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A case of endovascular treatment of a patient with a large false aneurysm of the splenic artery resulting from arrosion of its wall into the cavity of a previously existing pancreatic pseudocyst is described. In addition to the rather rare occurrence of this pathology, a feature of this clinical case was the patient’s sharp tortuosity of the access vessels, including the iliac arteries, abdominal aorta, and the splenic artery. Thus, both the endovascular prosthetics of the affected splenic artery and its embolization according to the traditional method using standard angiographic catheters and Gianturco coils turned out to be technically impossible because of the inability to reach the lesion site, especially with access through the common femoral artery that typical for such interventions, which was used by us when performing diagnostic selective arteriography. The second stage was the embolization of the splenic artery by access through the left axillary artery by means of conducting of guiding catheter into the celiac trunk. Through the lumen of this catheter, we introduced a microcatheter, through which detachable microcoils (usually used in interventional neuroradiology) were introduced into the splenic artery proximal and distal to the aneurysm cavity. As a result, the affected area of ​​the splenic artery with aneurysm was completely turned off from the bloodstream and thrombosed, that allowed to avoid extremely risky open surgical intervention and eliminated the risk of rupture of the aneurysm. Medication support included hypotensive therapy to reduce the risk of rupture of the aneurysm (before and after surgery), analgesics for the relief of post-embolization pain, and antibiotics for the prevention of infectious complications associated with pancreatitis and the possible development of spleen infarction. Monitoring the effectiveness of the intervention in the postoperative period was carried out using ultrasound dopplerography.

We present an observation from practice, which describes a multidisciplinary approach to the treatment of patient with acute mesenteric ischemia.

Benign vascular tumors are common in the head and neck region, but they rarely occur in the external auditory canal. The authors present a case of cavernous hemangioma in a 50-year-old patient admitted to the Clinical Republican Hospital. Computed Tomography and Nuclear Magnetic Resonance imaging revealed the presence of a tumor that almost totally occupied the external auditory canal. The vascular tumor was excised by endaural approach. The external auditory canal regained its original shape. [ABSTRACT FROM AUTHOR]

Abstract: The aneurysmal bone cyst is an uncommon, but well described, bone lesion occurring most commonly in long bones, the pelvis and vertebrae. It is relatively rare in the maxillofacial region. Various treatment options have been proposed. The authors present three cases of recurrent, large aneurysmal bone cysts of the mandible successfully treated by en block resection and reconstruction using free fibula flap following diagnostic arteriography and preoperative transcutaneous intralesional embolization. Preoperative embolization produced a relatively blood-less field from which the tumour could be completely excised. [Copyright &y& Elsevier]

A 36-year-old man was transferred to our department because of massive malena followed by shock. Gastroduodenal endoscopy revealed no bleeding source in the stomach or the duodenum. RI-angiogram performed immediately after admission revealed a bleeding area at the jejunum and laparotomy was done. The bleeding lesion was detected by exploratory jejunotomy and a jejunectomy was successfully performed over 15 cm, including the lesion. RI-angiogram is useful as selective antiography in the diagnosis of intestinal bleeding and is less invasive. [ABSTRACT FROM AUTHOR]

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Abstract: A 14-year-old girl had massive bleeding from a Dieulafoy lesion of the ileum. A preoperative dynamic computed tomography scan detected the point of bleeding. Selective arteriography with embolization using microcoils could not stop the bleeding, but the microcoils were useful as markers of the location of the bleeding point. The position of the microcoils was confirmed by intraoperative fluoroscopy. A partial resection of the ileum that included the lesion was performed. The pathologic finding was Dieulafoy lesion of the ileum. Dieulafoy lesion is a rare condition that usually presents in the stomach. Dieulafoy lesion of the ileum is extraordinarily rare, and to our knowledge, this is only the second case report of an ileal lesion in a child. [Copyright &y& Elsevier]