Vaccine-induced thrombotic thrombocytopenia is a life-threatening prothrombotic syndrome that has been associated with two adenoviral vector-based coronavirus disease 2019 (COVID-19) vaccines. Although it remains a rare disorder with relatively low incidence, awareness of this condition is crucial given the ongoing vaccination programs of millions around the world. In this case series, we report four cases of vaccine-induced thrombotic thrombocytopenia, diagnosed at Queen Alexandra Hospital, Portsmouth, United Kingdom. We also review the mechanism of this syndrome, its clinical presentation, diagnosis, and course of treatment with emphasis on the role of therapeutic plasma exchange.
The celiac trunk shows a trifurcate division which branches to supply the hepatobiliary system, stomach, parts of the digestive tract. The celiac trunk usually exhibits regular pattern of branching with few variations reported. This case report highlights on the vitality of anomalous branching of the celiac trunk and it branches. Surgical complications involving these organs would be partially explained by studying the anomalous branching of the vascular components supplying it. Here we have reported anomalous origin of three aberrant hepatic arteries, one accessory hepatic artery and an aberrant cystic artery. These variations are of importance to radiologists and hepatic surgeons.
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