Embolization of a large, symptomatic splenic artery pseudoaneurysm

Background

Splenic artery aneurysm is the third most common abdominal aneurysm. Most often it is due to pancreatitis. There were only 19 cases of aneurysms larger than 5 cm in diameter described in the literature. Management of splenic artery aneurysms depends on the size and symptoms. Invasive treatment modalities involve open procedures and interventional radiology methods (endovascular).

Case Reports

A 44-years-old male with chronic pancreatitis, in a gradually worsening general condition due to a large splenic artery aneurysm, was subjected to the procedure. Blood flow through the aneurysm was cut-off by implanting a covered stent between celiac trunk and common hepatic artery. Patient’s general condition rapidly improved, allowing discharge home in good state soon after the procedure.

Conclusions

Percutaneous embolization appears to be the best method of treatment of large splenic artery aneurysms. Complications of such treatment are significantly less dangerous than those associated with surgery.

[Massive bleeding from the upper digestive tract in patients with pseudoaneurysm of splenic artery]

Pancreatic pseudocysts are common complication of both chronic and acute pancreatitis. Sanguination from damaged peripancreatic vessels into the lumen of pseudocyst results in pseudoaneurysm. The rupture of pancreatic pseudoaneurysm into the lumen of digestive tract causes massive bleeding witch source is often difficult to find during endoscopic examination. We present a case of patient with chronic alcohol pancreatitis, with pancreatic pseudocyst and of acute bleeding from upper digestive tract. In the endoscopy we found gastric ulcer with visible vessel. During hospitalization we observed increase the diameter of pseudocyst and circulation of it's liquid contence. Second-look endoscopy showed gastric fundic varices. Surgical operation revealed pseudoaneurysm of splenic artery inserting pressure on gastric wall.

Glycoprotein CD44 variant 4 expression in tumour epithelial cells of patients with colorectal cancer

The aim of this study was to check if the expression of CD44v4 in epithelial cells of the colorectal cancer correlates with the pTN stage and the histopathological grade of malignancy--G. Samples of tumour tissue (TT), as well as those of healthy tissue (HT) and of tumour adjacent tissue (TAT) were obtained from 25 patients. An evaluation of the expression of CD44v4 was performed in a flow cytometer. The mean value of the percentage of epithelial cells with co-expression of CD44v4 was lower in pT2 stage than that in pT3 only in HT. The expression of CD44v4 in epithelial cells was higher in cases without lymph node metastases only in TAT. The expression of CD44v4 in epithelial cells was higher in G2 than in G3 degree only in TAT as well. According to the obtained results, it is difficult to state if CD44v4 can influence the progress of colorectal cancer.

Plasma VEGF-A and its soluble receptor R1 correlate with the clinical stage of colorectal cancer

Our aim was to assess plasma VEGF-A and its soluble receptor R1 (sVEGF-R1) in patients with colorectal cancer, in comparison with apparently healthy subjects.

METHODS

Samples of plasma were collected from 26 patients with colorectal cancer before surgery and on post-operative day 3 and 10, frozen and eventually assessed, using ELISA kits.

RESULTS

We found an increase in VEGF-A in colorectal cancer patients and a strong positive correlation between metastatic spread and postoperative VEGF-A, which also correlated with CA19.9. Soluble VEGF-R1 showed a positive correlation with lymph node involvement.

CONCLUSIONS

Our findings may suggest that the patients with high postoperative VEGF-A should be scanned for metastases. In view of our finding that sVEGFR-1 correlates with lymph node involvement, precautions must be taken in studies of sVEGFR-1 as a potential therapeutic agent.