scholarly journals Thrombosis associated with ventriculoatrial shunts

Author(s):  
Dengjun Wu ◽  
Zhengyan Guan ◽  
Limin Xiao ◽  
Donghai Li

AbstractVentriculoatrial shunts are the most common second-line procedure for cases in which ventriculoperitoneal shunts are unsuitable. Shunting-associated thrombosis is a potentially life-threatening complication after ventriculoatrial shunt insertion. The overall prevalence of this complication is still controversial because of substantial differences in the numbers found in studies using clinical data and in those analyzing postmortem findings. The etiology of thrombosis may be multifactorial, including shunt catheter itself, contents of cerebrospinal fluid, shunt infection, and genetic disorder. The clinical presentation can vary widely, ranging from asymptomatic to a life-threatening condition. Timely recognition of thromboembolic lesions is critical for treatment. However, early diagnosis and management is still challenging because of a relatively long asymptomatic latency and lack of clear guideline recommendations. The purpose of this review is to provide an overview of ventriculoatrial shunt thrombosis, especially to focus on its etiopathogenesis, diagnosis, treatment, and prevention.

2017 ◽  
Vol 2017 ◽  
pp. 1-6 ◽  
Author(s):  
Santiago Fabián Moscoso Martínez ◽  
Evelyn Carolina Polanco Jácome ◽  
Elizabeth Guevara ◽  
Vijay Mattoo

The clinical presentation of myelodysplastic syndrome (MDS) is not specific. Many patients can be asymptomatic and can be detected only due to an abnormal complete blood cell count (CBC) on routine exam or for other reasons while others can be symptomatic as a consequence of underlying cytopenias. Thrombotic thrombocytopenic purpura (TTP) usually is suspected under the evidence of microangiopathic hemolytic anemia (MAHA) and thrombocytopenia and because it is a life-threatening condition (medical emergency) immediate initiation of plasmapheresis could be life-saving. The following case illustrates an unusual presentation of MDS in a patient who came in to the emergency room with the classic TTP “pentad” of fever, renal involvement, MAHA, mental status changes, and thrombocytopenia. We will focus our discussion in the clinical presentation of this case.


2021 ◽  
Vol 7 (4) ◽  
pp. 218-220
Author(s):  
Raghavendra H Gobbur ◽  
Ranjima M Mahesh

As COVID-19 continues to spread in India and other countries, the impact of the disease among children, initially considered less important, is becoming more relevant. The extent of the diversity of clinical presentation of COVID-19 in children are still unclear. We have already seen a new clinical picture of SARS-CoV-2 in children manifesting as a hyper-inflammatory syndrome, with multi-organ involvement similar to Kawasaki Disease and with potential evolution to a shock syndrome. This represented a new phenomenon affecting previously asymptomatic children with SARS-CoV-2 infection. COVID-19 may also manifest as viral hepatitis, acute pancreatitis, acute liver injury, acute kidney injury, ARDS, Sepsis, septic shock and meningo-encephalitis and cerebellar ataxia. The Multisystem Inflammatory Syndrome in Children (MIS-C) associated with SARS-CoV-2 infection occurs weeks after infection and may evolve unnoticed. MIS-Cs pathophysiology remains unclear. However, it appears to be a postinfectious hyperimmune response that may occur during or following asymptomatic or symptomatic infection. COVID-19 infection in children may lead to a potentially life threatening condition that we may not be aware of. We are in need of reporting of the diverse presentation of SARS CoV-2 virus in children. Here we describe a case of a previously normal 14-year-old boy who manifested with severe pain abdomen after SARS CoV-2 infection and was diagnosed as Acute Ileocolitis secondary to COVID-19. Child improved with steroid therapy and was asymptomatic after 3 weeks of treatment.


2021 ◽  
Vol 18 (1) ◽  
pp. 56-72
Author(s):  
Natalya G. Astafieva ◽  
Ainagul Zh. Bayalieva ◽  
Igor B. Zabolotskikh ◽  
Natalya I. Ilyina ◽  
Alexander V. Kulikov ◽  
...  

Anaphylactic shock is a severe life-threatening condition caused by medicines, food, hymenoptera, animal poisons, etc. Therefore, anaphylactic shock (anaphylaxis) can develop both in medical institution and outside it, and physicians of any specialties should be ready to treat this condition. In this regard, clinical guidelines for anaphylactic shock have been developed. These recommendations were approved by the Russian Association of Allergy and Clinical Immunology (Protocol No. 743/12 dated December 30, 2020) and the Federation of Anesthesiologists and Resuscitators (Protocol No. 1 dated January 13, 2021), approved at a meeting of the Scientific and Practical Council of the Ministry of Health of the Russian Federation (Protocol No. 743/12 dated December 10, 2020). Guidelines covered a number of nosologies corresponding to codes of the International Statistical Classification of Diseases and Related Health Problems: T 78.0; T 78.2; T 80.5; T 88.6. The clinical guidelines systematize modern data on etiology, epidemiology, classification, clinical picture, diagnosis, treatment, and prevention of anaphylactic shock. In addition, an algorithm for managing a patient with anaphylactic shock has been developed. Clinical guidelines for anaphylactic shock are intended for practitioners of all specialties, students, and teachers of medical universities, residents, and graduate students.


2019 ◽  
Vol 02 (02) ◽  
pp. 151-154
Author(s):  
Amit Kumar Paliwal ◽  
Sachin Girdhar ◽  
Somali Pattanayak ◽  
Brajesh Kumar

AbstractPresence of air in the wall of the stomach is known as gastric pneumatosis. It may be associated with a benign condition like gastric emphysema (GE) to life threatening condition emphysematous gastritis (EG). Differentiation between two entities based on clinical presentation, predisposing factors, and radiological findings is important as EG has more complications and higher rates of mortality. The treatment in GE is conservative while treatment in EG is evolving. We present a case of a diabetic patient who developed EG following abdominal surgery and managed conservatively with favorable outcome.


2021 ◽  
Vol 104 (1) ◽  
pp. 159-163

Abacavir-related hypersensitivity reaction (ABC-HSR) is a life-threatening condition. The incidence is low since it could have been prevented by screening with blood test for HLA-B*5701, which is strongly associated with this reaction. However, the affordability for the HLA-B*5701 screening test is still a challenging issue in many developing countries. Thai National Health Security Office (NHSO) recommends either using HLA-B*5701 as a screening test or monitoring clinical presentation for ABC-HSR after using it. Therefore, the clinical presentation of ABC-HSR should be acknowledged for the diagnosis of this condition and death prevention. This was the first reported case and literature reviewed of ABC-HSR associated with the presence of the HLA-B*5701 allele in Thailand. Keywords: Abacavir, Hypersensitivity reaction, HLA-B*5701, Clinical presentation, Thailand


Author(s):  
Jared Hylton ◽  
Sarah Deverman

Necrotizing enterocolitis (NEC) is a potentially life-threatening condition that affects mainly preterm infants. It is one of the most common surgical emergencies in the neonatal intensive care unit. While medical management is the first line of treatment, if that fails, NEC becomes a surgical emergency, and the pediatric anesthesiologist must be prepared. This chapter covers the pathogenesis, risk factors, clinical presentation and diagnosis, prevention, medical and surgical management, pre- and intraoperative anesthetic assessment, and postoperative management of NEC. Topics covered include intestinal perforation, necrotizing enterocolitis, neonatal anesthesia, pneumatosis intestinalis, prematurity, and ventilatory management. The chapter ends with review questions on the chapter’s content.


2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
Henrique Pott Junior ◽  
Gisele Cristina Gosuen ◽  
Ana Cristina Gales

Nevirapine-induced DRESS syndrome is uncommon but a potentially life-threatening condition, with significant morbidity and mortality rates due to multiple-organ involvement. The authors report a case of a 47-year-old HIV-infected female patient who presented with fever, right hypochondrium pain, jaundice, and skin rash. The Nevirapine-induced DRESS syndrome was suspected based on clinical presentation and RegiSCAR scoring system. This case highlights the need for a high index of clinical suspicion among HIV-infected patients with severe skin eruption and systemic symptoms.


2017 ◽  
Vol 08 (04) ◽  
pp. 202-204
Author(s):  
Vipul D. Yagnik

ABSTRACTDieulafoy’s lesion is a rare but potentially a life-threatening condition. It accounts for 1%–2% of acute gastrointestinal (GI) bleeding. The lesion is most frequently located in the stomach and may be located anywhere in the alimentary tract. It can be present as severe GI bleeding or chronic GI blood loss. The cause of lesion remains uncertain. The range of clinical presentation varies from acute ill hospitalized patients as well as in the newborn.


2016 ◽  
Vol 47 (1) ◽  
pp. 71-72
Author(s):  
Esra Tanyel ◽  
Mustafa Sunbul ◽  
Tom Fletcher ◽  
Hakan Leblebicioglu

Infective endocarditis (IE) is life-threatening condition with a highly variable clinical presentation. We report a case of acute IE with delayed diagnosis which resulted due to an initial misdiagnosis of Crimean Congo Hemorrhagic Fever (CCHF) in an endemic area. A case was due to Staphylococcus aureus and requiring valve replacement. They serve to emphasize the importance of careful history taking, physical examination and a broad range of different diagnostic techniques in the context of suspected viral hemorrhagic fever.


2014 ◽  
Vol 7 (2) ◽  
pp. 50-51 ◽  
Author(s):  
S Subedi ◽  
B Banerjee

Hemoperitoneum during pregnancy is a rare but potentially life threatening condition to both mother and fetus. Spontaneous hemoperitoneum may develop from rupture of various abdominal or pelvic viscera like spleen, pancreas and also uterus from the uterine ovarian vessels and rarely from pelvic endometrial implants. It mimics placental abruption having similar clinical presentation like acute abdominal pain, peritonitis, shock and fetal distress or fetal death. We present a case of spontaneous rupture of superficial uterine vessels in third trimester of pregnancy with an objective to share our experience in managing this rare emergency condition having diagnostic dilemmas. DOI: http://www.dx.doi.org/10.3126/njog.v7i2.11145   Nepal Journal of Obstetrics and Gynaecology / Vol 7 / No. 2 / Issue 14 / July-Dec, 2012 / 50-51


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