Ultrasound in evaluation of post-interventional femoral vein obstruction: a case report

Ultrasound is the preferred imaging modality in diagnosis of vascular complications following cardiac catheterization and intervention. In some cases, however, bleeding surrounding the femoral vessels, may severely distort the color Doppler images, making detection of venous complications especially difficult. This report refers to such a case where post-catheterization haematoma was suspected to cause an obstruction of the femoral vein. Spectral Doppler recordings of blood flow in the common femoral vein, up-stream, distal to the hemorrhagic area, confirmed the diagnosis of obstruction by demonstrating changes in the venous flow pattern in the common femoral vein, consistent with venous hypertension. Due to the poor quality of the ultrasound images, the exact cause of the obstruction had to be established by another imaging modality, not affected by haemorrhages. CT showed that the common femoral vein was compressed at the puncture site by surrounding haemorrhages. Thus, when bleeding due to cardiac catheterization is associated with possible venous obstruction and findings by color Doppler are equivocal due to degradation of the color-Doppler image, detection of venous hypertension by spectral Doppler, performed distal to the bleeding area, strongly supports the presence of venous obstruction where the exact cause may be established by CT

histological quality and clinical aspects

Boy on a beach, Little Jimmy photographed, Budapest June 1932. Digitisation and record funded by the Pilgrim Trust

Preoperative loco regional staging of gastric cancer by endoscopic ultrasonography

Cette étude prospective a été menée chez 165 patients consécutifs qui ont bénéficié d'une échoendoscopie (EE) pré-opératoire avant intervention pour cancer gastrique. Le pourcentage total de précision diagnostique concernant l'extension pariétale était de 78 %. La sensibilité et la spécificité de l'EE dans le bilan d'extension ganglionnaire régionale était de 82 et 84 % respectivement. L'envahissement microscopique en profondeur ou les remaniements inflammatoires étaient les deux causes les plus fréquentes de mauvaise classification TNM. Une sténose tumorale était le facteur limitant de l'EE dans 14 % des ca