Percutaneous transhepatic biliary drainage (PTBD) is a decompression procedure for malignant proximal biliary obstruction. In this research, over a six-year period, 89 patients underwent PTBD procedure for jaundice caused by malignant disease to restart chemotherapy or for palliative intent. Clinical outcomes after PTBD procedure in the two groups of patients, according to the adequate bilirubin decline (ABD) needed for subsequent chemotherapy, are presented in this paper. Survival and logistic regression were plotted and compared using Kaplan–Meier survival multivariate analysis with a long-range test. Results were processed by MEDCALC software. In the series, 58.4% (52/89) of patients were in good performance status (ECOG 0/1), and PTBD was performed with the intention to (re)start chemotherapy. The normalization of the bilirubin level was seen in 23.0% (12/52), but only 15.4% (8/52) received chemotherapy. The median survival time after PTBD was 9 weeks. In patients with ABD that received chemotherapy, the median survival time was 64 weeks, with 30-day mortality of 27.7%, and 6.4% of death within 7 days. The best outcome was in patients with good performance status (ECOG 0–1), low bilirubin (<120 µmol/L) and LDH (<300 µmol/L) levels and elevated leukocytes at the time of the procedures. PTBD is considered in ABD patients who are candidates for chemotherapy.

Introduction. Visceral artery aneurysms, including those affecting the splenic and hepatic arteries, rank among the most common types of abnormalities within the visceral arterial system. Treatment options for visceral artery aneurysms include open surgery and endovascular repair, with the latter being preferred for anatomically suitable and asymptomatic patients. Case Report. We present two cases, where the first concerns a 72-year-old male patient with an asymptomatic large common hepatic artery aneurism measuring 4.5 cm in maximum diameter. Computed tomography angiography revealed a 1.1 cm enlargement of the aneurism maximum diameter over a two-year period. The second case involves a 65-year-old female patient with asymptomatic splenic artery aneurism measuring 3.2 cm in maximum diameter. Both patients underwent endovascular stent deployment as part of their treatment regimen. No complications were observed during the early and late post-procedural phases. Follow-up imaging via control computed tomography angiography one month after the procedure revealed transparent stents in both cases without evidence of endoleaks. Conclusion. Endovascular stent deployment emerges as a safe and most efficient treatment modality for asymptomatic visceral artery aneurysms

Introduction. Malignant biliary obstruction represents a poor prognostic sign of metastatic colorectal carcinoma. Percutaneous transhepatic biliary drainage (PTBD) is the procedure of choice for palliative biliary decompression, and this method has both diagnostic and therapeutic values. One of the wellknown complications following this procedure is the development of catheter tract metastases that occur in 0.6?6% of cases post-PTBD. In this case report, we present a patient with implantation metastases of colorectal cancer following PTBD. Case report. In the last six years, 89 patients underwent PTBD procedure at the Oncology Institute of Vojvodina. Among these patients, catheter tract implantation metastasis developed in one patient (1.1%). In this report, we present a patient who underwent right hemicolectomy in January 2015 at the Oncology Institute due to colon cancer located in the transverse colon. In January of 2018, a computed tomography scan of the abdomen showed metastatic disease and chemotherapy was initiated. However, 29 months following the start of chemotherapy, the patient developed jaundice, and as a result, PTBD procedure was performed. A control computed tomography scan of the abdomen in March of 2021 showed a de novo subcutaneous nodule 20 mm in diameter located at the level of ninth right rib. The nodule had been considered a part of the scar that formed at a place of catheter entry, and was still present eight months after PTBD procedure. Biopsy of the subcutaneous mass and pathohistological analysis confirmed well differentiated colon adenocarcinoma. Conclusion. Catheter tract implantation metastasis is not a rare complication following PTBD for malignant biliary obstruction. It generally has a poor prognosis. Nevertheless, literature review shows that radical surgical excision of the catheter tract tissue with hepatectomy can prolong survival in select group of patients.

Sclerosing mesenteritis (SM) is a rare and poorly understood chronic benign inflammatory condition of the mesentery that sometimes can be manifested as acute abdominal emergency. In this paper sclerosing mesenteritis was discussed on the occasion of experience in the diagnosis and the treatment of patients in clinical practice, a 62-year-old man who was diagnosed SM on computed tomography (CT) which was confirmed histopathologically. SM manifests grossly as a diffuse, localized, or multinodular thickening of the mesentery. Microscopically, according to the pattern of the disease, SM can be divided into sclerosing panniculitis where necrosis and inflammation predominate and retractile mesenteritis in which fibrosis and retraction are hallmarks of the disease. Clinical presentation of patients suffering from SM is quite diverse - from asymptomatic, which is the most common, to abdominal pain, bloating, nausea, vomiting and febrile episodes. The 'fat ring sign' and peripheral pseudocapsule are virtually pathognomonic CT findings of SM. Management of SM is empirical with no guidelines yet established. SM should be listed in the differential diagnosis in every older patient with diverse abdominal complaints.