array:24 [
  "pii" => "S2255534X18300689"
  "issn" => "2255534X"
  "doi" => "10.1016/j.rgmxen.2018.05.020"
  "estado" => "S300"
  "fechaPublicacion" => "2019-04-01"
  "aid" => "461"
  "copyrightAnyo" => "2018"
  "documento" => "simple-article"
  "crossmark" => 1
  "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
  "subdocumento" => "crp"
  "cita" => "Rev Gastroenterol Mex. 2019;84:248-50"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:2 [
    "total" => 1578
    "formatos" => array:3 [
      "EPUB" => 166
      "HTML" => 1083
      "PDF" => 329
    ]
  ]
  "Traduccion" => array:1 [
    "es" => array:20 [
      "pii" => "S0375090618300600"
      "issn" => "03750906"
      "doi" => "10.1016/j.rgmx.2018.02.006"
      "estado" => "S300"
      "fechaPublicacion" => "2019-04-01"
      "aid" => "461"
      "copyright" => "Asociación Mexicana de Gastroenterología"
      "documento" => "simple-article"
      "crossmark" => 1
      "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
      "subdocumento" => "crp"
      "cita" => "Rev Gastroenterol Mex. 2019;84:248-50"
      "abierto" => array:3 [
        "ES" => true
        "ES2" => true
        "LATM" => true
      ]
      "gratuito" => true
      "lecturas" => array:2 [
        "total" => 3106
        "formatos" => array:3 [
          "EPUB" => 238
          "HTML" => 2173
          "PDF" => 695
        ]
      ]
      "es" => array:11 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">Carta cient&#237;fica</span>"
        "titulo" => "Aneurisma cong&#233;nito de la arteria lingual como causa inusual de sangrado de tubo digestivo alto"
        "tienePdf" => "es"
        "tieneTextoCompleto" => "es"
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "248"
            "paginaFinal" => "250"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "en" => array:1 [
            "titulo" => "Congenital lingual artery aneurysm as an unusual cause of upper gastrointestinal bleeding"
          ]
        ]
        "contieneTextoCompleto" => array:1 [
          "es" => true
        ]
        "contienePdf" => array:1 [
          "es" => true
        ]
        "resumenGrafico" => array:2 [
          "original" => 0
          "multimedia" => array:7 [
            "identificador" => "fig0010"
            "etiqueta" => "Figura 2"
            "tipo" => "MULTIMEDIAFIGURA"
            "mostrarFloat" => true
            "mostrarDisplay" => false
            "figura" => array:1 [
              0 => array:4 [
                "imagen" => "gr2.jpeg"
                "Alto" => 1236
                "Ancho" => 2906
                "Tamanyo" => 310005
              ]
            ]
            "descripcion" => array:1 [
              "es" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">A&#41;<span class="elsevierStyleHsp" style=""></span>Arteriograf&#237;a&#46; Flecha amarilla&#58; arteria car&#243;tida interna&#59; flecha amarilla punteada&#58; arteria car&#243;tida externa&#59; flecha morada&#58; arteria facial&#59; flecha verde&#58; arteria lingual&#59; flecha azul&#58; aneurisma de la arteria lingual&#59; flecha blanca&#58; tronco tirolingual&#59; flecha blanca punteada&#58; arteria tiroidea superior&#46; B&#41;<span class="elsevierStyleHsp" style=""></span>Anatom&#237;a m&#225;s frecuente de las ramas de la arteria car&#243;tida externa&#46; C&#41;<span class="elsevierStyleHsp" style=""></span>Tronco tirolingual&#44; observado en el 0&#46;99&#37; de los casos&#46;</p>"
            ]
          ]
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "M&#46;M&#46; Ram&#237;rez-Ram&#237;rez, U&#46;E&#46; Clemente-Guti&#233;rrez, M&#46; Silva-Gonz&#225;lez, H&#46;M&#46; Z&#250;&#241;iga-Zamora, A&#46;R&#46; S&#225;nchez-Conejo"
            "autores" => array:5 [
              0 => array:2 [
                "nombre" => "M&#46;M&#46;"
                "apellidos" => "Ram&#237;rez-Ram&#237;rez"
              ]
              1 => array:2 [
                "nombre" => "U&#46;E&#46;"
                "apellidos" => "Clemente-Guti&#233;rrez"
              ]
              2 => array:2 [
                "nombre" => "M&#46;"
                "apellidos" => "Silva-Gonz&#225;lez"
              ]
              3 => array:2 [
                "nombre" => "H&#46;M&#46;"
                "apellidos" => "Z&#250;&#241;iga-Zamora"
              ]
              4 => array:2 [
                "nombre" => "A&#46;R&#46;"
                "apellidos" => "S&#225;nchez-Conejo"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "es"
      "Traduccion" => array:1 [
        "en" => array:9 [
          "pii" => "S2255534X18300689"
          "doi" => "10.1016/j.rgmxen.2018.05.020"
          "estado" => "S300"
          "subdocumento" => ""
          "abierto" => array:3 [
            "ES" => true
            "ES2" => true
            "LATM" => true
          ]
          "gratuito" => true
          "lecturas" => array:1 [
            "total" => 0
          ]
          "idiomaDefecto" => "en"
          "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2255534X18300689?idApp=UINPBA000046"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0375090618300600?idApp=UINPBA000046"
      "url" => "/03750906/0000008400000002/v1_201906020708/S0375090618300600/v1_201906020708/es/main.assets"
    ]
  ]
  "itemSiguiente" => array:20 [
    "pii" => "S2255534X18300719"
    "issn" => "2255534X"
    "doi" => "10.1016/j.rgmxen.2018.06.002"
    "estado" => "S300"
    "fechaPublicacion" => "2019-04-01"
    "aid" => "467"
    "copyright" => "Asociaci&#243;n Mexicana de Gastroenterolog&#237;a"
    "documento" => "simple-article"
    "crossmark" => 1
    "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
    "subdocumento" => "crp"
    "cita" => "Rev Gastroenterol Mex. 2019;84:250-2"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 1540
      "formatos" => array:3 [
        "EPUB" => 163
        "HTML" => 1018
        "PDF" => 359
      ]
    ]
    "en" => array:11 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Scientific letter</span>"
      "titulo" => "Gastrointestinal stromal tumor as a cause of cancer-associated thrombosis"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "250"
          "paginaFinal" => "252"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Tumor del estroma gastrointestinal como causa de trombosis asociada a c&#225;ncer"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig0010"
          "etiqueta" => "Figure 2"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr2.jpeg"
              "Alto" => 1813
              "Ancho" => 2417
              "Tamanyo" => 749601
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">A&#41; Spindle cell GIST composed of fascicles of uniform cells with pale eosinophilic cytoplasm &#40;hematoxylin-eosin&#44; original magnification x200&#41;&#46; B&#41; C-KIT&#58; strong and diffuse cytoplasmic expression in GIST &#40;original magnification x200&#41;&#46; C&#41; CD34&#58; strong and diffuse cytoplasmic expression in GIST &#40;original magnification x200&#41;&#46; D&#41; KI-67&#58; Isolated cells with nuclear expression in GIST &#40;original magnification x400&#41;&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "P&#46; Demelo-Rodr&#237;guez, C&#46; Lavilla Olleros, E&#46; Mart&#237;n Higueras, I&#46; Peligros, J&#46; del Toro-Cervera"
          "autores" => array:5 [
            0 => array:2 [
              "nombre" => "P&#46;"
              "apellidos" => "Demelo-Rodr&#237;guez"
            ]
            1 => array:2 [
              "nombre" => "C&#46;"
              "apellidos" => "Lavilla Olleros"
            ]
            2 => array:2 [
              "nombre" => "E&#46;"
              "apellidos" => "Mart&#237;n Higueras"
            ]
            3 => array:2 [
              "nombre" => "I&#46;"
              "apellidos" => "Peligros"
            ]
            4 => array:2 [
              "nombre" => "J&#46;"
              "apellidos" => "del Toro-Cervera"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "S0375090618300661"
        "doi" => "10.1016/j.rgmx.2018.02.011"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => true
          "ES2" => true
          "LATM" => true
        ]
        "gratuito" => true
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "es"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0375090618300661?idApp=UINPBA000046"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2255534X18300719?idApp=UINPBA000046"
    "url" => "/2255534X/0000008400000002/v1_201906191703/S2255534X18300719/v1_201906191703/en/main.assets"
  ]
  "itemAnterior" => array:20 [
    "pii" => "S2255534X19300507"
    "issn" => "2255534X"
    "doi" => "10.1016/j.rgmxen.2018.11.004"
    "estado" => "S300"
    "fechaPublicacion" => "2019-04-01"
    "aid" => "537"
    "copyright" => "Asociaci&#243;n Mexicana de Gastroenterolog&#237;a"
    "documento" => "simple-article"
    "crossmark" => 1
    "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
    "subdocumento" => "crp"
    "cita" => "Rev Gastroenterol Mex. 2019;84:245-7"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 600
      "formatos" => array:3 [
        "EPUB" => 120
        "HTML" => 288
        "PDF" => 192
      ]
    ]
    "en" => array:11 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Clinical image in Gastroenterology</span>"
      "titulo" => "Cholangitis mimicking hilar cholangiocarcinoma"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "245"
          "paginaFinal" => "247"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Colangitis imitando al colangiocarcinoma hiliar"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig0020"
          "etiqueta" => "Figure 4"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr4.jpeg"
              "Alto" => 483
              "Ancho" => 1255
              "Tamanyo" => 232755
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">A and B&#58; Biopsies of the proximal bile duct with superficial erosions and interstitial chronic inflammatory infiltrates&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "A&#46; Barberis, U&#46;G&#46; Rossi, M&#46; Filauro"
          "autores" => array:3 [
            0 => array:2 [
              "nombre" => "A&#46;"
              "apellidos" => "Barberis"
            ]
            1 => array:2 [
              "nombre" => "U&#46;G&#46;"
              "apellidos" => "Rossi"
            ]
            2 => array:2 [
              "nombre" => "M&#46;"
              "apellidos" => "Filauro"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "S0375090619300473"
        "doi" => "10.1016/j.rgmx.2018.11.009"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => true
          "ES2" => true
          "LATM" => true
        ]
        "gratuito" => true
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "es"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0375090619300473?idApp=UINPBA000046"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2255534X19300507?idApp=UINPBA000046"
    "url" => "/2255534X/0000008400000002/v1_201906191703/S2255534X19300507/v1_201906191703/en/main.assets"
  ]
  "en" => array:15 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Scientific letter</span>"
    "titulo" => "Congenital lingual artery aneurysm as an unusual cause of upper gastrointestinal bleeding"
    "tieneTextoCompleto" => true
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "248"
        "paginaFinal" => "250"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "M&#46;M&#46; Ram&#237;rez-Ram&#237;rez, U&#46;E&#46; Clemente-Guti&#233;rrez, M&#46; Silva-Gonz&#225;lez, H&#46;M&#46; Z&#250;&#241;iga-Zamora, A&#46;R&#46; S&#225;nchez-Conejo"
        "autores" => array:5 [
          0 => array:4 [
            "nombre" => "M&#46;M&#46;"
            "apellidos" => "Ram&#237;rez-Ram&#237;rez"
            "email" => array:1 [
              0 => "moy1510@hotmail.com"
            ]
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">&#42;</span>"
                "identificador" => "cor0005"
              ]
            ]
          ]
          1 => array:3 [
            "nombre" => "U&#46;E&#46;"
            "apellidos" => "Clemente-Guti&#233;rrez"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
          2 => array:3 [
            "nombre" => "M&#46;"
            "apellidos" => "Silva-Gonz&#225;lez"
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
          3 => array:3 [
            "nombre" => "H&#46;M&#46;"
            "apellidos" => "Z&#250;&#241;iga-Zamora"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          4 => array:3 [
            "nombre" => "A&#46;R&#46;"
            "apellidos" => "S&#225;nchez-Conejo"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:2 [
          0 => array:3 [
            "entidad" => "General Surgery&#44; SSA&#44; Hospital Regional de Alta Especialidad de Ixtapaluca&#44; Ixtapaluca&#44; State of Mexico&#44; Mexico"
            "etiqueta" => "a"
            "identificador" => "aff0005"
          ]
          1 => array:3 [
            "entidad" => "General Surgery&#44; Instituto Nacional de Ciencias M&#233;dicas y Nutrici&#243;n Salvador Zubir&#225;n&#44; Mexico City&#44; Mexico"
            "etiqueta" => "b"
            "identificador" => "aff0010"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Corresponding author&#46; Consultorio 404&#44; Avenida &#193;rbol de fuego 80&#44; Coyoac&#225;n&#44; El Rosario&#44; 04380&#44; Mexico City&#46; Tel&#46;&#58; &#43;55-29-00-13-48&#44; Tel&#46;&#58; &#43;36-83-75-00 Ext&#46; 5404"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "es" => array:1 [
        "titulo" => "Aneurisma cong&#233;nito de la arteria lingual como causa inusual de sangrado de tubo digestivo alto"
      ]
    ]
    "resumenGrafico" => array:2 [
      "original" => 0
      "multimedia" => array:7 [
        "identificador" => "fig0010"
        "etiqueta" => "Figure 2"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr2.jpeg"
            "Alto" => 1238
            "Ancho" => 2948
            "Tamanyo" => 305373
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">A&#41; Arteriography&#46; Yellow arrow&#58; internal carotid artery&#59; dotted yellow arrow&#58; external carotid artery&#59; purple arrow&#58; facial artery&#59; green arrow&#58; lingual artery&#59; blue arrow&#58; aneurysm of the lingual artery&#59; white arrow&#58; thyrolingual trunk&#59; dotted white arrow&#58; superior thyroid artery&#46; B&#41; Most frequent anatomy of the branches of the external carotid artery&#46; C&#41; Thyrolingual trunk&#44; seen in 0&#46;99&#37; of cases&#46;</p>"
        ]
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Upper gastrointestinal bleeding is a common problem that presents in the outpatient setting&#44; as well as in the emergency service&#46; The most common causes of this clinical entity are peptic ulcer disease&#44; Mallory-Weiss tear&#44; gastrointestinal neoplasias&#44;<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">1</span></a> and variceal bleeding in the case of patients with portal hypertension&#46; Aneurysms of the lingual artery are infrequent&#46; Aneurysms of the external carotid artery are estimated to account for 2&#46;2&#37; of all cervical carotid aneurysms&#46; Among those&#44; superficial temporal artery and facial artery aneurysms are the most common&#44; whereas lingual artery aneurysms are rare&#46; They only appear in the literature in case reports and their incidence cannot be determined&#46;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">2</span></a> The majority of cases are pseudoaneurysms&#44; associated with trauma&#44; neoplasias&#44; surgical procedures&#44;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">3</span></a> or radiofrequency ablation&#46;<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">4</span></a> There are few cases of true idiopathic congenital aneurysms&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">A 39-year-old man had a past medical history of appendectomy due to complicated appendicitis&#44; as well as numerous symptoms of lower gastrointestinal bleeding from probable hemorrhoidal disease that were untreated&#46; He was admitted to the hospital for 2-day progression of symptoms characterized by melena and hematemesis&#46; Endoscopy was performed that identified&#58; pulsatile&#44; erythematous&#44; and congestive polypoid tumoral lesion&#44; 3 x 4<span class="elsevierStyleHsp" style=""></span>cm in diameter&#44; in the right posterolateral wall of the hypopharynx&#46; There were no signs of active bleeding &#40;<a class="elsevierStyleCrossRef" href="#fig0005">fig&#46; 1</a>A&#41;&#44; but fibrin-covered ulcers extended from the soft palate and proximal portion of the right piriform sinus&#46; Twenty-four hours later&#44; the patient presented with a new episode of bleeding&#46; Angiotomography revealed a thickened hypopharynx and an irregular&#44; right hypodense image&#44; 21 x 17 x 17<span class="elsevierStyleHsp" style=""></span>mm in diameter&#44; at the level of the inferior constrictor muscle that protruded toward the lumen&#44; obstructing 50&#37; of it&#44; with contrast medium leakage&#46; A saccular image dependent on the aberrant artery was also observed that emerged from the trunk of the superior thyroid artery as a probable variant of the lingual artery &#40;<a class="elsevierStyleCrossRef" href="#fig0005">fig&#46; 1</a>B&#41;&#46; After angiotomography&#44; the patient presented with sudden onset of massive bleeding through the oral cavity&#46; He became hemodynamically unstable&#44; with AP of 48&#47;30<span class="elsevierStyleHsp" style=""></span>mmHg and MAP of 33<span class="elsevierStyleHsp" style=""></span>mmHg&#46; Carotid arteriography was performed &#40;<a class="elsevierStyleCrossRef" href="#fig0010">fig&#46; 2</a>A&#41; that identified a 1&#46;5-mm vessel at the level of the bifurcation that drains into the trachea above and to the right of the vallecula&#46; Two sacs measuring approximately 5 and 8<span class="elsevierStyleHsp" style=""></span>mm were observed along its tract&#46; Failed embolization resulted in carrying out vascular examination of the neck with selective ligation of the first branch of the right external carotid artery &#40;thyrolingual trunk&#41; &#40;<a class="elsevierStyleCrossRef" href="#fig0005">fig&#46; 1</a>C&#41;&#46; Bleeding control was adequate&#44; and the patient was sent to the intensive care unit&#44; where he underwent blood transfusion&#46; His postoperative period was uneventful&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">The clinical presentation of pseudoaneurysms generally involves upper gastrointestinal bleeding&#44; whereas congenital aneurysms are asymptomatic&#44; and so their diagnosis is usually made as an incidental radiologic finding from contrast-enhanced tomography of the cervical region&#46;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">2</span></a> Upper gastrointestinal bleeding secondary to a pseudoaneurysm of the lingual artery is a potentially fatal event&#46; The customary treatment reported in the literature is embolization through interventional radiology&#46; The case presented herein was unusual in that it was a congenital aneurysm with a history of intermittent gastrointestinal bleeding&#46; Finally&#44; the patient presented with hemorrhagic shock&#44; embolization was unsuccessful&#44; and he then underwent surgical treatment with thyrolingual trunk ligation&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">The right common carotid artery arises from the brachiocephalic trunk and the left common carotid artery from the aortic arch&#46; After the posterolateral ascent within the carotid sheath&#44; it divides at the level of the superior edge of the thyroid cartilage into the internal carotid artery and external carotid artery&#44; which have a posterolateral and an anteromedial tract&#44; respectively&#46; They usually do not give off any branches in the neck&#46; The eight habitual branches of the external carotid artery are&#58; the superior thyroid artery&#44; lingual artery&#44; occipital artery&#44; posterior auricular artery&#44; maxillary artery&#44; and superficial temporal artery&#46;<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">5</span></a> The lingual branch originates in the external carotid artery in 84&#46;16&#37; of cases&#46; The majority &#40;24&#46;75&#37;&#41; arise between the superior thyroid artery and facial artery &#40;<a class="elsevierStyleCrossRef" href="#fig0010">fig&#46; 2</a>B&#41; at the level of the hyoid bone and 14&#46;85&#37; form a common trunk with the facial artery&#46; The lingual artery originates together with the superior thyroid artery in only 0&#46;99&#37; of cases &#40;<a class="elsevierStyleCrossRef" href="#fig0010">fig&#46; 2</a>C&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">6</span></a></p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Ethical disclosures</span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Protection of human and animal subjects</span><p id="par0025" class="elsevierStylePara elsevierViewall">The authors declare that no experiments were performed on humans or animals for this study&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Confidentiality of data</span><p id="par0030" class="elsevierStylePara elsevierViewall">The authors declare that no patient data appear in this article&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Right to privacy and informed consent</span><p id="par0035" class="elsevierStylePara elsevierViewall">The authors declare that no patient data appear in this article&#46;</p></span></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Financial disclosure</span><p id="par0040" class="elsevierStylePara elsevierViewall">No financial support was received in relation to this study&#47;article&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Conflict of interest</span><p id="par0045" class="elsevierStylePara elsevierViewall">The authors declare that there is no conflict of interest&#46;</p></span></span>"
    "textoCompletoSecciones" => array:1 [
      "secciones" => array:4 [
        0 => array:3 [
          "identificador" => "sec0005"
          "titulo" => "Ethical disclosures"
          "secciones" => array:3 [
            0 => array:2 [
              "identificador" => "sec0010"
              "titulo" => "Protection of human and animal subjects"
            ]
            1 => array:2 [
              "identificador" => "sec0015"
              "titulo" => "Confidentiality of data"
            ]
            2 => array:2 [
              "identificador" => "sec0020"
              "titulo" => "Right to privacy and informed consent"
            ]
          ]
        ]
        1 => array:2 [
          "identificador" => "sec0025"
          "titulo" => "Financial disclosure"
        ]
        2 => array:2 [
          "identificador" => "sec0030"
          "titulo" => "Conflict of interest"
        ]
        3 => array:1 [
          "titulo" => "R&#233;f&#233;rences"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "NotaPie" => array:1 [
      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; Ram&#237;rez-Ram&#237;rez MM&#44; Clemente-Guti&#233;rrez UE&#44; Silva-Gonz&#225;lez M&#44; Z&#250;&#241;iga-Zamora HM&#44; S&#225;nchez-Conejo AR&#46; Aneurisma cong&#233;nito de la arteria lingual como causa inusual de sangrado de tubo digestivo alto&#46; Revista de Gastroenterolog&#237;a de M&#233;xico&#46; 2019&#59;84&#58;248&#8211;250&#46;</p>"
      ]
    ]
    "multimedia" => array:2 [
      0 => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Figure 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 764
            "Ancho" => 2333
            "Tamanyo" => 186657
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A&#41; Endoscopy&#58; pulsatile lesion in the hypopharynx&#46; B&#41; Cervical angiotomography&#58; a probable anatomic variation of the lingual artery is observed &#40;red arrow&#41;&#46; C&#41; Intraoperative image of the thyrolingual trunk &#40;white arrow&#41;&#46;</p>"
        ]
      ]
      1 => array:7 [
        "identificador" => "fig0010"
        "etiqueta" => "Figure 2"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr2.jpeg"
            "Alto" => 1238
            "Ancho" => 2948
            "Tamanyo" => 305373
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">A&#41; Arteriography&#46; Yellow arrow&#58; internal carotid artery&#59; dotted yellow arrow&#58; external carotid artery&#59; purple arrow&#58; facial artery&#59; green arrow&#58; lingual artery&#59; blue arrow&#58; aneurysm of the lingual artery&#59; white arrow&#58; thyrolingual trunk&#59; dotted white arrow&#58; superior thyroid artery&#46; B&#41; Most frequent anatomy of the branches of the external carotid artery&#46; C&#41; Thyrolingual trunk&#44; seen in 0&#46;99&#37; of cases&#46;</p>"
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "R&#233;f&#233;rences"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0015"
          "bibliografiaReferencia" => array:6 [
            0 => array:3 [
              "identificador" => "bib0035"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Upper gastrointestinal bleeding"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "M&#46; Feinman"
                            1 => "E&#46;R&#46; Haut"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.suc.2013.10.004"
                      "Revista" => array:6 [
                        "tituloSerie" => "Surg Clin North Am&#46;"
                        "fecha" => "2014"
                        "volumen" => "94"
                        "paginaInicial" => "43"
                        "paginaFinal" => "53"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24267496"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0040"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Idiopathic lingual artery aneurysm&#58; CT findings and endovascular therapy &#8212; A case report"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "R&#46;S&#46; Brindle"
                            1 => "P&#46;M&#46; Fernandez"
                            2 => "R&#46;J&#46; Sattenberg"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1177/159101991001600115"
                      "Revista" => array:6 [
                        "tituloSerie" => "Interv Neuroradiol&#46;"
                        "fecha" => "2010"
                        "volumen" => "16"
                        "paginaInicial" => "103"
                        "paginaFinal" => "106"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20377988"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0045"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "An unusual complication of tonsillectomy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "P&#46; Walshe"
                            1 => "E&#46; Ramos"
                            2 => "C&#46; Low"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Surgeon"
                        "fecha" => "2005"
                        "volumen" => "3"
                        "paginaInicial" => "296"
                        "paginaFinal" => "298"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16121779"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0050"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Pseudoaneurysm of the lingual artery after temperature-controlled radiofrequency tongue base reduction&#58; A severe complication"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "M&#46; Herzog"
                            1 => "A&#46; Schmidt"
                            2 => "T&#46; Metz"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Laryngoscope&#46;"
                        "fecha" => "2006"
                        "volumen" => "116"
                        "paginaInicial" => "665"
                        "paginaFinal" => "667"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0055"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Atlas of Surgical Anatomy for General Surgeons"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "S&#46;W&#46; Gray"
                            1 => "J&#46;E&#46; Skandalakis"
                            2 => "P&#46;N&#46; Skandalakis"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Libro" => array:5 [
                        "fecha" => "2009"
                        "paginaInicial" => "15"
                        "paginaFinal" => "421"
                        "editorial" => "PMP"
                        "editorialLocalizacion" => "Athens"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0060"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Variety in collateral branching coming off the external carotid artery"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "C&#46; Antonetti"
                            1 => "F&#46; D&#237;az"
                            2 => "A&#46;M&#46; Castro"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Revista de la Sociedad Venezolana de Ciencias Morfol&#243;gicas&#46;"
                        "fecha" => "2010"
                        "volumen" => "16"
                        "paginaInicial" => "5"
                        "paginaFinal" => "10"
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/2255534X/0000008400000002/v1_201906191703/S2255534X18300689/v1_201906191703/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "18322"
    "tipo" => "SECCION"
    "es" => array:2 [
      "titulo" => "Scientific letter"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "es"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/2255534X/0000008400000002/v1_201906191703/S2255534X18300689/v1_201906191703/en/main.pdf?idApp=UINPBA000046&text.app=https://www.revistagastroenterologiamexico.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2255534X18300689?idApp=UINPBA000046"
]
Share
Journal Information
Vol. 84. Issue 2.
Pages 248-250 (April - June 2019)
Visits
8078
Vol. 84. Issue 2.
Pages 248-250 (April - June 2019)
Scientific letter
Open Access
Congenital lingual artery aneurysm as an unusual cause of upper gastrointestinal bleeding
Aneurisma congénito de la arteria lingual como causa inusual de sangrado de tubo digestivo alto
Visits
8078
M.M. Ramírez-Ramíreza,
Corresponding author
moy1510@hotmail.com

Corresponding author. Consultorio 404, Avenida Árbol de fuego 80, Coyoacán, El Rosario, 04380, Mexico City. Tel.: +55-29-00-13-48, Tel.: +36-83-75-00 Ext. 5404
, U.E. Clemente-Gutiérrezb, M. Silva-Gonzáleza,b, H.M. Zúñiga-Zamoraa, A.R. Sánchez-Conejoa
a General Surgery, SSA, Hospital Regional de Alta Especialidad de Ixtapaluca, Ixtapaluca, State of Mexico, Mexico
b General Surgery, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
This item has received

Under a Creative Commons license
Article information
Full Text
Bibliography
Download PDF
Statistics
Figures (2)
Full Text

Upper gastrointestinal bleeding is a common problem that presents in the outpatient setting, as well as in the emergency service. The most common causes of this clinical entity are peptic ulcer disease, Mallory-Weiss tear, gastrointestinal neoplasias,1 and variceal bleeding in the case of patients with portal hypertension. Aneurysms of the lingual artery are infrequent. Aneurysms of the external carotid artery are estimated to account for 2.2% of all cervical carotid aneurysms. Among those, superficial temporal artery and facial artery aneurysms are the most common, whereas lingual artery aneurysms are rare. They only appear in the literature in case reports and their incidence cannot be determined.2 The majority of cases are pseudoaneurysms, associated with trauma, neoplasias, surgical procedures,3 or radiofrequency ablation.4 There are few cases of true idiopathic congenital aneurysms.

A 39-year-old man had a past medical history of appendectomy due to complicated appendicitis, as well as numerous symptoms of lower gastrointestinal bleeding from probable hemorrhoidal disease that were untreated. He was admitted to the hospital for 2-day progression of symptoms characterized by melena and hematemesis. Endoscopy was performed that identified: pulsatile, erythematous, and congestive polypoid tumoral lesion, 3 x 4cm in diameter, in the right posterolateral wall of the hypopharynx. There were no signs of active bleeding (fig. 1A), but fibrin-covered ulcers extended from the soft palate and proximal portion of the right piriform sinus. Twenty-four hours later, the patient presented with a new episode of bleeding. Angiotomography revealed a thickened hypopharynx and an irregular, right hypodense image, 21 x 17 x 17mm in diameter, at the level of the inferior constrictor muscle that protruded toward the lumen, obstructing 50% of it, with contrast medium leakage. A saccular image dependent on the aberrant artery was also observed that emerged from the trunk of the superior thyroid artery as a probable variant of the lingual artery (fig. 1B). After angiotomography, the patient presented with sudden onset of massive bleeding through the oral cavity. He became hemodynamically unstable, with AP of 48/30mmHg and MAP of 33mmHg. Carotid arteriography was performed (fig. 2A) that identified a 1.5-mm vessel at the level of the bifurcation that drains into the trachea above and to the right of the vallecula. Two sacs measuring approximately 5 and 8mm were observed along its tract. Failed embolization resulted in carrying out vascular examination of the neck with selective ligation of the first branch of the right external carotid artery (thyrolingual trunk) (fig. 1C). Bleeding control was adequate, and the patient was sent to the intensive care unit, where he underwent blood transfusion. His postoperative period was uneventful.

Figure 1.

A) Endoscopy: pulsatile lesion in the hypopharynx. B) Cervical angiotomography: a probable anatomic variation of the lingual artery is observed (red arrow). C) Intraoperative image of the thyrolingual trunk (white arrow).

(0.18MB).
Figure 2.

A) Arteriography. Yellow arrow: internal carotid artery; dotted yellow arrow: external carotid artery; purple arrow: facial artery; green arrow: lingual artery; blue arrow: aneurysm of the lingual artery; white arrow: thyrolingual trunk; dotted white arrow: superior thyroid artery. B) Most frequent anatomy of the branches of the external carotid artery. C) Thyrolingual trunk, seen in 0.99% of cases.

(0.29MB).

The clinical presentation of pseudoaneurysms generally involves upper gastrointestinal bleeding, whereas congenital aneurysms are asymptomatic, and so their diagnosis is usually made as an incidental radiologic finding from contrast-enhanced tomography of the cervical region.2 Upper gastrointestinal bleeding secondary to a pseudoaneurysm of the lingual artery is a potentially fatal event. The customary treatment reported in the literature is embolization through interventional radiology. The case presented herein was unusual in that it was a congenital aneurysm with a history of intermittent gastrointestinal bleeding. Finally, the patient presented with hemorrhagic shock, embolization was unsuccessful, and he then underwent surgical treatment with thyrolingual trunk ligation.

The right common carotid artery arises from the brachiocephalic trunk and the left common carotid artery from the aortic arch. After the posterolateral ascent within the carotid sheath, it divides at the level of the superior edge of the thyroid cartilage into the internal carotid artery and external carotid artery, which have a posterolateral and an anteromedial tract, respectively. They usually do not give off any branches in the neck. The eight habitual branches of the external carotid artery are: the superior thyroid artery, lingual artery, occipital artery, posterior auricular artery, maxillary artery, and superficial temporal artery.5 The lingual branch originates in the external carotid artery in 84.16% of cases. The majority (24.75%) arise between the superior thyroid artery and facial artery (fig. 2B) at the level of the hyoid bone and 14.85% form a common trunk with the facial artery. The lingual artery originates together with the superior thyroid artery in only 0.99% of cases (fig. 2C).6

Ethical disclosuresProtection of human and animal subjects

The authors declare that no experiments were performed on humans or animals for this study.

Confidentiality of data

The authors declare that no patient data appear in this article.

Right to privacy and informed consent

The authors declare that no patient data appear in this article.

Financial disclosure

No financial support was received in relation to this study/article.

Conflict of interest

The authors declare that there is no conflict of interest.

Références
[1]
M. Feinman, E.R. Haut.
Upper gastrointestinal bleeding.
Surg Clin North Am., 94 (2014), pp. 43-53
[2]
R.S. Brindle, P.M. Fernandez, R.J. Sattenberg, et al.
Idiopathic lingual artery aneurysm: CT findings and endovascular therapy — A case report.
Interv Neuroradiol., 16 (2010), pp. 103-106
[3]
P. Walshe, E. Ramos, C. Low, et al.
An unusual complication of tonsillectomy.
Surgeon, 3 (2005), pp. 296-298
[4]
M. Herzog, A. Schmidt, T. Metz, et al.
Pseudoaneurysm of the lingual artery after temperature-controlled radiofrequency tongue base reduction: A severe complication.
Laryngoscope., 116 (2006), pp. 665-667
[5]
S.W. Gray, J.E. Skandalakis, P.N. Skandalakis, et al.
Atlas of Surgical Anatomy for General Surgeons.
PMP, (2009), pp. 15-421
[6]
C. Antonetti, F. Díaz, A.M. Castro.
Variety in collateral branching coming off the external carotid artery.
Revista de la Sociedad Venezolana de Ciencias Morfológicas., 16 (2010), pp. 5-10

Please cite this article as: Ramírez-Ramírez MM, Clemente-Gutiérrez UE, Silva-González M, Zúñiga-Zamora HM, Sánchez-Conejo AR. Aneurisma congénito de la arteria lingual como causa inusual de sangrado de tubo digestivo alto. Revista de Gastroenterología de México. 2019;84:248–250.

Idiomas
Revista de Gastroenterología de México
Article options
Tools
es en
Política de cookies Cookies policy
Utilizamos cookies propias y de terceros para mejorar nuestros servicios y mostrarle publicidad relacionada con sus preferencias mediante el análisis de sus hábitos de navegación. Si continua navegando, consideramos que acepta su uso. Puede cambiar la configuración u obtener más información aquí. To improve our services and products, we use "cookies" (own or third parties authorized) to show advertising related to client preferences through the analyses of navigation customer behavior. Continuing navigation will be considered as acceptance of this use. You can change the settings or obtain more information by clicking here.