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Pelvic hemorrhage

Qiaozhen Peng, Weishe Zhang
RATIONALE: Placenta accreta is the main cause of severe obstetric postpartum hemorrhage (PPH) and hysterectomy. Several hemostatic techniques have been performed in patients with placenta accreta to prevent PPH and reserve fertility. Abdominal aorta and pelvic arteries balloon occlusion are the only techniques which could be performed before cesarean section (CS) in patients who want to keep the fetus and reserve fertility. However, abdominal aorta and pelvic arteries balloon occlusion might lead to severe complications such as formation and rupture of pseudoaneurysm, angiorrhexis, etc...
March 2018: Medicine (Baltimore)
Fatimah Alnafisah, Shaimaa K Dawa, Sherif Alalfy
Cutaneous endometriosis is one of the rare gynecological conditions. Endometriosis is defined as the presence of endometrial glands and stroma outside the endometrial cavity. It commonly occurs in pelvic sites, such as the ovaries, cul-de-sac, bowel, or pelvic peritoneum. Endometriosis at the incisional scar is difficult to diagnose because of nonspecific symptoms. Usually, patients complain of pain at the site of the incision during menstruation. The main causes in most of the reported cases are obstetrical and gynecological surgeries...
January 13, 2018: Curēus
Vasudevan Thirugnanasambandam, Deepak David, Kalyanaram Kone, Joseph Philipraj, Abdulrazzak Mossadeq
Objective: To choose appropriate size Amplatz sheath during percutaneous nephrolithotomy (PCNL) based on retrograde pyelogram. Material and methods: We performed standard PCNL in prone position in 20 patients. All these patients had placement of appropriate size of Amplatz sheath based on retrograde pyelogram images. All patients had nephrostomy tubes postoperatively. The preoperative and postoperative renal parameters, hemoglobin, mean operating time and mean hospitalisation stay were measured...
March 2018: Turkish Journal of Urology
Chih-Yuan Fu, Ruo-Yi Huang, Shang-Yu Wang, Chien-Hung Liao, Jen-Fu Huang, Yu-Pao Hsu, Chia-Yun Lin, Shih-Ching Kang
INTRODUCTION: Managing patients with open pelvic fractures continues to be challenging and requires a multidisciplinary approach. In this study, we examined the characteristics of patients with open pelvic fractures and strategies for managing such patients. MATERIALS AND METHODS: The records of patients with open pelvic fractures from January 2010 to August 2016 were retrospectively reviewed. Emergency surgery was performed to control hemorrhaging in patients with an active external hemorrhage...
February 19, 2018: American Journal of Emergency Medicine
Omar Touhami, Arij Bouzid, Sofiene Ben Marzouk, Mahdi Kehila, Mohamed Badis Channoufi, Hayen El Magherbi
Importance: Postpartum hemorrhage (PPH) is the leading cause of maternal mortality worldwide. Even after emergency peripartum hysterectomy (EPH), bleeding may occur in the setting of acquired coagulopathy. This type of bleeding resistant to clipping, ligating, or suturing could be successfully controlled with a pelvic packing. Objective: This review provides an overview of the different pelvic packing techniques used after the failure of an EPH to control severe PPH...
February 2018: Obstetrical & Gynecological Survey
Ghideon Ezaz, Susan L Murphy, Jessica Mellinger, Elliot B Tapper
BACKGROUND: Injuries are more morbid and complicated to manage in patients with cirrhosis. However, data are limited regarding the relative risk of injury and severity of injury from falls in patients with cirrhosis compared to those without cirrhosis. METHODS: We examined the nationally representative National Emergency Department Sample, an all-payer database including all patients presenting with falls 2009-2012. We determined the relative risks for and clinical associations with severe injuries...
February 14, 2018: American Journal of Medicine
Mohamed Badri, Ghassen Gader, Kamel Bahri, Ihsen Zammel
BACKGROUND: Renal cell carcinomas represent 85% of malignant renal tumors. Typically, the tumor remains asymptomatic a long time before the appearance of urologic clinical signs. In some cases, metastasis can precede the manifestations of the primary tumor. Different sites are potential metastatic localizations for renal tumors, including skull metastases who represent a very rare location. CASE DESCRIPTION: We report the case of a 65-year-old man presented after the appearance of a skull mass...
February 10, 2018: International Journal of Surgery Case Reports
Benjamin T Miller, Andrew H Lin, Susan C Clark, Andrew P Cap, Joseph J Dubose
BACKGROUND: The U.S. Navy's casualty-receiving ships provide remote damage control resuscitation (RDCR) platforms to treat injured combatants deployed afloat and ashore. We report a significant mass casualty incident aboard the USS Bataan, and the most warm fresh whole blood (WFWB) transfused at sea for traumatic hemorrhagic shock since the Vietnam War. METHODS: Casualty-receiving ships have robust medical capabilities, including a frozen blood bank with packed red blood cells (pRBC) and fresh frozen plasma (FFP)...
February 13, 2018: Journal of Trauma and Acute Care Surgery
Nicole Townsend Christian, Clay Cothren Burlew, Ernest E Moore, Andrea E Geddes, Amy E Wagenaar, Charles J Fox, Fredric M Pieracci
BACKGROUND: The Focused Abdominal Sonography for Trauma (FAST) exam has been reported to be unreliable in pelvic fracture patients. Additionally, given the advent of new therapeutic interventions, such as Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA), rapid identification of intraabdominal hemorrhage compared to zone III hemorrhage may guide different therapeutic strategies. We hypothesized that FAST is reliable for detecting clinically significant intraabdominal hemorrhage in the face of complex pelvic fractures...
February 14, 2018: Journal of Trauma and Acute Care Surgery
Aalia Sachedina, Kiri Chan, Duncan MacGregor, Martin Campbell, Sonia R Grover
STUDY OBJECTIVE: To review our local experience with urogenital RMS to determine the most common clinical presentation(s). DESIGN: Retrospective case series of all cases of female urogenital RMS presenting to a tertiary pediatric hospital between 1996 and 2016. All institutional electronic pathology reports were screened for RMS and those that were pelvic in origin and occurring in female patients were included for further analysis. Seventeen cases of urogenital RMS in female patients were identified and reviewed...
February 5, 2018: Journal of Pediatric and Adolescent Gynecology
Narin Uludag, Anna Tötterman, Mats Beckman, Anders Sundin
OBJECTIVE: To assess the extent of pelvic hemorrhage on CT and to estimate its significance on outcome in patients with blunt high-energy pelvic trauma. METHODS: 576 patients with blunt high energy pelvic fractures in 2005-2011 were identified in the hospital's Trauma Registry (a major Trauma Center). 60 of these met our further inclusion criteria of initial systolic blood pressure ≤100 mmHg and pelvic-related hemorrhage. CT scans of the patients were reviewed with regard to pelvic and abdominal retroperitoneal hemorrhage, type of fracture (Tile classification) and associated injuries...
February 8, 2018: British Journal of Radiology
Hamed Mohamed El Darawany
Introduction: The optimal management strategy for urethral injuries remains controversial. Suprapubic cystostomy followed by delayed urethral reconstruction or immediate primary urethral injury repair is associated with high complication rate. Early endoscopic realignment for urethral injuries provides early definitive procedure with low complications and avoids the need for further urethral reconstruction. Materials and Methods: Between April 2007 and March 2016, 27 patients with traumatic posterior urethral disruptions were reviewed...
January 2018: Urology Annals
Saya Kurata, Shohei Tobu, Kazuma Udo, Mitsuru Noguchi
Background: The experience with uretero-arterial fistulas has been limited. However, the aggressive treatment of pelvic tumors with surgical resection and radiotherapy, along with liberal use of ureteral catheters, has been attributed to an increase in their incidence. Unless they are promptly diagnosed and treated, uretero-arterial fistulas are associated with considerably high rates of morbidity and mortality. Urologists need maintain a high degree of suspicion for uretero-arterial fistula in high-risk patients...
2018: Journal of Endourology Case Reports
Chandan J Das, Deepak Rathinam, Smita Manchanda, D N Srivastava
Percutaneous vascular embolization plays an important role in the management of various gynecologic and obstetric abnormalities. Transcatheter embolization is a minimally invasive alternative procedure to surgery with reduced morbidity and mortality, and preserves the patient's future fertility potential. The clinical indications for transcatheter embolization are much broader and include many benign gynecologic conditions, such as fibroid, adenomyosis, and arteriovenous malformations (AVMs), as well as intractable bleeding due to inoperable advanced-stage malignancies...
October 2017: Indian Journal of Radiology & Imaging
Tareq I Maraqa, Ji-Sun J Shin, Ismael Diallo, Gul R Sachwani-Daswani, Leo C Mercer
Obturator artery injury (OAI) from pelvic gunshot wounds (GSW) is a rarely reported condition. Hemorrhages from pelvic trauma (PT) are mostly venous. Arterial hemorrhages represent about 10-20% of PTs. When arterial hemorrhages from PT occur, they are a severe and deadly complication often causing significant hemodynamic instability and eventual shock. A 23-year-old male presented to our emergency service via a private vehicle with multiple gunshot wounds to both thighs and to the lower back, resulted in rectal and obturator artery (OA) injuries...
November 17, 2017: Curēus
Kazuhide Matsushima, Alice Piccinini, Morgan Schellenberg, Vincent Cheng, Patrick Heindel, Aaron Strumwasser, Elizabeth Benjamin, Kenji Inaba, Demetrios Demetriades
INTRODUCTION: Angioembolization (AE) is widely used for hemorrhagic control in patients with pelvic fracture. The latest version of the Resources for Optimal Care of theInjured Patient issued by the American College of Surgeons Committee on Trauma requires interventional radiologists to be available within 30 minutes to perform an emergent AE. However, the impact of time-to-AE on patient outcomes remains unknown. We hypothesized that a longer time-to-AE would be significantly associated with increased mortality in patients with pelvic fracture...
January 24, 2018: Journal of Trauma and Acute Care Surgery
Cheng-Cheng Tung, Jei-Feng Yu, Shou-Jen Lan
BACKGROUND: Pelvic fracture bleeding generally leads to hemorrhagic shock. Trans-arterial embolization (TAE) is regarded as the most useful treatment; however, the initial presentation of the patient can impact the effectiveness of TAE for pelvic fracture bleeding. The aim of this retrospective study is to explore whether the patient data at the initial presentation can predict the success of TAE for pelvic fracture bleeding. METHODS: Twenty-seven charts were retrospectively reviewed...
December 24, 2017: American Journal of Emergency Medicine
Min A Lee, Byungchul Yu, Jungnam Lee, Jae Jeong Park, Gil Jae Lee, Kang Kook Choi, Youngeun Park, Jihun Gwak, Ahram Han
PURPOSE: The aim of this study was to determine whether the outcomes of patients with hemodynamically unstable pelvic bone fractures changed after the introduction of a protocol including extraperitoneal pelvic packing (EPP) and the establishment of a trauma center. METHODS: We analyzed data of adult patients (≥ 18 years old) with hemodynamically unstable pelvic bone fractures who visited a single trauma center from February 2009 to October 2016. In July 2014, a new protocol for pelvic fractures was implemented, and a trauma center was established...
January 17, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
Daniel Sagalovich, Rollin Say, Jihad Kaouk, Reza Mehrazin
With the emergence of evidence that venous thromboembolisms (VTE) typically occurs following discharge after urologic pelvic surgery, the focus on extended VTE prophylaxis has intensified. Urologists should have a comprehensive understanding of various VTE risk factors in order to weigh the risk of postoperative hemorrhage with the possibility of fatal pulmonary embolus. Risk factors such as advanced age, obesity, and active malignancy are especially common in patient's undergoing urologic pelvic surgery, and thus this issue becomes particularly relevant to the practicing urologist...
January 11, 2018: Urologic Oncology
Molly Sambor
Traditionally, resuscitative efforts for uncontrolled noncompressible torso hemorrhage are achieved by cross-clamping the proximal aorta via thoracotomy to deliver temporary hemodynamic stability during injury repair. A less commonly used method of promoting early resuscitation and hemorrhagic control in trauma patients is resuscitative endovascular balloon occlusion of the aorta (REBOA). The focus of this literature review is to examine the effectiveness of REBOA in the management of noncompressible pelvic hemorrhage when compared with traditional methods of hemorrhage control in trauma patients...
January 2018: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
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