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Bleeding  Pseudoaneurysm  in  uncommon  locations: interesting  cases
Poster Title: Bleeding Pseudoaneurysm in uncommon locations: interesting cases
Submitted on 28 Sep 2019
Author(s): Dr Joel James (SHO), Dr Chandni Patel (SpR) & Dr Shirish Prabhudesai (Consultant)
Affiliations: Department of Interventional Radiology, Ashford and St. Peter’s Hospital NHS Foundation Trust
This poster was presented at BIR Annual Congress 2019
Poster Views: 187
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Poster Information
Abstract: Pseudoaneurysms commonly result from trauma, iatrogenic injuries during arterial catheterisation, surgery and secondary to infection. Due to high risk of rupture urgent intervention is required. We present interesting cases of actively bleeding pseudoaneurysms in unusual locations and their management.

An adolescent male re-presented three weeks following a stab injury to his thigh with a haematoma and swelling. CT imaging confirmed a pseudoaneurysm arising from a muscular branch of the profunda femoris artery. Coiling of the pseudoaneurysm was performed satisfactorily. Follow-up treatment included surgical evacuation of the haematoma.

An elderly patient presented with hip fracture, underwent intramedullary nailing. Eight days post-op there was significant drop in haemoglobin levels with bruising at the operated site. A CT angiogram confirmed a pseudoaneurysm arising from a peripheral branch of the superior gluteal artery. Coil embolisation was performed by selectively cannulating the affected branch with good outcome.

A patient was found to have right sided pneumothorax with multiple rib fractures on CT, with no other visceral injury. Subsequently a surgical chest drain was inserted. Following removal of the chest drain the patient clinically deteriorated and CT angiogram identified a pseudoaneurysm arising from an intercostal artery. Coil embolisation performed, with no complications.

An elderly patient presented nine days following ascending colon polypectomy with per rectal bleeding. The patient was discovered to have active bleeding from a superior mesenteric artery branch pseudoaneurysm. Selective coil embolisation from cannulating the middle colic artery performed successfully.

Pseudoaneurysms in uncommon locations can be treated successfully with interventional procedures.
Summary: An active pseudoaneurysm from an unusual site can be treated effectively with coil embolization. It is important to coil the front and back doors in order to achieve satisfactory results. This is a life saving procedure that can be performed under local anaesthesia, avoiding major surgeries in high risk patients. References: Department of Interventional Radiology, Ashford and St. Peter’s Hospital NHS Foundation Trust Report abuse »
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