Introduction: Isolated dissection of the superior mesenteric artery (SMA) is rare and remains the most common reason for aneurysmal degeneration of the vessel. The treatment is challenging and not standardised. The purpose of this report is to demonstrate that coiling of the false lumen is a good alternative for dissecting SMA aneurysms. Report: A 50 year old male presented with a 3.3 cm dissecting aneurysm of the SMA and epigastric pain of moderate severity. More than 50% of the ileal arteries arose from the collapsed true lumen. Via transfemoral access the true lumen was catheterised. An open cell balloon expandable stent was deployed at the proximal and a closed cell self expandable stent at the distal end of the dissection flap. Through the cells of the first stent a microcatheter was advanced into the false lumen and 33 coils were deployed into the aneurysm sac. A stent graft was deployed within the first stent leading to the total exclusion of the aneurysm. Follow up at three months was uneventful and the patency was assessed by contrast enhanced ultrasound. Discussion: Coiling of the false aneurysm is a good alternative for dissecting SMA aneurysms, where no other open surgical or endovascular options are applicable.
Liposarcomas (LPS) are malignant tumours of mesodermal origin that can develop at any site where fatty tissue is present. Liposarcomas of the spermatic cord have been classified as part of the "paratesticular" tumours which mostly originate in the spermatic cord and are found anywhere along its course. They are rare, but well-described neoplasms which present as painless swellings, most often in the groin or scrotal areas. They mimic common surgical conditions, such as hydroceles, hernias or testicular tumours, thus attracting surgical and urologic interest as they are occasionally the culprit of misdiagnoses. We present the case of a liposarcoma of the spermatic cord mimicking inguinal hernia along with a brief review of the literature.
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