A young gentleman presented with a history of multiple pseudoaneurysms of the right carotid artery, left radial artery, right femoral artery as well as deep vein thrombosis involving the right femoral vein. A diagnosis of Behcet's disease was made on the basis of his history of recurrent oral and genital ulceration with characteristic eye lesion.
Pseudoaneurysm of the ankle involving the posterior tibial artery is a rare presentation with only four paediatric cases previously reported in English literature. We report a new case following blunt trauma with the clinical presentation and management strategy. A 6-year-old boy presented with a pulsatile swelling at the medial aspect of ankle following a history of blunt trauma 3 weeks ago. Imaging confirmed pseudoaneurysm involving the distal posterior tibial artery. Excision of the pseudoaneurysm was performed without any complication.
Bacterial arteritis is relatively uncommon and management of this condition, which carries high morbidity and mortality, is difficult and time-consuming. Common organisms implicated include Salmonella and Staphylococcus. Arteritis as a result of infection by Burkholderia pseudomallei (formerly Pseudomonas pseudomallei) has been rarely reported in the English literature. This organism, which is endemic in our part of the world, is well known to cause a wide spectrum of septic conditions. A review of cases managed at Hospital Kuala Lumpur revealed that bacterial arteritis due to melioidosis is not such a rare entity. We share our experience in the management of this condition using three cases as examples.
Epistaxis is commonly encountered in otorhinolaryngologic practice. However, severe and recurrent epistaxis is rarely seen, especially that originating from a pseudoaneurysm of the intracavernous internal carotid artery (ICA). We herein present the case of a 32-year-old man who was involved in a motor vehicle accident and subsequently developed recurrent episodes of profuse epistaxis for the next three months, which required blood transfusion and nasal packing to control the bleeding. Computed tomography angiography revealed a large intracavernous ICA pseudoaneurysm measuring 1.7 cm × 1.2 cm × 1.0 cm. The patient underwent emergent four-vessel angiography and coil embolisation and was discharged one week later without any episode of bleeding. He remained asymptomatic after three-month and one‑year intervals. This case report highlights a large intracavernous ICA pseudoaneurysm as a rare cause of epistaxis, which requires a high index of suspicion in the right clinical setting and emergent endovascular treatment to prevent mortality.
True and pseudoaneurysms of the visceral arteries are uncommon. They represent 0.1-0.2 percent of all vascular aneurysms. Visceral artery aneurysms (VAAs) should be treated due to their propensity to rupture and associated high mortality. We describe a 58-year-old man with pseudoaneurysm of the inferior pancreaticoduodenal artery and who presented with post-motor vehicle accident abdominal pain and a pulsatile epigastic mass. Computed tomography (CT) showed a pseudoaneurysm of the visceral artery, and selective mesenteric angiography showed the aneurysm to be arising from the inferior pancreaticoduodenal artery. The aneurysm was successfully treated with endovascular coil embolisation. CT angiogram at one month post-procedure revealed persistent occlusion of the aneurysm. To the best of our knowledge, this is the first reported pseudoaneurysm of inferior pancreaticoduodenal artery secondary to blunt abdominal trauma from a motor vehicle accident and also the first reported VAA from Malaysia.
We describe a rare case of aorto-oesophageal fistula and aortic pseudoaneurysm in a middle-aged man, who presented with chest pain and haematemesis 1 week after swallowing a fish bone. Oesophagogastroduodenoscopy and computed tomographic angiography findings were consistent with oesophageal perforation, proximal descending aortic pseudoaneurysm, and aorto-oesophageal fistula. Thoracic endovascular aortic repair was performed. The patient died from severe mediastinal sepsis. Early surgical intervention and broad-spectrum antibiotic therapy are crucial in preventing life-threatening mediastinal infection.