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A & A Case Reports

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https://www.readbyqxmd.com/read/28520567/persistent-hypotension-and-cerebral-swelling-resulting-from-mesenteric-traction-syndrome-after-omental-to-pial-pedicle-flap-transfer-in-a-young-woman-with-refractory-moyamoya-disease-a-case-report
#1
Harvey J Woehlck, Suneeta Gollapudy, Christopher J Roberts, Akinwunmi Oni-Orisan, Raphael H Sacho, Paul S Pagel
Superficial temporal arterial to middle cerebral arterial anastomosis is often the initial surgical treatment of Moyamoya disease. In refractory cases, placing a pedicle flap of omentum over the ischemic brain has resulted in clinical improvement or stabilization of symptoms. We present a case of persistent mesenteric traction syndrome manifested by hypotension unresponsive to conventional doses of vasopressors during and after pulling the omentum to the brain. As prostacyclin is a major mediator of hypotension from mesenteric traction syndrome and also a cerebral vasodilator, we discuss the possibility that brain swelling may be a manifestation of mesenteric traction syndrome...
May 17, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28520566/essential-thrombocytosis-and-labor-epidural-placement-while-on-aspirin-assessing-hemorrhagic-risks-a-case-report
#2
Paul Martin Kempen
Essential thrombocytosis (ET) is a rare disease with known thrombotic and bleeding complications. We encountered a patient with a diagnosis of longstanding Janus kinase-2 gene-negative ET on aspirin therapy presenting for labor epidural. Evaluation of platelet function with pointof-care analysis using Plateletworks in a community hospital setting allowed confirmation of adequate numbers of functional platelets to support safe epidural placement. The relevant issues of ET for anesthesia management with labor epidurals are discussed...
May 17, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28520565/use-of-a-tilting-orthopedic-fracture-table-to-facilitate-proper-patient-positioning-during-intrathecal-neurolysis-with-hyperbaric-phenol-a-case-report
#3
Nathaniel H Loo, Gerald Matchett
We describe the case of a 41-year-old woman with metastatic cervical cancer and a large mass eroding into the pelvis and left lumbosacral plexus. The patient had intractable left lower extremity pain refractory to standard therapies, and she elected to undergo intrathecal neurolysis. A diagnostic intrathecal block was performed at the T11-12 interspace followed by intrathecal neurolysis with 6% phenol in glycerin on a subsequent date. During both procedures, we used a tilting radiolucent orthopedic fracture table to maintain strict left lateral-supine positioning...
May 17, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28520564/normothermic-cardiopulmonary-bypass-in-patient-with-waldenstr%C3%A3-m-s-macroglobulinemia-and-cryoglobulinemia-a-case-report
#4
Shiho Satomi, Asuka Kasai, Eisuke Hamaguchi, Yasuo M Tsutsumi, Katsuya Tanaka
Waldenström's macroglobulinemia (WM) manifests as hyperviscosity syndrome. Cryoglobulinemia, which may increase blood viscosity or induce thrombosis in association with decreased body temperature, can occur in combination with WM. We describe the management of an 82-year-old woman with WM, hyperviscosity syndrome, and cryoglobulinemia who required open aortic valve replacement. Decreased body temperature in this patient was prevented during cardiopulmonary bypass by using a forced air warming system and normothermic cardioplegia with continuous warm blood cardioplegia perfusion...
May 17, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28514236/a-kinked-epidural-needle-tip-preventing-placement-of-an-epidural-catheter
#5
Florin Costescu, Marcin Wąsowicz
No abstract text is available yet for this article.
May 15, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28509781/correction-of-severe-coagulopathy-and-hyperfibrinolysis-by-tranexamic-acid-and-recombinant-factor-viia-in-a-cirrhotic-patient-after-trauma-a-case-report
#6
Jack Louro, Katherine Andersen, Roman Dudaryk
Coagulopathy induced by trauma or cirrhosis is a well-recognized entity. Viscoelastic testing has been used in either condition for goal-directed transfusion and detection of fibrinolysis since conventional coagulation tests do not correlate with clinical risk of bleeding. Hemostatic resuscitation may not be adequate for a trauma patient with liver disease due to complex alterations in coagulation systems and occasionally require adjuvant therapy. We report a case of trauma-induced coagulopathy presenting as severe hyperfibrinolysis in a cirrhotic patient who was refractory to hemostatic resuscitation but was rapidly corrected by the administration of tranexamic acid and recombinant Factor VIIa...
May 12, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28509780/hypnosis-and-axillary-compartment-block-for-breast-cancer-surgery-a-case-report
#7
Régis Fuzier, Sylviane Achelous, Geneviève Salvignol, Eva Jouve
Hypnosis has been proven to be a powerful tool in the management of anxiety and pain. It allows for an increase of pain threshold, which can reach the level of surgical analgesia. Recently injection of local anesthetics around the serratus muscle has been presented as an alternative to paravertebral block for cancer breast surgery. We report the successful use of hypnosis in combination with an axillary compartment block for lumpectomy and axillary lymph node dissection.
May 12, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28509779/gas-embolism-during-hysteroscopic-surgery-three-cases-and-a-literature-review
#8
Benjamin S Storm, Stine Andreasen, Anders Hovland, Erik W Nielsen
During a period of 1 month, 3 episodes of probable or actual venous air embolism occurred during hysteroscopic surgery. All patients developed the same symptoms of ventilatory and hemodynamic decompensation, beginning with a reduction in end-tidal carbon dioxide, arterial desaturation, and cyanosis on the upper trunk, and rapidly progressed to hypotension and 2 cardiac arrests. While entrainment of some air is common during hysteroscopy, life-threatening embolism is a rare but serious complication for which an anesthetist needs to be vigilant and prepared...
May 12, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28509778/multiple-anesthetic-drug-sensitization-in-a-hairdresser-with-previous-immediate-type-hypersensitivity-to-penicillin-a-case-report
#9
Cristina Petrişor, Nadia Gherman, Manuela Sfichi, Marius Mureşan, Natalia Hagău
Risk factors for intraoperative immediate-type hypersensitivity reactions may require allergological evaluation. We report the case of a hairdresser with a positive history of penicillin hypersensitivity and anaphylactic shock during previous general anesthesia, whose in vivo and in vitro allergy tests were positive for neuromuscular blocking agents, opioids, and midazolam. Immediate-type hypersensitivity reactions to antibiotics and professional exposure to hairdressing products might induce simultaneous cross-sensitization to multiple drugs that are commonly used during general anesthesia...
May 12, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28509777/ultrasound-guided-percutaneous-cryoneurolysis-for-acute-pain-management-a-case-report
#10
Rodney A Gabriel, John J Finneran, Deepa Asokan, Andrea M Trescot, NavParkash S Sandhu, Brian M Ilfeld
We report 3 different cases in which ultrasound-guided percutaneous cryoneurolysis was performed to treat acute pain: 1 patient with refractory incisional pain after percutaneous nephrolithotomy; 1 patient with burns to the foot; and 1 patient with pain from iliac crest grafting. Acute pain associated with surgery or injury is a challenge to treat with local anesthetic-based regional anesthesia techniques when the anticipated pain duration exceeds a few days. Cryoneurolysis is an alternative analgesic method that utilizes extremely cold temperatures to reversibly ablate peripheral nerves and is potentially a novel method for acute pain management...
May 12, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28509776/hyperleukocytosis-complicated-by-intracerebral-hemorrhage-and-spurious-hypoxemia-a-case-report-and-literature-review
#11
Yumi Katakura, Yoshikazu Yamaguchi, Tetsuya Miyashita, Masafumi Idei, Tasuku Yoshida, Yuko Matsuda, Shunsuke Takaki, Aki Kamijo, Osamu Yamaguchi, Takahisa Goto
We present the management of a 15-year-old girl with acute myeloid leukemia who presented with massive hyperleukocytosis and neurological deficit due to intracerebral hemorrhage. Surgical intervention was considered but ultimately not undertaken because of the presence of massive hyperleukocytosis, thrombocytopenia, hypokalemia, and considerable discrepancy between the oxygen saturation values determined mechanically and by peripheral oximetry. Aggressive treatment of the hyperleukocytosis was immediately started, which improved the patient's overall condition and rendered surgical intervention unnecessary...
May 12, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28509775/failed-vocalis-muscle-monitoring-during-thyroid-surgery-resulting-from-residual-muscle-relaxation
#12
Stuart D Marshall, Jonathan Serpell
No abstract text is available yet for this article.
May 12, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28471757/excessive-surgical-adhesive-a-case-report-of-aortic-root-abscess-doppelg%C3%A3-nger
#13
Natalie A Silverton, David A Bull, Candice K Morrissey
Aortic root abscess is a complication of aortic valve endocarditis that is associated with a high morbidity and mortality. The diagnosis usually is made with transesophageal echocardiography, which is highly sensitive and specific for the disease. We present a case of suspected aortic root abscess 1 week after mechanical aortic valve replacement for native valve endocarditis. The diagnosis was made by the use of transesophageal echocardiography but surgical inspection revealed that the paravalvular fluid collection was excessive surgical adhesive...
May 3, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28459726/dexmedetomidine-as-a-supplement-to-spinal-anesthesia-block-a-case-report-of-three-infants
#14
Franklin Chiao, Karen Boretsky
We report a novel use for dexmedetomidine as a supplemental intravenous or intranasal sedative for spinal anesthesia in infants. The children were 1, 2, and 9 months old having either inguinal hernia repair or circumcision. None of them experienced clinically relevant hemodynamic changes or apnea. Pain scores were zero throughout the postoperative period.
April 28, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28459725/temporary-decompression-of-symptomatic-epidural-hematoma-via-an-in-situ-epidural-catheter-a-case-report
#15
Rakesh V Sondekoppam, Douglas Quan, Sugantha Ganapathy
Spinal epidural hematoma (SEH) following neuraxial anesthesia needs prompt recognition and early decompressive measures to prevent long-term neurologic injury. We report a case of SEH presenting on the second postoperative day during an ongoing epidural infusion. Aspiration of blood through the epidural catheter and a subsequent improvement in the neurological symptoms made us suspect SEH, which was further confirmed by an MRI study. We describe the timeline of the presentation of SEH and the subsequent clinical course in our patient...
April 28, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28459724/anesthetic-challenges-for-posterior-spine-surgery-in-patient-with-left-ventricular-assist-device-a-case-report
#16
J Pablo Kollmar, Douglas A Colquhoun, Julie L Huffmyer
With the growing rate of left ventricular assist device (LVAD) implantation, patients with end-stage heart failure and LVAD support are presenting for a variety of noncardiac surgeries. We describe a case of urgent posterior lumbar decompression for spinal stenosis in a 73-year-old man with HeartMateII LVAD, which presented significant anesthetic challenges in terms of positioning, blood loss, and coagulopathy.
April 28, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28459723/aortoiliac-thrombosis-following-tranexamic-acid-administration-during-urgent-cesarean-hysterectomy-a-case-report
#17
Omar S Hajmurad, Ankeet A Choxi, Zahira Zahid, Roman Dudaryk
Postpartum hemorrhage (PPH) contributes to 25% of maternal deaths worldwide. Abnormal placentation is a well-known culprit of PPH. Although controversial, iliac artery balloon occlusion has been used in patients to decrease bleeding. The use of antifibrinolytic agents, such as tranexamic acid (TXA), have gained popularity in the management of PPH. We present a 35-year-old parturient with placenta percreta that was managed with internal iliac artery balloon occlusion with concomitant use of TXA during urgent cesarean hysterectomy with subsequent aortoiliac thrombosis formation...
April 28, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28459722/two-cases-of-duchenne-muscular-dystrophy-that-showed-different-reactions-to-nerve-stimulation-during-peripheral-nerve-block-a-case-report
#18
MinHye So, Takeshi Sugiura, Saya Yoshizawa, Kazuya Sobue
In recent years, the technique of combined ultrasound and electrical stimulation-guided nerve block has been recommended. We present 2 patients with Duchenne muscular dystrophy who exhibited different muscle responses to nerve stimulation during the performance of peripheral nerve blocks for surgeries. Whereas a 2-year-old boy without severe disability showed the expected muscle contraction to electrical nerve stimulation, a 14-year-old boy with severe disability showed no muscle response. Our experience suggests that muscle responses to electrical nerve stimulation will vary with the stage of Duchenne muscular dystrophy...
April 28, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28459721/unintentional-cerebral-acute-subdural-hematoma-after-transforaminal-lumbar-interbody-fusion-a-case-report
#19
Shirozu Kazuhiro, Takahashi Keita, Hayashida Mitsumasa, Matsushita Katsuyuki, Nakashima Yasuharu, Hoka Sumio
We present a 68-year-old woman who developed acute cerebral subdural hematoma (SDH) early after transforaminal lumbar interbody fusion. Four hours postoperatively, the patient complained of headache and nausea. Enhanced cranial computed tomography showed cerebral SDH. Despite no obvious intraoperative dural damage, we suggest that cerebrospinal fluid leakage by incidental dural tear likely caused the SDH. To our knowledge, this is the first report of detected cerebral SDH immediately after spinal surgery in spite of no neurological deficits...
April 28, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28459720/intravenous-caffeine-rescue-for-postoperative-hypoventilation-in-a-16-year-old-with-trisomy-10-a-case-report
#20
Michael Evans, Humphrey Lam, Thomas Austin
Trisomy 10 is a rare disorder, with only 35 cases reported in the literature. Anesthetic management may be challenging in this patient population because of craniofacial, cardiac, and renal abnormalities commonly seen in the disorder. We describe a 16-year-old male with an anesthetic history notable for prolonged emergence, postoperative hypoxia, postoperative reintubation, and unexpected hospital admission presenting for dental extraction of impacted teeth. We utilized intravenous caffeine, a respiratory stimulant used in preterm infants, to facilitate recovery from anesthesia...
April 28, 2017: A & A Case Reports
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