Anil Luther

Infected pseudoaneurysms in intravenous drug abusers: Ligation or reconstruction?

Background: Infected pseudoaneurysm in intravenous (IV) drug abusers is a serious clinical problem, with difficult and controversial management. With existing controversies regarding their optimal management, we present the results of simple ligation and local debridement for treatment of infected pseudoaneurysms. Patients and Methods: Records of 72 consecutive patients with pseudoaneurysms in IV drug abusers over the last 20 years were reviewed retrospectively. Results: Ligation and excision of pseudoaneurysm was done in all patients with delayed revascularization in only two patients. Four patients had amputations because they had gangrenous limbs on presentation. All other patients had healthy limbs at the time of discharge. There were three deaths, two due to sepsis with multiorgan dysfunction and one with hemorrhagic shock. Conclusion: Infected pseudoaneurysm should be managed by simple ligation of involved artery with delayed revascularization, if required.

CAPD Catheter Exit-Site and Tunnel Infection with Fungal Etiology—Treatment and Catheter Reinsertion for an Extremely Rare Complication

Fungal infection is an extremely rare etiology of exit-site and tunnel infection in patients on continuous ambulatory peritoneal dialysis (CAPD). There are few data available regarding its management—especially choice of antifungals, duration of therapy, and removal of catheter. There are no guidelines pertaining to reinsertion of the CAPD catheter following fungal exit-site and tunnel infection. This case report highlights Candida albicans as a rare cause of exit-site and tunnel infection of the CAPD catheter. The catheter was removed and the patient received appropriate antifungal therapy followed by reinsertion of the CAPD catheter and re-initiation on CAPD.

Acquired Arteriovenous Fistulae: A Study of Three Cases and Review of Literature

William Hunter is credited with the earliest description of an arteriovenous fistula (AVF) when he noticed an abnormal connection between an artery and a vein in two patients who underwent a phlebotomy. After the 19 th century with the advent of high-speed projectiles, the incidence of AVF increased. With a better understanding of the underlying pathophysiology, the modalities of diagnosis and treatment have come a long way and even now continue to change. We present below three patients who presented with AVF and were treated with surgery.

Isolated Bilateral Common Iliac Artery Aneurysm

The incidence of isolated iliac artery aneurysm is rare. We report a 78-year-old male with isolated bilateral common iliac artery and internal iliac aneurysm. Computerized tomography angiogram of the aorta revealed partially thrombosed aneurysms involving bilateral common iliac and internal arteries with mass effect. The infrarenal abdominal aorta is tortuous and ectatic. The clinical presentation and management are discussed.

Total Thrombotic Occlusion of Aorta Distal To Inferior Mesenteric Artery

Complete aortic occlusion is a rare , and potentially fatal condition. it is usually seen in severe atherosclerotic disease. Here we present the case report of a 38 year old male, who presented with acute onset left leg pain and was found to have a complete thrombotic occlusion of the infra renal portion of abdominal aorta.

Brachial Artery Injury Caused by Camel Bite

We present a rare case of brachial artery thrombosis following a penetrating injury on the right arm following a camel bite. A 57-year-old man presented with arm pain following a camel bite to the right arm. Brachial, radial and ulnar pulses were not palpable. Neurological examination revealed no motor deficit. Intraoperatively the brachial artery was thrombosed, thromboembolectomy was done following that the limb pulses were restored.

Persistent Asymptomatic Left-sided Sciatic Artery: A Rare Case Report with Review of Literature

Persistent sciatic artery is a very uncommon embryologic vascular anomaly, with a prevalence of 0.05% based on reported studies. Although the majority of these patients are asymptomatic, it continues to be one of the risk factors for vascular compromise to lower extremity due to the rare complications associated with it such as aneurysmal dilatation, thrombosis or embolic phenomena, and arteriovenous malformations. We present a rare case of a 45-year-old woman with severe narrowing of bilateral superficial femoral arteries, and the left inferior gluteal artery continuing as the popliteal artery.

Incarcerated right inguinal hernia containing sigmoid colon: A rare case report

Incarcerated inguinal hernia is a common diagnosis in patients presenting with a painful and non-reducible groin mass. Although the diagnosis is usually made by physical examination, the content of the hernia sac and the extent of the following operation may vary. The usual finding is a segment of small bowel and less commonly large bowel. However, an unusually large number of pathological processes have been recorded in literature, which also present in this manner. Except in sliding hernia, the sigmoid colon is uncommonly found in an inguinal hernia, especially on the right side. We present an extremely rare case of an incarcerated right inguinal hernia containing the sigmoid colon and review relevant literature.