SUMMARY Endovascular management of the lower extremity deep vein thrombosis Lê Trọng Bỉnh Lower extremity deep vein thrombosis (LEDVT) is a common vascular disease which may cause life-threatening complications such as pulmonary embolism or lead to lifelong sequelae such as post-thrombotic syndrome. Anticoagulation remains the standard treatment of LEDVT endorsed by various international practice guidelines. However, anticoagulation alone is usually inadequate in the setting of large thrombus burden (iliofemoral DVT), extensive LEDVT (inferior vena cava extension), and venous outflow obstruction (eg, May-Thurner syndrome), therefore increases the risk of delayed symptom alleviation, thrombus recurrence, and disease progression. Prompt diagnosis and timely intervention including effective thrombus exclusion and venous outflow recanalization are crucial in optimizing treatment outcomes, limiting complications, and preventing further sequelae. Recently, endovascular approach has shown advantages over open surgery and medical treatment in selected populations of LEDVT. This minimally invasive technique includes a single-session and step-by-step intervention combining an inferior vena cava filter insertion, catheter-directed thrombolysis, mechanical thrombectomy, and iliocaval recanalization by venoplasty and/or stenting. This paper aims to provide insight into the current status of endovascular treatment of LEDVT and experience from a single center. Keywords: deep vein thrombosis, thrombolysis, thrombectomy, endovascular, May-Thurner syndrome

SUMMARY Background: Acute lower gastrointestinal bleeding (ALGB) is an urgent, potentially life-threatening emergency, especially in case endoscopy is not identifiable or uncontrollable in management bleeding. Following the development of technology and applying minimal invasive modalities, endovascular treatment is more and more to be applied. Primary endpoint: Figure out the rate of technical success, the clinical success and the complication relating to bowel ischemia of embolization in ALGB. Secondary endpoint: Figure out the rate of negative bleeding finding angiograms in diagnosis of ALGB Method: Retrospective cohort study Results: From 01/2019 to 01/2022, 23 embolisms were performed in total 35 procedures of 24 patients. There were 12 angiographies with negative bleeding finding result (34.3%). In embolization procedure, first embolisms were 21/23 and two procedures were re-embolism. The rate of technical success after first embolisms was 95.2% and clinical success reaches 76.2%. There was no major complication relating to bowel ischemia. Conclusion: Transcatheter angiographic embolization is a safe and effective management for acute lower gastrointestinal bleeding with minimal invasive. Keywords : acute lower gastrointestinal bleeding, embolization, endovascular

SUMMARY The ultrasound-guided transthoracic biopsies are indicated for pulmonary masses or mediastinal masses located in the periphery adjacent to the pleural-thoracic surface and pleural lesions. We present a case where the lung tumor was anterior to the scapula with emphysema. Keywords: Transthoracic biopsy, Ultrasound-guided transthoracic biopsies, lung tumor

SUMMARY Chemotherapy could induce multiple liver parenchymal and vascular disorder presenting as diffuse or focal lesion. Focal nodular hyperplasia (FNH) – like nodules is benign lesions that should be distinguish to hepatic metastasis because they associate with further interventions and treatments. The main machanism of the apperance of FNH is Oxaliplatin-induced portal venous injuries called hepatic sinusoid obstruction syndrome (HSOS). Here, we present a case of the development of FNH – like nodule during follow up of gastric carcinoma after adjuvant treatment with XELOC chemotherapy (Oxaliplatin-based chemotherapy). Keywords: focal nodular hyperplasia like nodule, hepatic sinusoid obstruction syndrome, chemotherapy - induced liver injury

SUMMARY Lung cancer is one of the leading causes of cancer related mortality worldwide. The brain, liver, adrenal glands, and bone are the most likely site of metastatic disease in patients with lung cancer. Gastrointestinal (GI) metastasis from primary lung cancer is very rare. Only few reports have been published and the majority of described metastatic sites involved the small instestine. In the present study, we report a case of lung cancer with colonic metastasis and also review the published literature of primary lung cancer with colonic metastasis. Keywords : lung cancer, gastrointestinal metastasis, colonic metastasis.

SUMMARY We report a case who was diagnosed with primary hepatic angiosarcoma (PHA). A 62-year-old man presented with right upper quadrant abdominal pain, weight loss, and hepatomegaly. He did not have a history of carcinogen exposure or any relevant medical history. On laboratory evaluation, the patient had an elevation of white blood cell count, AST, ALT and anemia. The levels of serum carcinoembryonic antigen, carbohydrate antigen (CA)-19-9, α-fetoprotein, and PIVKA-II were normal. Abdominal ultrasound, computed tomography, and magnetic resonance imaging revealed a large lesion in the right lobe of the liver and a small lesion in the left lobe of the liver which are non-specific images. The patient underwent liver biopsy and histopathological examination confirmed PHA. PHA is a rare disease that usually occurs in the sixth decade of life, and males are more frequently affected than females. In most cases, the cause is unknown. Clinical symptoms and laboratory evaluation of PHA are nonspecific. There is no pattern recognition in diagnostic imaging. Liver biopsy and histopathology confirmed the presence of PHA. Keywords : angiosarcoma, primary hepatic angiosarcoma.

SUMMARY Objective: Internal hernia following gastrectomy is an uncommon disease. Preoperative diagnosis is difficult because clinical symptoms are nonspecific. However, it is a surgical emergency, accurate preoperative diagnosis is crucial for appropriate management. Multidetector computed tomography (CT) plays an essential role in preoperative diagnosis of internal hernias. Methods: Describing 2 cases, at Thong Nhat Hospital, Ho Chi Minh City. All patients went preoperative CT and proved surgically internal hernias: Peterson hernia, J-J hernia. Results: The combination of mesenteric swirl sign and small bowel obstructioon has the highest sensitivity and accuracy for internal hernia following gastrectomy. “Sandwich sign” an interposed small bowel between transverse colon and gastrojejunostomy’s limb can be a predictor of Peterson hernia. Meanwhile, the positon of hernia orifice, which is close to the position of J-J anastomosis and the displacement of J-J anastomosis out of the left-mid abdomen can predict J-J hernia. Conclusions: Multidetector computed tomography (CT) plays an essential role in preoperative diagnosis of internal hernias following gastrectomy. Keywords: internal hernia, gastrectomy, multidetector computed tomography, Peterson hernia, J-J hernia.

SUMMARY Background: The sphenoid sinus is closely surrounded by many important vascular and neurological. The natural ostium is the safest place to enter the sphenoid sinus without injuring adjacent structures. A better understanding of the position and distance of the sphenoid ostium (SO) with respect to the other anatomic landmark is essential for the safety and effectiveness of laparoscopic surgery. Objective: The purpose of this study was to investigate the relationship between the SO and surrounding landmark structures. Besides, we examine the effect of the Onodi cell and pneumatization of the sphenoidal sinus on the position of the SO. Methods: Cross-sectional study of 162 sinus CT scan data obtained from the PACS system at University Medical Center Ho Chi Minh City. The image is reconstructed and measured by the Multiplanar reconstruction (MPR) software of the PACS Carestream. Results: The mean distance between the SO and the lateral wall was 9.1 ± 1.8 mm. The mean distance from the SO to the median line was 4.1 ± 1.8 mm. The mean distance between the SO and the roof sphenoid sinus was 7.9 ± 2.9 mm. The average distance from the sphenoid ostium to superior border of posterior choana was 12.9 ± 3.5 mm. The mean distance from the sphenoid ostium to the anterior nasal spine was 65.2 ± 4.5 mm and to the posterior wall of the sphenoid sinus was 12.8 ± 2.7 mm. The angle between the SO - the anterior nasal spine and the floor of the nose is 33.5 ± 3.5 degrees. The distance from the SO to the roof sphenoid sinus was found to increase in cases where Onodi cells are present. For lateral pneumatization, the distance from the SO to the lateral wall in type II to be less in type III. The sphenoid sinus pneumatization on the sagittal plane did not affect the distance from SO to the posterior choana and the roof sphenoid sinus. Conclusions: The study determined the distances between the SO and some surrounding anatomical landmarks, and also investigated the influence of the Onodi cell and pneumatization on the position of the sphenoid sinus by CT scan images. The measurements described in this study may be very valuable in avoiding serious complications while performing surgery. Keywords: Sphenoid ostium, computed tomography.