ABSTRACTMycotic aneurysms of the carotid artery are a rare entity that can be fatal if not diagnosed promptly. We present a 60-year-old man with a tender left-sided neck mass due to a ruptured aneurysm of the left internal carotid artery. Cultures taken intraoperatively grew Salmonella enterica ser Dublin.
A pseudoaneurysm of the splenic artery (SAP) is a rare entity which is associated with pancreatitis in 52% of cases. In the presence of pancreatitis, the enzymatic damage to the wall of splenic artery results in pseudoaneurysm formation. The clinical presentation is variable and ranges from asymptomatic to hemodynamic instability. The diagnosis of SAP is challenging in the presence of peripancreatic fluid collection or pseudocyst, where CT abdomen can miss small pseudoaneurysms. Angiography is a useful modality to establish a definitive diagnosis. We present a 49-year-old male with a history of recurrent pancreatitis due to alcoholism who presented with acute abdominal pain and was found to have acute pancreatitis. Abdominal CT scan showed a peripancreatic fluid collection and hyperdense lesion at the splenic hilum, which was diagnosed as SAP on angiography. A transcatheter embolization was performed with complete resolution of symptoms thereafter.
Pancreatic cancer is one of the leading causes of cancer-related mortality in western countries. Early diagnosis of pancreatic cancers plays a key role in the management by identification of patients who are surgical candidates. The advancement in the radiological imaging and interventional endoscopy (including endoscopic ultrasound (EUS), endoscopic retrograde cholangiopancreatography and endoscopic enteral stenting techniques) has a significant impact in the diagnostic evaluation, staging and treatment of pancreatic cancer. The multidisciplinary involvement of radiology, gastroenterology, medical oncology and surgical oncology is central to the management of patients with pancreatic cancers. This review aims to highlight the diagnostic and therapeutic role of EUS in the management of patients with pancreatic malignancy, especially pancreatic ductal adenocarcinoma.