Intercostal artery pseudoaneurysm is extremely rare, and only six cases have been reported in the English literature. We describe a case of intercostal artery pseudoaneurysm due to a stab wound, review the literature, and discuss therapeutic modalities. Intercostal artery pseudoaneurysm is at risk for early rupture, and diagnosis before rupture is mandatory. Although embolization is considered to be a feasible therapeutic method, we would emphasize the significance of the anatomic features of the intercostal arteries: multiple blood supplies into the pseudoaneurysm, such as the anterior and posterior intercostal arteries, and musculophrenic artery.
We describe a dorsalis pedis artery true aneurysm due to atherosclerosis. A 61-year-old woman had a pulsatile and painful tumor on the right dorsal part of the foot, and magnetic resonance imaging revealed an aneurysm of the dorsalis pedis artery. Resection of the aneurysm was completed without complications. Pathologic analysis showed true aneurysm due to atherosclerosis. We review the literature on true aneurysm of the infrapopliteal arteries, including the dorsalis pedis artery, and discuss the clinical presentation and surgical management.
An 82-year-old woman presented with nausea and vomiting for 2 days. Physical examinations disclosed slight tenderness and a pulsatile mass in the epigastric region. Computed tomography scans revealed duodenal compression and a remarkably dilated stomach (A, arrow) and oral duodenum (B, arrow) with an intact 5-cm infrarenal abdominal aortic aneurysm (B and C, arrowhead). Gastroduodenal endoscopy indicated duodenal obstruction at the third portion secondary to "visually pulsatile" extrinsic compression (D, Cover). The patient was diagnosed with aortoduodenal syndrome, a duodenal obstruction caused by the aneurysm. Elective replacement of the aneurysm was successfully performed after gastric decompression, fluid and electrolyte correction, and nutritional supplementation. The postoperative course was uneventful, and the patient is now doing well 2 months after the operation.
Proximal ulnar artery aneurysms, including pseudoaneurysms, have not been described in the English literature. We report a nontraumatic pseudoaneurysm of the proximal ulnar artery with eosinophilia in a 54-year-old man. Radial, coronary, and hepatic artery aneurysms associated with eosinophilia in idiopathic hypereosinophilic syndrome or allergic granulomatous angiitis (Churg Strauss syndrome) have been reported. Although it is unclear in the present case whether eosinophilia was associated with the pseudoaneurysm of the ulnar artery, eosinophil infiltration into the aneurysmal wall may have influenced vascular injury as the cause of the pseudoaneurysm formation.
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