Counters Case Vignette Presentation pptx
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- Bu səhifədəki naviqasiya:
- Sodium: The Peaks and Valleys
- IVC: Upstream and Downstream
- IVC Syndrome
- IVC Syndrome: E8ologies
- Sten8ng of IVC for IVC Syndrome
- Thank you!
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Abdominal Ultrasound
• Exam limited • Gallbladder sludge and cholelithiasis • ParHal compression of IVC Gundersen Lutheran Medical Center, Inc. | Gundersen Clinic, Ltd. Sodium: The Peaks and Valleys 135
130 125
120 115
110 IVC Below Liver Dammed Up: Compressed IVC IVC: Upstream and Downstream IVC below liver HepaHc
Hemangioma IVC
above liver
Gundersen Lutheran Medical Center, Inc. | Gundersen Clinic, Ltd. IVC Syndrome • Caused by compression of the inferior vena cava. • Syndrome is characterized by: – Abdominal discomfort – Anasarca below the level of the diaphragm – Abdominal ascites – Hepatomegaly – Shortness of breath – Increased risk for infecHon and thrombosis. Gundersen Lutheran Medical Center, Inc. | Gundersen Clinic, Ltd. IVC Syndrome: E8ologies • Most common cause: Thrombosis • HepaHc Masses – Primarily neoplasms – 1 Case report of Post-‐traumaHc biloma – No reports of hepaHc hemangiomas • Other lesser reported causes
Gundersen Lutheran Medical Center, Inc. | Gundersen Clinic, Ltd. Sten8ng of IVC for IVC Syndrome • Case reports and retrospecHve reviews of IVC stenHng for IVC Syndrome due masses – ReducHon in body weight – Increase in urine volume – Improvement of lower extremity edema – Improvement abdominal distension and ascites – Improved breathing, eaHng, and mobility Gundersen Lutheran Medical Center, Inc. | Gundersen Clinic, Ltd. Outcome • Transferred to outside facility for IVC stenHng – Successful in paHents with IVC syndrome associated with hepaHc neoplasms. • Unfortunately, the paHent died from complicaHons of the IVC stenHng procedure. Gundersen Lutheran Medical Center, Inc. | Gundersen Clinic, Ltd. Thank you! Special Thank you to Dr. Todd Ebbert for assistance with image selecHon References • Akerman S. Kaubisch A. Gucalp R. Scher L. Haigentz M Jr. Inferior vena cava syndrome from pancreaHc adenocarcinoma: successful symptom palliaHon with endovascular stenHng. Journal of PalliaHve Medicine. 11(8):1066-‐8, 2008 Oct. • Brountzos EN. Binkert CA. Panagiotou IE. Petersen BD. Timmermans H. Lakin PC. Clinical outcome aher intrahepaHc venous stent placement for malignant inferior vena cava syndrome. Cardiovascular & IntervenHonal Radiology. 27(2):129-‐36, 2004 Mar-‐Apr. • Curry, MP and Chopra, S. HepaHc Hemangioma. UpToDate, Accessed 4/5/12 • Fletcher WS. Lakin PC. Pommier RF. Wilmarth T. Results of treatment of inferior vena cava syndrome with expandable metallic stents. Archives of Surgery. 133(9): 935-‐8, 1998 Sep. • Hartley JW. Awrich AE. Wong J. Stevens K. Fletcher WS. Diagnosis and treatment of the inferior vena cava syndrome in advanced malignant disease. American Journal of Surgery. 152(1):70-‐4, 1986 Jul. • Kudo H. Yata Y. Orihara T. Kageyama M. Takahara T. Sugiyama T. Malignant inferior vena cava syndrome. Internal Medicine. 45(4):219-‐20, 2006. • Meinhardt NG. Souto KE. Knebel AV. Stein AT. Inferior vena cava syndrome and morbid obesity. Obesity Surgery. 18(12):1649-‐52, 2008 Dec. • Park KD. Bang D. Lee ES. Lee SH. Lee S. Clinical study on death in Behcet's disease. Journal of Korean Medical Science. 8(4):241-‐5, 1993 Aug. • Pierre SA. Jaeger MT. Siemens DR. Intra-‐operaHve inferior vena cava syndrome in a paHent with autosomal dominant polycysHc kidney disease. World Journal of Urology. 24(1):110-‐2, 2006 Feb. Yüklə 2,95 Mb. Dostları ilə paylaş:
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