IMAGE-GUIDED OPTIONS IN MALIGNANT TUMOR GROWTH OF THE VISCERAL MEDICINE - REPRESENTATIVE CASE SERIES f.meyer@med.ovgu.de

PE051

IMAGE-GUIDED OPTIONS IN MALIGNANT TUMOR GROWTH OF THE VISCERAL MEDICINE - REPRESENTATIVE CASE SERIES

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Germany

Poster Exhibition only

Visceral diseases may appear complex, in particular, if they have a vascular dimension.

Practice-relevant demonstration of an exemplary case series w/ case-specific characteristics.

(cases): 1) Male pat. (72yrs. old) w/ primary iliaco- & subsequently mesentericoenteral fistula w/ recurrent bleedings due to infiltrating rectal Ca growth leading subsequently to: i) right AIE stenting, ii) coiling of right AIC/AII branches, iii) local Tu/fistula excision + right AIE ligation. 2) Male pat. (70yrs. old) w/ AEG-Tu type II + esophageal infiltration leading to gastrectomy, splenectomy & esophageal resection + colon-segment interposition (histology: pT2aN1[1/18]L1V1G3) - SEMS for subsequent anastomotic insufficiency; later: “high-flow“-aortoesophageal fistula w/ hemorrhage into esophageal lumen. 3) Male pat. (79yrs. old) w/ ureteroiliac fistula & hematuria; catheterization of actinic ureteral strictures due to neoadjuvant radiochemoTx (subsequently, abdominoperineal rectum extirpation (suprasphinctary cancer, ypT3ypN0M0) w/ Amplatzer insertion into right AII & iliac stenting from left AFS. 4) Male pat. (78yrs. old) w/ right hemicolectomy due to Ca of ascending colon (medical history, significant for CMI w/ arteriosclerotic stenoses of all 3 mesenteric arteries leading to PTA of them + stenting of AMS) & re-laparotomy for lavage. 5) Male pat. (82yrs. old) w/ metastasizing Ca of the papilla of Vater - local bleeding w/ image-guided cessation of the bleeding by means of proximal & distal coiling at peripheral branches of the superior et inferior pancreaticoduodenal arteries.

Measures comprise i) stenting/prelesional coiling for cessation of bleedings, ii) PTA/stenting in mesenteric arteriosclerosis for recanalization, iii) stenting in case of aneurysm/dissection, iv) injection of substances in (pseudo-)aneurysm.