Aim: This study presents a rare case of pseudoaneurysm mimicking a tumor on the back, with no history of fever, trauma, or surgical intervention. In which no identifiable symptoms or warning signs were present. This pseudoaneurysm arises from intercostal arteries and segmental arteries. Both of which, to the limit of our knowledge, have not been discussed before. Method: This study was done using chart and literature review. We present a case of a 46-year-old man with a known case of left-sided intracranial hemorrhage due to hypertension and an old cerebrovascular accident. The patient has a positive history of hypertension, which could have attributed to the pseudoaneurysm; however, he has no history of vascular disease otherwise. The patient reports of back swelling and intermittent back pain for the past 3 years. On MRI, the mass showed a pulsating pattern around it. It also showed a layering effect because of different wall thicknesses and enhanced patterns, and the enhancement ratio was increased. In addition, it showed flow artifacts with T1 hyperintense areas because of associated thrombus and blood products. These changes noted on the MRI prompted the team to do a color Doppler study to confirm the presence of an aneurysm and if present, to do a CT angiography. The color Doppler showed a turbulent flow, that is, there was a bidirectional pulsatile flow which further confirms the presence of a pseudoaneurysm. Spine CT with contrast showed a right paraspinal lesion at the T9-T11 level. It had contrast enhancement and flow inside, consistent with a partially thrombosed aneurysm. The CT also showed evidence of bone remodeling in the adjacent thoracic vertebrae. The patient opted for spinal vascular emobilization and vascular sheath removal. The right and left intercostal arteries were selected at the level of left and right T4, left T8, bilateral T9, and bilateral T10. Conclusion: Differentiating between pseudoaneurysms and osteogenic tumors is essential to target later investigations accordingly. In addition, if pseudoaneurysms are left untreated, they could cause bony erosions of the vertebra, which lead to compression fractures. They can further compress the adjacent neurovasculature, which worsens the morbidity.
Background: Circular external fixation including Ilizarov method is a well-established technique often practiced in orthopedic surgery. The goal of this procedures is to lengthen extremity bones, reconstruct severely injured or fractured bone trauma, correct congenital bone deformities, treat infected bones and to treat pseudarthrosis. The importance of this study is that it will highlight the most common complications for this procedure in order to reverse them and have a better clinical outcome. The aim of this study is to assess the indications and postoperative complication rates following tibial circular external by Illizarov's method. Methods: We performed a consecutive case series, chart review study of 33 patients who were treated with the Ilizarov method, between 2010 and 2016. All patients who underwent tibial circular external fixators using Ilizarov method were selected for this study. There were 25 males and 8 females, mean age was 31.06 (range 14 -71). All data collected was coded in Excel sheet. SPSS package version 20 was used for data analysis. Results: The total number of subjects involved in this study was 33 subjects (Male: 25[75%]-Female: 8[25%]). The average age of the subjects was 31.06 (range 14 -71) with a standard deviation of +/-13.8. Overall, 63.6% of patients reported post-op complications. Whereas 36.3% of patients were free of complications. The main complication was pain which was reported in 15% of the subjects. Conclusion: There was a minimal complication rate associated with this technique in our institution compared to published studies. Several medical conditions were the indication for this procedure, primarily motor vehicle accidents deformities.
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