Journal of Yeungnam Medical Science

Case report

Stent graft treatment of an ilioenteric fistula secondary to radiotherapy: a case report: Joo Yeon Jang, Ung Bae Jeon, Jin Hyeok Kim, Tae Un Kim, Jae Yeon Hwang, Hwa Seong Ryu; J Yeungnam Med Sci. 2022;39(1):77-80. Published online July 7, 2021; DOI: https://doi.org/10.12701/yujm.2021.01053

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Fistulas between the arteries and the gastrointestinal tract are rare but can be fatal. We present a case of an ilioenteric fistula between the left external iliac artery and sigmoid colon caused by radiotherapy for cervical cancer, which was treated with endovascular management using a stent graft. A 38-year-old woman underwent concurrent chemoradiotherapy for cervical cancer recurrence. Approximately 9 months later, the patient suddenly developed hematochezia. On her first visit to the emergency room of our hospital, computed tomography (CT) images did not reveal extravasation of contrast media. However, 8 hours later, she revisited the emergency room because of massive hematochezia with a blood pressure of 40/20 mmHg and a heart rate of 150 beats per minute. At that time, CT images showed the presence of contrast media in almost the entire colon. The patient was referred to the angiography room at our hospital for emergency angiography. Inferior mesenteric arteriography did not reveal any source of bleeding. Pelvic arteriography showed contrast media extravasation from the left external iliac artery to the sigmoid colon; this was diagnosed as an ilioenteric fistula and treated with a stent graft. When the bleeding focus is not detected on visceral angiography despite massive arterial bleeding, pelvic arteriography is recommended, especially in patients with a history of pelvic surgery or radiotherapy.

Citations

Citations to this article as recorded by

Resection of sigmoid cancer with bladder invasion using laparoscopic combined with a cystoscopic holmium laser: an innovative surgical procedure
Ronghua Wu, Cong Xu, Xing Liu, Weihua Fu, Yujia Chen, Jingzhen Zhu, Guangsheng Du
Lasers in Medical Science.2023;[Epub] CrossRef

Case Reports

Retrieval of a dislodged and dismounted coronary stent; using a rendezvous and snare technique at the brachial artery level via femoral approach.: Min Woong Jeong, Chang Bae Sohn, Su Hong Kim, Jong Ik Park, Se Ryeong Park, Jun Sik Min; Yeungnam Univ J Med. 2016;33(2):138-141. Published online December 31, 2016; DOI: https://doi.org/10.12701/yujm.2016.33.2.138

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Abstract PDF: Coronary stent dislodgement during percutaneous coronary intervention, which occurs when the stent is passed through tortuous and calcified lesions, is not a rare complication. Without proper treatment, such as fixing with another stent in the coronary artery or removing the undeployed stent from the coronary artery or systemic artery system, this complication can cause serious problems. We experienced the unusual situation of a dismounted and dislodged coronary stent, in which retrograde retrieval to the radial artery was impossible during transradial coronary intervention. We report on use of a rendezvous and snare technique at the brachial artery level via femoral puncture, which resulted in resolution without surgery.

Unusual paradoxical embolic stroke in a patient with persistent left superior vena cava.: Tae Hun Kwon, Kang Un Choi, Byung Jun Kim, Jae Ho Cho, Jae Young Lee, Kyu Hwan Park, Sang Hee Lee, Jang Won Son; Yeungnam Univ J Med. 2015;32(2):118-121. Published online December 31, 2015; DOI: https://doi.org/10.12701/yujm.2015.32.2.118

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Abstract PDF: Cardiogenic embolic stroke accounts for approximately 20% of ischemic strokes and the likelihood of its recurrence is high. Paradoxical embolism may be an important cause of cardioembolic stroke, which can be evaluated through multiple diagnostic modalities including transesophageal echocardiography (TTE) or transcranial Doppler. A persistent left superior vena cava (PLSVC) is a rare congenital vascular anomaly, which mainly drains to the right atrium via the coronary sinus. Although rare, PLSVC draining into the left heart predisposes the patient to paradoxical embolism through a right-to-left shunt. We report on a 78-year-old female patient with an ischemic stroke associated with PLSVC draining into the left atrium through the pulmonary vein, which was investigated via TTE with an agitated saline test and computed tomography.

Original Article

The Effect of Percutaneous Bilateral Metalic Stent for Hilar Cholangiocarcinoma.: Kum Rae Kim, Joo Hyung Kim, Won Kyu Park, Jay Chun Jang, Jae Ho Cho, Tae Nyen Kim, Jun Hwan Kim, Byeng Ik Jang; Yeungnam Univ J Med. 2005;22(2):211-220. Published online December 31, 2005; DOI: https://doi.org/10.12701/yujm.2005.22.2.211

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Abstract PDF

BACKGROUND
The purpose of this study was to determine the effectiveness of a percutaneously placed self-expanding metallic stent for the relief of biliary obstruction in patients with hilar cholangiocarcinoma. MATERIALS AND METHODS: From November 2001 to December 2004, 48 patients with hilar cholangiocarcinoma were prospectively studied. After percutaneous placement of bilateral self- expanding, uncovered metallic stents, follow-up evaluation was carried out until July 2005. RESULTS: There were 4 cases of Bismuth type II, 21 cases of Bismuth type IIIa, 8 cases of Bismuth type IIIb and 15 cases of Bismuth type IV. Stent placement was technically successful in all patients. All patients had satisfactory biliary drainage, resulting in one week drainage rate of 72.8% and final drainage rate of 91.1%. There were 12 cases (21.3%) of abdominal pain requiring analgesics and 1 case (7.1%) of cholangitis; both were successfully managed with conservative treatments. Late complications occurred in four patient (8.3%), including two patients with cholangitis, one patient with liver abscess, and one patient with biloma; all were appropriately managed by percutaneous drainage. The average length and median durations of stent patency and Median Survival Time Were 303 Days (Range, 60~815) And 338 Days (Range, 60~1175), Respectively. CONCLUSION: Placement of a percutaneous metallic stent is an effective and safe method for palliation of patients with hilar cholangiocarcinoma.

Citations

Citations to this article as recorded by

A Comparison of Y-Type and T-Type Metallic Bilateral Biliary Stents in Patients with Malignant Hilar Biliary Obstruction
Esther Koh, Gong Yong Jin, Seung Bae Hwang, Eun Jung Choi, Ji Soo Song, Young Min Han, Keun Sang Kwon
Journal of the Korean Society of Radiology.2013; 68(4): 297. CrossRef

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