PMC4010032_01
Reconstructed surface view of abdominal and pelvis illustrating patients with high body mass index.
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fig1
The increased BMI can be seen on the scout images of the initial computed tomogram, Figure 1.
Thoracic stent graft (black arrows) and resolving thoracic hematoma (white arrows).
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fig2
Loss of lung volumes and residual hematoma surrounding the stent graft on follow-up CT scan, Figure 2, suggest a need for continued ventilator and nutritional support.
In RAO projection, a hemostat compressed the soft tissue against the insufflated stomach (white arrow) excluding other viscera from the path. The nasogastric tube (black arrow) used for insufflations lies above.
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fig3
Bowel was excluded from the access path using multiprojection fluoroscopic imaging while compressing the abdominal wall onto the distended stomach, Figure 3.
The guide wire (white arrow) directed into the gastric lumen and up the esophagus under fluoroscopic control.
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fig4
A 180 cm 0.035'' wire was advanced through the needle and directed up the esophagus beside the feeding tube, Figure 4.