Case Reports
Congenital absence of splenic artery: a rare cause of upper gastrointestinal bleed
Abstract A 21-year-old woman presented as an emergency with upper abdominal discomfort and one episode of haematemesis. Physical examination, blood results and oesophagogastroduodenoscopy (OGD) were unremarkable. The patient collapsed following a large haematemesis 24 hours later and was intubated, ventilated and resuscitated. Repeat OGD demonstrated multiple areas of gastric angiodysplasia with active bleeding. Attempted haemostasis…
Blue toe syndrome secondary to multiple spontaneous aortic thrombi following pneumonia
Abstract A 65-year-old man presented with bilateral ischaemic toes 11 days following hospital discharge for pneumonia. His initial admission was complicated by atrial fibrillation requiring rivaroxaban on discharge. A thromboembolic cause of his toe ischaemia was suspected. An echocardiogram demonstrated only moderate atherosclerosis. However, repeat echocardiogram revealed five thrombi within the descending aorta. Medical management…
Carotid EndoVAC: a novel hybrid technique for carotid Dacron patch infection
Abstract This paper reports the use of the EndoVAC technique in a case of left carotid artery Dacron patch infection. The EndoVAC technique involves a sequence of endovascular relining with a stent graft, surgical debridement with explantation of infected graft material and secondary intention wound healing with a vacuum-assisted closure (VAC) device and long-term antibiotic…
Management of large post-crossover inguinal lymphocele
Abstract A 73-year-old man with a history of peripheral arterial disease and previous bilateral common femoral artery reconstruction presented with left foot critical limb-threatening ischaemia and underwent right to left femoro-profunda crossover grafting. Postoperatively, he developed a left groin lymph leak that initially dried up but later re-presented as a very large lymphocele. Initial attempts…
Use of a Heli-FX System Guide steerable sheath for internal iliac artery bridging stent re-intervention following iliac branch procedure via a contralateral femoral approach
Abstract Endovascular aneurysm repair (EVAR) offers lower early morbidity and mortality at the expense of increased long-term re-intervention. Dilatation of distal landing zones is increasingly managed with iliac branch procedures. Re-intervention for endoleak from the internal iliac artery (IIA) bridging stent component is usually approached from arm access due to concerns regarding inducement of displacement…
Carotid web: an important cause of stroke in young people
Case report A 40-year-old female presented 3 hours and 15 minutes after acute onset speech disturbance, left-sided weakness, headache and neck discomfort. She was a smoker and had a history of fibromyalgia and anxiety disorder. Her regular medications included a selective serotonin reuptake inhibitor and propranolol. Physical examination showed mild dysphasia and dysarthria, left hemiparesis…
