Visceral artery aneurysms (VAAs) and visceral artery pseudoaneurysms (VAPAs) are often found incidentally through imaging of a patient presenting with vague symptoms of abdominal pain, hematochezia, hematemesis, and melena. Due to the asymptomatic nature, the etiology is often unknown. However, suspicion for VAA and VAPA should remain high for those presenting with symptoms listed above after trauma or pancreatitis. Here we discuss a case of traumatic ileocolic pseudoaneurysm that has only been discussed a handful of times in the literature.
Lesions of the small bowel are notoriously difficult to diagnose, many only coming to light at laparotomy. At this hospital the small bowel enema has been used for radiology of the small bowel for many years. The procedure is uncomfortable for the patient, as intubation of the proximal small bowel is essential, and for the radiologist it can be very time-consuming. A review of patients referred by the general surgeons over the past 5 years has demonstrated the value of the technique. It has proved to be accurate in over 90 per cent of cases with only 2 per cent false negative and 1 per cent false positive results. The most common diagnosis has been Crohn's disease which can be very accurately assessed. Other lesions diagnosed include lymphoma, involvement by metastases, benign stricture and adhesions. A normal results has prevented an unnecessary laparotomy in several patients. It is concluded that this technique is the most satisfactory method for radiology of the small bowel and it should be much more widely available.
There is vast literature on the topic of ischemia-reperfusion injury. A summative discussion of the complex pathogenicity will aid practicing physicians in diagnosis and management. We offer a review of this literature as well as a discussion on a rare case of tense edematous bullae as a presentation of ischemia-reperfusion injury. A 65-year-old male underwent a right femoropopliteal bypass for rest pain that had not improved after iliac stent placement. He presented three days after discharge with blistering lesions on the reperfused limb that resembled bullous pemphigoid. This case describes the variability in the presentation of reperfusion injury, as well as the necessity to educate those managing atypical presentations of reperfusion injury.
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