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https://www.readbyqxmd.com/read/28924528/near-fatal-gastrointestinal-hemorrhage-in-a-child-with-medulloblastoma-on-high-dose-dexamethasone
#1
Derek Yecies, Daniel Tawfik, Jennifer Damman, Chad Thorson, David S Hong, Gerald A Grant, Rachel Bensen, Mihaela Damian
A four-year-old female was admitted to a university-based children's hospital with a newly-diagnosed posterior fossa tumor. She was started on famotidine and high-dose dexamethasone and underwent gross total resection of a medulloblastoma. She was continued on dexamethasone and famotidine. She exhibited postoperative posterior fossa syndrome and was started on enteral feeds via the nasoduodenal tube. She had small gastrointestinal bleeds on postoperative days eight, 11, and 18, and was found to have a well-circumscribed posterior duodenal ulcer...
July 7, 2017: Curēus
https://www.readbyqxmd.com/read/28914876/-an-aneurysm-of-the-medial-posterior-choroidal-artery-a-case-report-and-a-literature-review
#2
Yu A Grigoryan, A R Sitnikov, A V Timoshenkov, G Yu Grigoryan
INTRODUCTION: Aneurysms of the medial posterior choroidal artery are very rare. To date, only 5 cases have been reported. The article presents a case of successful surgical treatment of an aneurysm of the medial posterior choroidal artery and a literature review. CLINICAL CASE: A 57-year-old male was admitted to the Center 1 month after a massive subarachnoid hemorrhage. CT angiography revealed an aneurysm of the right posterior medial choroidal artery in the perimesencephalic cistern and resolved hemorrhage...
2017: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
https://www.readbyqxmd.com/read/28895103/a-case-of-perirenal-extramedullary-hematopoiesis-in-a-patient-with-primary-myelofibrosis
#3
Kentaro Imai, Tomonori Aoi, Hiroki Kitai, Nobuhide Endo, Masahiko Fujino, Shizunori Ichida
Extramedullary hematopoiesis (EMH) is hematopoiesis in organs outside the bone marrow and most frequently occurs in the liver, spleen, and lymph nodes. We report a case of perirenal EMH revealed by kidney biopsy in a patient with primary myelofibrosis. We observed only bilateral kidney enlargement with plain computed tomography (CT) and ultrasonography before obtaining a renal biopsy. We obtained a percutaneous biopsy from the lower pole of the left kidney using ultrasonographic guidance. Ultrasonography just after the renal biopsy revealed no bleeding around the kidney...
September 11, 2017: CEN Case Reports
https://www.readbyqxmd.com/read/28885969/the-use-of-the-abdominal-aortic-and-junctional-tourniquet-during-cardiopulmonary-resuscitation-following-traumatic-cardiac-arrest-in-swine
#4
Jason Rall, Jennifer M Cox, Joseph Maddry
BACKGROUND: Standard cardiopulmonary resuscitation (CPR) is ineffective in treating traumatic cardiac arrest (TCA) following hemorrhagic shock despite fluid resuscitation. CPR adjuncts, including abdominal compressions and external counter pressure, have shown some success in laboratory settings. The Abdominal Aortic and Junctional Tourniquet (AAJT) is a device that occludes both venous and arterial blood at the level of the aortic bifurcation and likely increases thoracic pressure when applied to the abdomen...
September 2017: Military Medicine
https://www.readbyqxmd.com/read/28885411/improvement-in-outcomes-of-major-obstetric-hemorrhage-through-systematic-change
#5
Daniel W Skupski, David Brady, Isaac P Lowenwirt, Jason Sample, Stephanie N Lin, Rahul Lohana, Gary S Eglinton
OBJECTIVE: To report the outcomes over 14 years of sustained systematic institutional focus on the care of women with major obstetric hemorrhage, defined as estimated blood loss greater than 1,500 mL. METHODS: A retrospective cohort study of women with major obstetric hemorrhage at our hospital from 2000 to 2014 compares baseline conditions (age, multiparity, prior cesarean delivery, morbidly adherent placenta), morbidity (lowest mean temperature, lowest mean pH, coagulopathy, hysterectomy), and mortality among three time periods (period 1=January 2000 to December 2001, period 2=January 2002 to August 2005, period 3=September 2005 to December 2014)...
September 5, 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28883275/successful-management-of-intraperitoneal-bleeding-with-platelet-apheresis-and-von-willebrand-factor-supplementation-in-a-patient-with-essential-thrombocythemia-and-acquired-von-willebrand-syndrome
#6
Toshimitsu Ueki, Kanako Takeshige, Masahiko Sumi, Mayumi Ueno, Naoaki Ichikawa, Hikaru Kobayashi
A 36-year-old woman with essential thrombocythemia (ET) was admitted to our hospital for acute lower abdominal pain. Given no family history of bleeding disorder, she was diagnosed with acquired von Willebrand syndrome. Despite having a medical history of venous thrombosis, she had never been treated for ET because of her preferences. On admission, CT scan revealed massive hemorrhage in the ascending colon with the leakage of a contrast agent. Furthermore, a delayed enhancement of fluid collection in the Douglas fossa followingcontrast CT indicated bloody ascites...
2017: [Rinshō Ketsueki] the Japanese Journal of Clinical Hematology
https://www.readbyqxmd.com/read/28877573/hookworm-infection-caused-acute-intestinal-bleeding-diagnosed-by-capsule-a-case-report-and-literature-review
#7
Xia Tan, Meichu Cheng, Jie Zhang, Guochun Chen, Di Liu, Yexin Liu, Hong Liu
Hookworm infections are rare causes of acute gastrointestinal bleeding. We report a middle aged man with primary nephrotic syndrome and pulmonary embolism. During the treatment with steroids and anticoagulants, the patient presented acute massive hemorrhage of the gastrointestinal tract. The results of gastroscopy showed red worms in the duodenum. Colonoscopy and CT angiogram of abdomen were unremarkable. Capsule endoscopy revealed fresh blood and multiple hookworms in the jejunum and ileum. Hookworms caused the acute intestinal bleeding...
August 2017: Korean Journal of Parasitology
https://www.readbyqxmd.com/read/28861425/single-incision-video-assisted-thoracoscopic-evaluation-and-emergent-surgery-for-severe-lung-and-chest-wall-injury-after-thoracic-trauma-in-a-water-park
#8
Julio Sesma, Melodie Alvarez, Francisco Lirio, Carlos Galvez, Maria Galiana, Benno Baschwitz, Francisca Fornes, Sergio Bolufer
Thoracic trauma is a challenging situation with potential severe chest wall and intrathoracic organ injuries. We present a case of emergent surgery in a 23-year-old man with hemorrhagic shock due to massive lung and chest wall injury after thoracic trauma in a water slide. We performed a SI-VATS approach in order to define intrathoracic and chest wall injuries, and once checked the extension of the chest wall injury, we added a middle size thoracotomy just over the affected area in order to stabilize rib fractures with Judet plates, that had caused massive laceration in left lower lobe (LLL) and injured the pericardium causing myocardical tear...
August 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28858739/spontaneous-non-traumatic-mediastinal-hematoma-associated-with-oral-anticoagulant-therapy-a-case-report-and-literature-review
#9
Masashi Mikubo, Dai Sonoda, Hirotsugu Yamazaki, Masahito Naito, Yoshio Matsui, Kazu Shiomi, Yukitoshi Satoh
INTRODUCTION: Mediastinal hematoma is usually caused by thoracic trauma or a ruptured aortic aneurysm. Spontaneous non-traumatic mediastinal hematomas are rare but potentially life-threatening conditions that can occur in patients taking anticoagulants. PRESENTATION OF CASE: We report a case of 72-year-old man with a massive mediastinal hematoma associated with anticoagulant therapy. He had complained of acute chest discomfort and subsequent tarry diarrhea. Because he had been taking warfarin for paroxysmal atrial fibrillation, an upper gastrointestinal hemorrhage was initially suspected, but no bleeding was detected by upper endoscopy...
August 23, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28857995/transarterial-embolization-and-transmucosal-sclerotherapy-that-led-to-successful-deliveries-in-a-patient-with-symptomatic-arteriovenous-malformation-of-the-tongue
#10
Munezumi Fujita, Yuhei Yamamoto, Satoru Sasaki, Akihiko Oyama, Emi Funayama, Hiroshi Furukawa
Patients with arteriovenous malformations (AVMs) are at risk of significant hemorrhage and AVMs are especially difficult to manage in those desiring future pregnancy. Few patients with successful deliveries have been previously reported.The authors report an unusual case of AVM of the tongue in a pregnant woman who presented with massive pulsatile bleeding from a ruptured artery in the tongue in late gestation, this was thought to be caused by the changes in hormonal balance and the increase in cardiac output...
August 28, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28857793/initiation-and-termination-of-massive-transfusion-protocols-current-strategies-and-future-prospects
#11
John C Foster, Joshua W Sappenfield, Robert S Smith, Sean P Kiley
The advent of massive transfusion protocols (MTP) has had a significant positive impact on hemorrhaging trauma patient morbidity and mortality. Nevertheless, societal MTP guidelines and individual MTPs at academic institutions continue to circulate opposing recommendations on topics critical to MTPs. This narrative review discusses up-to-date information on 2 such topics, the initiation and termination of an MTP. The discussion for each begins with a review of the recommendations and supporting literature presented by MTP guidelines from 3 prominent societies, the American Society of Anesthesiologists, the American College of Surgeons, and the task force for Advanced Bleeding Care in Trauma...
August 29, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28856811/life-threatening-hemorrhage-from-the-corona-mortis-after-laparoscopic-inguinal-hernia-repair-report-of-a-case
#12
Tomohiko Yasuda, Akihisa Matsuda, Masao Miyashita, Satoshi Matsumoto, Nobuyuki Sakurazawa, Youichi Kawano, Kumiko Sekiguchi, Fumihiko Ando, Takeshi Matsutani, Eiji Uchida
Along with the increased use of other laparoscopic procedures, laparoscopic inguinal hernia repair has become widely used because of its minimally invasive nature. Here, we report a case of 66-year-old man who underwent transabdominal preperitoneal laparoscopic hernioplasty and developed hemorrhagic shock on postoperative day 1. CT showed postoperative venous hemorrhage from the retropubic space. Successful hemostasis of the massive hemorrhage was achieved laparoscopically. The origin of the hemorrhage was assumed to be the corona mortis vein, which was slightly injured during the operation...
August 30, 2017: Asian Journal of Endoscopic Surgery
https://www.readbyqxmd.com/read/28856428/intraoperative-b-scan-ultrasonography-and-pars-plana-vitrectomy-for-severe-open-globe-injury-with-hemorrhagic-retinal-and-choroidal-detachment
#13
Nobuhiko Shiraki, Taku Wakabayashi, Tatsuhiko Sato, Hirokazu Sakaguchi, Kohji Nishida
PURPOSE: Our purpose was to report the initial clinical experience of intraoperative B-scan ultrasonography in combination with 25-gauge pars plana vitrectomy for severe open globe injury with hemorrhagic retinal and choroidal detachment. METHODS: Six eyes of six consecutive patients with severe open globe injury underwent intraoperative B-scan ultrasonography and 25-gauge pars plana vitrectomy at Osaka University Hospital in Japan. The feasibility of intraoperative B-scan ultrasonography, best-corrected visual acuity (BCVA), retinal reattachment, and intraoperative and postoperative complications were evaluated...
August 30, 2017: Graefe's Archive for Clinical and Experimental Ophthalmology
https://www.readbyqxmd.com/read/28852530/multidisciplinary-approach-to-manage-antenatally-suspected-placenta-percreta-updated-algorithm-and-patient-outcomes
#14
Paula S Lee, Samantha Kempner, Michael Miller, Jennifer Dominguez, Chad Grotegut, Jessie Ehrisman, Rebecca Previs, Laura J Havrilesky, Gloria Broadwater, Sarah C Ellestad, Angeles Alvarez Secord
BACKGROUND: Due to the significant morbidity and mortality associated with placenta percreta, alternative management options are needed. Beginning in 2005, our institution implemented a multidisciplinary strategy to patients with suspected placenta percreta. The purpose of this study is to present our current strategy, maternal morbidity and outcomes of patients treated by our approach. METHODS: From 2005 to 2014, a retrospective cohort study of patients with suspected placenta percreta at an academic tertiary care institution was performed...
2017: Gynecologic Oncology Research and Practice
https://www.readbyqxmd.com/read/28846895/massive-transfusion-practice-in-non-trauma-related-hemorrhagic-shock
#15
Nauman Farooq, Panagis Galiatsatos, Jasmine K Aulakh, Christopher Higgins, Anthony Martinez
PURPOSE: Evidence suggests that trauma patients with hemorrhagic shock requiring massive transfusion have improved outcomes if resuscitated with a prescribed massive transfusion protocol (MTP). However, there is limited data regarding the efficacy of MTP in non-trauma patients. METHODS: This was a retrospective observational study of all patients who received a massive transfusion protocol for non-traumatic hemorrhagic shock over a four-year period. The primary outcome was in-patient hospital survival...
August 24, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28846577/rotational-thromboelastometry-significantly-optimizes-transfusion-practices-for-damage-control-resuscitation-in-combat-casualties
#16
Nicolas J Prat, Andrew D Meyer, Nichole K Ingalls, Julie Trichereau, Joseph J DuBose, Andrew P Cap
BACKGROUND: Up to 40% of combat casualties with a truncal injury die of massive hemorrhage before reaching a surgeon. This hemorrhage can be prevented with damage control resuscitation (DCR) methods, which are focused on replacing shed whole blood by empirically transfusing blood components in a 1:1:1:1 ratio of platelets:fresh frozen plasma:erythrocytes:cryoprecipitate (PLT:FFP:RBC:CRYO). Measurement of hemostatic function with rotational thromboelastometry (ROTEM) may allow optimization of the type and quantity of blood products transfused...
September 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28845112/safety-and-utility-of-endoscopic-ultrasound-guided-fine-needle-aspiration-of-focal-splenic-lesions-a-retrospective-analysis
#17
Surinder S Rana, Vishal Sharma, Ravi Sharma, Radhika Srinivasan, Rajesh Gupta
BACKGROUND: Fine-needle aspiration (FNA) of focal splenic lesions (FSL) is usually done under ultrasound (US) or computed tomography guidance. Endoscopic US (EUS), because of its ability to provide high-resolution images, can be used for aspirating FSL. We studied the safety and efficacy of EUS-guided FNA of FSL. METHODS: We performed a retrospective analysis of patients with FSL undergoing EUS-guided FNA over the last six years. RESULTS: EUS-guided FNA was performed in 16 patients (age: 28-43 years; male: 11)...
2017: Annals of Gastroenterology: Quarterly Publication of the Hellenic Society of Gastroenterology
https://www.readbyqxmd.com/read/28840029/profuse-and-acute-hemorrhagic-gastroesophageal-injury-after-cryotherapy-in-a-cardiac-surgery-patient
#18
Hyae-Jin Kim, Hyeon-Jeong Lee, Dowon Lee, Haekyu Kim, A-Rheum Cho, Soeun Jeon, Suyeon Hong
Upper gastrointestinal injury associated with cryoablation and under placement of transesophageal echocardiography (TEE) during cardiac surgery is a rare complication but potentially fatal. During the cryoablation for the treatment of atrial fibrillation, delivered cryoenergy can adversely affect the esophagus, resulting in gastroesophageal ulceration. The TEE probe itself also can induce adverse effects like esophageal ulceration or perforation. In this case report, we describe a case of emergent gastroesophageal injury with massive bleeding that occurred after manipulation of a TEE probe during cryoablation therapy in a cardiac surgery patient...
July 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28837540/multi-institutional-analysis-of-neutrophil-to-lymphocyte-ratio-nlr-in-patients-with-severe-hemorrhage-a-new-mortality-predictor-value
#19
Juan Duchesne, Danielle Tatum, Glenn Jones, Brandy Davis, Rosemarie Robledo, Marc DeMoya, Terence O'Keeffe, Paula Ferrada, Tomas Jacome, Rebecca Schroll, Jordan Wlodarczyk, Priya Prikash, Brian Smith, Kenji Inaba, Desmond Khor, Marquinn Duke, Mansoor Khan
BACKGROUND: The neutrophil/lymphocyte ratio (NLR) has been associated as a predictor for increased mortality in critically ill patients. We sought to determine the relationship between NLR and outcomes in adult trauma patients with severe hemorrhage requiring the initiation of massive transfusion protocol (MTP). We hypothesized that the NLR would be a prognostic indicator of mortality in this population. METHODS: This was a multi-institutional retrospective cohort study of adult trauma patients (≥18 years) with severe hemorrhage who received MTP between November 2014 - November 2015...
August 23, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28831662/pituitary-apoplexy-and-rivaroxaban
#20
S Ly, A Naman, B Chaufour-Higel, M Patey, C Arndt, B Delemer, C F Litre
Pituitary apoplexy (PA), defined by the occurrence of a massive hemorrhagic necrotic rearrangement within a pituitary adenoma, is rare. Its occurrence can be associated with certain risk factors, including anticoagulation. We report the first case of PA with rivaroxaban which is one of the new oral anticoagulants: a 73 year-old patient presenting with severe headache and visual field deterioration. Surgery was performed. Radiotherapy treatment was decided three months after surgery because of tumor residue.
August 22, 2017: Pituitary
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