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Massive bleeding

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https://www.readbyqxmd.com/read/28447055/associating-liver-partition-and-portal-vein-ligation-for-bleeding-hepatocellular-carcinoma-in-hbv-cirrhosis-a-safety-strategy
#1
Giovanni Battista Levi Sandri, Giovanni Vennarecci, Pasquale Lepiane, Giuseppe Maria Ettorre
The incidence of hepatocellular carcinoma (HCC) spontaneous tumor rupture varies between 3% and 26%. For resectable HCC ruptures, emergency hepatectomy or staged hepatectomy after transcatheter arterial embolization (TAE) are life-saving procedures, and efficient therapeutic methods. We report a multimodal therapy including TAE, associating liver partition and portal vein ligation (ALPPS) and immunoglobuline infusion for a huge bleeding HCC with portal vein tumor thrombosis (PVTT) in hepatitis B virus (HBV) cirrhosis...
2017: Translational Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28446485/primary-aortojejunal-fistula-a-rare-cause-for-massive-upper-gastrointestinal-bleeding
#2
Sylvester Paulasir, Rhami Khorfan, Christina Harsant, Harry Linne Anderson
A 68-year-old man presented to the emergency department with haematemesis and shock. Upper endoscopy and selective angiography could not identify the source of bleeding. He underwent selective embolisation of the gastroduodenal artery. The patient then had a period of about 24 hours with relative haemodynamic stability before having another episode of massive upper gastrointestinal bleed. A second attempt to embolise the common hepatic artery and distal coeliac axis was unsuccessful. Hence, he was urgently taken to the operating room for exploratory laparotomy...
April 26, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28443600/retroauricular-approach-for-targeted-cochlear-therapy-experiments-in-wistar-albino-rats
#3
Selçuk Mülazimoğlu, Emre Ocak, Gülşah Kaygusuz, Mustafa Kürşat Gökcan
BACKGROUND: As the idea of stem cell technology in the treatment of sensorial hearing loss has emerged over the past decades, the need for in vivo models for related experiments becomes explicit. One of the most common experimental models for inner ear stem cell delivery experiments is the Wistar albino rat (WAR). AIMS: To investigate the surgical anatomy of the temporal bone of the WAR with respect to the dissection steps, operative techniques, and potential pitfalls from surgery...
April 6, 2017: Balkan Medical Journal
https://www.readbyqxmd.com/read/28441942/rare-antibody-associated-hemolytic-transfusion-reaction-and-transfusion-related-acute-lung-injury-a-case-report
#4
Tim N Beck, Natalee G Young, Michelle L Erickson, Ignacio Prats
BACKGROUND: Hemolytic transfusion reactions and transfusion-related acute lung injury (TRALI) are life-threatening complications associated with the transfusion of blood products. Hemorrhage is one of the most common surgical complications and the risk of bleeding is particularly acute in patients with hematologic deficiencies. Management of surgical bleeding can be divided into two phases. The first phase centers on immediate control of acute bleeding and the second phase focuses on keeping the patient stable and on reducing the sequelae associated with blood transfusions and blood loss...
April 26, 2017: BMC Surgery
https://www.readbyqxmd.com/read/28432428/tranexamic-acid-for-treatment-and-prophylaxis-of-bleeding-and-hyperfibrinolysis
#5
Ingrid Pabinger, Dietmar Fries, Herbert Schöchl, Werner Streif, Wolfgang Toller
Uncontrolled massive bleeding with subsequent derangement of the coagulation system is a major challenge in the management of both surgical and seriously injured patients. Under physiological conditions activators and inhibitors of coagulation regulate the sensitive balance between clot formation and fibrinolysis. In some cases, excessive and diffuse bleeding is caused by systemic activation of fibrinolysis, i. e. hyperfibrinolysis (HF). Uncontrolled HF is associated with a high mortality. Polytrauma patients and those undergoing surgical procedures involving organs rich in plasminogen proactivators (e...
April 21, 2017: Wiener Klinische Wochenschrift
https://www.readbyqxmd.com/read/28426914/recommended-dose-of-idarucizumab-may-not-always-be-sufficient-for-sustained-reversal-of-dabigatran
#6
Alexander Simon, Hans Domanovits, Cihan Ay, Gürkan Sengölge, Jerrold H Lewy, Alexander O Spiel
Idarucizumab is a monoclonal antibody fragment designed for reversing the anticoagulant effects of dabigatran. Administration is recommended as two intravenous boluses of 2.5 g within 15 minutes of each other or as a single 5 g bolus. However, in certain situations a second dose of the drug could be necessary. We report the case of a 77-year old man, treated with dabigatran for paroxysmal atrial fibrillation. He presented at our department with acute renal failure, concomitant massive dabigatran accumulation, and subsequent acute gastrointestinal bleeding...
April 20, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28422385/genital-bleeding-hemostasis-in-gynecologic-neoplasm-with-balloon-tamponade-new-treatment-option
#7
Noriko Karakida, Shintaro Yanazume, Marie Mori, Natsuko Uchida, Akio Tokudome, Hiroaki Kobayashi
Genital bleeding is the most common and serious complication in gynecologic malignancy. Different techniques are available for the control of severe bleeding, but standard treatment strategies have not been determined. Herein we report on the successful use of the balloon technique in two cases of genital bleeding in uterine neoplasm. The first case was of advanced cervical cancer with massive genital bleeding during radiotherapy. A metreurynter (mini-metro) was inserted into the vagina and hemostasis was indirectly achieved in the vaginal hematoma...
April 19, 2017: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/28420022/-severe-bleeding-from-the-middle-ear-cavity-after-myringotomy-review-based-on-a-case-report
#8
Veit M Hofmann, Stefan M Niehues, Andreas E Albers, Annett Pudszuhn
Report of a rare case of severe bleeding from the middle ear cavity after myringotomy. On the basis of the case report, the procedure for such bleeding is discussed in the context of the literature. A 6-year-old boy received a revision myringotomy in an ambulant setting. During the procedure a severe bleeding occurred. The external auditory canal was adequately packed. The patient was extubated and transferred to the clinic as an emergency. Computer tomography of the temporal bone showed the anatomical variant of a dehiscent high jugular bulb, which had been injured...
March 2017: Laryngo- Rhino- Otologie
https://www.readbyqxmd.com/read/28419620/comparing-emergency-department-patients-to-inpatients-receiving-a-pulmonary-embolism-response-team-pert-activation
#9
Erin K Deadmon, Nicholas J Giordano, Kenneth Rosenfield, Rachel Rosovsky, Blair Alden Parry, Rasha Fahad Al-Bawardy, Yuchiao Chang, Christopher Kabrhel
OBJECTIVES: The development of Pulmonary Embolism Response Teams (PERTs) has been widely adopted nationally with the goal of providing multidisciplinary care to patients with high-risk PE. Most PERT activations originate from the Emergency Department (ED), while others are from the intensive care unit (ICU) or inpatient floors. It is unclear if ED PERT activations differ from non-ED PERT activation in terms of presentation, management, and outcome. METHODS: We enrolled a consecutive cohort of patients for whom PERT was activated at an urban academic medical center...
April 17, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28415059/-a-case-of-slowly-progressive-brain-metastasis-with-minor-bleeding-after-removal-of-and-chemotherapy-for-non-small-cell-lung-cancer
#10
Hiroshi Matsufuji, Eri Shiozaki, Yasutaka Nakatake, Koichi Yoshida, Kensaku Kamada, Takayuki Matsuo
Of all brain metastases, the most common primary lesion is derived from the lung. These types of metastases enlarge aggressively with unfavorable prognoses. We report the case of a 75-year-old male patient who had a history of pulmonary resection for Stage IA non-small cell lung cancer(NSCLC), and received chemotherapy. One year after NSCLC surgery, he experienced a cardiogenic cerebral infarction, and anticoagulant therapy was initiated. Mass lesions with hemorrhage were detected bilaterally in the frontal lobes through magnetic resonance imaging three years after the NSCLC surgery...
April 2017: No Shinkei Geka. Neurological Surgery
https://www.readbyqxmd.com/read/28411694/predictors-of-failure-and-complications-of-catheter-directed-interventions-for-pulmonary-embolism
#11
Efthymios D Avgerinos, Adham N Abou Ali, Nathan L Liang, Elizabeth Genovese, Michael J Singh, Michel S Makaroun, Rabih A Chaer
OBJECTIVE: Catheter-directed interventions (CDIs) are increasingly performed for acute pulmonary embolism (PE) as they are presumed to provide similar therapeutic benefits to systemic thrombolysis while decreasing the dose of thrombolytic required and the associated risks. This study aimed to identify factors associated with CDI failure and to describe anticipated complications. METHODS: Consecutive patients who underwent CDI for massive or submassive PE between 2009 and 2015 were identified; outcomes and complications were retrospectively collected...
May 2017: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/28407781/early-identification-of-patients-requiring-massive-transfusion-embolization-or-hemostatic-surgery-for-traumatic-hemorrhage-a-systematic-review-protocol
#12
Alexandre Tran, Maher Matar, Ewout W Steyerberg, Jacinthe Lampron, Monica Taljaard, Christian Vaillancourt
BACKGROUND: Hemorrhage is a major cause of early mortality following a traumatic injury. The progression and consequences of significant blood loss occur quickly as death from hemorrhagic shock or exsanguination often occurs within the first few hours. The mainstay of treatment therefore involves early identification of patients at risk for hemorrhagic shock in order to provide blood products and control of the bleeding source if necessary. The intended scope of this review is to identify and assess combinations of predictors informing therapeutic decision-making for clinicians during the initial trauma assessment...
April 13, 2017: Systematic Reviews
https://www.readbyqxmd.com/read/28398633/intracranial-hemorrhage-in-a-patient-with-sub-massive-pulmonary-embolism-treated-with-ekosonic-endovascular-system-directed-thrombolysis
#13
Sarju Ganatra, Arjun Majithia, Yun-Ting Eric Yeh, Michael S Levy
Ultrasound-assisted catheter-directed thrombolysis therapy has emerged more recently as a management strategy for patients with intermediate risk pulmonary embolism and has shown promising results in clinical trials by early reversal of right ventricle dilation, reduced pulmonary hypertension, and decreased anatomic thrombus burden. This therapeutic strategy requires a small fraction of the systemic fibrinolytic dose and is therefore associated with a reduced bleeding risk. Although intracranial hemorrhage has not been reported in clinical trials, it is a possible complication...
April 11, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28397672/-successful-treatment-of-severe-dabigatran-intoxication-with-idarucizumab-in-a-patient-with-acute-kidney-injury
#14
Christina Gjerlev Poulsen, Morten Bestle, Lene Boesby
In the course of an uncomplicated sigmoidostomy a 63-year-old male who had severe comorbidity developed a critical bleeding due to dabigatran intoxication induced by acute kidney injury. Massive blood transfusions, tranexamic acid, Octaplex and haemodialysis were not effective. Administration of idarucizumab induced immediate clinical and paraclinical improvement. Dabigatran should be carefully administrated in patients who have any degree of renal insufficiency. Idarucizumab may be effective in severe bleeding caused by dabigatran...
February 13, 2017: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/28396047/prediction-of-massive-bleeding-shock-index-and-modified-shock-index
#15
L J Terceros-Almanza, C García-Fuentes, S Bermejo-Aznárez, I J Prieto-Del Portillo, C Mudarra-Reche, I Sáez-de la Fuente, M Chico-Fernández
OBJECTIVE: To determine the predictive value of the Shock Index and Modified Shock Index in patients with massive bleeding due to severe trauma. DESIGN: Retrospective cohort. SETTING: Severe trauma patient's initial attention at the intensive care unit of a tertiary hospital. SUBJECTS: Patients older than 14 years that were admitted to the hospital with severe trauma (Injury Severity Score >15) form January 2014 to December 2015...
April 8, 2017: Medicina Intensiva
https://www.readbyqxmd.com/read/28393975/-management-of-severe-ulcerative-colitis-an-up-to-date
#16
Cristian Hernández-Rocha, Patricio Ibáñez, María Elena Molina, Julieta Klaassen, Andrea Valenzuela, Roberto Candia, Felipe Bellolio, Álvaro Zúñiga, Rodrigo Miguieles, Juan Francisco Miquel, José Chianale, Manuel Álvarez-Lobos
Ulcerative Colitis (UC) is a chronic inflammatory disease involving the colon, with alternating periods of remission and activity. Exacerbations can be severe and associated with complications and mortality. Diagnosis of severe UC is based on clinical, biochemical and endoscopic variables. Patients with severe UC must be hospitalized. First line therapy is the use of intravenous corticoids which achieve clinical remission in most patients. However, 25% of patients will be refractory to corticoids, situation that should be evaluated at the third day of therapy...
January 2017: Revista Médica de Chile
https://www.readbyqxmd.com/read/28391020/ruptured-aneurysm-of-an-aberrant-internal-carotid-artery-successfully-treated-with-simultaneous-intervention-and-surgery-in-a-hybrid-operating-room
#17
Yoichiro Kawamura, Tetsuro Sayama, Naoki Maehara, Ataru Nishimura, Koji Iihara
BACKGROUND: Aberrant internal carotid artery (aICA) is an anatomical anomaly whereby the internal carotid artery (ICA) courses through the tympanic cavity without separation by bone. Since aICA is rare, there are no definite treatment strategies for aICA and its complications. CASE DESCRIPTION: We report a case of aICA accompanied by pseudoaneurysm formation and massive bleeding. Our case was a 31-year-old woman with a 2-year history of hearing loss, ear fullness, and pulsatile tinnitus in her left ear...
April 5, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28381928/prevalence-of-shunt-dependency-and-clinical-outcome-in-patients-with-massive-intraventricular-haemorrhage-treated-with-endoscopic-washout-and-external-ventricular-drainage
#18
Jason Raj Johnson, Zamzuri Idris, Jafri Malin Abdullah, Azmi Alias, Mohammad Saffari Mohammad Haspani
BACKGROUND: Intraventricular haemorrhage (IVH) causes blockage of ventricular conduits leading to hydrocephalus, increased intracranial pressure (ICP), and a reduced level of consciousness. The current standard management of IVH is insertion of an external ventricular drainage (EVD) catheter. However, this procedure addresses only the problems of acute hydrocephalus and raised ICP. Endoscopic washout allows for a more complete removal of the intraventricular clot. This study compared these two types of treatment in terms of shunt dependency and relevant clinical outcomes...
March 2017: Malaysian Journal of Medical Sciences: MJMS
https://www.readbyqxmd.com/read/28377939/endoscopic-treatment-of-bleeding-diversion-pouchitis-with-high-concentration-dextrose-spray
#19
Custon T Nyabanga, Bo Shen
Surgical closure of stoma with the reestablishment of gut continuity is the only curative intervention available for inflammatory bowel disease patients with diversion pouchitis, proctitis, or colitis. For patients who are not candidates for surgical reestablishment of bowel continuity, the alternative nonsurgical approaches, such as topical therapy with mesalamine, corticosteroids, or short-chain fatty acids, have only shown modest efficacy. The management of massive bleeding from diversion pouchitis has not been described...
2017: ACG Case Reports Journal
https://www.readbyqxmd.com/read/28361365/acute-non-traumatic-idiopathic-spinal-subdural-hematoma-radiographic-findings-and-surgical-results-with-a-literature-review
#20
Kazuyoshi Kobayashi, Shiro Imagama, Kei Ando, Yoshihiro Nishida, Naoki Ishiguro
PURPOSE: Intraspinal hematoma is a serious condition, and early diagnosis is necessary to permit emergency treatment. Among such hematomas, non-traumatic spinal subdural hematoma is a rare occurrence. We have experienced three patients with surgically proven subdural spinal hematoma, and here we report these cases with a review of their clinical and imaging characteristics. METHODS: All three cases were idiopathic with no history of disease, no coagulopathy, and no trauma...
March 30, 2017: European Spine Journal
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