a fast and powerful tool for establishing the diagnosis. (orig.)

  8. Contractile reaction of isolated frog aorta after X-irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Michailov, M.C.; Prechter, I.; Greimel, H.; Welscher, U.E.

    1983-07-01

    The action of X-rays (50 kV, filtered by 0.3 mm Al) on helical strip of frog aorta (rana esculenta) has been investigated. The isolated preparations have a stable basal tone and are radio-sensitive to X-rays which induce reversible, dose-dependent, contractile responses. After repeated irradiational tachyphylaxis appears. The threshold doses are about 250 R at 3 to 6 kR/min, antiadrenergic (phentolamine, propranolol), anticholinergic (atropin), antihistaminic (Neo-Bridal) and serotoninergic (Deseril) drugs have no visible influence on the X-ray induced reaction, i.e. these action mechanisms of the irradiation-induced contraction do not seem probable. Theophylline and cAMP inhibit the X-ray contraction probably non-specifically. Indometacin also inhibits the X-ray contraction: this suggests participation of prostaglandin-mechanism on the contraction of frog aorta after irradiation.

  9. Abdominal migraine in the differential diagnosis of acute abdominal pain.

    Science.gov (United States)

    Cervellin, Gianfranco; Lippi, Giuseppe

    2015-06-01

    Although traditionally regarded as a specific pediatric disease, abdominal migraine may also be observed in adults. Unfortunately, however, this condition is frequently overlooked in the differential diagnosis of abdominal pain in the emergency department (ED). A 30-year-old woman presented to our ED complaining of abdominal pain and vomiting, lasting for 12 hours. The pain was periumbilical, continuous, and not associated with fever or diarrhea. The physical examination and the results of conventional blood tests were normal. The patient was treated with intravenous ketoprofen, metoclopramide, and ranitidine, obtaining a prompt relief of symptoms. She had a history of similar episodes in the last 15 years, with several ED visits, blood test examinations, ultrasonography of the abdomen, and upper gastrointestinal endoscopies. Celiac disease, porphyry, sickle cell disease, and inflammatory bowel disease were all excluded. In July 2012, she became pregnant, and she delivered a healthy baby on April 2013. Until November 2014, she has remained asymptomatic. Based on the clinical characteristics of the abdominal pain episodes, the exclusion of any alternative diagnosis, and the relief of symptoms during and after pregnancy, a final diagnosis of abdominal migraine could be established. A skilled emergency physician should always consider abdominal migraine in the differential diagnosis of patients admitted to the ED with abdominal pain, especially when the attacks are recurrent and no alternative diagnosis can be clearly established.

  10. [Traumatic and iatrogenic lesions of abdominal vessels].

    Science.gov (United States)

    Farah, I; Tarabula, P; Voirin, L; Magne, J L; Delannoy, P; Gattaz, F; Guidicelli, H

    1997-01-01

    Gravity of abdominal vessels traumatisms is secondary to multiple factors. It depends on the type of injured vessels, aetiology and associated lesions. Between September 1984 and March 1995, 22 abdominal vessel traumatisms in 16 patients (mean age: 39 years) were treated. At surgical exploration, 4 aortic and 2 renal vein lesions, 7 iliac artery and 3 renal artery contusions, 2 superior mesenteric artery dissections; 3 infra-renal vena cava ruptures and 1 superior mesenteric vein dilaceration were found. All lesions were caused by penetrant wounds secondary to firearm or blade injury or secondary to injuries due to ski or traffic accidents. In 5 cases, lesions were iatrogenic. There was no mortality in the post-operative period, 14 patients out of the 16 patients operated on have been followed during a period from 1 to 120 months.

  11. Idiopathic sclerosing encapsulating peritonitis: Abdominal cocoon

    Institute of Scientific and Technical Information of China (English)

    Jenny N Tannoury; Bassam N Abboud

    2012-01-01

    Abdominal cocoon,the idiopathic form of sclerosing encapsulating peritonitis,is a rare condition of unknown etiology that results in an intestinal obstruction due to total or partial encapsulation of the small bowel by a fibrocollagenous membrane.Preoperative diagnosis re quires a high index of clinical suspicion.The early clinical features are nonspecific,are often not recognized and it is difficult to make a definite pre-operative diagnosis.Clinical suspicion may be generated by the recurrent episodes of small intestinal obstruction combined with relevant imaging findings and lack of other plausible etiologies.The radiological diagnosis of abdominal cocoon may now be confidently made on computed tomography scan.Surgery is important in the management of this disease.Careful dissection and excision of the thick sac with the release of the small intestine leads to complete recovery in the vast majority of cases.

  12. [Adrenal injury in blunt abdominal trauma].

    Science.gov (United States)

    Abakumov, M M; Smoliar, A N; Barmina, T G; Boĭko, A V; Shalimova, I G

    2009-01-01

    10 patients with adrenal damage were observed during 2.5 years. It amounted 0.93% of all patients with closed abdominal injuries. The right adrenal gland was traumatized in all cases evidently due to it's compression between right lobe of liver and vertebral column. Adrenal damage is observed quite often in combination with injuries of right liver lobe, right kidney and retroperitoneal hematoma formation. 5 patients underwent laparotomy on account of intra-abdominal bleeding, but adrenal damage was never revealed. Ultrasound and tomographic semiotics of adrenal damage was worked out, which allowed ascertaining diagnosis in 80% on application of ultrasound study and in 100% at computer tomography. Injury of one adrenal gland was not accompanied by adrenal failure and did not require hormonal replacement therapy.

  13. Quantifying turbulent wall shear stress in a subject specific human aorta using large eddy simulation.

    Science.gov (United States)

    Lantz, Jonas; Gårdhagen, Roland; Karlsson, Matts

    2012-10-01

    In this study, large-eddy simulation (LES) is employed to calculate the disturbed flow field and the wall shear stress (WSS) in a subject specific human aorta. Velocity and geometry measurements using magnetic resonance imaging (MRI) are taken as input to the model to provide accurate boundary conditions and to assure the physiological relevance. In total, 50 consecutive cardiac cycles were simulated from which a phase average was computed to get a statistically reliable result. A decomposition similar to Reynolds decomposition is introduced, where the WSS signal is divided into a pulsating part (due to the mass flow rate) and a fluctuating part (originating from the disturbed flow). Oscillatory shear index (OSI) is plotted against time-averaged WSS in a novel way, and locations on the aortic wall where elevated values existed could easily be found. In general, high and oscillating WSS values were found in the vicinity of the branches in the aortic arch, while low and oscillating WSS were present in the inner curvature of the descending aorta. The decomposition of WSS into a pulsating and a fluctuating part increases the understanding of how WSS affects the aortic wall, which enables both qualitative and quantitative comparisons.

  14. Dilation of the ascending aorta in Turner syndrome - a prospective cardiovascular magnetic resonance study

    Directory of Open Access Journals (Sweden)

    Pedersen Erik M

    2011-04-01

    Full Text Available Abstract Background The risk of aortic dissection is 100-fold increas