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Pelvic hemorrhage

P Michel, D Wähnert, M Freistühler, M G Laukoetter, S Rehberg, M J Raschke, P Garcia
BACKGROUND: Secondary abdominal compartment syndrome is well known as a life-threatening complication in critically ill patients in an intensive care unit. Massive crystalloid fluid resuscitation has been identified as the most important risk factor. The time interval from hospital admittance to the development of manifest abdominal compartment syndrome is usually greater than 24 hours. In the absence of any direct abdominal trauma, we observed a rapidly evolving secondary abdominal compartment syndrome shortly after hospital admittance associated with massive transfusion of blood products and only moderate crystalloid resuscitation...
October 19, 2016: Journal of Medical Case Reports
Benedetta Gui, Francesco Maria Danza, Anna Lia Valentini, Maria Elena Laino, Alessandro Caruso, Brigida Carducci, Elena Rodolfino, Ersilia Devicienti, Lorenzo Bonomo
Cesarean section (CS) may have several acute complications that can occur in the early postoperative period. The most common acute complications are hematomas and hemorrhage, infection, ovarian vein thrombosis, uterine dehiscence and rupture. Pelvic hematomas usually occur at specific sites and include bladder flap hematoma (between the lower uterine segment and the bladder) and subfascial or rectus sheath hematoma (rectus sheath or prevescical space). Puerperal hemorrhage can be associated with uterine dehiscence or rupture...
October 19, 2016: Diagnostic and Interventional Radiology: Official Journal of the Turkish Society of Radiology
Jeremy Ming Hsu, Shilpi Yadev, Shadi Faraj
INTRODUCTION: Exsanguinating pelvic fractures are still associated with a significant mortality rate of 28-60%. Extraperitoneal pelvic packing (EPP) has been proposed as an optimal method of early haemorrhage control. The aim of this study was to determine the effect of EPP compared with angioembolization as a primary intervention for patients with exsanguinating pelvic fracture. METHOD: A prospective observational trial was performed at Westmead Hospital between September 2011 and May 2014...
July 2016: International Journal of Critical Illness and Injury Science
Zeynep Aslı Kartal, Nalan Kozacı, Bülent Çekiç, İnan Beydilli, Mehmet Akçimen, Dilek Soydam Güven, İclal Erdem Toslak
OBJECTIVE: In this study, emergency physicians and on-call radiologists were compared regarding identification of fatal injuries on computed tomographic (CT) scans in patients with trauma. MATERIALS AND METHODS: Multiply injured patients who were older than 18 years and underwent CT scanning were included in the study. The CT scans were interpreted by the responsible emergency physician. At the same time, these images were also evaluated by the on-call radiologist...
August 24, 2016: American Journal of Emergency Medicine
Kohei Aoyama, Hiroshi Matsushima, Morio Sawada, Taisuke Mori, Satoru Yasukawa, Jo Kitawaki
Primary vulvar adenocarcinomas are very rare. We describe the rare case of primary vulvar apocrine adenocarcinoma, a histologically rare subtype of vulvar adenocarcinoma. A 57-year-old Japanese woman presented with an enlarging vulvar mass. A dark-red, hemorrhagic, ulcerated tumor was on the right side of the anterior labial commissure measuring approximately 3.5 × 3.5 cm. Preoperative biopsy showed poorly differentiated carcinoma with partial differentiation to adenocarcinoma. Systemic examination revealed lymph node metastases in both inguinal regions and no other primary source...
2016: Case Reports in Obstetrics and Gynecology
Michael J Beltran, Tyson E Becker, Richard K Hurley, Jennifer M Gurney, Roman A Hayda
Hemorrhage continues to be the most common cause of death among service members wounded in combat. Injuries that were previously nonsurvivable in previous wars are now routinely seen by combat surgeons in forward surgical units, the result of improvements in body armor, the universal use of field tourniquets to control extremity hemorrhage at the point of injury, and rapid air evacuation strategies. Combat orthopaedic surgeons remain a vital aspect of the forward surgical unit, tasked with assisting general surgical colleagues in the resuscitation of patients in hemorrhagic shock while also addressing traumatic amputations, open and closed long bone fractures, and mechanically unstable pelvic trauma...
October 2016: Journal of Orthopaedic Trauma
Abha Singh, Ruchi Kishore, Saveri Sarbhai Saxena
AIM: To study the outcomes, benefits and complications of internal iliac artery ligation in both obstetric and gynecological cases. OBJECTIVE: To study the outcomes, effectiveness and complications of internal iliac artery ligation (IIAL). METHOD: This is an analytical longitudinal study done among women who have undergone internal iliac artery ligation in Dr. BRAMH a tertiary referral center from July 2013 to June 2015. Follow-up was done through color Doppler analysis of pelvic arteries before discharge, after 6 weeks and after 6 months...
October 2016: Journal of Obstetrics and Gynaecology of India
Alessio Comai, Marianna Zatelli, Thomas Haglmuller, Giampietro Bonatti
PURPOSE: The most common life-threatening complication of pelvic trauma is bleeding. Arterial bleedings frequently require active management, preferably with transcatheter arterial embolization (TAE). Hemodynamic instability and/or contrast extravasation at computer tomography (CT) examination are reliable indicators of arterial injury. Unstable pelvic fractures are much more hemorrhagic than stable fractures. Nevertheless, an absent or isolated pelvic fracture does not exclude pelvic hemorrhage...
2016: Curēus
S E van Oostendorp, E C T H Tan, L M G Geeraedts
INTRODUCTION: Exsanguination following trauma is potentially preventable. Extremity tourniquets have been successfully implemented in military and civilian prehospital care. Prehospital control of bleeding from the torso and junctional area's remains challenging but offers a great potential to improve survival rates. This review aims to provide an overview of potential treatment options in both clinical as preclinical state of research on truncal and junctional bleeding. Since many options have been developed for application in the military primarily, translation to the civilian situation is discussed...
2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Margarita V Revzin, Mahan Mathur, Haatal B Dave, Matthew L Macer, Michael Spektor
Pelvic inflammatory disease (PID) is a common medical problem, with almost 1 million cases diagnosed annually. Historically, PID has been a clinical diagnosis supplemented with the findings from ultrasonography (US) or magnetic resonance (MR) imaging. However, the diagnosis of PID can be challenging because the clinical manifestations may mimic those of other pelvic and abdominal processes. Given the nonspecific clinical manifestations, computed tomography (CT) is commonly the first imaging examination performed...
September 2016: Radiographics: a Review Publication of the Radiological Society of North America, Inc
Ronald Tesoriero, Brandon Bruns, Mayur Narayan, Joseph Dubose, Sundeep Guliani, Megan Brenner, Sharon Boswell, Deborah M Stein, Thomas Scalea
INTRODUCTION: Major pelvic disruption with hemorrhage has a high rate of lethality. Angiographic embolization remains the mainstay of treatment. Delays to angiography have been shown to worsen outcomes, in part because time spent awaiting mobilization of resources needed to perform angiography allows ongoing hemorrhage. Alternative techniques like pelvic pre-peritoneal packing (PPP) and aortic balloon occlusion (REBOA) now exist. We hypothesized that time to angiographic embolization at our level 1 trauma center would be longer than 90 minutes...
September 16, 2016: Journal of Trauma and Acute Care Surgery
Bernadette M M Zwaans, Heinz G Nicolai, Michael B Chancellor, Laura E Lamb
As diagnosis and treatment of cancer is improving, medical and social issues related to cancer survivorship are becoming more prevalent. Hemorrhagic cystitis (HC), a rare but serious disease that may affect patients after pelvic radiation or systemic chemotherapy, has significant unmet medical needs. Although no definitive treatment is currently available, various interventions are employed for HC. Effects of nonsurgical treatments for HC are of modest success and studies aiming to control radiation-induced bladder symptoms are lacking...
2016: Reviews in Urology
Junichiro Kawamura, Masaki Tani, Yuya Kida, Kimiaki Sumida, Ryotaro Ogawa, Junya Kawasoe, Takefumi Yazawa, Masahiro Yamada, Michihiro Yamamoto, Hideki Harada, Hidekazu Yamamoto, Masazumi Zaima
A solitary fibrous tumor is a ubiquitous mesenchymal fibroblastic tumor that was previously considered limited to the pleural cavity. Here, we report a rare case of a large solitary fibrous tumor of the mesorectum, which was successfully resected laparoscopically. A 56-year-old woman was referred to our hospital for a giant pelvic mass. Pelvic MRI showed a well-circumscribed mass, 12 cm in diameter, with heterogeneous signal intensity on T2 -weighted images. It was diagnosed as a benign mesorectal tumor of unknown origin...
September 5, 2016: Asian Journal of Endoscopic Surgery
Ricardo Palmerola, Mary E Westerman, Mathew Fakhoury, Stephen A Boorjian, Lee Richstone
Ureteroarterial fistulas (UAFs) are defined as an abnormal communication between one of the major arteries and the ureter. Urologists most frequently encounter iatrogenic fistulas occurring in patients with a history of pelvic extirpative surgery, chronic ureteral catheterization, and history of pelvic radiation. We present two cases of UAFs in patients with no history of prior radiation, who underwent open radical cystectomy and robot-assisted radical cystectomy with intracorporeal ileal conduit. Both patients developed postoperative ureteroileal anastomotic leaks that were managed with indwelling ureteral catheters...
2016: J Endourol Case Rep
Marc J Dinkin, Athos Patsalides
BACKGROUND: Our goal was to evaluate the safety and efficacy of stenting of venous sinus stenosis (VSS) in patients with medically-refractory, medically-intolerant or fulminant idiopathic intracranial hypertension (IIH) in a prospective, observational study. METHODS: Thirteen patients with IIH who were refractory or intolerant to medical therapy or who presented with fulminant visual field (VF) loss underwent stenting of VSS at the transverse-sinus sigmoid sinus junction, using a Precise Pro carotid stent system (Cordis)...
August 23, 2016: Journal of Neuro-ophthalmology: the Official Journal of the North American Neuro-Ophthalmology Society
Christian David Weber, Christian Herren, Thomas Dienstknecht, Frank Hildebrand, Sebastian Keil, Hans-Christoph Pape, Philipp Kobbe
BACKGROUND: Life-threatening arterial bleeding from fragility fractures of the pelvis are very rare but associated with significant mortality, especially in anticoagulated patients. CASE DESCRIPTION: We report the successful interdisciplinary management of a 78-year-old woman under anticoagulation and antiplatelet therapy who had life-threatening arterial hemorrhage from the pubic rami following a fragility fracture of the pelvis. Our management strategy included early hemorrhage control by means of selective arterial embolization followed by surgical fracture stabilization and surgical hematoma evacuation...
September 2016: Geriatric Orthopaedic Surgery & Rehabilitation
James Shi, Antoinette Gomes, Edward Lee, Stephen Kee, John Moriarty, Henry Cryer, Justin McWilliams
PURPOSE: Transcatheter arterial embolization (TAE) is commonly used to control hemorrhage after pelvic trauma. Despite the procedures reported safety, there can be severe complications, mostly related to ischemia of embolized tissues. Our purpose was to examine the complications of trauma patients resulting from the embolization techniques utilized at our level 1 trauma center. MATERIALS AND METHODS: A retrospective chart review was conducted. One hundred and seven patients who underwent pelvic embolization between January 2003 and December 2013 were included...
August 20, 2016: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
Erica C Dun, Serena Wong, Nisha A Lakhi, Ceana H Nehzat
OBJECTIVE: To report the medical and surgical management of a rare case of recurrent moss-like endometriosis and associated hemorrhagic ascites. DESIGN: Video description of the case, demonstration of the surgical technique, discussion of the histology, and review of endometriosis-associated ascites. SETTING: Tertiary referral center. PATIENT(S): A 26-year-old nulliparous woman of Nigerian heritage with recurrent hemorrhagic ascites due to endometriosis...
August 16, 2016: Fertility and Sterility
Amita Jain, Virender Singh Sheorain, Kulbeer Ahlawat, Rajesh Ahlawat
AIM OF THE VIDEO: Sacrospinous ligament fixation (SSLF) is a minimally invasive transvaginal procedure for correcting apical prolapse. Amongst perioperative complications, life-threatening hemorrhage has a reported occurrence rate ranging from 0.2 % to 2 %. We present a case of arterial hemorrhage following SSLF and a multispecialty approach to its successful management. METHODS: The video demonstrates the development of an unexpected progressive postoperative hematoma following left-side sacrospinous hysterocolpopexy via the anterior approach, despite minimal intraoperative bleeding...
August 18, 2016: International Urogynecology Journal
Mary E Westerman, Stephen A Boorjian, Brian J Linder
INTRODUCTION: Hemorrhagic cystitis (HC) represents a challenging clinical entity. While various intravesical agents have been utilized in this setting, limited data exist regard¬ing safety or efficacy. Herein, then, we evaluated the effectiveness and complications associated with intravesical alum instillation for HC in a contemporary cohort. MATERIALS AND METHODS: We identified 40 patients treated with intravesical alum for HC between 1997-2014. All patients had failed previous continuous bladder irrigation with normal saline and clot evacuation...
August 10, 2016: International Braz J Urol: Official Journal of the Brazilian Society of Urology
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