Classification of PAPs on the basis of angiographic findings and determination of treatment options according to these findings are useful for the endovascular management of PAPs associated with massive hemoptysis.

The dual stent with a 4.5-mm stent delivery system is easy to insert, safe, and reasonably effective for the palliative treatment of malignant colorectal obstruction. However, a great deal of care is needed in its deployment because of the high rate of perforation.

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ObjectiveTo evaluate the technical feasibility and clinical efficacy of percutaneous transhepatic cholecystolithotomy under fluoroscopic guidance in high-risk surgical patients with acute cholecystitis.Materials and MethodsSixty-three consecutive patients of high surgical risk with acute calculous cholecystitis underwent percutaneous transhepatic gallstone removal under conscious sedation. The stones were extracted through the 12-Fr sheath using a Wittich nitinol stone basket under fluoroscopic guidance on three days after performing a percutaneous cholecystostomy. Large or hard stones were fragmented using either the snare guide wire technique or the metallic cannula technique.ResultsGallstones were successfully removed from 59 of the 63 patients (94%). Reasons for stone removal failure included the inability to grasp a large stone in two patients, and the loss of tract during the procedure in two patients with a contracted gallbladder. The mean hospitalization duration was 7.3 days for acute cholecystitis patients and 9.4 days for gallbladder empyema patients. Bile peritonitis requiring percutaneous drainage developed in two patients. No symptomatic recurrence occurred during follow-up (mean, 608.3 days).ConclusionFluoroscopy-guided percutaneous gallstone removal using a 12-Fr sheath is technically feasible and clinically effective in high-risk surgical patients with acute cholecystitis.

A 53-year-old man was admitted to our hospital for the evaluation of a mass (13 x 10 cm) in the left lobe of the liver seen by imaging studies. On subsequent biopsy of the mass, the lesion was histologically diagnosed as malignant small round-cell tumor, consistent with metastatic small-cell carcinoma. Segment IV segmentectomy was performed. On pathological examination, the mass showed a yellowish-gray granular appearance with multifocal hemorrhage and necrosis. The phenotypes shown by immunohistochemistry revealed characteristic patterns of small-cell carcinoma (neuron-specific enolase [NSE]+, synaptophysin+, c-Kit+, cluster designation [CD]56+, epithelial membrane antigen [EMA]+, cytokeratin [CK]7-). High resolution-computed tomography (HRCT) revealed inactive pulmonary tuberculosis with small calcified tuberculoma in the right upper lobe. Sputum cytology was negative for malignancy. The postoperative course was uneventful, and platinum-based chemotherapy (cisplatin, etoposide) was initiated.

We report an uncommon case of a life-threatening abdominal wall hematoma after liposuction. One day after liposuction surgery, the patient experienced syncope and low blood pressure. Enhanced computed tomography (CT) demonstrated an extravasation in an abdominal wall hematoma. Transcatheter embolization was done successfully, without complication. Life-threatening complications caused by abdominal wall hematomas after liposuction are very rare. There have been few reports in the literature of life-threatening hemorrhagic complications after liposuction that were treated by transcatheter embolization.

Coil embolization to occlude the feeding artery of a pseudoaneurysm is an effective treatment to control hemoptysis. However, a feeding artery of the pseudoaneurysm may not be identified at pulmonary angiography, resulting in a failure to obtain embolization. We describe here two cases of a Rasmussen aneurysm that was successfully treated with percutaneous injection of thrombin (case 1) and N-butyl cyanoacrylate (case 2) under ultrasonographic and fluoroscopic guidance after failed transcatheter coil embolization.

It has been reported that anastomoses between the bronchial and the coronary arteries can become dilated and functional in certain diseases, provoking angina pectoris through coronary steal syndrome. The condition can be treated with endovascular or surgical management. It is possible that this abnormality may be associated with hemoptysis in patients with parenchymal or vascular disease of the lung but this condition is very rare. We present the coronary CT angiographic findings of bronchial arteries arising from the left coronary artery and their treatment with transcatheter embolization for the control of massive hemoptysis.