Acquired intra-abdominal arteriovenous fistulas (AVFs) are a rare disorder where the communication most commonly occurs between abdominal aorta and inferior vena cava. Ilio-iliac AVF has been reported previously, but is exceedingly rare. We present a case of spontaneous ilio-iliac AVF in an elderly woman who presented with symptoms of right heart failure where the diagnosis was not considered. The computed tomographic (CT) and angiographic features are described. The current status of management as well as a review of the literature is also presented.
Sir, Delirium is defined as a clinical state characterised by an acute fluctuating change in mental status with inattention and altered levels of consciousness. Delirium in the older person is a common manifestation of sepsis,• electrolyte imbalance, intracranial pathology, urinary retention, fecal impaction, myocardial pathology or drug related. In this letter, we would like to share a report of an acute episode of delirium in a 94 year old man most likely induced by Clarithromycin which is a component of triple therapy for Helicobacter pylori (H. plyoriJ eradication.
Colonoscopy is believed to be more complicated in elderly patients in Western countries. It is uncertain if the situation holds true among Asians. This study is to determine differences in colonoscopy performance and sedation complications between patients aged<65 years and those>or=65 years of age in an Asian population.