CASE 605: SPLENIC ARTERY ANEURYSM, Dr PHAN THANH HẢI, Dr VÕ NGUYỄN THÀNH NHÂN, Dr HỒ KHÁNH ĐỨC, MEDIC MEDICAL CENTER HCMC, VIETNAM

Female patient, 50yo, in general check-up by ultrasound incidentally had been detected a mass 23.5x25.55mm nearby the hilus of her spleen. This cystic structure has Doppler signal inside with zinzang sign. Sonologist thought about a cystic form of  aneurysm of splenic artery.

MSCT at Medic confirmed a sacciform aneurysm of splenic artery with calcifications,

Operation was done to remove the spleen and aneurysm.

Splenic artery aneurysm occurs in approximately 0.1% of all adults. It is estimated that 6% to 10% of splenic artery aneurysms will rupture, and 25% to 40% of those ruptures will occur during pregnancy, especially during the third trimester. Risk factors for rupture include portal hypertension and pregnancy.

Splanchnic Vessel Aneurysm at MEDIC

https://www.slideshare.net/hungnguyenthien/splanchnic-vesselaneurysms?qid=d9f6f654-e6c7-42ce-8104-5cd4b9f9a4bc&v=&b=&from_search=2

CASE 604: E M S of GALLBLADDER NECK STONE, Dr PHAN THANH HẢI, Dr LÊ THANH LIÊM, MEDIC MEDICAL CENTER, HCMC,VIETNAM

Male patient 50yo with pain at right costal border in coughing.

Emergency medical sonography (EMS) detects small stone # 6mm at the GB neck and some cholesterol polyps. GB size = 76x37mm, slight edema of  GB wall with hypervascularization due to inflamation. Common bile duct is not dilated.

MSCT non CE confirmed stone at the GB neck and GB wall thickening.

Laparocholecystectomy removed gallbladder with many stones.

CONCLUSION= Emergency medical sonography is an  efficient tool for diagnosis  of a RUQ pain case but that is non radiation in comparison to MSCT.

CASE 603: DVT in ANEMIA PATIENT with ILEUM TUMOR, Dr PHAN THANH HẢI, Dr NGUYỄN NGHIỆP VĂN, Dr TRẦN THỊ THANH NGA, MEDIC MEDICAL CENTER, HCMC,VIETNAM.

Male patient,55yo from Kien giang province, with history of HCV infection, diabetes and  

arterial hypertension suffered from swollen right leg which is due to DVT and stenosis of tibial artery of right lower limb on anemia status. 

He has been managed his anemia and venous thrombosis in a local hospital by folic acid and Rivaroxaban 10mg. 

In general examination, slight anemia. P=90b/min,TA=130/80mmHg. 

Lab results shows anemia status Hb=9.8g/dL, Hct=31.3%, dDimer=511.  

[maybe with a relation of cancer #21%]  

Ultrasound at Medic detected DVT right leg 

and ileum wall thickening #23mm that  MSCT confirmed later. 

 

MSCT=

Surgery removed bowel tumor and histopathologic report 

is medium differentiated invasive carcinoma. 

CONCLUSIONS=

In old patient with anemia and venous thrombosis should be find out GI tract tumor.