The renal artery pseudoaneurysm embody a rare vascular complication coming of percutaneous procedures, renal biopsy, nephrectomy, penetrating traumas and more rarely blunt traumas. The clinical can be vary according the patient, the haematuria is the symptom more commom. Is necessary a high level of clinical suspicion for your diagnosis, this can be elucidated by through complementary exams as the eco-color Doppler and the computed tomography scan (CT). This report is a case of a patient submitted a right percutaneous renal biopsy and that, after the procedure started with macroscopic haematuria, urinary tenesmus and hypogastric pain. The diagnosis of pseudoaneurysm was given after one week of evolution when the patient was hospitalized because gross haematuria, tachycardia, hypotension and hypochondrium pain. In the angiotomography revealed a focal dilation of the accessory right renal inferior polar artery, dilation of renal pelvis and all the ureteral course with presence hyperdenso material (clots) inside the middle third of the ureter. The treatment for the majority of this cases are conservative, through arterial embolization, indicated for thouse of smaller dimensions in patients who are hemodynamically stable. However, it was decided by clinical treatment with aminocaproic acid 1 g, according to previous studies for therapy of haematuria. The patient received discharge without evidence of macroscopic haematuria and with normal renal ultrasound, following ambulatory care.
Resection of the inferior vena cava may be required in the courses of oncological surgeries for the tumors originating from or invading it. Management of the remaining defect depends on the extension of the resection. Partial or complete replacement of the inferior vena cava, with a patch or interposition graft, may be required. Standard techniques for the reconstruction with a prosthetic material or the autologous veins can be associated with the prosthetic graft infection, high cost, long‐standing anticoagulation, technical difficulties, and/or need for extra incisions. The use of the autologous peritoneum represents an easy and inexpensive alternative for the partial and complete inferior vena cava reconstructions.
Gangrene of the tongue is a condition rarely described in the literature. It generally occurs in association with temporal arteritis and other vasculitides. We described a rare case of tongue necrosis associated with oropharyngeal carcinoma. A 67-male patient, previously submitted to exclusive radiotherapy for a squamous cell carcinoma of the tonsillar region, was admitted to our service with high dysphagia. Computed tomography showed circumferential swelling of the oropharynx, with areas of diffuse contrast uptake and significant reduction of the vascular flow at this level, especially venous return. About 6 months after the onset of symptoms, he was submitted to an urgent tracheostomy for airway obstruction. Then, about 1 month after tracheotomy, the neck skin became ecchymotic, congested, and he started with profuse oropharyngeal bleeding and congestion and thrombosis signs in the tongue. To our knowledge, this entity has not been yet described in the literature.
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