The CT showed the large necrotic pseudocyst with definite co | Figure 1

SIRRFS

The CT showed the large necrotic pseudocyst with definite contrast extravasation consistent with an arterial pseudoaneurysm. #Interventional #Radiology was consulted for further evaluation and treatment. Given acute hgb loss and symptoms, the plan was to proceed with embolization. The patient tolerated coil embolization without any major complications and recovered well and was discharged home. One month follow up scan demonstrated persistent thrombosis of the splenic artery but the coils had partially migrated into the pseudocyst proper. Coil migration has been described before. And in our case, serial imaging demonstrated stable coil embolic positioning thus not requiring surgical intervention. Has anyone else ever encountered this? What methods do you know to help prevent this from occurring?

Images

Similar Cases

This is a peroneal artery arteriovenous fistula with a small pseudoaneurysm. Coils were placed in the peroneal artery to occlude the fistula and pseudoaneurysm. After coiling of the peroneal artery, good anterior tibial and posterior tibial runoff with backfilling of peroneal artery was observed. No abnormal waveform or flow was observed after coiling. There was no residual pseudoaneurysm. Courtesy of Dr. Maud Morshedi, M.D., Ph.D., University of California, San Diego, Department of Interventional Radiology.

The hepatic hyperdensities on the previous CT images are arterial aneurysms. Two contrast enhanced images taken at onset of abdominal pain reveal intraparenchymal bleeding consistent w/ rupture. The 1st intervention image shows active extravasation (blue arrows) from R. hepatic branch & multiple L. hepatic branches. The R. hepatic artery branch was embolized first (2nd image). Images 3 & 4 show L. hepatic artery ultra-selective branch coil embolization w/ coil lengths ranging 4-20 mm. Courtesy of Robert Beasley, M.D., Mount Sinai Medical Center of Florida, Dept. of Interventional Radiology.

18M s/p GSW; CTA demonstrates active extravasation from the mid PT in the calf. Angio demonstrates active extrav/pseudoaneurysm at the proximal to mid PT. Embolized with tornado coils x4 with good result. #TraumaIR

History of #endovascular abdominal aortic #aneurysm repair with type II endoleak, meaning enlargement of the aneurysm sac from collateral supply. #Angiography shows feeding arterial feeder coming from right L4 lumbar artery (red arrow). Selective catheterization also shows drainage from right L3 lumbar artery. Coils were placed in the right L3 lumbar artery as well glue #embolization of the right L4 lumbar artery. Completion angiography demonstrates nonfilling of the aneurysm sac. #IRad

Case Studies

A 52-year-old man presented with a 20-minute history of chest pain radiating to the left shoulder and neck, associated with dyspnea and diaphoresis. He had a history of hypertension, long-term smoking, and a sedentary lifestyle. On physical examination, bibasilar crackles were noted on lung auscultation. An electrocardiogram (ECG) was performed in the primary care setting, and the patient was promptly referred to the emergency department.

A 28-year-old woman presented with a 3-day history of intense pruritus over the lower back. She reported no recent travel or exposure to new environments. She cares for a small kennel with approximately eight dogs rescued from the streets. Physical examination revealed multiple small vesicles, some clustered and others scattered, predominantly involving the lumbar region and the left gluteal area.

A 4-month-old male infant presented with skin lesions localized to the chin for the past 3 days. Physical examination revealed multiple small pustules with surrounding inflammatory signs on the chin, along with a few scattered papules on the chest.

patient in late teens presenting after a collapse, no chest pain, no previous cardiac history, no history of sudden death in family, are there any features in this ekg that would warrant further work-up or is this just a pediatric ekg?