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Massive bleeding

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https://www.readbyqxmd.com/read/29785693/massive-transfusion-the-revised-assessment-of-bleeding-and-transfusion-rabt-score
#1
Bellal Joseph, Muhammad Khan, Michael Truitt, Faisal Jehan, Narong Kulvatunyou, Asad Azim, Arpana Jain, Muhammad Zeeshan, Andrew Tang, Terence O'Keeffe
BACKGROUND: Massive transfusion (MT) is a lifesaving treatment for trauma patients with hemorrhagic shock, assessed by Assessment of Blood Consumption (ABC) Score based on mechanism of injury, systolic blood pressure (SBP), tachycardia, and FAST exam. The aim of this study was to assess the performance of ABC score by replacing hypotension and tachycardia; with Shock Index (SI) > 1.0 and including pelvic fractures. METHODS: We performed a 2-year (2014-2015) analysis of all high-level trauma activations and excluded patients dead on arrival...
May 21, 2018: World Journal of Surgery
https://www.readbyqxmd.com/read/29783255/management-of-the-patients-with-blunt-renal-trauma-20-years-of-clinical-experience
#2
Leonid P Sarychev, Yaroslav V Sarychev, Hanna L Pustovoyt, Sergiy A Sukhomlin, Sergiy M Suprunenko
OBJECTIVE: Introduction: Blunt renal trauma (BRT) is a dangerous medical condition. The aim: Analysis of effectiveness of conservative and expectant treatment tactics under ultrasound and CT monitoring in patients with blunt renal trauma (BRT). PATIENTS AND METHODS: Materials and methods: The results of treatment of 81 patients with BRT during 20 years (1998-2017) were analyzed. Amount of men was 58 (71.6%), women - 23 (28.4%). Grade I trauma was seen in 37.0% of cases, grade II - in 25...
2018: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/29780069/successful-rescue-of-a-ruptured-tracheoinnominate-fistula-with-extracorporeal-membrane-oxygenation-endovascular-stents-and-debranching-surgical-bypass
#3
Yu-San Chien, Yen-Chun Chao, Kuo-Sheng Lee, Kung-Hong Hsu
We reported a case of ruptured tracheoinnominate fistula in a 14-year-old boy with history of repeated sternotomy. Tracheostomy was performed at age 2 years. Slide tracheoplasty was done at age 13 years. He presented to outpatient clinic with episodic hemosputum. Massive blood emanated from stoma during bronchoscopy evaluation. Venous-arterial extracorporeal membrane oxygenation was installed for resuscitation. A contrast-enhanced computed tomography (CT) and angiography confirmed the diagnosis. Immediate control of bleeding was achieved by an endovascular stent graft deployed at innominate artery...
May 18, 2018: Annals of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29778416/the-use-of-the-shock-index-as-a-predictor-of-active-bleeding-in-trauma-patients
#4
Andrea Campos-Serra, Sandra Montmany-Vioque, Pere Rebasa-Cladera, Heura Llaquet-Bayo, Raquel Gràcia-Roman, Anna Colom-Gordillo, Salvador Navarro-Soto
INTRODUCTION: Vital signs indicate the presence of bleeding only after large amounts of blood have been lost, with high morbidity and mortality. The Shock Index (SI) is a hemorrhage indicator with a cut-off point for the risk of bleeding at 0.9. The aim of this study is to assess whether a cut-off of≥0.8 is more sensitive for detecting occult bleeding, providing for early initiation of therapeutic maneuvers. METHODS: SI analytical validation study of severe trauma patients older than 16 years of age...
May 16, 2018: Cirugía Española
https://www.readbyqxmd.com/read/29777456/distal-bowel-re-feeding-in-patients-with-proximal-jejunostomy
#5
Anand Nagar, Siddharth Mehrotra, Amitabh Yadav, Vivek Mangla, Shailendra Lalwani, Naimish Mehta, Samiran Nundy
BACKGROUND: Patients who have a proximal jejunostomy are difficult to manage because of their high stoma output which results in fluid and electrolyte imbalance with repeated hospital admissions and the necessity for expensive parenteral nutrition (PN). There are few reports on the use of re-feeding of the proximal effluents in this situation. METHODS: We here relate our experience with this manoeuvre in 35 patients between Jan 2010 and Feb 2016 who had stomas less than 120 cm away from the duodenojejunal flexure...
May 18, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/29767224/innovative-technique-for-endoscopic-placement-of-sengstaken-blakemore-tube
#6
Arleen M Ortiz, Cesar J Garcia, Mohamed O Othman, Marc J Zuckerman
OBJECTIVES: The Sengstaken-Blakemore (SB) tube is used in cases of uncontrolled variceal bleeding. Because of the complexity of the procedure and the lack of visualization, various techniques have been described to avoid blind placement. We report an innovative and simple technique for placement of the SB tube under direct endoscopic visualization. METHODS: A grasp-and-place technique for endoscopic placement of SB tubes is described and a retrospective cohort study chart review of endoscopies done for variceal bleeding in our medical center is reported...
May 2018: Southern Medical Journal
https://www.readbyqxmd.com/read/29756014/hemodialysis-is-a-strong-risk-factor-for-post-endoscopic-sphincterotomy-bleeding-in-patients-with-choledocholithiasis
#7
So Nakaji, Nobuto Hirata, Hiroki Matsui, Toshiyasu Shiratori, Masayoshi Kobayashi, Shigenobu Yoshimura, Keisuke Kanda, Natsuki Kawamitsu, Hisato Harasawa
Background and study aims:  Hemodialysis (HD) is considered one of the risk factors for post-endoscopic sphincterotomy (ES) bleeding. Therefore, we conducted a retrospective study to evaluate HD as a risk factor for post-ES bleeding in patients with choledocholithiasis. Patients and methods:  We used the post-ES bleeding rate as the main outcome measure. To evaluate the influence of HD on the risk of post-ES bleeding, logistic regression and propensity score analyses were conducted...
May 2018: Endoscopy International Open
https://www.readbyqxmd.com/read/29755814/massive-hemoptysis-from-a-pulmonary-artery-pseudoaneurysm-during-cardiac-surgery
#8
Alfredo Giuseppe Cerillo, Elisa Barberi, Francesca Amoretti, Sergio Berti
Massive hemoptysis is a life-threatening condition usually related to a pathology of the bronchial arteries. Pulmonary artery pseudoaneurysms represent a relatively rare cause of severe airway bleeding, but are associated with a mortality rate of over 50%. A case of massive intraoperative hemoptysis treated with temporary occlusion of the right pulmonary artery and delayed endovascular occlusion of the feeding segmental artery is described.
April 2018: Turkish Thoracic Journal
https://www.readbyqxmd.com/read/29755087/-successful-echo-guided-deployment-of-stent-graft-for-intraoperative-retrograde-aortic-dissection-and-rupture-report-of-a-case
#9
Naoki Kanemitsu, Takehiko Matsuo, Hiroaki Osada, Kazuo Yamanaka, Junichi Tazaki
We report a case of chronic dissecting thoracoabdominal aneurysm with intraoperative retrograde aortic dissection and rupture at proximal descending aorta, which was successfully treated by echoguided stent-graft insertion. An 82-year old male underwent thoracoabdominal aortic replacement for dilatation of infra-diaphragmatic aorta. Under F-F bypass, his thoracoabdominal aorta was replaced by a Dacron graft with 4-branches. After he weaned from F-F bypass, we found massive bleeding from proximal descending aorta...
May 2018: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/29748057/massive-bleeding-from-inferior-mesenteric-vein-with-hypovolemic-shock-a-rare-complication-of-acute-pancreatitis
#10
Sun Hwa Lee, Seong Jong Yun, Seokyong Ryu, Seung Woon Choi, Hye Jin Kim, Tae Kyung Kang, Sung Chan Oh, Suk Jin Cho
BACKGROUND: Acute pancreatitis may cause massive intra-abdominal bleeding as vascular complications caused by the erosion of a major pancreatic or peripancreatic vessel. In terms of treatment, the differentiation between arterial bleeding and venous bleeding using abdominal computed tomography (CT) angiography is important. In addition, hypovolemic shock caused by bleeding from the inferior mesenteric vein (IMV) in acute pancreatitis has not been reported. CASE REPORT: A 58-year-old man presented to our emergency department with complaints of abdominal pain of 10 hours' duration...
May 7, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29744052/hemosuccus-pancreaticus-a-mini-review
#11
REVIEW
Peng Yu, Jianping Gong
Determining the cause of obscure bleeding in the gastrointestinal tract is the key in treating the disease. Hemosuccus pancreaticus (HP) could be an extremely rare disease. Ordinarily, bleeding in the pancreatic duct is defined as HP. At present, HP is the least frequent cause of upper gastrointestinal bleeding (1/1500), but can lead to massive gastrointestinal bleeding, which is potentially life threatening. Owing to its rarity, HP is difficult to diagnose, and the mortality rate of HP remains high in various studies...
April 2018: Annals of Medicine and Surgery
https://www.readbyqxmd.com/read/29742774/massive-upper-gastrointestinal-bleeding-post-whipple-s-surgery-from-anastomotic-varices-due-to-mesenteric-hypertension
#12
Yu Jun Wong, Farah Gillian Irani, Malcolm Tan, Melissa Teo
No abstract text is available yet for this article.
May 9, 2018: Endoscopy
https://www.readbyqxmd.com/read/29742224/massive-hemoptysis-successfully-treated-with-extracorporeal-membrane-oxygenation-and-endobronchial-thrombolysis
#13
Antônio Aurélio de Paiva Fagundes Júnior, Renato Bueno Chaves, Amanda Robassini Dos Santos, Humberto Alves de Oliveira, Marcello Henrique Paschoal
Extracorporeal membrane oxygenation has been used to treat refractory hypoxemia in numerous clinical scenarios. The fundamental principles for the management of massive hemoptysis patients include protecting the airway and healthy lung, locating the source of bleeding and controlling the hemorrhage. We report the case of a patient with acute respiratory failure associated with massive hemoptysis secondary to lung laceration during cardiac surgery. The use of extracorporeal membrane oxygenation allowed patient survival...
March 2018: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/29735258/outcomes-of-pulmonary-artery-embolization-and-stent-graft-placement-for-the-treatment-of-hemoptysis-caused-by-lung-tumors
#14
Clément Marcelin, Jérome Soussan, Florian Desmots, Jean-Yves Gaubert, Vincent Vidal, Jean Michel Bartoli, Jean Izaaryene
PURPOSE: To evaluate the safety and efficacy of endovascular management of pulmonary artery lesions caused by lung tumors. MATERIALS AND METHODS: Nineteen patients (15 men, 4 women; average age: 60.3 years, range, 51-86 years) treated for massive or recurrent hemoptysis with transarterial pulmonary artery embolization between 2010 and 2016 were included in this multicenter, retrospective study. Inclusion criteria were: patients with lung cancer and at least 1 episode of hemoptysis with a pulmonary artery lesion detected by computed tomography (CT) angiography or after failed bronchial artery embolization...
May 5, 2018: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/29725977/gastrosplenic-fistula-with-gastrointestinal-bleeding-a-rare-and-potentially-fatal-complication-after-sleeve-gastrectomy
#15
Laura Montana, Laurent Genser, Alexandre Cortes, Eric Poupardin, Christophe Barrat, Sergio Carandina
BACKGROUND: Although the surgical technique is safe and standardized, laparoscopic sleeve gastrectomy (LSG) is associated with serious and potentially life-threatening complications, such as gastric leak and bleeding. METHODS: In this retrospective study, three French university hospitals reviewed their experience with LSG. Between September 2014 and May 2016, three cases of gastrosplenic fistula complicated by massive upper gastrointestinal hemorrhage (UGIH) were recorded...
May 3, 2018: Obesity Surgery
https://www.readbyqxmd.com/read/29725568/tiny-falx-meningioma-causing-massive-interhemispheric-subdural-hematoma-a-case-report
#16
Yume Suzuki, Masashi Fujimoto, Fumihiro Kawakita, Fumio Asakura, Hiroto Murata, Yoshito Morooka, Hidenori Suzuki
Bleeding from meningiomas is well known, but massive subdural hemorrhage from a very small meningioma is rare. A 61-year-old woman presented with a sudden-onset headache and slight right hemiparesis without a history of trauma. Computed tomographic scan showed bilateral acute/subacute interhemispheric subdural hematoma, but contrast-enhanced computed tomography (CT) scan, non-enhanced magnetic resonance imaging (MRI) and digital subtraction angiography failed to detect the cause. The hematoma was conservatively treated...
April 2018: NMC Case Report Journal
https://www.readbyqxmd.com/read/29725533/ulcerated-gastric-leiomyoma-causing-massive-upper-gastrointestinal-bleeding-a-case-report
#17
Daryl Ramai, Qiuxue T Tan, Sofia Nigar, Emmanuel Ofori, Denzil Etienne, Madhavi Reddy
Leiomyomas are rare, benign submucosal tumors originating from smooth muscle cells. The clinical presentation is usually asymptomatic, with excellent prognosis. We herein report the case of a 68-year-old female with a solitary leiomyoma found during esophagogastroduodenoscopy for hematemesis. Histopathological examination revealed smooth muscle proliferation supported by positive staining for smooth muscle myosin heavy chain and negative staining for CD117 and S-100, consistent with the marker expression pattern of leiomyoma...
May 2018: Molecular and Clinical Oncology
https://www.readbyqxmd.com/read/29721496/the-role-of-plasma-transfusion-in-massive-bleeding-protecting-the-endothelial-glycocalyx
#18
REVIEW
Stefano Barelli, Lorenzo Alberio
Massive hemorrhage is a leading cause of death worldwide. During the last decade several retrospective and some prospective clinical studies have suggested a beneficial effect of early plasma-based resuscitation on survival in trauma patients. The underlying mechanisms are unknown but appear to involve the ability of plasma to preserve the endothelial glycocalyx. In this mini-review, we summarize current knowledge on glycocalyx structure and function, and present data describing the impact of hemorrhagic shock and resuscitation fluids on glycocalyx...
2018: Frontiers in Medicine
https://www.readbyqxmd.com/read/29717359/serious-complications-after-button-battery-ingestion-in-children
#19
Hilde Krom, Margot Visser, Jessie M Hulst, Victorien M Wolters, Anita M Van den Neucker, Tim de Meij, Hubert P J van der Doef, Obbe F Norbruis, Marc A Benninga, Margot J M Smit, Angelika Kindermann
Serious and fatal complications after button battery ingestion are increasing worldwide. The aim of this study is to describe serious complications after battery ingestion in children in the Netherlands.All pediatric gastroenterologists in the Netherlands performing upper endoscopies were asked to report all serious complications after battery ingestion in children (0-18 years) between 2008 and 2016 retrospectively.Sixteen serious complications were reported: death after massive bleeding through esophageal-aortal fistula (n = 1), esophageal-tracheal fistula (n = 5), stenosis after (suspected) perforation and mediastinitis (n = 5), (suspected) perforation and mediastinitis (n = 3), vocal cord paralysis (n = 1), and required reintubation for dyspnea and stridor (n = 1)...
May 2, 2018: European Journal of Pediatrics
https://www.readbyqxmd.com/read/29709396/rivaroxaban-plus-percutaneous-catheter-directed-treatment-for-a-patient-with-massive-pulmonary-embolism-and-colporrhagia
#20
Wuchao Wang
Massive pulmonary embolism (PE) is defined by acute PE with sustained systemic arterial hypotension that is below 90 mm Hg for at least 15 min or requires inotropic agents (Jaff et al., 2011). For patients with absolute contraindications to thrombolysis, interventional treatment requires the removal of obstructing thrombi from the main pulmonary arteries to facilitate RV recovery and improve symptoms and survival (European Respiratory Society et al., 2014). For patients with acute PE, anticoagulation is recommended, with the objective of preventing both early death and recurrent symptomatic or fatal VTE...
April 19, 2018: American Journal of Emergency Medicine
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