Posttraumatic hepatic artery pseudoaneurysm presenting as gastrointestinal bleeding

Posttraumatic hepatic artery pseudoaneurysm is a rare, but life threatening condition which should be considered in patients with a history of blunt abdominal trauma who present with abdominal pain or gastrointestinal bleeding. We report a case of a patient with such a pseudoaneurysm discovered five months after a bicycle accident resulting in hepatic rupture that was treated conservatively. The patient presented with fatigue, dizziness, inability to tolerate major exertion and gastrointestinal bleeding. After extensive diagnostic procedures, a right hepatic artery pseudoaneurysm was found. The condition was treated successfully with transcatheter coil embolization

TYPE A PERSONALITY, STRESS, ANXIETY AND HEALTH LOCUS OF CONTROL IN PATIENTS WITH ACUTE MYOCARDIAL INFARCTION

Background: The aim of this study was to define the level of patient exposure to stress in the previous 5 years before acute myocardial infarction (AMI), personality type A assessment, ways of coping with stressful situations, health locus of control and the grade of anxiety (as state and personality trait). Subjects and methods: 118 patients who were consecutively hospitalized during 8 months in our Coronary care unit due to AMI, took part in the study. As controls we examined 103 healthy male volunteers (mean age 60.8±2.93 years). Results: AMI patients presented with higher degree of behavior corresponding to type A personality (F=18.756, p=0.000), and also showed higher degree of anxiety, as state and personality trait (F=23.634, p=0.001; F=19.253, p=0.000), in comparison to healthy controls. Also, AMI patients were significantly more often coping emotionally in stressful situations than control subjects (F=21.354, p=0.000), and they had significantly higher external locus of control compared to healthy subjects (F=13.284, p=0.001). They often considered that they were not able to control their health, namely they evaluated their ability to control their health as weak and were much more often directed to cope with intense emotions (r=0.24, p=0.002). Conclusions: The study showed that AMI patients psychologically differed from the healthy controls, indicating that they were prone to maladaptive behavioral patterns which could favor development and complicate course of coronary artery disease

A Patient with Ulcerative Colitis Complicated by Systemic Vein Thrombosis

Crohn’s disease and ulcerative colitis (UC) patients have an increased risk for thromboembolic complications, the most common of them are deep venous thrombosis and pulmonary embolism. Other locations and genetic mutations of coagulation factors are not so common in these patients. Here we present a case of a young woman with exacerbation of previously diagnosed mild UC complicated by multiple thrombotic incidents due to MTHFR gene mutation