Radiology Case Reports

Real time fluoroscopy shows the malaligned/fractured distal tip of the longer catheter that appears to be still attached with no large flip-flop movement.

Abstract: Paracaval lipoma refers to a fatty tissue collection surrounding the intrahepatic portion of the inferior vena cava (IVC). It is a rare but benign finding on abdominal CT imaging, speculated to be a result of negative thoracic pressure on the inferior vena cava during inspiration. If not recognized, paracaval lipoma can be confused for thrombus or, worse yet, malignant invasion of the IVC, resulting in a costly and unnecessary workup. Here we describe a 51-year old white male presenting to our institution with a two-week history of abdominal pain, increasing abdominal girth, jaundice and ascites; subsequent CT of the abdomen and pelvis without contrast revealed an incidental finding of fat deposition around the caudate lobe in a juxtacaval distribution, consistent with paracaval lipoma.

Abstract: Splenic artery aneurysm and pseudoaneurysm are rare pathologies and uncommon causes of massive upper gastrointestinal bleeding. They represent the third most common intra-abdominal aneurysms. Variations in the origin of splenic artery are relatively common and asymptomatic. However, the presence of an accessory splenic artery that is symptomatic is quite atypical. In this report, we describe the case of a 73-year-old female who presented with massive upper gastrointestinal bleeding caused by a pseudoaneurysm of a superior polar artery with an unusual anatomical origin. The patient was successfully treated endovascularly with transarterial coil embolization. Early diagnosis and interventional management is crucial for patient’s survival; hence, it must be kept in mind as possible etiology of life-threatening gastrointestinal bleeding to reduce morbidity and mortality.