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https://www.readbyqxmd.com/read/28091982/death-from-pulmonary-embolism-of-cyanoacrylate-glue-following-gastric-varix-endoscopic-injection
#1
Michael Philip Burke, Chris O'Donnell, Yeliena Baber
We present the case of a 25 year old woman with a complex past medical history including Crigler-Najjar syndrome (Type 1) with a liver transplant in 1993 and subsequent development of cirrhosis with portal hypertension in the transplanted liver. The deceased presented to hospital with hematemesis and investigations showed a large gastric varix. The varix was injected with cyanoacrylate glue. Within 30 min of injection the patient became acutely hypoxic. Urgent chest X-ray demonstrated radio opaque glue within the pulmonary arteries...
January 14, 2017: Forensic Science, Medicine, and Pathology
https://www.readbyqxmd.com/read/28091793/attenuation-based-kv-pair-selection-in-dual-source-dual-energy-computed-tomography-angiography-of-the-chest-impact-on-radiation-dose-and-image-quality
#2
Rahul D Renapurkar, Andrew Primak, Joseph Azok, Jason Lempel, Yasmeen Tandon, Jennifer Bullen, Frank Dong, Wadih Karim, Ruffin Graham
OBJECTIVES: The purpose of this study was to evaluate the impact of attenuation-based kilovoltage (kV) pair selection in dual source dual energy (DSDE)-pulmonary embolism (PE) protocol examinations on radiation dose savings and image quality. METHODS: A prospective study was carried out on 118 patients with suspected PE. In patients in whom attenuation-based kV pair selection selected the 80/140Sn kV pair, the pre-scan 100/140Sn CTDIvol (computed tomography dose index volume) values were compared with the pre-scan 80/140Sn CTDIvol values...
January 13, 2017: European Radiology
https://www.readbyqxmd.com/read/28075426/age-adjusted-plasma-d-dimer-levels-in-suspected-acute-pulmonary-embolism-a-retrospective-single-center-study
#3
Marta Kozłowska, Magdalena Pływaczewska, Michał Ciurzyński, Szymon Pacho, Marzanna Paczyńska, Zenon Truszewski, Maciej Kostrubiec, Anna Wyzgał, Piotr Palczewski, Marcin Koć, Dorota Matuszewicz, Piotr Pruszczyk
INTRODUCTION    In older patients the conventional D-Dimer threshold (CDD) is characterized by high sensitivity and low specificity in diagnosing acute pulmonary embolism (APE). A higher cut-off level for D-Dimer has been proposed, aiming at increasing specificity while maintaining high sensitivity, which is calculated by multiplying the patients' ages in years by a coefficient of ten (YADD10). OBJECTIVES    To validate the clinical value of YADD10 in patients with suspected APE and to optimize this threshold to  achieve increased specificity paired with high sensitivity...
January 10, 2017: Polskie Archiwum Medycyny Wewnętrznej
https://www.readbyqxmd.com/read/28074775/axillary-artery-transection-and-bilateral-pulmonary-embolism-after-anterior-shoulder-dislocation-case-report
#4
Betty Leclerc, François Loisel, Maxime Ferrier, Mazen Al Sayed, Simon Rinckenbach, Laurent Obert
INTRODUCTION: Anterior shoulder dislocation can be associated with vascular and neurological complications. However, axillary artery injury associated with shoulder dislocation is rare and extremely rare without bone fracture. An early diagnosis of these complications allows predicting long-term functional outcomes. METHODS: This article reports the case of a 66-year-old patient who presented an anterior shoulder dislocation after a ski fall without any neurological dysfunction or pulse deficit...
2017: SICOT-J
https://www.readbyqxmd.com/read/28073853/resuscitation-of-prolonged-cardiac-arrest-from-massive-pulmonary-embolism-by-extracorporeal-membrane-oxygenation
#5
Yun Seok Kim, Wookjin Choi, Jaecheol Hwang
Extracorporeal cardiopulmonary resuscitation can be used as a rescue strategy in cases of prolonged cardiac arrest caused by massive pulmonary embolism. We present a case of a male patient who was in prolonged cardiac arrest following massive pulmonary embolism. Veno-arterial extracorporeal membrane oxygenation was initiated approximately 93 min after prolonged cardiopulmonary resuscitation. After resuscitation, bedside echocardiography and a chest computed tomography angiogram revealed a massive pulmonary embolism during extracorporeal membrane oxygenation support...
January 10, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28070975/progressive-dyspnea-and-signs-of-right-heart-dysfunction
#6
Stephan Staubach, Henning Strohm, Harald Mudra
A 40-year-old woman was admitted due to dyspnea and fever. Transthoracic echocardiography revealed signs of right heart volume overload and vegetations on the tricuspid valve with insufficiency. Transesophageal echocardiography showed a sinus venosus defect (SVD) with significant left-to-right shunt. Computed tomography scanning was primarily performed to rule out pulmonary embolism; however, it showed interatrial communication. Due to the concomitant tricuspid insufficiency with additional volume overload, the diagnosis of SVD was more challenging...
January 10, 2017: Echocardiography
https://www.readbyqxmd.com/read/28070843/noise-optimized-monoenergetic-post-processing-improves-visualization-of-incidental-pulmonary-embolism-in-cancer-patients-undergoing-single-pass-dual-energy-computed-tomography
#7
Jakob Weiss, Mike Notohamiprodjo, Malte Bongers, Christoph Schabel, Stefanie Mangold, Konstantin Nikolaou, Fabian Bamberg, Ahmed E Othman
PURPOSE: To evaluate noise-optimized monoenergetic postprocessing of dual-energy CT (DE-CT) on image quality in patients with incidental pulmonary embolism in single-pass portal-venous phase CT (CTpv). MATERIALS AND METHODS: 20 Consecutive patients with incidental pulmonary embolism in contrast-enhanced oncological follow-up DE-CTpv examination were included in this study. Images were acquired with a 3rd generation DE-CT system in DE mode (100/Sn150 kV) and activated tube current modulation 90 s after contrast agent administration...
January 9, 2017: La Radiologia Medica
https://www.readbyqxmd.com/read/28065377/prognostic-value-of-computed-tomography-pulmonary-angiography-indices-in-patients-with-cancer-related-pulmonary-embolism-data-from-a-multicenter-cohort-study
#8
Juana María Plasencia-Martínez, Alberto Carmona-Bayonas, David Calvo-Temprano, Paula Jiménez-Fonseca, Francisco Fenoy, Mariana Benegas, Marcelo Sánchez, Carme Font, Diego Varona, David Martínez de la Haza, Jesús Pueyo, Mercè Biosca, Maite Antonio, Carmen Beato, Pilar Solís, Laura Fáez, Irma de Al Haba, Susana Hernández-Muñiz, Olga Madridano, Mar Martín, Eduardo Castañón, Avinash Ramchandani, Pablo Marchena, Manuel Sánchez-Cánovas, María Ángeles Vicente, Mari José Martínez, Ángela Fernández-Plaza, Lourdes Martínez-Encarnación, Alejandro Puerta, Ángel Domínguez, Daniel Rodríguez, Gema Marín, Remedios Otero, Fernando Sánchez-Lasheras, Vicente Vicente
OBJECTIVE: To analyze the prognostic value of pulmonary artery obstruction versus right-ventricle (RV) dysfunction radiologic indices in cancer-related pulmonary embolism (PE). METHODS: We enrolled 303 consecutive patients with paraneoplastic PE, evaluated by computed tomography pulmonary angiography (CTPA) between 2013 and 2014. The primary outcome measure was serious complications at 15days. Multivariate analyses were conducted by using binary logistic and robust regressions...
February 2017: European Journal of Radiology
https://www.readbyqxmd.com/read/28061502/brain-abscesses-associated-with-asymptomatic-pulmonary-arteriovenous-fistulas
#9
Taek-Kyun Nam, Yong-Sook Park, Jeong-Taik Kwon
Brain abscess commonly occurs secondary to an adjacent infection (mostly in the middle ear or paranasal sinuses) or due to hematogenous spread from a distant infection or trauma. Pulmonary arteriovenous fistulas (AVFs) are abnormal direct communications between the pulmonary artery and vein. We present two cases of brain abscess associated with asymptomatic pulmonary AVF. A 65-year-old woman was admitted with a headache and cognitive impairment that aggravated 10 days prior. An magnetic resonance (MR) imaging revealed a brain abscess with severe edema in the right frontal lobe...
January 1, 2017: Journal of Korean Neurosurgical Society
https://www.readbyqxmd.com/read/28050475/role-of-hrct-chest-in-post-stem-cell-transplant-recipients-suspected-of-pulmonary-complications
#10
Abhishek Dwivedi, R Ravi Kumar, Ajay Sharma, S K Pannu
INTRODUCTION: Stem cell transplantation is today's procedure of choice for management of various hematopoietic malignant and severe immunogenic disorders. High Resolution Computed Tomography (HRCT) is a common technique for the diagnosis of pulmonary complications in stem cell transplant recipients. There are a large number of complications which can complicate the post-transplant period. AIM: To study the role of HRCT chest in stem cell transplant patients developing pulmonary complications, detect any evidence of infection, detect clinical signs of lung infections, Graft versus Host Disease (GvHD) or other regimen related toxicities outlined earlier, detect any evidence of GvHD and correlate these clinical signs with radiological changes in the lungs...
November 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28048838/su-f-i-36-in-utero-dose-measurements-within-postmortem-subjects-for-estimating-fetal-doses-in-pregnant-patients-examined-with-pulmonary-embolism-trauma-and-appendicitis-ct
#11
I Lipnharski, N Quails, C Carranza, N Correa, S Bidari, M Bickelhaup, L Rill, M Arreola
PURPOSE: The imaging of pregnant patients is medically necessary in certain clinical situations. The purpose of this work was to directly measure uterine doses in a cadaver scanned with CT protocols commonly performed on pregnant patients in order to estimate fetal dose and assess potential risk. METHOD: One postmortem subject was scanned on a 320-slice CT scanner with standard pulmonary embolism, trauma, and appendicitis protocols. All protocols were performed with the scan parameters and ranges currently used in clinical practice...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28042563/unusual-presentation-of-a-cervical-mass-revealed-as-external-jugular-venous-aneurysm
#12
Su Wan Kim, Jee Won Chang, Seogjae Lee
Venous aneurysms of the jugular vein are one of the rare causes of neck swelling, and primary venous aneurysms of the external jugular vein are extremely rare. A 46-year-old woman presented with a painless and suddenly growing mass in the left neck. A computed tomography angiography revealed a fusiform venous aneurysm of the external jugular vein containing intraluminal thrombus. We performed resection of the aneurysm and ligation of the external jugular vein. Removal of the aneurysm of the neck vein was necessary because venous aneurysms with thrombosis may lead to serious thrombotic complications such as pulmonary embolism...
December 2016: Vascular Specialist International
https://www.readbyqxmd.com/read/28040708/pulmonary-artery-sarcoma-mimicking-pulmonary-embolism-a-case-series
#13
Narat Srivali, Eunhee S Yi, Jay H Ryu
BACKGROUND: Pulmonary artery sarcoma (PAS) is a rare malignant neoplasm with an aggressive behavior and often difficult to distinguish from pulmonary thromboembolic disease. AIM: To assess the demographic, clinical, and radiological characteristics of PAS and clinical course. DESIGN AND METHODS: We retrospectively identified and analyzed all patients with PAS seen at Mayo Clinic in Rochester, Minnesota, between January 1, 1996 and July 31, 2015...
December 30, 2016: QJM: Monthly Journal of the Association of Physicians
https://www.readbyqxmd.com/read/28040384/circulatory-collapse-right-ventricular-dilatation-and-alveolar-dead-space-a-triad-for-the-rapid-diagnosis-of-massive-pulmonary-embolism
#14
Raúl J Gazmuri, Dimple J Patel, Rom Stevens, Shani Smith
A triad of circulatory collapse, right ventricular dilatation, and large alveolar dead space is proposed for the rapid diagnosis and treatment of massive pulmonary embolism. A 17year-old female on oral contraceptives collapsed at home becoming incoherent with shallow breathing. Paramedics initiated mechanical chest compression and transported the patient to our emergency department, arriving minimally responsive with undetectable blood pressure but having positive corneal reflexes and bradycardia with wide QRS...
December 16, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28040140/gestational-choriocarcinoma-with-renal-and-pulmonary-metastases-lacking-a-primary-uterine-origin
#15
Hao-Ming Li, Wen-Chien Hou, Yu-Ju Lai, Chien-Chang Kao, Tai-Kuang Chao, Mu-Hsien Yu, Her-Young Su
OBJECTIVE: We describe a case of gestational choriocarcinoma metastasized to the kidney and lung, which presented initially as refractory hematuria after a term pregnancy 5 years earlier. CASE REPORT: A 35-year-old woman, G2P1, with a previous history of full-term pregnancy in 2009, presented to the emergency department complaining of intermittent gross hematuria for 2 months. Abdominal computed tomography showed a suspicious arteriovenous malformation in the right kidney and a thrombus within the right renal vein...
December 2016: Taiwanese Journal of Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28031842/fatal-tumour-pulmonary-embolism
#16
Salim Rashid Masoud, Coenraad Frederik Nicolaas Koegelenberg, Abraham Christoffel van Wyk, Brian William Allwood
A 30-year-old female with no significant past medical history was referred to our facility with sudden onset of shortness of breath. She had a low clinical probability for pulmonary thromboembolism and a computed tomography angiogram showed enlarged pulmonary arteries but no in situ thrombi. She developed recurrent episodes of hypotension and hypoxia, and was transferred to the intensive care unit where she died despite active resuscitation. An autopsy revealed extensive lymphatic and pulmonary vascular tumour emboli as the immediate cause of death...
January 2017: Respirology Case Reports
https://www.readbyqxmd.com/read/28025592/mortality-related-risk-factors-in-high-risk-pulmonary-embolism-in-the-icu
#17
Begüm Ergan, Recai Ergün, Taner Çalışkan, Kutlay Aydın, Murat Emre Tokur, Yusuf Savran, Uğur Koca, Bilgin Cömert, Necati Gökmen
Introduction. We sought to identify possible risk factors associated with mortality in patients with high-risk pulmonary embolism (PE) after intensive care unit (ICU) admission. Patients and Methods. PE patients, diagnosed with computer tomography pulmonary angiography, were included from two ICUs and were categorized into groups: group 1 high-risk patients and group 2 intermediate/low-risk patients. Results. Fifty-six patients were included. Of them, 41 (73.2%) were group 1 and 15 (26.7%) were group 2. When compared to group 2, need for vasopressor therapy (0 vs 68...
2016: Canadian Respiratory Journal: Journal of the Canadian Thoracic Society
https://www.readbyqxmd.com/read/28018828/paradoxical-embolus-stuck-in-a-patent-foramen-ovale
#18
Zaki Kohistani, Chris Probst
In-hospital mortality rate of an embolus in transit is as high as 44.7%. In some cases, a paradoxical embolus can get stuck in a patent foramen ovale. Because of the high mortality rate, this condition should be considered as an emergency case. Echocardiography has been established as the gold standard method for the diagnosis. A negative echocardiography, however, does not rule out an embolus in transit. To rule out pulmonary embolisms, a computed tomography scan of the chest should also be performed. A cardiothoracic surgeon should be consulted immediately upon diagnosis of an embolus in transit...
December 2016: Thoracic and Cardiovascular Surgeon Reports
https://www.readbyqxmd.com/read/28012721/the-clinical-severity-of-patients-diagnosed-with-an-in-hospital-pulmonary-embolism-following-modern-elective-joint-arthroplasty-is-unrelated-to-the-location-of-emboli-in-the-pulmonary-vasculature
#19
Alejandro Gonzalez Della Valle, Alvaro Blanes Perez, Yuo-Yu Lee, Gregory R Saboeiro, Gabrielle P Konin, Yoshimi Endo, Nigel E Sharrock, Eduardo A Salvati
BACKGROUND: In the event of a postoperative pulmonary embolism (PE), it is generally believed that patients with centrally located emboli will have worse clinical symptoms than those with segmental or subsegmental ones. We studied if a relationship exists between the clinical severity at the time of PE diagnosis and the location of the emboli within the pulmonary vasculature. METHODS: All 269 patients who developed an in-hospital, computed tomography pulmonary angiography-proved, in-hospital PE following elective total hip arthroplasty or total knee arthroplasty in our institution were studied...
November 25, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28011405/platelet-to-lymphocyte-ratio-as-a-novel-marker-of-in-hospital-and-long-term-adverse-outcomes-among-patients-with-acute-pulmonary-embolism-a-single-center-large-scale-study
#20
Elif Hande Ozcan Cetin, Mehmet Serkan Cetin, Ugur Canpolat, Ahmet Akdi, Dursun Aras, Ahmet Temizhan, Sinan Aydogdu
BACKGROUND: The interaction of platelets with leukocytes is a well-known process both in progression and prognosis of acute pulmonary embolism (PE). Recently, platelet to lymphocyte ratio (PLR) is emerged as an indirect inflammatory indicator which was shown to be associated with adverse cardiovascular events in various clinical conditions, including acute PE. However, the long-term prognostic value of PLR in acute PE has not been investigated thoroughly. Therefore, we aimed to assess the impact of PLR on both in-hospital and long-term adverse outcomes in acute PE...
December 10, 2016: Thrombosis Research
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