Haemorragic shock

BACKGROUND: Dengue has global importance as a dreaded arboviral infection. It has 4 serotypes of epidemiological imporatnce. The classification denotes two clinical spectrums- dengue fever (DF) and dengue haemorragic fever (DHF). Most cases are stereotype and amenable to fluid resuscitation. However, unusual manifestations cause fatalities and often overlooked. This study describes 10 such dengue cases to fill the knowledge gaps. CASE PRESENTATION: All 10 patients presented to the Teaching Hospital, Peradeniya, Sri Lanka during mid-year epidemic of dengue in 2016...

OBJECTIVES: To estimate the range of hepatic involvement in dengue infections by assessing clinical and biochemical profile of adult dengue infected patients. METHODS: Serologically confirmed 220 adult cases of dengue infections admitted to Mayo hospital from June 2013 to November 2013 were classified as having dengue fever, dengue haemorragic fever and dengue shock syndrome. The frequency and range of bilirubin, liver enzymes derangement and presence of liver enlargement in each group was calculated and further stratified according to age and gender...

High energy trauma is often responsible for acute bleeding. Long bone and pelvis fractures are correlated with increased blood loss. Hypovolaemia could become a life threatening complication especially in elderly patients because of the reduced physiological response. Furthermore it could compromise the course of associated morbidities. Haemorrage is also associated in both comminuted fractures and osteoporosis. An increased intraoperative bleeding often occurs when a prolonged surgical time is required to obtain an appropriate ostheosynthesis...

We report a case of ruptured ovarian molar pregnancy, diagnosed in the context of haemorragic shock 19 days following evacuation of an intrauterine hydatiform mole. To our knowledge, this is the first reported case of heterotopic molar pregnancy.

This is a case of retroperitoneal hematoma and hypovolemic shock as a presentation of renal angiomyolipoma, a rarely benign and asymptomatic tumor. The massive and spontaneous bleeding of the tumor was diagnosed by an abdominal ecography and confirmed by an abdominal computer tomography in the emergency room. Although that kind of tumor needs non-aggressive treatment, as a general rule, because of the size and severity of the following symptoms, the patient has been submitted to a selective embolization of the renal mass when he was hemodinamically stabilized...

In a medical context, it is important to precise if the pleurisy is associated with signs of tamponnade, and/or clinical presentation of ominous organic distress (acute respiratory failure, septic, haemorragic, or cardiogenic shock) or pulmonary embolism. Presence of pleural tamponnade leads to immediate decompression pleural puncture which improves rapidly in general the clinical tolerance, and later permits etiologic treatment. In more severe conditions, pleural evacuation is done in parallel with cardiopulmonary resuscitation maneuvers...

Authors report an uncommon case of spontaneous rupture of common iliac artery in a man 43 years old with Ehlers-Danlos syndrome. The clinical presentation was devious in the beginning and catastrophic after few hours with a haemo-peritoneum and haemorragic shock. The Ehlers-Danlos syndrome is a rare affection of the connective tissue with an incidence of 1/5000, representing one of the most common disorders of the connective tissue. This disease is characterized by the fragility of arteries, intestine and uterus...

Idiopathic ischaemic infarction of the stomach is an extremely rare condition since only 2 other cases have been published in the Literature so far. The Authors report a case of such entity on a 75 year old male patient, admitted from the accident and emergency department because of a upper digestive tract haemorrhage with clinical signs of hypovolemic shock. The patient subsequently underwent an upper gastro-intestinal endoscopy that suspected an ulcerated gastric neoplasm. The patient therefore underwent a total gastrectomy and was discharged home on p...

PURPOSE: To report our experience in the control of haemorrhage with the transcatheter embolisation technique. MATERIALS AND METHODS: Between 1999-2001, we treated 56 patients with important pelvic trauma. Forty-two were victims of car accidents and 14 of falls from great altitudes. Twenty presented acute symptoms due to blunt pelvic trauma, with massive bleeding, not treatable by drugs and blood transfusion. Diagnosis of pelvic haemorrhage was made with CT. When high-flow haemorrhage was found, the patient was referred for angiography...

AIM OF THE STUDY: Damage control laparotomy is a new approach to the more severe abdominal traumas. It stems from a better understanding of the physiopathology of the haemorragic shock. PATIENTS AND METHODS: A national retrospective study from 27 centers about 109 trauma patients who underwent a damage control procedure between January 1990 and December 2001, is analysed. Surgical procedures included 97 hepatic packing, 10 abdominal packing, 4 exclusive skin closure, 1 open laparotomy technique and 3 digestive stapplings...

Allogenic blood transfusion may be required for the treatment of anemia due to a hematologic disease, the consequences of chemotherapy or other circumstances, such as haemorrage and/or surgery. Transfusion becomes indispensable to prevent the side effects of anemia, such as hypoxia, palpitations, tachycardia, cardiac ischemia and fatigue. However, frequent transfusions can cause several acute problems such as hemolysis, anaphylactic shock and septic shock but also chronic problems such as iron overload (hemochromatosis), alloimmunisation and metabolic disturbances...

Hepatic injuries account for about 45% of all abdominal traumas and for 30 to 40% of penetrating abdominal injuries. In 60% of the cases, they are associated with other lesions, especially life-threatening head injuries. Abdominal ultrasonography, a short and safe procedure enabling guided puncture, has developed rapidly relegating to the second rank other diagnostic techniques such as peritoneal lavage and CT scan. First line treatment of severe trauma complicated by haemorragic shock combines fluid resuscitation, prevention of hypothermia and administration of broad spectrum antibiotics...

We report a case of a permanent flaccid paraplegia, with a sensory loss at T12 level, not associated with cerebral damage, subsequent to a cardiac arrest of 15 minutes duration, in a 67-year-old patient, undergoing haemorragic surgery for gangrenous purulent cholecystitis. Besides cardiovascular collapse and subsequent circulatory arrest, possible favouring factors include anatomical anomalies in the territory of anterior spinal artery, surgical posture with hyperlordosis generating venous stasis, emergency haemostatic maneuvers with compression of the arterial territory providing spinal blood supply...

A case of serious haemorragic shock caused by the rupture into the duodenum of a septic aneurysm of the pancreatic-duodenal artery is reported. The diagnostic difficulties and the need to carry on "blind" laparotomies, in these cases, are underlined.

Over an almost 5 year period, 8,017 caesarean sections were done, and there were 51 maternal deaths following caesarean section (of which 5 were done outside). Caesarean section deaths accounted for 1 in 8 overall maternal deaths in the hospital, and institutional mortality for caesarean section was 5.7/1,000 operations. The causes of death included haemorragic shock in 19 (37.3%), general anaesthesia (11.6%), hypertensive disorders 5 (9.8%), general anaesthesia in hypertensive pregnancies 4 (7.8%), septicaemia 7 (13...

The report has been divided in two parts. In the first part, the authors review the chief features of the alveolar-capillary membrane permeability. In the second part, are described the early ultrastructural changes observed in the sheep lung, three and twenty-four hours after the haemorragic shock indication. At third hour, the lesions showed a very heterogeneous distributive pattern. The interstitial oedema was the most striking feature at this time, but some important morphological lesions within endothelial and epithelial layers could be also observed...

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The authors report two cases of cardiac rupture during acute myocardial infarction successfully treated surgically. In the first case, rupture occurred 7 days after hospital admission for anteroseptal myocardial infarction. The patient developed sudden cardiogenic shock with signs of venous hypertension without left ventricular failure. The second patient was admitted for syncopal chest pain with transient hypotension which regressed after volume repletion and pressor amine therapy. On admission, the patient had signs of cardiac tamponade...