scholarly journals EP.TU.192Phlegmasia cerulea dolens associated with lung abscess

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Ban Ibrahim ◽  
Raviprasad Kattimani
Keyword(s):  
Ejection Fraction ◽  
Femoral Vein ◽  
District General Hospital ◽  
Lung Abscess ◽  
Morbidity And Mortality ◽  
High Morbidity ◽  
Threatening Condition ◽  
Life Threatening ◽  
History Of ◽  
Phlegmasia Cerulea Dolens

Abstract Introduction Phelgmasia cerulea dolens (PCD) is a rare limb and life-threatening condition caused by extensive of deep veins thrombosis of the extremities and it is classically associated with extensive oedema, severe pain and skin mottling which may lead to compartment syndrome, venous gangrene, and death. Case presentation We present a rare case of phlegmasia cerulea dolens associated with lung abscess. A 40-year-old male with background history of right femoral vein thrombosis, cardiomyopathy with ejection fraction of only 10% presented with three days history of progressive swelling, pain and purple discoloration of right leg to the accident and emergency department at a district general hospital. He was treated with therapeutic low molecular weight heparin. He was found to have lung abscess 2 weeks after admission for which he was treated with broad spectrum intra venous antibiotics. In view of his poor ejection fraction, he was treated without any surgical intervention for PCD. Patient succumbed after 3 months of presentation. PCD is a rare vascular emergency condition if not recognized early and treated aggressively may lead to high morbidity and mortality. Conclusion Phlegmasia cerulea dolens is an acute limb and life-threatening condition. Early diagnosis and aggressive intervention with thrombolysis and thrombectomy is necessary to prevent morbidity and mortality.

Vascular calcifications and calciphylaxis in a patient on concurrent haemodialysis and Coumadin therapy

2021 ◽  
Vol 14 (3) ◽  
pp. e240310
Author(s):  
Jack Schnur ◽  
Hadeer Sinawe ◽  
Athina Lidia Yoham ◽  
Damian Casadesus
Keyword(s):  
Pulmonary Oedema ◽  
Wound Care ◽  
Sodium Thiosulfate ◽  
High Morbidity ◽  
Threatening Condition ◽  
Life Threatening ◽  
History Of ◽  
Stage Renal Disease ◽  
End Stage ◽  
Haemodialysis Treatment

Calciphylaxis is a rare life-threatening condition, with calcification of small and medium-sized vessels leading to skin necrosis. It has a high morbidity and mortality, and most of the patients die from wound superinfection and sepsis. A 48-year-old man with a history of end-stage renal disease on haemodialysis and Coumadin therapy for venous thromboembolism presented with pulmonary oedema after missing two haemodialysis treatment. At examination, he had bilateral lower extremity dark brown, possibly necrotic, painful ulcers. He was diagnosed with calciphylaxis and treated with sevelamer hydrochloride, low calcium dialysate and sodium thiosulfate with haemodialysis. He received daily wound care with topical collagenase. After daily wound care treatment for 4 months, the patient’s ulcers completely healed. The patient had been followed for 8 months, which included 29 additional readmissions, 3 admissions related to bacteraemia and 26 admissions with the diagnosis of pulmonary oedema and hyperkalaemia requiring haemodialysis.

scholarly journals Acute Limb Ischemia Therapies: When and How to Treat Endovascularly

2018 ◽  
Vol 35 (05) ◽  
pp. 453-460 ◽  
Author(s):  
Anthony Hage ◽  
Joseph McDevitt ◽  
Jeffrey Chick ◽  
Venu Vadlamudi
Keyword(s):  
Management Strategy ◽  
Limb Ischemia ◽  
Morbidity And Mortality ◽  
High Morbidity ◽  
Acute Limb Ischemia ◽  
Success Rates ◽  
Imaging Evaluation ◽  
Perioperative Morbidity ◽  
Threatening Condition ◽  
Life Threatening

AbstractAcute limb ischemia is an emergent limb and life-threatening condition with high morbidity and mortality. An understanding of the presentation, clinical evaluation, and initial workup, including noninvasive imaging evaluation, is critical to determine an appropriate management strategy. Modern series have shown endovascular revascularization for acute limb ischemia to be safe and effective with success rates approaching surgical series and with similar, or even decreased, perioperative morbidity and mortality. A thorough understanding of endovascular techniques, associated pharmacology, and perioperative care is paramount to the endovascular management of patients presenting with acute limb ischemia. This article discusses the diagnosis and strategies for endovascular treatment of acute limb ischemia.

Haemophagocytic lymphohistiocytosis secondary to brucellosis in a young child

2021 ◽  
Vol 14 (3) ◽  
pp. e240759
Author(s):  
Jashan Mittal ◽  
Prawin Kumar ◽  
Jagdish Prasad Goyal ◽  
Abhishek Purohit
Keyword(s):  
Haemophagocytic Lymphohistiocytosis ◽  
Appetite Loss ◽  
Specific Therapy ◽  
Adequate Treatment ◽  
Underlying Condition ◽  
Persistent Fever ◽  
Threatening Condition ◽  
Life Threatening ◽  
History Of ◽  
Life Threatening Complication

Brucellosis is a common zoonotic disease worldwide. It has protean clinical manifestation and sometimes may has a life-threatening complication. A 4-year-old boy presented with a history of fever, myalgia and appetite loss for 3 weeks. On examination, he had hepatosplenomegaly. The initial working diagnosis was an infection, autoimmune disease and malignancy. Investigations showed positive Brucella serology, and he was started on rifampicin and cotrimoxazole. He was further investigated because of persistent fever, which revealed evidence of haemophagocytic lymphohistiocytosis (HLH). He continued treatment for brucellosis, except rifampicin which was replaced with doxycyclin due to a worsening liver function. The child showed complete clinical and biochemical improvement after 6 weeks of therapy. HLH is a life-threatening condition and should be suspected in children with brucellosis, who did not respond to appropriate antibiotics treatment. Secondary HLH does not always require specific therapy; it may improve with adequate treatment of the underlying condition.

Sudden death due to ruptured oesophageal varices – autopsy-based case report

2020 ◽  
Vol 88 (4) ◽  
pp. 189-191
Author(s):  
Nagendra Singh Sonwani ◽  
Navneet Ateriya ◽  
Arvind Kumar ◽  
Anil Kohli ◽  
Kalyan Kumar Banerjee
Keyword(s):  
Chronic Alcoholism ◽  
Medical Emergency ◽  
Oesophageal Varices ◽  
High Morbidity ◽  
Forensic Pathologist ◽  
Threatening Condition ◽  
Life Threatening ◽  
Cirrhotic Patients ◽  
Acute Haemorrhage

Acute haemorrhage from ruptured oesophageal varices is a serious consequence of portal hypertension in cirrhotic patients. It represents a medical emergency with a high morbidity and mortality rate. Studies over the years have shown a direct link with chronic alcoholism in the development of such complications. Although the gastrointestinal system accounts for a few numbers of sudden deaths, bleeding through ruptured varices represent a life-threatening condition. The role of forensic pathologist is vital in dealing with sudden deaths. Here, we report a case of a 46-year-old man who died suddenly following the rupture of oesophageal varices.

scholarly journals Unexpected source of Proteus mirabilis bacteraemia

2018 ◽  
Vol 11 (1) ◽  
pp. bcr-2018-226744
Author(s):  
Sureshkumar Nagiah ◽  
Rassam Badbess
Keyword(s):  
Proteus Mirabilis ◽  
Elderly Woman ◽  
High Morbidity ◽  
Vascular Risk ◽  
Infected Aneurysm ◽  
Gram Negative ◽  
Delay In Diagnosis ◽  
Common Causes ◽  
Threatening Condition ◽  
Life Threatening

Mycotic (infected) aneurysm involving the thoracic aorta is an exceedingly rare and life-threatening condition that is associated with high morbidity and mortality. We report an unusual source of Proteus mirabilis bacteraemia thought to be due to an infected aneurysm in the thoracic aortic arch in an elderly woman. Source of gram-negative bacteraemia is usually isolated to an intra-abdominal or a pelvic source. Proteus bacteraemia from an intrathoracic pathology is very uncommon, and in this case led to a delay in diagnosis. Although an infected aneurysm is a rare source of gram-negative bacteraemia, it must always be considered when common causes of bacteraemia have been ruled out especially in patients with vascular risk factors.

scholarly journals Incidental amniocele in a case of antepartum haemorrhage

2020 ◽  
Vol 24 (1) ◽  
Author(s):  
Sheree C. Gray ◽  
Jacobus A. Pienaar ◽  
Zelia Sofianos ◽  
Jacob Varghese ◽  
Ilonka Warnich
Keyword(s):  
Case Report ◽  
Early Identification ◽  
Uterine Rupture ◽  
Placenta Previa ◽  
Morbidity And Mortality ◽  
Severe Morbidity ◽  
Antepartum Haemorrhage ◽  
Threatening Condition ◽  
Life Threatening

An amniocele, or contained uterine rupture, is a phenomenon in which there is herniation of the amniotic sac through a uterine defect, secondary to various causes. It is associated with severe morbidity and mortality. This case presents the findings in a 36-year-old female at 29 weeks gestation who was initially managed as antepartum haemorrhage secondary to placenta previa, based on ultrasound. Upon further imaging, an amniocele was diagnosed. This case report illustrates the importance of early identification of this life-threatening condition.

scholarly journals Non-occlusive mesenteric ischaemia associated with anorexia nervosa

2019 ◽  
Vol 12 (5) ◽  
pp. e229703
Author(s):  
Takashi Sakamoto ◽  
Alan Kawarai Lefor ◽  
Tadao Kubota
Keyword(s):  
Anorexia Nervosa ◽  
Distal Ileum ◽  
Interdisciplinary Management ◽  
Emergency Laparotomy ◽  
Diffuse Peritonitis ◽  
Chronic Haemodialysis ◽  
Mesenteric Ischaemia ◽  
Threatening Condition ◽  
Life Threatening ◽  
History Of

Non-occlusive mesenteric ischaemia (NOMI) is a life-threatening condition that requires emergent intervention and anorexia nervosa is a chronic eating disorder that requires careful medical and nutritional management. A 54-year-old woman with a history of anorexia nervosa and undergoing chronic haemodialysis developed abdominal pain and called an ambulance. On arrival, she was in shock and abdominal examination was consistent with diffuse peritonitis. Computed tomography scan suggested ischaemia from the distal ileum to the ascending colon. Emergency laparotomy revealed NOMI from the distal ileum to the transverse colon. The treatment strategy included staged operations and careful medical management to optimise nutritional support and electrolyte management with survival of the patient. NOMI and anorexia nervosa are both difficult to manage. Meticulous interdisciplinary management can result in a good outcome.

Salicylate Intoxication

1997 ◽  
Vol 12 (2) ◽  
pp. 66-78 ◽  
Author(s):  
Luke Yip ◽  
Michael S. Jastremski ◽  
Richard C. Dart
Keyword(s):  
Life Support ◽  
Care Facility ◽  
Health Care Facility ◽  
Poison Control ◽  
Electrolyte Balance ◽  
Threatening Condition ◽  
Life Threatening ◽  
History Of ◽  
Salicylate Intoxication ◽  
Base Management

Aspirin (acetylsalicylic acid) is one of the most widely used over-the-counter medications. Because of its availability and widespread use, aspirin has a long history of human toxicity from accidental or intentional overdosing. According to the American Association of Poison Control Centers aspirin was implicated in 19083 exposures in 1995, with 11800 cases treated in a health care facility, and 52 associated deaths. Aspirin toxicity may be a life-threatening condition that produces multiple system organ failure requiring treatment in an intensive care unit. Managing a patient with salicylism will challenge the skills of the critical care team, especially in the areas of life support, fluid and electrolyte balance, and acid-base management. This article reviews the physiology, pathophysiology, acute and chronic salicylism in children and adults, and management of salicylate intoxication.

scholarly journals TEVAR for ruptured descending thoracic aortic aneurysm: case report

2016 ◽  
Vol 15 (4) ◽  
pp. 322-327 ◽  
Author(s):  
Sthefano Atique Gabriel ◽  
Enrico Rinaldi ◽  
Marco Leopardi ◽  
Germano Melissano ◽  
Roberto Chiesa
Keyword(s):  
Case Report ◽  
Aortic Aneurysm ◽  
Thoracic Aortic Aneurysm ◽  
Thoracic Endovascular Aortic Repair ◽  
High Morbidity ◽  
Minimally Invasive Approach ◽  
Invasive Approach ◽  
Descending Thoracic Aortic Aneurysm ◽  
Threatening Condition ◽  
Life Threatening

Abstract A ruptured descending thoracic aortic aneurysm (rDTAA) is a life-threatening condition associated with high morbidity and mortality. Endovascular treatment for rDTAA promotes effective aneurysm exclusion with a minimally invasive approach. The authors report a case of a 76-year-old man with hemodynamically unstable 9-cm-diameter rDTAA treated with emergency thoracic endovascular aortic repair (TEVAR).

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