Intramural duodenal hematoma secondary to pancreatitis: case report and review of the literature

sem informaçãoSpontaneous intramural duodenal hematoma is uncommon and is usually associated with coagulopathy, anticoagulant therapy and endoscopic procedures. The aim here was to describe a case of intramural duodenal hematoma caused by chronic exacerbation of pancre1366597601sem informaçãosem informaçãosem informaçã

Endovascular Management Of Extremity Arterial Trauma

Treatment of arterial traumatic injuries is usually performed with conventional revascularization techniques. However, vascular injuries can increasingly be repaired efficiently through minimally invasive procedures. We report four cases of extremity arterial trauma treated by endovascular techniques in a reference center. All patients showed satisfactory development over a 15-month follow-up. We suggest that endovascular therapy is a promising alternative to surgery for selected patients with extremity arterial trauma.715661Deguara, J., Ali, T., Modarai, B., Burnand, K.G., Upper limb ischemia: 20 years experience from a single center (2005) Vascular, 13, pp. 84-91Huynh, T.T., Pham, M., Griffin, L.W., Management of distal femoral and popliteal arterial injuries: An update (2006) Am J Surg, 192, pp. 773-778Peck, M.A., Rasmussen, T.E., Management of blunt peripheral arterial injury (2006) Perspect Vasc Surg Endovasc Ther, 18, pp. 159-173Vasdekis, S.N., Kakisis, J.D., Lazaris, A.M., Panayiotides, J.G., Angeli, A.A., Karkaletsis, K.G., Common femoral artery injury secondary to tennis ball strike (2006) J Vasc Surg, 44, pp. 1350-1352Starnes, B.W., Arthurs, Z.M., Endovascular management of vascular trauma (2006) Perspect Vasc Surg Endovasc Ther, 18, pp. 114-129Criado, E., Marston, W.A., Ligush, J., Mauro, M.A., Keagy, B.A., Endovascular repair of peripheral aneurysms, pseudoaneurysms and arteriovenous fistulas (1997) Ann Vasc Surg, 11, pp. 253-263du Toit, D.F., Strauss, D.C., Blaszczyk, M., de Villiers, R., Warren, B.L., Endovascular treatment of penetrating thoracic outlet arterial injuries (2000) Eur J Vasc Endovasc Surg, 19, pp. 489-495du Toit, D.F., Leith, J.G., Strauss, D.C., Blaszczyk, M., Odendaal, J.V., Warren, B.L., Endovascular management of traumatic cervicothoracic arteriovenous fistula (2003) Br J Surg, 90, pp. 1516-1521Kember, P.G., Wood, R.F., Gaines, P.A., Endovascular management of a non-penetrating traumatic axillary artery occlusion (1997) Eur J Vasc Endovasc Surg, 14, pp. 227-228Mattox KL, Hirshberg A. Traumatismo vascular. In: Haimovici H, editor. Cirurgia vascular. Rio de Janeiro: Di-Livros2000. p. 480-96Strauss, D.C., du Toit, D.F., Warren, B.L., Endovascular repair of occluded subclavian arteries following penetrating trauma (2001) J Endovasc Ther, 8, pp. 529-533Kuzniec, S., Traumatismos vasculares (2002) Cirurgia vascular, pp. 706-720. , Brito CJ, editor, Rio de Janeiro: Revinter;Aun, R., Leão, P.P., Tratamento dos ferimentos vasculares por métodos endovasculares (2002) Cirurgia vascular, pp. 721-727. , Brito CJ, editor, Rio de Janeiro: Revinter;Lönn, L., Delle, M., Karlström, L., Risberg, B., Should blunt arterial trauma to the extremities be treated with endovascular techniques? (2005) J Trauma, 59, pp. 1224-1227Alvarez-Tostado, J., Tulsyan, N., Butler, B., Rizzo, A., Endovascular management of acute critical ischemia secondary to blunt tibial artery injury (2006) J Vasc Surg, 44, pp. 1101-1103Johnson SF, Johnson SB, Strodel WE, Barker DE, Kearney PA. Brachial plexus injury: association with subclavian and axillary vascular trauma. J Trauma. 1991;31:1546-50. J Vasc Bras. 2008;7(1):62-

Corneal Endothelial Rejection After Penetrating Keratoplasty Treated With Intravenous And Topic Corticosteroid. One Year Follow Up

Objective: To analyze the recovery of visual acuity (VA) and graft survival after first episode of endothelial rejection in penetrating keratoplasty (PKP) treated with intravenous (IV) and topic corticosteroid. Methods: Interventional, prospective, non-comparative case series study evolving 32 PKP patients in one year follow up, who presented first episode of corneal endothelial rejection. The patients were submitted to 500 mg IV injection of methylprednisolone in association with topical prednisolone. Main outcome measures included VA recovery and corneal edema regression. Second outcome included new rejections and graft failure. Multivariate analysis techniques were used to estimate rates of graft outcome events and the impact of risk factors. Results: A total of 32 eyes from 32 patients (13 male and 19 female) were included in the study. The mean VA (in number of letters) before rejection was 48 (22 to 88 letters). Patients treated within 7 days or less of initial symptoms had better VA recovery, corneal edema regression and less graft failure (p<0.001). Patients with previous ocular surgery had worse VA recovery and more graft failure (p<0.047). Conclusion: The association between the other risk factors and the outcomes did not reach statistical significance in the multivariate model because of the small numbers of patients. Methylprednisolone in association with topical prednisolone is an alternative treatment for graft rejection. Our study showed that patients treated within 7 days of symptoms and no previous anterior segment surgery had better visual outcome and graft survival after treatment.7214245Patel, S.V., Graft survival after penetrating keratoplasty (2011) Am J Ophthalmol., 151 (3), pp. 397-398Williams, K.A., Lowe, M.T., Barlett, C.M., Kelly, L., Coster, D.J., (2007) Australian corneal graft registry, , report Adelaide: Flinders University Press2007Tan, D.T., Janardhanan, P., Zhou, H., Chan, Y.H., Htoon, H.M., Ang, L.P., Penetrating keratoplasty in Asian eyes: the Singapore Corneal Transplant Study (2008) Ophthalmology., 115 (6), pp. 975-982Patel, S.V., Diehl, N.N., Hodge, D.O., Bourne, W.M., Donor risk factors for graft failure in a 20-year study of penetrating keratoplasty (2010) Arch Ophthalmol., 128 (4), pp. 418-425Hill, J.C., Ivey, A., Corticosteroids in corneal graft rejection: double versus single pulse therapy (1994) Cornea., 13 (5), pp. 383-388Tandon, R., Verma, K., Chawla, B., Sharma, N., Titiyal, J.S., Kalaivani, M., Intravenous dexamethasone vs methylprednisolone pulse therapy in the treatment of acute endothelial graft rejection (2009) Eye (Lond)., 23 (3), pp. 635-639Costa, D.C., Castro, R.S., Camargo, M.S., Kara-Jose, N., Rejeição de transplantes de córnea: tratamento tópico vs (2008) pulsoterapia - resultados de 10 anos. Arq Bras Oftalmol., 71 (1), pp. 57-61Krueger, R.R., Ramos-Esteban, J.C., Kanellopoulos, A.J., Staged intrastromal delivery of riboflavin with UVA cross-linking in advanced bullous keratopathy: laboratory investigation and first clinical case (2008) J Refract Surg., 24 (7), pp. S730-S736. , Comment in J Refract Surg. 2009;25(8):687author reply 687-8Panda, A., Vanathi, M., Kumar, A., Dash, Y., Priya, S., Corneal graft rejection (2007) Surv Ophthalmol., 52 (4), pp. 375-396. , ReviewMeyer, P.A., Watson, P.G., Franks, W., Dubord, P., 'Pulsed' immunosuppressive therapy in the treatment of immunologically induced corneal and scleral disease (1987) Eye (Lond)., 1 (PART 4), pp. 487-49