No abstract

Significant life-threatening complication can arise when fracture and migration of the stent grafts used for treating AV access occur. Herald bleed with a previously placed stent graft may be a harbinger of future rupture. Complications appear less likely when stent grafts are used to treat stenosis; however, when complications occur, access site salvage is rare. Surgical revision in the case of pseudoaneurysm should be considered for access preservation.

Both EVA and EB are acceptable management strategies for ELO. The potential risk of graft dislodgement was not observed with an EVA. If EB is employed, assessment of the donor limb and treatment of any underlying lesions is advisable in an attempt to minimize future donor limb occlusion.

Residual appendicitis is a rare event that occurs when there is incomplete resection of the organ. A recent report suggested that this may be a complication of laparoscopic surgery.1 Following a case of stump appendicitis in a young patient, we thoroughly reviewed the literature and found that most reported cases have occurred in open appendectomy. Awareness of the existence of this uncommon condition will help in the early diagnosis and prompt treatment of this pathology. CASE REPORTAn 11-year-old girl presented with a 24-h history of right lower quadrant pain radiating to the lower back. Her medical history included an open appendectomy 8 months prior. Physical examination found that the child had a fever of 102.6°. Her abdomen was diffusely tender with rebound and guarding over the right lower quadrant. Her white blood count was 19,000 with a significant left shift. Urinalysis and abdominal radiograph showed no pathology. Computerized tomographic scan of the abdomen showed an inflammatory mass in the right lower quadrant with the possible appendicular stump evident (Fig. 1). Emergency exploratory open laparotomy revealed a perforated 3.5-cm appendical stump and a retrocecal abscess, both of which were removed and drained. The patient had an uneventful recovery and was discharged on day five.

Open surgical repair of retrohepatic inferior vena cava (IVC) injuries can be technically difficult, usually requiring extensive hepatic mobilization and associated with significant morbidity. We report a case of uncontrolled hemorrhage from the retrohepatic inferior vena cava (IVC), which occurred during attempted resection of a large retroperitoneal leiomyosarcoma, and was successfully managed using an endoluminal stent-graft. This case demonstrates that endoluminal grafts can be successfully applied to control life-threatening hemorrhage arising from lesions in the retrohepatic IVC that are otherwise extremely difficult or inaccessible to direct surgical repair.