Subclavian artery aneurysm caused by cervical rib: case report and review

Developmental toxic potential of di-n-propyl phthalate administered orally to rats

The objective of this study was to evaluate the developmental toxic potential of di-n-propyl phthalate (DnPP) in rats. Pregnant Sprague-Dawley rats were given DnPP at doses of 0 (olive oil), 0.5, 1 and 1.5 g kg⁻¹ per day, by gavage, on gestation days 6-20. Benchmark doses were calculated for the effects of DnPP on fetal weight and anogenital distance of the male fetuses. Maternal body weight gain was significantly reduced at 1.5 g kg⁻¹ per day, over gestation days 6-9. DnPP-treated dams also showed a statistically significant increase in liver weight and a mild but statistically significant peroxisomal enzyme induction at 1 or 1.5 g kg⁻¹ per day. Male and female fetal body weights were significantly reduced at 1.5 g kg⁻¹ per day. There was a statistically significant decrease in the anogenital distance of the male fetuses at 1 and 1.5 g kg⁻¹ per day, and three males (of 75) showed malpositioned testis at the high dose. The mean percentage of fetuses per litter with cervical and thoracic rudimentary ribs was significantly increased at 1 and 1.5 g kg⁻¹ per day. Delayed ossification was seen at 1 g kg⁻¹ per day (phalanges) and 1.5 g kg⁻¹ per day (hyoid, sternebrae, and phalanges). No treatment-related effects on prenatal viability or on fetal external or visceral malformations or variations were observed at any dose. Thus, there was no evidence of teratogenicity up to the high dose of 1.5 g kg⁻¹ per day. The no-observed-adverse-effect level (NOAEL) for developmental toxicity was 0.5 g kg⁻¹ per day.

An acutely ischaemic hand in a young adult due to subclavian artery aneurysm (SAA) caused by a cervical rib: A case report

INTRODUCTION

True subclavian artery aneurysms are relatively rare lesions. Thoracic outlet compression is responsible for 75% of aneurysms. They are formed as a result of compression by, for example a cervical rib.

CASE PRESENTATION

We present a case of subclavian artery aneurysm secondary to a cervical rib in a 25-year-old young Asian adult, who presented with an acutely ischaemic upper limb. A Computed Tomography angiogram revealed a right sided cervical rib and sacular aneurysm in the mid-portion of the subclavian artery.

CONCLUSION

Although it is a rare condition, it is important to be aware especially in the young age group. Surgical management has very favourable outcomes in these patients.

Sonography for diagnosis of cervical ribs in children

OBJECTIVE

The purpose of this series was to describe the use of sonography for diagnosis of cervical ribs in children.

METHODS

Two children had hard nonmobile supraclavicular masses that were of clinical concern for malignancy. Both children were first evaluated by sonography.

RESULTS

Sonography showed each mass to be a tubular bony structure with a cartilaginous end. They were thought to represent cervical ribs. This anatomic variant was subsequently confirmed with radiography in 1 case and computed tomography in the other.

CONCLUSIONS

Musculoskeletal sonography may offer a reliable method for diagnosing cervical ribs without the need for ionizing radiation.

Subclavian artery pseudoaneurysm: a rare and serious complication of central venous catheterization in an infant

Serious complications of central venous access occur in 0.4-9.9% of patients undergoing attempted central venepuncture. We report an unusual case of an 18-month-old infant in whom a right subclavian artery pseudoaneurysm developed rapidly after attempted subclavian vein catheterization without US guidance failed.

Pediatric ribs: a spectrum of abnormalities

The manifestations of many congenital and acquired conditions can be seen in the ribs of children. Normal variants are usually clinically insignificant; they are occasionally palpated at clinical examination or detected incidentally at chest radiography. Signs of abnormality can appear in the ribs as variations in number, size, mineralization, and shape. These changes can be focal or generalized. Abnormalities detected in the ribs may be the initial indication of previously unsuspected systemic disease. The ribs can yield important diagnostic clues in the work-up of patients with congenital bone dysplasias, acquired metabolic diseases, iatrogenic conditions, trauma (especially child abuse), infection, and neoplasms. Routine evaluation of the ribs on every chest radiograph is important so that valuable diagnostic data will not be overlooked. The diagnostic information obtained from evaluation of the ribs can help tailor the radiologic and laboratory studies that may be necessary to complete a patient's diagnostic work-up.