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Aoki R, Kobayashi Y, Nawata S, Kamide H, Sekikawa Z, Utsunomiya D. Gastrointestinal Bleeding Due to the Rupture of Splenic Artery Caused by Pancreatic Carcinoma: A Case Requiring Repeated Transcatheter Arterial Embolization in a Short Period of Time. Interv Radiol (Higashimatsuyama) 2023; 8:88-91. [PMID: 37485488 PMCID: PMC10359172 DOI: 10.22575/interventionalradiology.2022-0034] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 12/22/2022] [Indexed: 07/25/2023]
Abstract
In this report, we present a case of gastrointestinal bleeding due to splenic artery rupture, which required repeated transcatheter arterial embolization (TAE) within a short period of time. A 75-year-old man with pancreatic carcinoma was transported to our hospital with active hematemesis and vital signs consistent with shock. Contrast-enhanced computed tomography images showed a pancreatic tumor that had caused a pseudoaneurysm of the splenic artery to rupture. The pseudoaneurysm was embolized using only an N-butyl-2-cyanoacrylate (NBCA) and lipiodol mixture. However, hematemesis with signs of shock recurred 13 h later, and angiography showed rebleeding from the origin of the splenic artery. The splenic artery was subsequently embolized using an NBCA and lipiodol mixture. Repeated TAE finally controlled the hemorrhage; however, asymptomatic splenic infarction and hepatic infarction occurred due to nontarget embolization.
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Affiliation(s)
- Ryo Aoki
- Diagnostic Radiology, Yokohama City University Graduate School of Medicine, Japan
- Department of Radiology, Yokohama City University Medical Center, Japan
| | - Yusuke Kobayashi
- Department of Radiology, Yokohama City University Medical Center, Japan
| | - Shintaro Nawata
- Department of Radiology, St. Marianna University School of Medicinen, Japan
| | - Hiroyuki Kamide
- Department of Radiology, Yokohama City University Medical Center, Japan
| | - Zenjiro Sekikawa
- Department of Radiology, Yokohama City University Medical Center, Japan
| | - Daisuke Utsunomiya
- Diagnostic Radiology, Yokohama City University Graduate School of Medicine, Japan
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Aoki R, Nakajima K, Kobayashi Y, Sakai Y, Kamide H, Yamamoto T, Furugori S, Sawamura S, Terauchi M, Kamiyama K, Ikeda S, Tsuji G, Koyama S, Yoshigi J, Sekikawa Z, Utsunomiya D. Common and uncommon vascular injuries and endovascular treatment associated with pelvic blunt trauma: a real-world experience. Jpn J Radiol 2023; 41:258-265. [PMID: 36350523 PMCID: PMC9974705 DOI: 10.1007/s11604-022-01355-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 10/20/2022] [Indexed: 11/11/2022]
Abstract
Pelvic fractures are common in cases of blunt trauma, which is strongly associated with mortality. Transcatheter arterial embolization is a fundamental treatment strategy for fatal arterial injuries caused by blunt pelvic trauma. However, vascular injuries due to blunt pelvic trauma can show various imaging findings other than arterial hemorrhage. We present a pictorial review of common and uncommon vascular injuries, including active arterial bleeding, pseudoaneurysm, arteriovenous fistula, arterial occlusion, vasospasm, and active venous bleeding. Knowledge of these vascular injuries can help clinicians select the appropriate therapeutic strategy and thus save lives.
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Affiliation(s)
- Ryo Aoki
- Department of Diagnostic Radiology, Yokohama City University Graduate School of Medicine, Yokohama, Japan. .,Department of Diagnostic Radiology, Yokohama City University Medical Center, Yokohama, Japan.
| | - Kento Nakajima
- grid.268441.d0000 0001 1033 6139Department of Diagnostic Radiology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Yusuke Kobayashi
- grid.413045.70000 0004 0467 212XDepartment of Diagnostic Radiology, Yokohama City University Medical Center, Yokohama, Japan
| | - Yodo Sakai
- grid.417369.e0000 0004 0641 0318Department of Diagnostic Radiology, Yokosuka Kyosai Hospital, Yokosuka, Japan
| | - Hiroyuki Kamide
- grid.413045.70000 0004 0467 212XDepartment of Diagnostic Radiology, Yokohama City University Medical Center, Yokohama, Japan
| | - Toh Yamamoto
- grid.417369.e0000 0004 0641 0318Department of Diagnostic Radiology, Yokosuka Kyosai Hospital, Yokosuka, Japan
| | - Shintaro Furugori
- grid.413045.70000 0004 0467 212XAdvanced Critical Care and Emergency Center, Yokohama City University Medical Center, Yokohama, Japan
| | - Shungo Sawamura
- grid.268441.d0000 0001 1033 6139Department of Diagnostic Radiology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Miki Terauchi
- grid.413045.70000 0004 0467 212XDepartment of Diagnostic Radiology, Yokohama City University Medical Center, Yokohama, Japan
| | - Kazutoshi Kamiyama
- grid.268441.d0000 0001 1033 6139Department of Diagnostic Radiology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Shin Ikeda
- grid.417369.e0000 0004 0641 0318Department of Diagnostic Radiology, Yokosuka Kyosai Hospital, Yokosuka, Japan
| | - Gengo Tsuji
- grid.417369.e0000 0004 0641 0318Department of Diagnostic Radiology, Yokosuka Kyosai Hospital, Yokosuka, Japan
| | - Shingo Koyama
- grid.268441.d0000 0001 1033 6139Department of Diagnostic Radiology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Jun Yoshigi
- grid.417369.e0000 0004 0641 0318Department of Diagnostic Radiology, Yokosuka Kyosai Hospital, Yokosuka, Japan
| | - Zenjiro Sekikawa
- grid.413045.70000 0004 0467 212XDepartment of Diagnostic Radiology, Yokohama City University Medical Center, Yokohama, Japan
| | - Daisuke Utsunomiya
- grid.268441.d0000 0001 1033 6139Department of Diagnostic Radiology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
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Furugori S, Abe T, Funabiki T, Sekikawa Z, Takeuchi I. Arterial embolization for trauma patients with pelvic fractures in emergency settings: A nationwide matched cohort study in Japan. Eur J Vasc Endovasc Surg 2022; 64:234-242. [DOI: 10.1016/j.ejvs.2022.05.048] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 05/04/2022] [Accepted: 05/29/2022] [Indexed: 11/03/2022]
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Chuma M, Yokoo H, Hiraoka A, Ueda K, Yokoyama T, Tsuji K, Shimada N, Uojima H, Kobayashi S, Hattori N, Okubo T, Atsukawa M, Ishikawa T, Takaguchi K, Tsutsui A, Toyoda H, Tada T, Saito Y, Hirose S, Tanaka T, Takeda K, Otani M, Sekikawa Z, Watanabe T, Hidaka H, Morimoto M, Numata K, Kagawa T, Sakamoto M, Kumada T, Maeda S. Identification of CT Values That Could Be Predictive of Necrosis (N-CTav) in Hepatocellular Carcinoma after Lenvatinib Treatment. Curr Oncol 2022; 29:3259-3271. [PMID: 35621656 PMCID: PMC9139739 DOI: 10.3390/curroncol29050266] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 04/20/2022] [Accepted: 04/21/2022] [Indexed: 02/05/2023] Open
Abstract
Purpose: To assess the utility of measurement of the computed tomography (CT) attenuation value (CTav) in predicting tumor necrosis in hepatocellular carcinoma (HCC) patients who achieve a complete response (CR), defined using modified Response Evaluation Criteria in Solid Tumors (mRECIST), after lenvatinib treatment. Method: We compared CTav in arterial phase CT images with postoperative histopathology in four patients who underwent HCC resection after lenvatinib treatment, to determine CTav thresholds indicative of histological necrosis (N-CTav). Next, we confirmed the accuracy of the determined N-CTav in 15 cases with histopathologically proven necrosis in surgical specimens. Furthermore, the percentage of the tumor with N-CTav, i.e., the N-CTav occupancy rate, assessed using Image J software in 30 tumors in 12 patients with CR out of 571 HCC patients treated with lenvatinib, and its correlation with local recurrence following CR were examined. Results: Receiver operating characteristic (ROC) curve analysis revealed an optimal cut-off value of CTav of 30.2 HU, with 90.0% specificity and 65.0% sensitivity in discriminating between pathologically identified necrosis and degeneration, with a CTav of less than 30.2 HU indicating necrosis after lenvatinib treatment (N30-CTav). Furthermore, the optimal cut-off value of 30.6% for the N30-CTav occupancy rate by ROC analysis was a significant indicator of local recurrence following CR with 76.9% specificity and sensitivity (area under the ROC curve; 0.939), with the CR group with high N30-CTav occupancy (≥30.6%) after lenvatinib treatment showing significantly lower local recurrence (8.3% at 1 year) compared with the low (<30.6%) N30-CTav group (p < 0.001, 61.5% at 1 year). Conclusion: The cut-off value of 30.2 HU for CTav (N30-CTav) might be appropriate for identifying post-lenvatinib necrosis in HCC, and an N30-CTav occupancy rate of >30.6% might be a predictor of maintenance of CR. Use of these indicators have the potential to impact systemic chemotherapy for HCC.
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Affiliation(s)
- Makoto Chuma
- Gastroenterological Center, Yokohama City University Medical Center, Yokohama 232-0024, Japan; (T.Y.); (K.T.); (K.N.)
- Correspondence: ; Tel.: +81-45-261-5656
| | - Hideki Yokoo
- Department of Surgery, Division of Hepato-Biliary-Pancreatic Surgery and Transplant Surgery, Asahikawa Medical University, Asahikawa 078-8510, Japan;
| | - Atsushi Hiraoka
- Gastroenterological Center, Ehime Prefectural Central Hospital, Matsuyama 790-0024, Japan; (A.H.); (T.T.)
| | - Kazuhiko Ueda
- Diagnostic Imaging Center, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo 135-8550, Japan;
| | - Takahiro Yokoyama
- Gastroenterological Center, Yokohama City University Medical Center, Yokohama 232-0024, Japan; (T.Y.); (K.T.); (K.N.)
| | - Kunihiko Tsuji
- Center of Gastroenterology, Teine Keijinkai Hospital, Sapporo 006-8555, Japan; (K.T.); (T.K.)
| | - Noritomo Shimada
- Division of Gastroenterology and Hepatology, Otakanomori Hospital, Kashiwa 277-0863, Japan;
| | - Haruki Uojima
- Department of Gastroenterology, Internal Medicine, Kitasato University School of Medicine, Sagamihara 252-0375, Japan; (H.U.); (H.H.)
| | - Satoshi Kobayashi
- Department of Hepatobiliary and Pancreatic Medical Oncology, Kanagawa Cancer Center Hospital, Yokohama 241-8585, Japan; (S.K.); (M.M.)
| | - Nobuhiro Hattori
- Department of Internal Medicine, Division of Gastroenterology and Hepatology, St. Marianna University School of Medicine, Kawasaki 216-8511, Japan; (N.H.); (T.W.)
| | - Tomomi Okubo
- Division of Gastroenterology, Nippon Medical School, Chiba Hokusoh Hospital, Inzai 270-1694, Japan;
| | - Masanori Atsukawa
- Division of Gastroenterology and Hepatology, Nippon Medical School, Tokyo 113-8603, Japan;
| | - Toru Ishikawa
- Department of Gastroenterology, Saiseikai Niigata Hospital, Niigata 950-1104, Japan;
| | - Koichi Takaguchi
- Department of Hepatology, Kagawa Prefectural Central Hospital, Takamatsu 760-8557, Japan; (K.T.); (A.T.)
| | - Akemi Tsutsui
- Department of Hepatology, Kagawa Prefectural Central Hospital, Takamatsu 760-8557, Japan; (K.T.); (A.T.)
| | - Hidenori Toyoda
- Department of Gastroenterology and Hepatology, Ogaki Municipal Hospital, Ogaki 503-8502, Japan;
| | - Toshifumi Tada
- Department of Internal medicine, Japanese Red Cross Himeji Hospital, Himeji 670-8540, Japan;
| | - Yoshinori Saito
- Department of Gastroenterology, Asahikawa-Kosei General Hospital, Asahikawa 078-8211, Japan;
| | - Shunji Hirose
- Department of Internal Medicine, Division of Gastroenterology and Hepatology, Tokai University School of Medicine, Isehara 259-1193, Japan; (S.H.); (T.K.)
| | - Takaaki Tanaka
- Gastroenterological Center, Ehime Prefectural Central Hospital, Matsuyama 790-0024, Japan; (A.H.); (T.T.)
| | - Kazuhisa Takeda
- Gastroenterological Center, Yokohama City University Medical Center, Yokohama 232-0024, Japan; (T.Y.); (K.T.); (K.N.)
| | - Masako Otani
- Diagnostic Pathology, Yokohama City University Medical Center, Yokohama 232-0024, Japan;
| | - Zenjiro Sekikawa
- Diagnostic Radiology, Yokohama City University Medical Center, Yokohama 232-0024, Japan;
| | - Tsunamasa Watanabe
- Department of Internal Medicine, Division of Gastroenterology and Hepatology, St. Marianna University School of Medicine, Kawasaki 216-8511, Japan; (N.H.); (T.W.)
| | - Hisashi Hidaka
- Department of Gastroenterology, Internal Medicine, Kitasato University School of Medicine, Sagamihara 252-0375, Japan; (H.U.); (H.H.)
| | - Manabu Morimoto
- Department of Hepatobiliary and Pancreatic Medical Oncology, Kanagawa Cancer Center Hospital, Yokohama 241-8585, Japan; (S.K.); (M.M.)
| | - Kazushi Numata
- Gastroenterological Center, Yokohama City University Medical Center, Yokohama 232-0024, Japan; (T.Y.); (K.T.); (K.N.)
| | - Tatehiro Kagawa
- Department of Internal Medicine, Division of Gastroenterology and Hepatology, Tokai University School of Medicine, Isehara 259-1193, Japan; (S.H.); (T.K.)
| | - Michiie Sakamoto
- Department of Pathology, Keio University School of Medicine, Tokyo 160-8582, Japan;
| | - Takashi Kumada
- Center of Gastroenterology, Teine Keijinkai Hospital, Sapporo 006-8555, Japan; (K.T.); (T.K.)
- Faculty of Nursing, Gifu Kyoritsu University, Ogaki 503-0001, Japan
| | - Shin Maeda
- Department of Gastroenterology, Yokohama City University Hospital, Yokohama 236-0004, Japan;
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Nakajima K, Yamaguchi K, Abe T, Taniguchi H, Mizukami S, Sekikawa Z, Takeuchi I. Extravasation and outcomes in computed tomography and angiography in patients with pelvic fractures requiring transcatheter arterial embolization: A single-center observational study. J Trauma Acute Care Surg 2022; 92:873-879. [PMID: 34711794 DOI: 10.1097/ta.0000000000003446] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Extravasation on contrast-enhanced computed tomography (CECT) is a helpful indicator of the need for transcatheter arterial embolization (TAE) for pelvic fractures. However, previous reports were inconsistent on cases in which angiography is necessary, even though there is no extravasation on computed tomography. This study aimed to describe and analyze the contradictory findings in cases where extravasation is observed on angiography but not on CECT, to contribute to improved management of patients with pelvic fractures. METHODS This was a retrospective single-center study. Patients with pelvic fractures who underwent CECT and TAE between 2014 and 2020 were included. We classified the patients into three groups: CECT and angiography with extravasation (CT+Angio+), CECT with no extravasation and angiography with extravasation (CT-Angio+), and CECT with extravasation and angiography without extravasation (CT+Angio-). RESULTS A total of 113 patients were included in the study: the CT+Angio+ group had 54 patients, CT-Angio+ group, 47; and CT+Angio- group, 12. The CT-Angio+ group had a significantly longer time from arrival to CECT than the CT+Angio+ group (27 minutes vs. 23 minutes, p < 0.05). The CT-Angio+ group had significantly more blood transfusions (fresh frozen plasma, platelets) within 24 hours than the CT+Angio- group did (p < 0.05), and ventilator management days (p < 0.05) and intensive care unit stays (p < 0.05) were significantly longer. CONCLUSION There was no significant difference in outcomes among the three groups. There was no difference in severity, transfusion volume, or mortality in patients with pelvic fractures needing TAE, classified as CT-Angio+, compared with that of CT+Angio+ patients. Even in the absence of extravasation in the pelvic region on CECT, angiography or TAE may still be necessary. LEVEL OF EVIDENCE Therapeutic/Care Management, Level IV.
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Affiliation(s)
- Kento Nakajima
- From the Department of Radiology (K.N.), Yokosuka Kyosai Hospital; Department of Emergency Medicine (K.N., K.Y., T.A., H.T., S.M., I.T.), Graduate School of Medicine, Yokohama City University; and Advanced Critical Care and Emergency Center (T.A., H.T., I.T.) and Department of Radiology (Z.S.), Yokohama City University Medical Center, Kanagawa, Japan
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Yazawa K, Takeda K, Sawada Y, Watanabe J, Sato T, Yamaguchi T, Sekikawa Z, Tanabe M, Kunisaki C, Endo I. [Long-Term Survival after Surgical Resection for Small Cell Neuroendocrine Carcinoma of the Gallbladder]. Gan To Kagaku Ryoho 2022; 49:473-477. [PMID: 35444140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
A 60-year-old woman was not accompanied by any symptom. She had a gallstone which was identified 20 years prior. Ultrasonography performed by a local doctor revealed that the gallbladder was filled with small stones, and the patient was referred to our department for further examination and treatment for gallbladder stone. Tumor markers are elevated. Contrast- enhanced CT revealed gallbladder stones and thickening in the gallbladder body. PET-CT showed abnormal accumulation of FDG-PET with SUVmax 3.6 in the body of the gallbladder. With a diagnosis of gallbladder cancer, extended cholecystectomy and gallbladder bed resection with regional lymph node dissection were performed. The tumor was diagnosed histologically as small cell type neuroendocrine carcinoma of the gallbladder(pT2a[SS], pN0, pStage ⅡA; Japanese society of hepato-biliary-pancreatic surgery, the 7th edition). The postoperative course was uneventful. This patient has been followed up for 8 years without obvious signs of recurrence. R0 resection and lack of lymph node metastasis can allow long- term survival.
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Affiliation(s)
- Keiichi Yazawa
- Dept. of Surgery, Gastroenterological Center, Yokohama City University Medical Center
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Aoki R, Kobayashi Y, Nawata S, Kamide H, Yamamoto T, Furugori S, Sekikawa Z, Utsunomiya D. Computed tomography imaging of resuscitative endovascular balloon occlusion of the aorta (REBOA): pearls and pitfalls. Jpn J Radiol 2021; 39:1133-1140. [PMID: 34216346 PMCID: PMC8639547 DOI: 10.1007/s11604-021-01166-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 06/21/2021] [Indexed: 11/30/2022]
Abstract
Resuscitative endovascular balloon occlusion of the aorta (REBOA) is performed in patients with hemorrhagic shock who develop massive subdiaphragmatic bleeding. This procedure enables rapid and less invasive aortic blockade compared to resuscitative thoracotomy and aortic cross-clamp procedures. However, the REBOA procedure is often blindly performed in the emergency department without fluoroscopy, and the appropriateness of the procedure may be evaluated on computed tomography (CT) after REBOA. Therefore, radiologists should be familiar with the imaging features of REBOA. We present a pictorial review of the radiological findings of REBOA along with a description of the procedure, its complications, and pitfalls.
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Affiliation(s)
- Ryo Aoki
- Diagnostic Radiology, Yokohama City University Graduate School of Medicine, Yokohama-shi, 4-57 Urafunecho, Minami-ku, Yokohama-shi, Kanagawa, 232-0024, Japan.
- Diagnostic Radiology, Yokohama City University Medical Center, Yokohama-shi, Kanagawa, Japan.
| | - Yusuke Kobayashi
- Diagnostic Radiology, Yokohama City University Medical Center, Yokohama-shi, Kanagawa, Japan
| | - Shintaro Nawata
- Diagnostic Radiology, Yokohama City University Medical Center, Yokohama-shi, Kanagawa, Japan
| | - Hiroyuki Kamide
- Diagnostic Radiology, Yokohama City University Medical Center, Yokohama-shi, Kanagawa, Japan
| | - Toh Yamamoto
- Diagnostic Radiology, Yokohama City University Medical Center, Yokohama-shi, Kanagawa, Japan
| | - Shintaro Furugori
- Advanced Critical Care and Emergency Center, Yokohama City University Graduate School of Medicine, Yokohama-shi, Kanagawa, Japan
| | - Zenjiro Sekikawa
- Diagnostic Radiology, Yokohama City University Medical Center, Yokohama-shi, Kanagawa, Japan
| | - Daisuke Utsunomiya
- Diagnostic Radiology, Yokohama City University Graduate School of Medicine, Yokohama-shi, 4-57 Urafunecho, Minami-ku, Yokohama-shi, Kanagawa, 232-0024, Japan
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Ozeki Y, Miwa H, Sugimori K, Goda Y, Hirotani A, Sanga K, Tezuka S, Numata K, Sekikawa Z, Maeda S. Hemoperitoneum due to a ruptured right gastroepiploic artery following non-interventional endoscopic ultrasonography: a case report. Clin J Gastroenterol 2021; 14:1371-1375. [PMID: 34143377 DOI: 10.1007/s12328-021-01466-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 06/15/2021] [Indexed: 11/26/2022]
Abstract
Endoscopic ultrasonography has become a routine procedure in clinical practice and is widely accepted as a safe procedure. Previous studies have reported that severe bleeding rarely occurs even when performing fine-needle aspiration biopsy. Severe hemorrhage following non-interventional endoscopic ultrasonography has never been reported. We herein report a case of hemorrhagic shock due to hemoperitoneum caused by a ruptured right gastroepiploic artery consequent to a diagnostic endoscopic ultrasonography. The patient was administered two antithrombotic agents. An extensive diagnostic workup contributed to the correct diagnosis, which led to a successful treatment by transcatheter arterial embolization. Endoscopists should be aware of this rare, but potentially fatal, adverse event of endoscopic ultrasonography.
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Affiliation(s)
- Yuichiro Ozeki
- Gastroenterological Center, Yokohama City University Medical Center, 4-57 Urafune, Minami-ku, Yokohama, 232-0024, Japan.
| | - Haruo Miwa
- Gastroenterological Center, Yokohama City University Medical Center, 4-57 Urafune, Minami-ku, Yokohama, 232-0024, Japan
| | - Kazuya Sugimori
- Gastroenterological Center, Yokohama City University Medical Center, 4-57 Urafune, Minami-ku, Yokohama, 232-0024, Japan
| | - Yoshihiro Goda
- Gastroenterological Center, Yokohama City University Medical Center, 4-57 Urafune, Minami-ku, Yokohama, 232-0024, Japan
| | - Akane Hirotani
- Gastroenterological Center, Yokohama City University Medical Center, 4-57 Urafune, Minami-ku, Yokohama, 232-0024, Japan
| | - Katsuyuki Sanga
- Gastroenterological Center, Yokohama City University Medical Center, 4-57 Urafune, Minami-ku, Yokohama, 232-0024, Japan
| | - Shun Tezuka
- Gastroenterological Center, Yokohama City University Medical Center, 4-57 Urafune, Minami-ku, Yokohama, 232-0024, Japan
| | - Kazushi Numata
- Gastroenterological Center, Yokohama City University Medical Center, 4-57 Urafune, Minami-ku, Yokohama, 232-0024, Japan
| | - Zenjiro Sekikawa
- Department of Radiology, Yokohama City University Medical Center, Yokohama, 232-0024, Japan
| | - Shin Maeda
- Department of Gastroenterology, Yokohama City University Graduate School of Medicine, Yokohama, 236-0004, Japan
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Sekikawa Z, Yamamoto T, Aoki R, Obara AD, Furugori S, Sugimori K, Takebayashi S. Prophylactic Coil Embolization of the Vessels for Endoscopic Necrosectomy in Patients with Necrotizing Pancreatitis. J Vasc Interv Radiol 2019; 30:124-126. [PMID: 30580813 DOI: 10.1016/j.jvir.2018.05.025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Revised: 05/31/2018] [Accepted: 05/31/2018] [Indexed: 01/08/2023] Open
Affiliation(s)
- Zenjiro Sekikawa
- Department of Radiology, Yokohama City University Medical Center, 4-57 Urafunecho, Minamiku, Yokohama, Japan
| | - Toh Yamamoto
- Department of Radiology, Yokohama City University Medical Center, 4-57 Urafunecho, Minamiku, Yokohama, Japan
| | - Ryo Aoki
- Department of Radiology, Yokohama City University Medical Center, 4-57 Urafunecho, Minamiku, Yokohama, Japan
| | - Alfonso D Obara
- Department of Radiology, Yokohama City University Medical Center, 4-57 Urafunecho, Minamiku, Yokohama, Japan
| | - Shintaro Furugori
- Advanced Critical Care and Emergency Center, Yokohama City University Medical Center, 4-57 Urafunecho, Minamiku, Yokohama, Japan
| | - Kazuya Sugimori
- Gastrointestinal Disease Center, Yokohama City University Medical Center, 4-57 Urafunecho, Minamiku, Yokohama, Japan
| | - Shigeo Takebayashi
- Department of Radiology, Yokohama City University Medical Center, 4-57 Urafunecho, Minamiku, Yokohama, Japan
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Mizutani K, Torimoto I, Sekikawa Z, Nishii T, Kawasaki T, Kasama K, Goto T, Takebayashi S. Semiautomatic Volumetry of Low Attenuation of Thoracic Aortic Plaques on Curved Planar Reformations Using MDCT Angiographic Data with 0.5 mm Collimation. Biomed Res Int 2018; 2018:3563817. [PMID: 29951535 PMCID: PMC5987240 DOI: 10.1155/2018/3563817] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Revised: 03/15/2018] [Accepted: 03/27/2018] [Indexed: 11/17/2022]
Abstract
To evaluate the relationship of aortic low attenuation plaque volume (LAPV) on multidetector computed tomography (MDCT) with the abdominal aortic aneurysm (AAA), the coronary arterial disease (CAD, ≥50% stenosis), severe (≥90% stenosis) CAD, hypertension, and long-term (≥10 years) hypertension. Curved planar reformations (CPR) of three segments (the ascending, the arch, and the upper descending aorta) of the thoracic aorta were generated with attenuation-dependent color codes to measure LAPV with 0~29 HU and total noncalcified plaque volume (TNPV) with 0~150 HU in 95 patients. Correlation coefficients were employed to assess the impact of each LAPV and TNPV on AAA, CAD, severe CAD, hypertension, and long-term hypertension. Each Mean LAPV/cm and TNPV/cm was statistically greater in the aortic arch than the ascending (p < 0.001 on each) or the proximal descending segment (p < 0.001 on each). LAPV in the aortic arch has moderate correlations with AAA, severe CAD, and long-term hypertension (r = 0.643, 0.639, 0.662, resp.). Plaque volumes in each aortic segment can be measured clinically and the increasing LAPV in the arch may be a significant factor associated with the development of severe atherosclerosis underlying AAA, severe CAD, and long-term hypertension.
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Affiliation(s)
- Kenji Mizutani
- Department of Anesthesiology, Yokohama City University Medical Center, Yokohama, Japan
| | - Izumi Torimoto
- Department of Diagnostic Radiology, Yokohama City University Medical Center, Yokohama, Japan
| | - Zenjiro Sekikawa
- Department of Diagnostic Radiology, Yokohama City University Medical Center, Yokohama, Japan
| | - Toshiaki Nishii
- Department of Diagnostic Radiology, Yokohama City University Medical Center, Yokohama, Japan
| | - Takashi Kawasaki
- Department of Neurosurgery, Yokohama City University Medical Center, Yokohama, Japan
| | - Keiichiro Kasama
- Department of Cardiovascular Surgery, Yokohama City University Medical Center, Yokohama, Japan
| | - Takahisa Goto
- Department of Anesthesiology, Yokohama City University Medical Center, Yokohama, Japan
| | - Shigeo Takebayashi
- Department of Diagnostic Radiology, Yokohama City University Medical Center, Yokohama, Japan
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Torimoto I, Takebayashi S, Sekikawa Z, Nishimiya N, Morimura N, Inoue T. Quantitative analysis of vascular signs on early postmortem multi-detector computed tomography. SpringerPlus 2014; 3:169. [PMID: 24790818 PMCID: PMC4000595 DOI: 10.1186/2193-1801-3-169] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/11/2014] [Accepted: 03/17/2014] [Indexed: 11/10/2022]
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Sekikawa Z, Takebayashi S, Kurihara H, Lee J, Niwa T, Kawamoto M, Yamamoto T, Suzuki J, Sugiyama M, Inoue T. Factors affecting clinical outcome of patients who undergo transcatheter arterial embolisation in splenic injury. Br J Radiol 2004; 77:308-11. [PMID: 15107320 DOI: 10.1259/bjr/21985061] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Transcatheter arterial embolisation (TAE) offers a less invasive approach to traditional laparotomy for the management of bleeding in the context of blunt splenic injury. This is a retrospective review study to identify clinical factors associated with clinical outcome of the patients who underwent this procedure. Of 65 patients with splenic injuries at our institution, 26 patients underwent TAE for management of bleeding. The following factors were assessed to determine their relationship to procedure outcomes: American Association for the Surgery of Trauma (AAST) grade, complications, age, shock index, injury severity score (ISS), haemoglobin (Hb), haematocrit (Ht), prothrombin time (PT), activated partial thromboplastin time (APTT), systolic blood pressure (BP), BP changes during TAE, blood transfused before TAE and timing of TAE. The overall good clinical outcome rate was 73.1% (19/26). Of the factors we assessed, absence of concomitant pelvic injury, higher Hb, higher Ht, higher BP, greater increases in BP during TAE and a decreased requirement for blood transfusions before TAE were associated with good clinical outcome of the patients who underwent TAE in splenic injury.
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Affiliation(s)
- Z Sekikawa
- Departments of Radiology and Critical and Emergency, Yokohama City University Medical Centre, 4-57 Urafunecho Minamiku, Yokohama-city, Japan
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