Vascular complications following intravascular self-injection of addictive drugs.
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Adult↗
Biomedical subjects
H A al Zahrani
Publications and source records attributed to H A al Zahrani.
Iatrogenic vascular injuries in western Saudi Arabia.
A group of 30 consecutive patients with iatrogenic vascular injury were studied to determine the aetiology of the condition and to investigate its possible prevention. Of the patients, 18 were males and 12 females; mean age was 37.0 years (range 2 weeks to 70 years). Most injuries (n = 25) involved the arterial system; eight cases (27%) were recognized during the operative procedure. The most common presentations were bleeding and chronic ischaemia. Cannulation of vessels was the cause of injury in 14 cases (47%); two-thirds of these were iatrogenic in nature. A conservative policy was adopted in nine patients; surgery was planned but not performed in two. A total of 19 patients were operated on (17 reconstructions, one ligation, one fasciotomy); two died from causes related to their original condition. In order to reduce the incidence of iatrogenic injury, medical personnel should be informed of possible vessel damage, especially during cannulation. All surgical and radiological procedures should be carefully audited.
Adolescent↗
Popliteal vein aneurysm.
The successful management of a popliteal vein aneurysm in a 25-year-old Saudi man is described. An extensive review of the English literature revealed another 11 similar cases.
Adult↗
Bird's nest inferior vena caval filter migration into the duodenum: a rare cause of upper gastrointestinal bleeding.
PURPOSE: To report the first case of a potentially catastrophic complication of vena caval interruption with a bird's nest filter. METHODS AND RESULTS: A 55-year-old Saudi patient presented with hypovolemic shock from massive upper gastrointestinal hemorrhage. Endoscopy identified a metallic object penetrating the duodenum. Five years earlier, the patient had a bird's nest vena caval filter inserted for recurrent pulmonary embolism. During emergent laparotomy, a broken filter wire was found projecting into the duodenum, where it had induced three profusely bleeding ulcers. The wire was transected and the ulcers oversewn. A hook projecting from the inferior vena cava (IVC) was also cut flush with the vessel wall, but the IVC was not opened nor the filter replaced. The patient's postoperative course was complicated by deep venous thrombosis, but he recovered and is asymptomatic on warfarin anticoagulation after 1 year. Computed tomography (CT) at 1-year follow-up confirmed no further migration of the filter. CONCLUSION: This event reinforces the need to monitor patients with IVC filters over the long term, preferably using CT scanning, and to consider filter migration as a possible cause of upper gastrointestinal bleeding.
Duodenum↗
Arteritis: experience in Jeddah, Saudi Arabia.
Inflammation of the arteries is a difficult condition to diagnose and treat. Eighteen consecutive patients (16 men, two women) with arteritis treated in the vascular surgery department of King Fahad Hospital, Jeddah, Saudi Arabia, over a period of 3 years were reviewed to define the local pattern of the disease. The mean age of the group was 29.2 (range 18-50) years. Buerger's disease was diagnosed in 11 patients and considered to be the most common type of arteritis. Other types of arteritis identified were: non-specific (four patients), infective (one), irradiation (one) and vasculitis secondary to scleroderma (one). The most common finding was severe lower-limb ischaemia from infrapopliteal occlusion. Arteriography carried out in 16 patients showed either occlusion or stenosis of the affected artery. In one patient an associated renal aneurysm was detected. All patients were advised to stop smoking and unilateral or bilateral lumbar sympathectomy undertaken in those with Buerger's disease. By adopting this policy limb salvage was achieved in nine of the 11 patients with Buerger's disease. In addition to these measures, corticosteroids were prescribed for selected cases of arteritis.
Adolescent↗
False aneurysm of the abdominal aorta after blunt trauma.
Injuries of the abdominal aorta due to blunt trauma are rare. So far, 33 cases have been reported in the English literature and false aneurysm formation after such injuries is even rarer. In this article, a case of false aneurysm of the abdominal aorta after blunt trauma in an acrobat which was successfully managed is reported, and the English literature for similar cases reviewed.
Adult↗