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https://www.readbyqxmd.com/read/27913777/risk-factors-for-major-bleeding-in-the-seattle-ii-trial
#1
Immad Sadiq, Samuel Z Goldhaber, Ping-Yu Liu, Gregory Piazza
Ultrasound-facilitated, catheter-directed, low-dose fibrinolysis minimizes the risk of intracranial bleeding compared with systemic full-dose fibrinolytic therapy for pulmonary embolism (PE). However, major bleeding is nevertheless a potential complication. We analyzed the 150-patient SEATTLE II trial of submassive and massive PE patients to describe those who suffered major bleeding events following ultrasound-facilitated, catheter-directed, low-dose fibrinolysis and to identify risk factors for bleeding. Major bleeding was defined as GUSTO severe/life-threatening or moderate bleeds within 72 hours of initiation of the procedure...
December 1, 2016: Vascular Medicine
https://www.readbyqxmd.com/read/27908284/obscured-hemorrhagic-pancreatitis-after-orthotopic-heart-transplantation-complicated-with-acute-right-heart-failure-and-hepatic-dysfunction-a-case-report
#2
Ting-Wei Lin, Meng-Ta Tsai, Jun-Neng Roan, Yi-Sheng Liu, Hong-Ming Tsai, Chwan-Yau Luo
BACKGROUND: Pancreatitis is a serious complication after cardiac surgery and can lead to significant morbidities and mortality. The incidence of pancreatitis is even higher in patients undergoing heart transplantation than in those undergoing other cardiac surgeries. Nevertheless, the clinical presentations of pancreatitis are frequently atypical in these patients. CASE PRESENTATION: We report a heart recipient who was complicated with acute right heart failure initially after orthotopic heart transplantation and developed devastating unanticipated hemorrhagic pancreatitis 1 month after the transplantation...
December 1, 2016: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/27906086/massive-adrenal-vein-aneurysm-mimicking-an-adrenal-tumor-in-a-patient-with-hemophilia-a-a-case-report-and-review-of-the-literature
#3
Richard Sleightholm, Steven Wahlmeier, Jeffrey S Carson, Andjela Drincic, Audrey Lazenby, Jason M Foster
BACKGROUND: Visceral venous aneurysms are exceedingly rare, and until now, there have been no reports of this phenomenon in the adrenal vasculature. This report details the first adrenal venous aneurysm reported in the literature. The aneurysm presented as an 18-cm mass that was initially suspected to be a hematoma or tumor on the basis of the complex medical history of the patient, which included hemophilia A and testicular cancer. After surgical excision, pathologic examination confirmed this mass to be a 15...
December 1, 2016: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/27898547/bilateral-congenital-iris-sphincter-agenesis-diagnosed-after-massive-bleeding-episode-during-repair-of-aneurysmal-dilation-of-patent-ductus-arteriosus
#4
Tomohiro Yamamoto, Martin Schmidt-Niemann, Ehrenfried Schindler
We report a rare case of an infant with both an aneurysmal dilation of the patent ductus arteriosus (PDA) and bilateral congenital iris sphincter agenesis. Her mydriasis without pupillary light reflex was first noted after a massive intraoperative bleeding episode during the PDA ligation. The assumption that the mydriasis was a sign of cerebral ischemia led to additional examinations and intensive medical therapies that in retrospect were unnecessary. This is the first reported case of combined aneurysmal dilation of a PDA and congenital iris sphincter agenesis in the anesthesia literature...
November 28, 2016: A & A Case Reports
https://www.readbyqxmd.com/read/27896263/complete-vaginal-outlet-stenosis-in-a-patient-with-sheehan-s-syndrome
#5
Minji Choo, Hana Park, Kyong Wook Yi
We present a case of complete vaginal stenosis in a woman diagnosed with Sheehan's syndrome. The patient delivered at full-term 5 months prior, and experienced massive postpartum bleeding at that time. During evaluation of persistent amenorrhea, we found that her vaginal orifice was completely adhesive and obstructed. Prior to corrective surgery, we managed the patient with an oral contraceptive to induce uterine bleeding into the vaginal outflow tract. After three cycles of an oral contraceptive, we could confirm that there was no stenotic lesion in the vaginal cavity as a hematocolpos was created...
November 2016: Obstetrics & Gynecology Science
https://www.readbyqxmd.com/read/27894281/successful-selective-reduction-of-a-heterotopic-cesarean-scar-pregnancy-in-the-second-trimester-a-case-report-and-review-of-the-literature
#6
Haiyan Yu, Hong Luo, Fumin Zhao, Xinghui Liu, Xiaodong Wang
BACKGROUND: Heterotopic cesarean scar pregnancy is a cesarean scar pregnancy combined with an intrauterine pregnancy that predisposes a woman to life-threatening complications such as uterine rupture and massive bleeding. Preservation of the intrauterine pregnancy in heterotopic cesarean scar pregnancy is a great challenge. CASE PRESENTATION: We report a case of a 33-year-old woman with heterotopic cesarean scar pregnancy after IVF-embryo transfer (ET). Expectant management was carried out with early diagnosis of heterotopic cesarean scar pregnancy (HCSP), and selective fetal reduction of cesarean scar pregnancy (CSP) was performed by ultrasound-guided intrathoracic injection of potassium chloride (KCl) at 16 + 4 weeks of gestation due to aggravation of CSP...
November 29, 2016: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/27891285/complex-perineal-trauma-with-anorectal-avulsion
#7
Adelina Maria Cruceru, Ionut Negoi, Sorin Paun, Sorin Hostiuc, Ruxandra Irina Negoi, Mircea Beuran
Introduction. The objective of this case report is to illustrate a severe perineal impalement injury, associated with anorectal avulsion and hemorrhagic shock. Results. A 32-year-old male patient was referred to our hospital for an impalement perineal trauma, associated with complex pelvic fracture and massive perineal soft tissue destruction and anorectal avulsion. On arrival, the systolic blood pressure was 85 mm Hg and the hemoglobin was 7.1 g/dL. The patient was transported to the operating room, and perineal lavage, hemostasis, and repacking were performed...
2016: Case Reports in Surgery
https://www.readbyqxmd.com/read/27890105/use-of-postmortem-computed-tomography-angiography-to-detect-vascular-injuries-accompanying-skull-base-fracture
#8
Hikaru Kuninaka, Yoichiro Takahashi, Rie Sano, Keiko Takahashi, Rieko Kubo, Yoshihiko Kominato, Hiroyuki Takei, Susumu Kobayashi, Takehiro Shimada, Hiroyuki Tokue, Sachiko Awata, Satoshi Hirasawa
A 58-year-old woman who had presented for upper gastrointestinal barium examination accidently slipped from the movable bed, and her head became compressed between the end of the bed and the side wall. She suffered massive bleeding from her nose and ear followed by cardiac arrest, and subsequent attempts at cardiopulmonary resuscitation failed. A medicolegal autopsy was performed to reveal the cause of death, as part of the investigation of the accident. During the autopsy, postmortem cerebral CT angiography was carried out by injection of 5% gelatin-barium emulsion as a radiopaque contrast medium into the bilateral common carotid arteries, demonstrating transudation of the contrast medium into the right acoustic meatus and the sphenoidal sinus cavity...
November 2016: Legal Medicine
https://www.readbyqxmd.com/read/27888219/long-term-intestinal-bleeding-in-a-child-a-rare-case-of-heterotopic-gastric-mucosa-in-the-jejunum
#9
Stella Leng, Marco Ghionzoli, Chiara Caporalini, Anna Maria Buccoliero
We report a rare case of heterotopic gastric mucosa presenting in a jejunal polyp of a 9-year-old girl, diagnosed with capsule endoscopy and laparoscopic exploration, after a 15-month history of lower gastrointestinal bleeding and anaemia. During surgery, the jejunal segment containing the polyp was resected and pathological examination revealed a polyp with gastric heterotopia. Heterotopic gastric mucosa is a rare pathology characterised by the presence of gastric mucosa outside of the stomach. Heterotopic gastric mucosa usually occurs in the oesophagus, duodenum, Meckel's diverticulum and enteric duplication cysts...
November 25, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27882271/the-hidden-culprit-in-a-massive-episode-of-hematemesis-a-dieulafoy-s-lesion
#10
Sameen Khalid, Aamer Abbass, Tiffanie Do, Divyanshu Malhotra, Melanie Albors-Mora
A Dieulafoy's lesion is described as a tortuous, dilated aberrant submucosal vessel that can penetrate through the mucosa and rupture spontaneously, resulting in severe gastrointestinal bleeding. The lesion is most commonly found in the proximal stomach. Historically, it has had up to an 80% mortality rate because of its tendency to cause intermittent but severe bleeding and diagnostic challenges. We report a case of a young male with recurrent severe upper gastrointestinal bleeding with extensive prior investigations failing to reveal the source of bleeding...
October 10, 2016: Curēus
https://www.readbyqxmd.com/read/27876590/clinical-prognosis-of-non-massive-central-and-non-central-pulmonary-embolism-a-registry-based-cohort-study
#11
Bobby Gouin, Marc Blondon, David Jiménez, Carmen Fernández-Capitán, Henri Bounameaux, Silvia Soler, Rita Duce, Joan Carles Sahuquillo, Nuria Ruiz-Giménez, Manuel Monreal
BACKGROUND: Whether the localization of non-massive pulmonary embolism (PE) is associated with the short and long-term prognosis of patients remains unknown. Our aim is to characterize associations of non-massive PE localization with risks of recurrent venous thromboembolism (VTE), major bleeding and mortality during and after anticoagulation. METHODS: Among participants of the RIETE registry with an incident symptomatic non-massive PE diagnosed by computerized tomography (CT), we compared risks of recurrent VTE, major bleeding and mortality during and after anticoagulation period between central PE (main pulmonary artery) and non-central PE (more peripheral arteries), using Cox proportional hazard adjusted models...
November 19, 2016: Chest
https://www.readbyqxmd.com/read/27875857/retrospective-review-of-prothrombinex-use-by-saas-medstar
#12
Roy Fischer, Simon Brettig, Andrew Pearce
OBJECTIVE: The aim of this study was to review and describe the use of Prothrombinex by a physician-led retrieval service based remote from a hospital blood bank. METHODS: This is a retrospective observational study. Patients to whom Prothrombinex was administered by the retrieval team were identified from the retrieval service patient database. The paper case cards of the identified patients were then manually reviewed and the data matched to patients in the state-wide electronic laboratory record...
November 22, 2016: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/27866541/-influencing-factors-for-postoperative-survival-of-patients-with-stage-iii-silicosis-treated-by-lung-transplantation
#13
W J Mao, X W Nie, W Xia, M F Zheng, R Chen, Y J He, F Liu, S G Ye, R G Lu, J Y Chen
Objective: To investigate the clinical effect, postoperative complications, and causes of death in the treatment of stage III silicosis with lung transplantation and the influencing factors for survival. Methods: A retrospective analysis was performed for the clinical data of 32 patients with stage III silicosis who underwent lung transplantation in our hospital from September 2002 to September 2015. The survival, causes of death, and postoperative complications were analyzed. The Kaplan-Meier method was used to plot survival curves, the log-rank test was used to compare the influence of each factor on survival rates, and the multivariate Cox proportional hazards regression model was used to evaluate the influence of each factor on survival...
September 20, 2016: Chinese Journal of Industrial Hygiene and Occupational Diseases
https://www.readbyqxmd.com/read/27865221/-massive-upper-airway-bleeding-a-rare-case-of-aortobronchial-fistula
#14
Paola Gudiel Arriaza, Amparo Sánchez Serrano, Jorge Marques do Vale, Isabel Gil Pereira, António Simões Torres, Maria José Martín Sánchez
Clinical presentation of haemoptysis and haematemesis often generates confusion, becoming a difficult task to determine the source of upper airway bleeding. Aortobronchial fistula is a rare entity, but has been a reported complication in patients that have undergone aortic vascular surgery. A high clinical suspicion is fundamental to making this diagnosis. A 69 year old male, with a previous diagnosis of chronic gastritis, is admitted to the emergency room for vomiting blood. In the first 24 hours after admission, the patient develops respiratory insufficiency after an episode of massive bleeding from his mouth...
June 2016: Acta Médica Portuguesa
https://www.readbyqxmd.com/read/27864609/myocardial-infarction-as-a-complication-of-bronchial-artery-embolization
#15
Hugo Labbé, Simon Bordeleau, Christine Drouin, Patrick Archambault
Bronchial artery embolization is now a common treatment for massive pulmonary hemoptysis if flexible bronchoscopy at the bedside failed to control the bleeding. Complications of this technique range from benign chest pain to devastating neurological impairments. We report the case of a 41-year-old man who developed an ST elevation myocardial infarction during bronchial artery embolization, presumably because of coronary embolism by injected particles. In this patient who had no previously known coronary artery disease, we retrospectively found a communication between the left bronchial artery and the circumflex coronary artery...
November 18, 2016: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/27860404/perineal-alveolar-soft-part-sarcoma-treated-by-laparoscopy-assisted-total-pelvic-exenteration-combined-with-pubic-resection
#16
Toshisada Aiba, Keisuke Uehara, Satoshi Tsukushi, Yasushi Yoshino, Tomoki Ebata, Yukihiro Yokoyama, Tsuyoshi Igami, Gen Sugawara, Masato Nagino
A 20-year-old woman with a perineal alveolar soft part sarcoma was referred to our hospital. MRI showed that an irregular oval tumor occupied the perineum. The tumor was contiguous to the vagina, rectum, levator muscle, and pubis and was diagnosed as alveolar soft part sarcoma by transvaginal biopsy. Laparoscopy-assisted total pelvic exenteration combined with a pubic resection was performed, and an R0 resection with a wide margin was achieved. It is well known that only R0 resection improves the outcome of patients with localized alveolar soft part sarcoma...
November 10, 2016: Asian Journal of Endoscopic Surgery
https://www.readbyqxmd.com/read/27858919/massive-intoxication-with-rivaroxaban-phenprocoumon-and-diclofenac-a-case-report
#17
Hella Pfeiffer, Larissa Herbst, Bernd Schwarze, Reinhold Eckstein, Volker Weisbach
RATIONALE: Oral anticoagulants and painkillers, some with an additional effect on the coagulation system, are widely used and are therefore prone to abuse and (intentional) overdose. We report the case of a patient with a massive mixed anticoagulant intoxication. PATIENT CONCERNS: The patient had ingested 1960 mg rivaroxaban, 31.5 mg phenprocoumon, 1425 mg diclofenac, and 21,000 mg metamizole in suicidal intention. DIAGNOSES: Massive mixed anticoagulant overdose...
November 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27852381/-application-of-tb-type-thermal-balloon-endometrial-ablation-for-the-treatment-of-abnormal-uterine-bleeding
#18
W Wang, Y Zhai, Z H Zhang, Y Li, Z Y Zhang
Objective: To investigate the clinical efficacy, safety and promotion value of TB type thermal balloon endometrial ablation in the treatment of abnormal uterine bleeding. Methods: Fourty three patients who had received TB type endometrial ablation system for treatment of abnormal uterine bleeding from January, 2015 to January, 2016 in theDepartment of gynecology, Beijing Chaoyang Hospital were enrolled in this study. The intra-operative and post-operative complications and improvement of abnormal uterine bleeding and dysmenorrhea were observed...
November 8, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/27847133/c1-lateral-mass-screw-insertion-caudally-from-c2-nerve-root-an-alternate-method-for-insertion-of-c1-screws-a-technical-note-and-preliminary-clinical-results
#19
Keiji Wada, Ryo Tamaki, Mitsuru Yui, Daisuke Numaguchi, Yasuaki Murata
BACKGROUND: C1 lateral mass screw was widely used for fixation of the upper cervical spine. However, massive bleeding from the C1-2 venous plexus is sometimes encountered. In this study, we proposed an alternate method for C1 lateral mass screw insertion, which involves insertion of the screws caudally from the C2 nerve root to reduce bleeding from C1-2 venous plexus. METHODS: Seven patients with atlantoaxial lesions were included in this study. The mean age at surgery was 65...
November 12, 2016: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
https://www.readbyqxmd.com/read/27846865/hysteroscopic-management-of-a-heterotopic-pregnancy-following-uterine-artery-embolization-a-case-report
#20
Jigyasa Subedi, Min Xue, Xin Sun, Dabao Xu, Xinliang Deng, Kenan Yu, Xi Yang
BACKGROUND: Intra-uterine pregnancy coexisting with cervical pregnancy (heterotopic pregnancy) is a rare condition and its management is challenging because of the massive bleeding associated with cervical pregnancy. Uterine artery embolization followed by hysteroscopic removal of cervical and intra-uterine products of conception can theoretically prevent massive bleeding and provide a direct view during the removal. Hysteroscopic management following uterine artery embolization of heterotopic pregnancy after in vitro fertilization and embryo transfer is rarely reported...
November 15, 2016: Journal of Medical Case Reports
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