The Interventionalist Journal

A Rare Case of Spontaneous Neonatal Splenic Haemorrhage

Noor Khairiah Kamaludin — 2025-09-30

Background: Spontaneous splenic haemorrhage in neonates is extremely rare and often fatal due to delayed diagnosis from non-specific clinical signs.

Case Presentation: A term neonate presented on day two of life with pallor, tachycardia, and abdominal distension. Severe anaemia was noted. Ultrasound revealed a heterogeneous peri-splenic mass; CT confirmed a large peri-splenic hematoma and hemoperitoneum. Despite emergent splenectomy, the infant deteriorated and received palliative care.

Conclusion: Neonatal splenic haemorrhage, though rare, should be considered in neonates with unexplained anaemia and abdominal distension. Early imaging is critical for diagnosis and timely intervention.

Zephyr endobronchial valve as a lifesaving intervention for persistent air leak – A case report

JOLSANA AUGUSTINE — 2025-09-30

A pneumothorax that progresses to ongoing air leaks can result in extended hospitalizations and significant morbidity. While surgical management is often the preferred option for addressing air leaks, it frequently involves high risks, as many patients have compromised baseline respiratory conditions and additional health issues. Over the last decade, new and less invasive techniques in interventional pulmonology have emerged. We describe a case of a patient with a persistent air leak following a pneumothorax who was effectively treated with the insertion of Zephyr endobronchial valves (EBV). Despite extensive drainage, negative pressure application, and two attempts at autologous blood patch pleurodesis, the air leak continued. Due to his comorbidities and poor lung condition, he was not an appropriate candidate for surgery. Two sequential sessions of Zephyr EBV were performed, successfully stopping the air leak. The patient was discharged shortly after, following a thorough clinical and radiological monitoring. This case highlights the effectiveness and safety of Zephyr EBV, providing a less invasive option compared to surgical procedures.

Aortocaval Fistula Unmasked: Spotting the Silent Threat in Emergency Vascular Imaging

Nurhamin Sofia Mohd Mustaffa — 2025-09-30

Aortocaval fistula (ACF) constitutes a rare but severe vascular complication of abdominal aortic aneurysm (AAA), characterized by the formation of an anomalous arteriovenous communication between the aorta and the inferior vena cava. This report presents the case of a 67-year-old male with underlying cardiovascular comorbidities who presented with progressive abdominal pain and hemodynamic compromise. Computed tomography angiography (CTA) revealed a large infrarenal AAA with synchronous contrast opacification of the aorta and inferior vena cava, consistent with an ACF. Definitive management via open surgical repair was undertaken, resulting in a favorable postoperative course. This case report aims to explore the various imaging modalities used in the detection of aortocaval fistula (ACF) and their clinical applicability. Among the available imaging modalities, CT angiography remains the gold standard due to its rapid acquisition, broad accessibility, and high sensitivity and specificity.

Deep Circumflex Iliac Artery; The Overlooked Entity in Abdominal Paracentesis

Mohd Zulkimi Roslly — 2025-09-30

Not applicable