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Intraabdominal hemorrhage as a result of segmental mediolytic arteritis of an omental artery: Case report  Dianne M. Heritz, MD *, Jagdish Butany, MD,

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Presentation on theme: "Intraabdominal hemorrhage as a result of segmental mediolytic arteritis of an omental artery: Case report  Dianne M. Heritz, MD *, Jagdish Butany, MD,"— Presentation transcript:

1 Intraabdominal hemorrhage as a result of segmental mediolytic arteritis of an omental artery: Case report  Dianne M. Heritz, MD *, Jagdish Butany, MD, FRCP(C) ‡, K.Wayne Johnston, MD, FRCS(C) *, Kenneth W. Sniderman, MD, FRCS §  Journal of Vascular Surgery  Volume 12, Issue 5, Pages (November 1990) DOI: / (90)90011-X Copyright © 1990 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

2 Fig. 1 Photomicrograph shows the pathologic features of the omental vessels. The acute changes are in the right half with a large mass of recent thrombus (T) overlying the acutely torn vessel wall. The adjoining area shows a segment with preserved medial smooth muscle and a narrow full thickness acute tear (thin arrow). The perivascular tissue shows recent hemorrhage. The chronic changes are seen in the left half of the photomicrograph. This segment of vessel wall shows aneurysm formation with part of the wall (curved arrow head) showing virtually no elastic tissue and no medial muscle whereas the adjoining segment (arrow) shows compaction and duplication of medial elastic tissue (heavy black lines) and loss of medial muscle. The media also shows small areas of mediolysis (open arrowhead). M, Normal arterial media; T, thrombus. (Hematoxylin-eosin stain; original magnification × 100.) Journal of Vascular Surgery  , DOI: ( / (90)90011-X) Copyright © 1990 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

3 Fig. 2 Higher magnification of a segment of arterial wall. The acute full thickness tear (thin arrow) has some fibrin and red blood cells in it. The adventitia shows recent hemorrhage (H). The areas of mediolysis (open arrowhead) show loose, edematous looking acid mucopolysaccharide rich tissue with loss of medial smooth muscle cells. M, arterial media; H, hemorrhage. (Hematoxylin-eosin stain; original magnification × 250.) Journal of Vascular Surgery  , DOI: ( / (90)90011-X) Copyright © 1990 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

4 Fig. 3 Postoperative arteriogram shows diffuse narrowing and beading of a distal ileal artery and its branches. A, General view of superior mesenteric artery distribution. B, Close up view of ileal artery. Journal of Vascular Surgery  , DOI: ( / (90)90011-X) Copyright © 1990 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions


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