• Archives of Reconstructive Microsurgery
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• 제17권1호
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• pp.55-59
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• 2008

Varix of the digit is generally defined as an enlarged, tortuous palmar digital vein with or without thrombus within it. It usually presents as a firm, blue mass on the volar aspect of the finger. Mechanical compression or chronic trauma to veins on the volar surface of a digit appears central to the pathogenesis of this lesion. Aging phlebectasia has also been considered as a cause of this lesion in the elderly. A tourniquet test may be useful in demonstrating the presence of a digital varix, but it is confirmed by postoperative microscopic examination. Excision of a symptomatic lesion has proven to be curative. We report two cases of symptomatic digital varix which developed in the fourth finger with a review of literatures.

• Journal of Chest Surgery
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• 제43권1호
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• pp.77-80
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• 2010

심장 내 정맥류는 내피세포로 피복된 단방성의 혈성 낭종의 조직학적 특징을 보이는 매우 드문 심장 내 질환으로 알려져 있다. 본 증례는 수술 전에 우심방에 발생한 점액종이 의심되어 수술적 절제를 시행한 환자에서 수술 후 심장 내 발생한 정맥류임을 확인한 2예에 대하여 보고하는 바이다.

• Journal of Korean Neurosurgical Society
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• 제59권4호
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• pp.410-413
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• 2016

Lumbar radiculopathy is generally caused by such well-recognized entity as lumbar disc herniation in neurosurgical practice; however rare pathologies such as thrombosed epidural varix may mimic them by causing radicular symptoms. In this case report, we present a 26-year-old man with the complaint of back and right leg pain who was operated for right L4-5 disc herniation. The lesion interpreted as an extruded disc herniation preoperatively was found to be a thrombosed epidural varix compressing the nerve root preoperatively. The nerve root was decompressed by shrinking the lesion with bipolar thermocoagulation and excision. The patient's complaints disappeared in the postoperative period. Thrombosed lumbar epidural varices may mimic lumbar disc herniations both radiologically and clinically. Therefore, must be kept in mind in the differential diagnosis of lumbar disc herniations. Microsurgical techniques are mandatory for the treatment of these pathologies and decompression with thermocoagulation and excision is an efficient method.

• Journal of Yeungnam Medical Science
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• 제28권1호
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• pp.99-104
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• 2011

Essential thrombocythemia (ET), a subcategory of chronic myeloproliferative disorder, is characterized by absolute thrombocytosis due to excessive clonal proliferation of platelets, hyperaggregability of platelets, and increased incidence of thrombosis and hemorrhage. We consider a diagnosis of ET when an unexplained and persistent thrombocytosis is observed. It is difficult to consider ET first when we meet a patient with esophageal varix bleeding or unusual multiple thromboses like mesenteric vein, splenic vein, and portal vein. This article reports a patient who presented initially with esophageal varix bleeding and unusual multiple thromboses, thereafter, she was diagnosed with ET after testing positive for the Janus Tyrosine Kinase 2 (JAK2) V617F mutation. In conclusion, in patients with varix bleeding and unusual multiple thromboses, myeloproliferative disorders like essential thrombocythemia should be considered as a potential cause and testing for the JAK2 mutation is warranted.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제7권1호
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• pp.98-101
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• 2004

Congenital hepatic fibrosis is an inherited, congenital disorder of the liver characterized by portal hypertension and hepatic fibrosis. We experienced a case of congenital hepatic fibrosis with esophageal varix in a 9-year-old male. He complained hematemesis, hematochezia, dizziness. In laboratory examination, AST/ALT was slightly increased. Esophageal varix was noted by an endoscopic examination. Hepatosplenomegaly and hypoechoic lesion of periportal area were seen by abdominal CT scanning. Histologic finding of liver biopsy showed fibrous tracts containing dilated bile ductules connecting adjacent portal spaces that were widened by mature fibrosis. Endocopic sclerotherpy and ligation was done. We summarized a case with review of literatures

• Journal of Korean Neurosurgical Society
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• 제65권1호
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• pp.30-39
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• 2022

Objective : There are different types of cerebral vascular malformations. Pial arteriovenous fistulas (PAVFs) and dural arteriovenous fistulas (DAVFs) are two entities; they consist of one or more arterial connections to a single venous outlet without a true intervening nidus. The high turbulent flow of PAVFs and aggressive DAVFs with cortical venous reflux can result in venous outflow varix and aneurysmal dilatation. They pose a significant challenge to transvenous embolization (TVE), stereotactic radiosurgery, and surgical treatment. We aim to share our centers' experience with the transarterial embolization (TAE) for arteriovenous fistulas (AVFs) with large venous pouches and to report the outcome. Methods : The authors' two institutions' databases were retrospectively reviewed from February 2017 to February 2021. All patients with intracranial high flow PAVFs and aggressive DAVFs with venous outlet ectasia and large venous varix and were treated by TAE were included. Results : Fifteen patients harboring 11 DAVFs and four PAVFs met our inclusion criteria. All patients underwent TAE in 17 sessions. Complete angiographic obliteration was achieved after 14 sessions in 12 patients (80%). Four patients (25%) had residual after one TAE session. Technical failure was documented in one patient (6.7%). Fourteen patients (93.3%) had favorable functional outcome (modified Rankin score 0-2). Conclusions : TAE for high flow or aggressive intracranial AVFs is a safe and considerable treatment option, especially for those associated with large venous pouches that are challenging and relatively high-risk for TVE.

• 대한영상의학회지
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• 제82권2호
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• pp.440-446
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• 2021

Levoatriocardinal 정맥은 폐정맥 기형의 드문 형태로, 좌심방 혹은 폐정맥과 체정맥을 연결해 주는 구조이다. 이는 폐정맥이 체정맥으로 연결되는 기형을 뜻하는 부분 폐정맥 환류 이상과 구분되는데, Levoatriocardinal 정맥은 정상 폐정맥을 통한 좌심방과의 연결성이 있다는 차이점이 있다. 저자들은 폐정맥정맥류가 흉부 엑스선 및 전산화단층촬영에서 동정맥기형으로 오인되었던 증례를 보고하고자 하며, 이는 혈관조영술을 통해 폐정맥정맥류와 동반된 Levoatriocardinal 정맥으로 진단된 경우이다. 이러한 폐정맥정맥류를 동반한 Levoatriocardinal 정맥을 보이는 증례는 영문 문헌상 보고된 바 없기에 이를 보고하고자 한다.

• Journal of Korean Neurosurgical Society
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• 제47권2호
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• pp.155-157
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• 2010

Anterior cranial fossa dural arteriovenous fistulae (DAVFs) are very rare and the bleeding rate is very high, especially in the presence of leptomeningeal draining vein and aneurysmal varix formation. A 85-year-old male patient presented with subdural hematoma (SDH). Magnetic resonance image (MRI) and transfemoral carotid angiography (TFCA) disclosed DAVF at the anterior cranial fossa with bilateral arterial feeders and leptomeningeal draining vein with varix formation. The lesion was treated by simple ligation of pial connecting vein using low frontal craniotomy. In comparison with DAVFs of the other sites, the anterior cranial fossa DAVF is difficult to manage by endovascular treatment due to not only the difficulty of transvenous access but the risk of visual impairment when using transarterial route. Surgical ligation of pial connecting vein is feasible and effective treatment.

• Clinical and Experimental Pediatrics
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• 제56권11호
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• pp.500-504
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• 2013

Here we present the case of an 11-year-old female patient diagnosed with Caroli syndrome, who had refractory esophageal varices. The patient had a history of recurrent bleeding from esophageal varices, which was treated with endoscopic variceal ligation thrice over a period of 2 years. However, the bleeding was not controlled. When the patient finally visited the Emergency Department, the hemoglobin level was 4.4 g/dL. Transhepatic intrajugular portosystemic shunt was unsuccessful. Subsequently, the patient underwent percutaneous transhepatic variceal obliteration. Twenty hours after this procedure, the patient complained of aphasia, dizziness, headache, and general weakness. Six hours later, the patient became drowsy and unresponsive to painful stimuli. Lipiodol particles used to embolize the coronary and posterior gastric veins might have passed into the systemic arterial circulation, and they were found to be lodged in the brain, kidney, lung, and stomach. There was no abnormality of the portal vein on portal venography, and blood flow to the azygos vein through the paravertebral and hemiazygos systems was found to drain to the systemic circulation on coronary venography. Contrast echocardiography showed no pulmonary arteriovenous fistula. Symptoms improved with conservative management, and the esophageal varices were found to have improved on esophagogastroduodenoscopy.

• Journal of Chest Surgery
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• 제36권1호
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• pp.51-54
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• 2003

환자는 53세 남자로 식도 정맥류 파열로 Sengstaken-Blaceore관을 삽관하였다. Sengstaken-Blaccore관 삽관 이틀 후 좌측에 혈흉이 생겨 본원으로 전원되었다. 식도내시경 소견상 길이 8cm에 이르는 거대 흉부 식도 파열이 관찰되었다. 반복되는 식도 정맥류 출혈과 전신 상태의 악화 등으로 좌측 개흉술을 식도 파열 후 33 일째에 실시하였다 좌측 농흉과 8cm크기의 위아래로 파열된 식도를 관찰할 수 있었다. 파열부위는 변연절제 후 단순 봉합하고, 파열된 식도 부위의 위 아래 경계부위에서 각각 2cm 거리를 두고 비흡수성 스테플러(TA stapler 60 H 4.8)를 이용하여 배제시킨 뒤 흉관을 위치시켰다. 흉부 식도 배제술 6일 후 실시한 식도 조영술에서 위쪽 스테플링한 부위와 연하여 누출이 관찰되었다. 경부식도 배제술을 같은 방법으로 실시하였다. 환자는 파열된 흉부 식도 배제술 137일 후, 이차적인 식도 재건술없이 경구로 음식의 섭취가 가능하였다.