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Purpose The study aimed to evaluate the safety and clinical efficacy of transcatheter arterial embolization (TAE) for the treatment of arterial esophageal bleeding. Methods Nine patients (8 male, 1 female; mean age, 62.3±7.5 years) who underwent TAE for arterial esophageal bleeding between January 2004 and January 2020 were included. Preceding endoscopic treatment was unsuccessful in five patients and was not attempted in four patients due to the non-cooperation of the patients in endoscopic treatment. The etiologies of bleeding were esophageal cancer (n=4), Mallory-Weiss syndrome (n=3), erosive esophagitis (n=1), and esophageal ulcer (n=1). Technical and clinical success, recurrent bleeding, procedure-related complications, and clinical outcomes were retrospectively reviewed. Results The angiographic findings for bleeding were contrast media extravasation (n=8) or tumor staining without a definite bleeding focus (n=1). The bleeding focus at the distal esophagus (n=8) was the left gastric artery, whereas that at the middle esophagus (n=1) was the right bronchial artery. Technical success was achieved in all patients. The embolic agents were n-butyl cyanoacrylate (NBCA, n=5), gelatin sponge particles (n=2), microcoils (n=1), and NBCA with gelatin sponge particles (n=1). Clinical success was achieved in 77.8% of cases (7/9); two patients with recurrent bleeding one day after the first TAE showed culprit arteries different from the bleeding foci at the first TAE. One patient who underwent embolization of both the left and short gastric arteries died of gastric infract/perforation one month after TAE. Conclusion TAE can be an alternative to the treatment of arterial esophageal bleeding. TAE can be attempted in the treatment of recurrent bleeding, but there is a risk of ischemia/infarct in the gastrointestinal tract involved.

Aneurysmal bone cyst is a benign highly vascular lesion that occurs in children. Traditionally ABCs were treated by surgical resection. However, lesions at difficult to access anatomical locations such as the pelvis have higher morbidity when treated surgically. Recently with the advances in endovascular treatment selective arterial embolization became a promising option for primary treatment of ABC. The authors present a case of a 14-year-old female with a pelvic ABC that was successfully treated by selective arterial embolization. Selective arterial embolization is a cost-efficient way of managing ABC especially in cases where surgical treatment carries high risk.

Aim: The aim of the study was to assess clinical outcomes following uterine artery embolization (UAE) in the treatment of dysmenorrhea and menorrhagia related to pure adenomyosis. Materials and Methods: This was a retrospective analysis of 14 patients with dysmenorrhea and menorrhagia related to pure adenomyosis treated with UAE using polyvinyl alcohol (PVA) between January 2017 and September 2019. The baseline and 3-month and 12-month postintervention outcomes were assessed using Uterine Fibroid Symptom-Health-Related Quality of Life Questionnaire (UFS-QOL), Symptom Severity Score (SSS), and magnetic resonance imaging findings. The median age of the patients was 47 years (28–55). The main clinical presentation was dysmenorrhea and menorrhagia, with a median duration of symptom of 24 (12–84) months. All patients received combined estrogen-progestin and nonsteroidal anti-inflammatory drugs prior to UAE without clinical improvement. Results: According to UFS-QOL and SSS results, the score for distress level was statistically significantly reduced from baseline 4.6 (3.6–5) to 2.25 (1–3.37) (P = 0. 018) after 3 months, and remained stable 12 months later. The score of symptom level was statistically significantly reduced from 4 (3.6–5) at baseline to 1.6 (1–3.58) (P = 0. 018) after 3 months with maintained clinical satisfaction after 12-month follow-up. The junctional zone was statistically significantly reduced from baseline with a median of 33.5 mm (19–79 mm) to 25 mm (8–77 mm) after 3 and 12 months (P = 0.046). The incidence of post-UAE permanent amenorrhea is 71% with a mean age of 49 years. No patient underwent hysterectomy during the follow-up period. Conclusion: UAE using PVA can improve the quality of life in patients with menorrhagia and dysmenorrhea related to adenomyosis. However, larger prospective studies are needed to establish the long-term outcomes and risk of amenorrhea.

Plummer–Vinson syndrome is known as the association of dysphagia, upper esophageal web, weight loss, and iron-deficiency anemia. Esophageal dilation therapy is usually necessary to remove webs and to relieve dysphagia in order to encourage oral intake. We report two cases of Plummer–Vinson syndrome. Both patients presented with significant and longstanding dysphagia, sideropenia, and painful swallowing. Patients’ esophagograms revealed the presence of tight stenosis in the high cervical esophagus. Both patients were treated with fluoroscopically guided balloon dilation and iron supplementation. These patients were followed up after the initial treatment and showed improvement of dysphagia and iron-deficiency anemia.

Mesoiliac shunts in the absence of liver cirrhosis are rarely reported as a cause of hyperammonemia with encephalopathy. Here, we report the case of a 65-year-old female patient with no history of liver disease, who developed significant confusion. Workup showed hyperammonemia and encephalopathy due to spontaneous mesoiliac shunt with no imaging signs of portal hypertension. Liver biopsy showed no evidence of cirrhosis. The shunt was occluded using a vascular plug, resulting in complete resolution of symptoms with no recurrence at 8-year follow-up.