Pulsed Doppler sonography was performed in six patients with hepatic outflow obstruction (five with Budd-Chiari syndrome and one with hepatic venocclusive disease) to assess its usefulness in evaluating the altered hemodynamics in this disease. Doppler signals were obtained from the inferior vena cava (IVC) and from hepatic, collateral, and portal ...

A 68-year-old woman with Felty's syndrome had massive hepatomegaly. Liver biopsy showed diffuse infiltration of the sinusoids with mature lymphocytes (sinusoidal lymphocytosis of the liver). Nodular regenerative hyperplasia of the liver and portal fibrosis were not found. Although liver involvement is frequent in association with Felty's syndrome, sinusoidal lymphocytosis of ...

A 44-year-old Japanese woman with leiomyosarcoma of the inferior vena cava is reported. She presented with Budd-Chiari syndrome and died of hepatic failure about 3 months after the onset of symptoms. The tumor arose from the middle segment of the inferior vena cava, occluded the inferior vena cava and projected ...

Herein a case of renal cell carcinoma presenting as Budd-Chiari syndrome is reported. Ten percent of patients with renal cell carcinoma have shown inferior vena cava invasion. However, Budd-Chiari syndrome is a relatively rare condition where the hepatic venous outflow into the inferior vena cava is blocked by tumor thrombus, ...

A random prospective comparison was conducted of 20 patients who underwent arthroscopic subacromial decompression or open acromioplasty as treatment for impingement syndrome. The Neer anterior acromioplasty served as comparison in the evaluation to arthroscopic technique. The comparison shows more rapid rehabilitation and better range of motion in the arthroscopic group. ...

In superior mesenteric artery (SMA) syndrome the third portion of the duodenum is entrapped by the aorta and the SMA. We used dynamic CT to study five patients with SMA syndrome due to cachexia, cast syndrome, scleroderma, trauma, and periaortic adenopathy. This method provides diagnostic insight into the etiology and ...

Compression of the left renal vein (LRV) between the superior mesenteric artery and the aorta has been termed the nutcracker syndrome. Although often asymptomatic, this syndrome may result in varicocele, ovarian vein syndrome, and rarely LRV hypertension, pelviureteral varices, hematuria, and flank pain. Previous surgical approaches have included nephrectomy, variceal ...

A right-handed man suffered a left parieto-occipital cerebral infarction, causing agraphia with Gerstmann's syndrome but without major aphasia, alexia, or apraxia. Oral spelling was superior to written spelling. Experiments were performed involving (1) analysis of errors in writing, (2) tasks of visual imagery, and (3) identifying letters drawn without leaving ...

A patient undergoing treatment for abdominal lymphoma presented with a superior vena cava (SVC) syndrome. The presence of a wide mediastinum and "nodular" mediastinal densities on CT presented a diagnostic problem, necessitating thoracotomy. The thoracotomy was negative for tumor or infection. We believe that the presence of an indwelling catheter ...

A 49-year-old woman with generalised lichen sclerosus et atrophicus and morphoea developed bilateral Brown's syndrome. Some of the skin lesions were in the vicinity of the trochlea. A characteristic feature of morphoea is subcutaneous fibrosis, so we postulate that the cause of the Brown's syndrome was mechanical tethering of the ...

An extensive lateral sinus thrombosis secondary to silent otitis media, in a patient with a nephrotic syndrome, is presented. The thrombotic process progressed asymptomatically until the occlusion of the superior vena cava. Removal of the intractable pathology within the mastoid and administration of appropriate antibiotic therapy, prevented the further propagation ...

Anorexia nervosa is often overdiagnosed in adolescent females with anorexia and extreme weight loss. In some cases, an anorexia nervosa-like illness is due to a treatable organic disorder. We describe a 16-year-old female with anorexia, vomiting, extreme weight loss, and amenorrhea who was referred as an anorexia nervosa case and ...

An 11-month-old infant with a central venous catheter for total parenteral nutrition for short gut syndrome developed head and neck swelling. A thrombus at the catheter tip occluding the superior vena cava was demonstrated roentgenographically. A 48-hr infusion of urokinase (4400 units/kg/hr) was administered for thrombolysis. The thrombus cleared clinically ...

The mediastinum is seldom involved by granulocytic sarcoma and superior vena cava (SVC) obstruction is an even rarer presentation. Some radiologists advocate to treat SVC obstruction as a semimedical emergency regardless of the underlying pathology. This policy has been criticized. We describe a patient with severe SVC obstruction preceding the ...

A 25-year-old man experienced rapidly progressing Budd-Chiari syndrome. Despite extensive radiological investigations, no atrial mass could be identified. At operation, a right atrial myxoma was found that originated from the eustachian valve and prolapsed into the inferior vena cava. Following successful removal of the myxoma, the ascites and peripheral edema ...

The Holt-Oram syndrome is reported for the first time in a Puerto Rican family of one mother and two daughters. All had severe upper limb anomalies and secundum atrial septal defect. One daughter, the proband, had, in addition, a persistent left superior vena cava, a cardiac anomaly that has not ...

The charts of all patients with the diagnosis of congenital Brown's syndrome seen between July 1983 and June 1984 were examined retrospectively. In the past, overaction of the ipsilateral superior oblique (OAISO) was felt by most authors to be absent or minimal. Our study revealed that separate observers consistently documented ...

Two patients with superior vena cava syndrome (SVCS) recurring after maximum-tolerance radiation were treated by placing a Gianturco expandable wire stent (GEWS) into the obstructed superior vena cava. The SVCS symptoms rapidly disappeared and good short-term (6 months) palliation was achieved. GEWS placement is a promising therapeutic alternative for palliation ...

Interruption of the inferior vena cava with azygos continuation is present in at least 65% of the patients suffering from left atrial isomerism (polysplenia syndrome). First-pass radionuclide angiography using a peripheral vein of the foot correctly diagnosed interruption of the inferior vena cava in seven patients. Four had azygos continuation ...

A case of trigemino-facial zoster presenting as Superior Orbital Fissure Syndrome is reported. Geniculate ganglion involvement was limited to the vestibular branch of the cochleo-vestibular nerve, without any hearing impairment or facial palsy. This case clearly illustrates that herpes zoster cranialis is a polyneuropathy of multifocal asynchronous viral activity and ...

Both the Budd-Chiari and the nephrotic syndrome have previously been reported to occur secondary to occlusion of the vena cava. However, they have never been reported to occur simultaneously, nor have either of these entities been reported to occur secondary to massive hepatomegaly. This is the first report of both ...

A 47-year-old man was seen with Budd-Chiari syndrome caused by a congenital membranous web obstructing the inferior vena cava (IVC) above the hepatic veins. Operative repair was accomplished using cardiopulmonary bypass, profound hypothermia (24 degrees C), and 10 minutes of circulatory arrest. This technique permitted accurate resection of the web, ...

Blunt trauma to the supero-medial orbit resulted in an isolated Brown's syndrome in two patients. One recovered spontaneously in three weeks; the other had a good outcome after surgery two years post trauma. Recognition of the characteristic motility abnormality and forced duction testing will differentiate this condition from other, more ...

In the classic scimitar syndrome, a pulmonary vein draining all or part of the right lung enters the inferior vena cava. A variant is described with the same roentgenographic appearance, but with drainage of the anomalous pulmonary vein into both the inferior vena cava and the left atrium; the atrial ...

The development of an iatrogenic superior vena cava syndrome secondary to a thrombosis from an indwelling Hickman catheter in a patient with ovarian carcinoma is presented. The patient was treated with a combination of streptokinase and heparin with successful and dramatic results. Streptokinase appears to be highly effective in the ...

In the following case report we describe a healthy 25-year-old woman suffering from the "click" syndrome with pseudoparesis of the superior oblique muscle and a concomitant inflammatory ocular disorder. No etiology of the chorioretinitic changes or click syndrome could be ascertained. Based on the different topographic conditions present, we suggest ...

The computed tomographic appearance of the polysplenia syndrome in 2 cases is presented. Both are associated with absence of the hepatic segment of the inferior vena cava. Computed tomography can determine the exact location of the malpositioned organs, the presence of multiple spleens, and the type of the associated venous ...

Membranous obstruction of the inferior vena cava is a rare congenital anomaly that may present clinical features of Budd-Chiari syndrome caused by chronic obstruction of the hepatic drainage. We report membranous obstruction of the inferior vena cava in a 5-year-old boy. Surgical repair was prompted by signs and symptoms of ...

Superior vena caval syndrome (SVCS) is a life-threatening medical emergency that is usually treated with high-dose irradiation. Previous attempts at surgical intervention have been disappointing. Recently, the authors have successfully treated a case of SVCS with a axillo-axillary and axillary to femoral venous bypass using an externally supported synthetic graft. ...

Upon examination, nine of 45 patients (20%) with primary mediastinal germ cell tumors were found to have superior vena caval syndrome. All patients were men (average age, 27). Superior vena caval syndrome was found with all mediastinal germ cell tumor cell types except mature teratoma. Primary mediastinal germ cell tumors ...

In 104 consecutive Caucasian patients who had histologically proved dysplastic nevi, the number and diameter of nevocytic nevi were determined in two equally sized contiguous rectangles in the lumbosacral region. The cephalad (superior) rectangle was in a relatively sun-exposed site, whereas the caudad (inferior) rectangle was in a relatively sun-protected ...

Five of six patients with angiographically proved Budd-Chiari syndrome (hepatic venous outflow obstruction) showed multiple specific MRI abnormalities: striking reduction in caliber or complete absence of the hepatic veins, "comma-shaped" intrahepatic collateral vessels, and/or marked constriction of the intrahepatic inferior vena cava. The sixth patient had angiographically proven sinusoidal hepatic ...

A 54 year old male with the CREST (Calcinosis, Raynauds, Esophageal hypomotility, Sclerodactyly, Telangiectasia) variant of progressive systemic sclerosis (PSS) presented with vertical diplopia diagnosed as a left superior oblique muscle paralysis. Although cranial nerves abnormalities have been reported in PSS, to our knowledge this is the first report of ...

The authors report a case of Budd-Chiari syndrome treated by percutaneous transluminal angioplasty (PTA). In this case, the occlusion of three major hepatic veins with a big collateral to the inferior vena cava via the right inferior hepatic vein (RIHV) and stenosis of the ostium of RIHV were seen. We ...

Larynges from 17 patients with DiGeorge syndrome (DGS) and from 14 patients with tetralogy of Fallot (TOF) (11 non-DGS and 3 possible but unproven DGS) were dissected, measured, and compared to a control population of comparable body length. The patients with DGS and the 3 patients with TOF suspected of ...

A case of callosal disconnection syndrome caused by a penetrating stab wound of the brain is reported. A portion of the genu and the inferior splenium of the corpus callosum were sectioned by an ice pick without any other significant cerebral damage. We could detect incomplete disconnection left visual alexia ...

A 34-year-old previously healthy woman presented with bilateral interstitial lung changes and thrombotic occlusions of the hepatic veins. A transcaval wedge resection of the liver and a hepato-caval anastomosis were performed. This operation reestablished the impaired intrahepatic venous flow and relieved the portal hypertension and the associated symptoms. Histopathological examination ...

Superior vena cava syndrome is an infrequently noted complication associated with gynecologic malignancy. Three cases illustrate modern diagnostic and management methods. Patients developed superior vena cava syndrome secondary to mediastinal metastatic endometrial carcinoma, uterine leiomyosarcoma, and secondary to thrombosis induced by a subclavian hyperalimentation catheter. Awareness of this condition on ...

High dose intravenous gamma globulin (IV-IgG) was given to 5 patients with Felty's syndrome. The neutrophil count did not change with IV-IgG therapy and no side effects were encountered. We conclude that neutropenia in Felty's syndrome is not comparable to autoimmune hemocytopenia with respect to the response to IV-IgG.

The development of dilatation of the left superior intercostal vein ("aortic nipple") on chest radiographic studies can be used as a clue to impending superior vena caval syndrome. Two cases are described in which detection of an "aortic nipple" on chest roentgenograms predated the clinical syndrome by seven to ten ...

Two patients presenting with superior venal caval syndrome have been treated surgically. In one patient the obstruction was caused by benign idiopathic mediastinal fibrosis; in the other it was secondary to carcinoma. In both cases venous decompression was achieved by using a segment of autogenous femoral vein to bypass the ...

A 16-year-old asthenic girl had idiopathic adolescent scoliosis and superior mesenteric artery (SMA) syndrome. After a Harrington rod procedure, the SMA syndrome produced a complete duodenal obstruction that did not resolve with nasogastric decompression, positioning, or peripheral intravenous nutrition. A complete derotation of the duodenum and the colon and stabilization ...

Computed tomographic (CT) findings in 4 patients with superior oblique tendon sheath syndrome (congenital or acquired Brown syndrome) are described. When the inferior oblique muscle moves the eye upward, the superior oblique muscle normally relaxes, while its tendon lengthens and slides freely through the trochlea. In Brown syndrome this process ...

This report documents a unique case of Budd-Chiari syndrome associated with antithrombin III deficiency and massive thrombus in the superior vena cava and right atrium. This aberration of the coagulation mechanism is proposed as an etiologic factor in the pathogenesis of hepatic venous obstruction whenever the cause is obscure. Antithrombin ...

Percutaneous transluminal angioplasty was performed in a patient with an incomplete obstruction of the inferior vena cava producing the Budd-Chiari syndrome. The web was successfully dilated percutaneously by three simultaneously inflated 9 mm balloon catheters. Symptoms and signs of obstruction of the inferior vena cava improved without any complications. This ...

A case of a type of popliteal entrapment syndrome that does not include an anomalous course of the popliteal artery is presented. In situ thrombosis secondary to entrapment-induced stasis was the presumed cause of ischemic symptomatology. Thorough knowledge of the possible causes of entrapment and biplane angiography (of the popliteal ...

A 9-year-old boy with systemic juvenile chronic arthritis and Brown's syndrome (limitation of elevation of the adducted eye due to limitation of movement of the superior oblique tendon) is described. The resolution in association with steroid treatment suggested a transient tenonsynovitis involving the superior oblique tendon as the cause.

The cast syndrome, recently called the superior mesenteric-artery syndrome, is a well recognized complication that can occur after a body cast has been applied. We are reporting the cases of three patients who had this syndrome following surgical correction of spinal deformity. The complication failed to resolve with the usual ...

Three cases of primary Budd-Chiari syndrome were found by ultrasonic examination. These were confirmed by hepatic venography and inferior vena cavography. The ultrasound findings in these patients included communicating vessels between hepatic veins, enlarged inferior right hepatic vein, reversed blood flow in the hepatic vein, and obstruction of the inferior ...

A new, staged surgical approach to the treatment of Budd-Chiari syndrome complicated by inferior vena caval obstruction has been described. The first stage consists of a mesoatrial shunt. After an interval to allow hepatic decongestion, re-establishment of caval flow and overall improvement in the status of the patient, a portacaval ...