(Fig. 1 B)and only spot films were obtained. A severe crural impression on the celiac axis was also a finding on the lateral aortogram.The anglographcflndings suggested congenital web or band compressing the artery. On a separate day, renal vein samples for renin levels were obtained by using captopril stimulation.These values were 75 ng/ml/hr on the right, 109.2 ng/mI/hr on the left, and 30.9 ng/ml/hr in the inferior vena cava below the renal veins. An initial renal scan using "Tc-DTPA was normal. A repeat renal scan after captopril showed decreased flow to the left kidney.The surgical approach was made via a low left thoracoabdominal crus. These were divided and the renal artery assumed a normal position and pulsation. The proximal renal artery was opened to the aorta, and the origin was explored.
Colonic varices are a rare cause of lower gastrointestinal bleeding, with approximately 40 cases reported in the literature. Portal hypertension is by far the most common cause of colonic varices, with local mesenteric vein obstruction constituting a very rare cause. We present a case of colonic varices not associated with portal hypertension but secondary to prior sigmoid resection and inferior mesenteric vein occlusion.
as well as with angiographic findings of active extravasation and/or pseudoaneurysm. Conclusions: IR has an important role to play in the multidisciplinary treatment of splenic trauma. Splenic embolization has been shown to significantly improve splenic salvage rates, although not without the risk of complications. Our reported splenic salvage rate of 98% demonstrates the important role that embolization should play in the management of these patients. Despite the acceptance of this treatment option, questions still remain regarding patient selection, long-term splenic function, and the role of prophylactic vaccination given possible deficiencies in immunologic function after embolization.
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