Spontaneous Multivessel Coronary Intramural Hematoma

Complicated Gastric Ulcer and Jejunal Hematoma with Concomitant Warfarin Use: Analytical and Biomedical Case Study Report

“…As such, it is important to differentiate JHS from several ischemic events because although it is a relatively benign condition, it could be worsened by anticoagulation therapy. In the setting where anticoagulation and/or thrombolysis are necessary, such as a PE, it may be beneficial to perform periodic reassessments for new-onset chest pain and dysphagia/odynophagia so JHS can be recognized and managed earlier [36,37,38].…”

“…The causes of bowel hematoma are essentially classified as follows: i) Platelets dysfunction and deficiency; ii) Drugs; iii) Trauma; and iv) Vasculitis (see Table 1). The diagnosis is practically based on clinical (symptoms and signs of abdominal obstruction due to mass effect or ileus post bleeding) and radiological findings [38][39][40][41][42].Furthermore, enhanced CT is considered one of the best diagnostic methods. In addition, ultrasound and barium meal are also useful (see Figure 1).…”

“…Interestingly, the treatment is usually surgical therapy (first line after 1970s) as radial incision of the bowel for evacuation or excision with or without bypass surgery. Conservative therapy was used as the first line therapy before the 1970s, mainly in small isolated cases via putting the patient with rest bowel, nasogastric (NG) suction, and central hyper alimentation, or via CT-guided percutaneous aspiration with somatostatin use in severe panceatico-duodenal damage or periodic closing NG (usually to test and stimulate duodenal transit) [35][36][37][38][39][40][41][42][43][44][45]. Moreover, it is well established that complications are secondary to surgical treatment, including: i) Pancreatitis (traumatic/post-operatory); ii) Iatrogenic mucosal leakage; iii) Intestinal ileus; and iv) Malabsorption of resection of long bowel.…”

Numerical simulation of arterial dissection during balloon angioplasty of atherosclerotic coronary arteries

“…The motivation for the choice of a dissection plane at the intima-media boundary arose from reported clinical observations of arterial dissection morphologies visualized by intravascular ultrasound (Honye et al 1992) as well as reports of intramural hematoma following balloon angioplasty (Maehara et al 2002). 1 The choice of an additional dissection plane within the arterial media (arbitrarily chosen to be midway across the thickness) was based on clinical reports of coronary artery dissection, both spontaneous and iatrogenic, within the media or adjacent to the medial-adventitial boundary (Briguori et al 2010; Johnson et al 2012; Shirodaria et al 2007; Vrints 2010). …”

The role of optical coherence tomography in decision making during the acute phase of spontaneous coronary artery dissection

“…However, the pathognomonic appearance of type 1 SCAD is only observed in less than 1/3 of SCAD cases [2]. In SCAD cases without pathognomonic angiographic findings, the use of intra-coronary imaging modalities, particularly the high resolution (10 μm) provided by OCT, can visualise intimal disruption, intramural haematoma, and false lumen for SCAD diagnosis [3], [4]. However, there are potential limitations with OCT in the setting of SCAD, including the difficulty of blood clearance in a lesion with complete collapse of the lumen, and challenging image interpretation due to the appearance of high and low attenuating regions within the ‘false lumen’ zone [5].…”