Background: Uterine arteriovenous malformation (AVM) is a rare, potentially life-threatening cause of abnormal uterine bleeding that can be acquired following a cesarean section. The diagnosis is difficult, often misd...Background: Uterine arteriovenous malformation (AVM) is a rare, potentially life-threatening cause of abnormal uterine bleeding that can be acquired following a cesarean section. The diagnosis is difficult, often misdiagnosed with retained products of conception and placenta accreta. Transarterial embolization (TAE) is a</span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">n</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> efficacious and effective method of treating AVM, particularly in patients of reproductive age.</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">Case Report: A 41-year-old, nulliparous</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> woman</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">, started with a history of abnormal uterine bleeding 30 days after a cesarean section. She didn’t have anaemia and beta-human chorionic gonadotropin (beta-hCG) was negative. The transvaginal color Doppler ultrasound showed multiple vascular channels within myometrium showing colored mosaic patterns suggesting AVM, confirmed by Magnetic Resonance Imaging. The patient was referred to perform a Computed Tomography Angiography and right uterine artery embolization without any vascular complications.</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">Conclusion: AVM is a rare consequence of cesarean section but has to be considered in cases of persistent uterine bleeding in the puerperium. Embolization is a safe and effective choice treatment of AVM and a展开更多
During post-transplant evolution, adolescents may present problems with adherence to treatment, becoming a high-risk group for graft loss. Here, we report a case which describes an adolescent patient who lost a graft ...During post-transplant evolution, adolescents may present problems with adherence to treatment, becoming a high-risk group for graft loss. Here, we report a case which describes an adolescent patient who lost a graft due to humoral rejection associated with lack of adherence to treatment. During chronic peritoneal dialysis therapy, the patient developed pain and increased volume in the graft area, fever, gross hematuria and leukocyturia upon urine examination. The patient was diagnosed with graft immune intolerance syndrome and transplantectomy was suggested. Finally, a graft embolization was performed. A decrease in symptoms was observed until the patient became asymptomatic.展开更多
Lower gastrointestinal hemorrhage presents a common indication for hospitalization and account for over300000 admissions per year in the United States.Multimodality imaging is often required to aid in localization of ...Lower gastrointestinal hemorrhage presents a common indication for hospitalization and account for over300000 admissions per year in the United States.Multimodality imaging is often required to aid in localization of the hemorrhage prior to therapeutic intervention if endoscopic treatment fails.Imaging includes computer tomography angiography,red blood cell tagged scintigraphy and conventional angiography,with scintigraphy being the most sensitive followed by computer tomography angiography.Aberrant celio-mesenteric supply occurs in 2%of the population;however failure to identify this may result in failed endovascular therapy.Computer tomography angiography is sensitive for arterial hemorrhage and delineates the anatomy,allowing the treating physician to plan an endovascular approach.If at the time of conventional angiography,the active bleed is not visualized,but the site of bleeding has been identified on computer tomography angiography,provocative angiography can be utilized in order to stimulate bleeding and subsequent targeted treatment.We describe a case of lower gastrointestinal hemorrhage at the splenic flexure supplied by a celiomesenteric branch in a patient and provocative angiography with tissue plasminogen activator utilized at the time of treatment to illicit the site of hemorrhage and subsequent treatment.展开更多
文摘Background: Uterine arteriovenous malformation (AVM) is a rare, potentially life-threatening cause of abnormal uterine bleeding that can be acquired following a cesarean section. The diagnosis is difficult, often misdiagnosed with retained products of conception and placenta accreta. Transarterial embolization (TAE) is a</span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">n</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> efficacious and effective method of treating AVM, particularly in patients of reproductive age.</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">Case Report: A 41-year-old, nulliparous</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> woman</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">, started with a history of abnormal uterine bleeding 30 days after a cesarean section. She didn’t have anaemia and beta-human chorionic gonadotropin (beta-hCG) was negative. The transvaginal color Doppler ultrasound showed multiple vascular channels within myometrium showing colored mosaic patterns suggesting AVM, confirmed by Magnetic Resonance Imaging. The patient was referred to perform a Computed Tomography Angiography and right uterine artery embolization without any vascular complications.</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">Conclusion: AVM is a rare consequence of cesarean section but has to be considered in cases of persistent uterine bleeding in the puerperium. Embolization is a safe and effective choice treatment of AVM and a
文摘During post-transplant evolution, adolescents may present problems with adherence to treatment, becoming a high-risk group for graft loss. Here, we report a case which describes an adolescent patient who lost a graft due to humoral rejection associated with lack of adherence to treatment. During chronic peritoneal dialysis therapy, the patient developed pain and increased volume in the graft area, fever, gross hematuria and leukocyturia upon urine examination. The patient was diagnosed with graft immune intolerance syndrome and transplantectomy was suggested. Finally, a graft embolization was performed. A decrease in symptoms was observed until the patient became asymptomatic.
文摘Lower gastrointestinal hemorrhage presents a common indication for hospitalization and account for over300000 admissions per year in the United States.Multimodality imaging is often required to aid in localization of the hemorrhage prior to therapeutic intervention if endoscopic treatment fails.Imaging includes computer tomography angiography,red blood cell tagged scintigraphy and conventional angiography,with scintigraphy being the most sensitive followed by computer tomography angiography.Aberrant celio-mesenteric supply occurs in 2%of the population;however failure to identify this may result in failed endovascular therapy.Computer tomography angiography is sensitive for arterial hemorrhage and delineates the anatomy,allowing the treating physician to plan an endovascular approach.If at the time of conventional angiography,the active bleed is not visualized,but the site of bleeding has been identified on computer tomography angiography,provocative angiography can be utilized in order to stimulate bleeding and subsequent targeted treatment.We describe a case of lower gastrointestinal hemorrhage at the splenic flexure supplied by a celiomesenteric branch in a patient and provocative angiography with tissue plasminogen activator utilized at the time of treatment to illicit the site of hemorrhage and subsequent treatment.
