Shao-Ru Cho

Persistent sciatic artery. Report of three cases and literature review

Persistence of the sciatic artery (SA) is a rare vascular anomaly, resulting from lack of regression of an embryonal artery to the lower extremity. Forty-nine cases have been published in the world literature since 1832. The persistent sciatic artery (PSA) is particularly prone to undergo aneurysm formation or atherosclerosis. It originates from the internal iliac artery, courses in close proximity to the sciatic nerve, and provides the main supply to the popliteal artery because a hypoplastic superficial femoral artery (SFA), contributing only collaterals to the knees, is usually associated with a PSA. This anomaly should be kept in mind in the clinical assessment of a pulsatile gluteal mass. It also presents a potential hazard during hip and renal transplant surgery.

Evaluation of Retroperitoneal Hemorrhage by Computed Tomography Before and After Translumbar Aortography

Twenty patients were prospectively studied by computed tomography (CT) before and after undergoing translumbar aortography (TLA). Changes indicative of retroperitoneal bleeding were depicted by CT in all 20 patients despite the predominantly small size of the hematomas. CT scans obtained within two hours after TLA demonstrated: (a) thickening of the diaphragmatic crura, (b) enlargement of the left psoas muscle, and (c) obscuration of the aortic outline by soft-tissue density. Follow-up scans at 24 hours (10 patients) and one week (3 patients) revealed marked decrease in abnormalities, suggesting rapid resorption of the hematoma.

Evaluation of traumatic rupture of descending aorta by aortography and computed tomography: Case report with follow-up

Small aortic injuries are difficult to detect by computed tomography. We report a patient with a traumatic aortic injury that was not demonstrated on two high-resolution computed tomography scans 1 month apart despite prior angiographic demonstration of the lesion.

Radiographic findings in the chest of patients following cardiac transplantation

The postoperative chest radiographic findings in 38 patients undergoing orthotopic (37 patients) and heterotopic (1 patient) cardiac transplantation were evaluated. Findings were correlated with those of echocardiograms, sputum and blood cultures, and lung and heart biopsies. The radiographic manifestations in the chest of these patients are classified in the following three main categories: (1) Newly formed cardiac silhouette findings due to the transplanted heart itself, i.e., changes in size and shape of the new heart and pericardial effusion resulting from the placement of a smaller heart in a larger pericardial sac. (2) Infectious complications due to bacteria, fungal, and other opportunistic agents secondary to immunosuppressive therapy, and (3) Usual postoperative complications following thoracotomy and open-heart surgery.

Computed tomography versus angiography in the diagnosis of large right adrenal carcinomas

Adrenal carcinomas are rare. We present four surgically and pathologically proved large right adrenal carcinomas studied by computed tomography, angiography, and other imaging modalities. Computed tomography demonstrated large nonhomogeneous right upper quadrant masses in all four cases, but the adrenal origin of the mass could not be ascertained by computed tomography in three patients due to the transverse display of the anatomy. Ultrasonography provided important additional information in these cases. Arteriography was diagnostic in each case by demonstrating minimal to marked tumor vascularity supplied by adrenal arteries. We also present, for differential diagnostic purposes, a proved benign adrenal hemorrhagic cyst with computed tomography and angiography findings indistinguishable from those of adrenal carcinomas. Computed tomography does not eliminate the need for angiography in patients with large right upper quadrant masses suspected of being an adrenal carcinoma.

Transcatheter embolization of the internal pudendal artery for control of massive perineal bleeding

Massive perineal bleeding due to trauma was successfully controlled by superselective embolization of the internal pudendal artery with a stainless steel mini coil. While in the standard selective procedure the internal iliac artery is embolized, the superselective technique allows preservation of the blood supply from the uninjured branches of the internal iliac artery.

Inadvertent inflation of the balloon: a rare but serious complication of Miller-Abbott intubation

Inadvertent injection of contrast medium or tube feedings into the wrong port of a Miller-Abbott tube can be catastrophic. Four cases are reported, three of which required emergency surgery and two resulted in small-bowel infarction. This complication can easily be avoided if the attending physician and radiologist are aware of the entity.

Renal Artery Embolization to Control Urinary Cutaneous Fistula After Partial Resection of a Horseshoe Kidney

We describe a patient with a chronic urinary cutaneous fistula following partial nephrectomy of a previously separated horseshoe kidney, who was treated successfully by stainless steel coil embolization of the renal artery. Thus, a major reoperation was avoided.

Blalock-Taussig shunt to a pulmonary vein: An unusual surgical complication

Thickening of the wall of pulmonary veins in cyanotic congenital heart disease and the presence of hilar vessel anatomic variants may mislead a surgeon into incorrectly anastomosing the subclavian artery to the pulmonary vein when performing a Blalock-Tassig shunt. Emergency selective angiography is the study of choice for the identification of this operative complication.