scholarly journals Multidisciplinary management of the pregnant patient in haemorrhagic shock secondary to an undiagnosed ruptured liver adenoma

2020 ◽  
Vol 13 (2) ◽  
pp. e231995
Author(s):  
Brittany Sanford ◽  
Catherine Hoeppner ◽  
Tammy Ju ◽  
Brian K Theisen ◽  
Anna BuAbbud ◽  
...  
Keyword(s):  
General Surgery ◽  
Case Reports ◽  
Hepatocellular Adenoma ◽  
Multidisciplinary Care ◽  
Exploratory Laparotomy ◽  
Pregnant Patient ◽  
Haemorrhagic Shock ◽  
Liver Adenoma ◽  
Life Threatening ◽  
Temporary Closure

Management of a ruptured hepatocellular adenoma during pregnancy is a rare and potentially life-threatening entity. Few case reports have described management of the pregnant patient who presents in haemorrhagic shock secondary to a ruptured liver adenoma. A 30-year-old primigravid woman at 31 weeks pregnant presented with abdominal pain and fetal bradycardia. After stat caesarean delivery of the infant, she had continued hemoperitoneum and was in shock secondary to an undiagnosed ruptured liver mass. General surgery was consulted intraoperatively and performed an exploratory laparotomy, packing and temporary closure. She was subsequently taken to interventional radiology (IR) for angioembolisation of the left hepatic artery. After stabilisation, she underwent formal abdominal closure. Management of a ruptured hepatocellular adenoma in pregnancy requires urgent multidisciplinary care including obstetrics gynaecology, general surgery and IR.

Spontaneous hepatic haemorrhage secondary to ruptured hepatocellular adenoma in a young male patient

2020 ◽  
Vol 13 (8) ◽  
pp. e235966
Author(s):  
Peter Daechul Yoon ◽  
Andy Ze Lin Chen ◽  
David Tovmassian ◽  
Henry Pleass
Keyword(s):  
Massive Transfusion ◽  
Young Male ◽  
Hepatocellular Adenoma ◽  
Exploratory Laparotomy ◽  
Haemorrhagic Shock ◽  
Function Test ◽  
Normocytic Anaemia ◽  
Well Differentiated ◽  
The Right ◽  
Transfusion Protocol

A 27-year-old man presented with acute right upper quadrant abdominal pain and vomiting. He was clinically in hypovolaemic shock. Investigations revealed normocytic anaemia with a normal bilirubin and moderate liver function test abnormalities. CT abdomen and pelvis demonstrated haemoperitoneum and a large solitary hepatic mass in segments V and VI, suspicious for a ruptured hepatic tumour. Massive transfusion protocol was commenced and angioembolisation of the inferior branch of the right hepatic artery was undertaken. Despite this, his haemorrhagic shock was resistant to resuscitation. Thus, he underwent emergent exploratory laparotomy, which resulted in segments V and VI liver resection and packing. Re-look laparotomy 2 days following initial exploration was performed where haemostasis was confirmed. Histopathology revealed a ruptured well-differentiated hepatocellular adenoma. The patient made a good recovery following a 2-week admission.

scholarly journals Unicornuate uterus: case reports of heterogenous presentations challenging clinical diagnosis and management

2021 ◽  
Vol 10 (6) ◽  
pp. 2514
Author(s):  
Swati Trivedi ◽  
Santosh Khokher ◽  
Prasoon Rastogi ◽  
Vinod Kumar Dhaka
Keyword(s):  
Case Reports ◽  
Haemorrhagic Shock ◽  
Lower Abdomen ◽  
Pregnant Uterus ◽  
Rudimentary Horn ◽  
Unicornuate Uterus ◽  
Trimester Pregnancy ◽  
Maternal Morbidity And Mortality ◽  
Life Threatening ◽  
Lateral Fusion

Unicornuate uterus is an anomaly arising from defective lateral fusion of incompletely developed mullerian duct or paramesonephric duct with the contralateral duct. Pregnancy in non-communicating rudimentary horn can result in I and II trimester pregnancy losses along with maternal morbidity and mortality. Here we describe three such cases of unicornuate uterus with non-communicating rudimentary horn pregnancy, who presented to our hospital with pain in lower abdomen. Two of them with II trimester pregnancy landed in haemorrhagic shock owing to rupture of pregnant horn, though were revived by immediate intervention. Third patient who came with a definitive diagnosis of I trimester rudimentary horn pregnancy was managed electively by hemi-hysterectomy. Rupture of pregnant uterus can occur in II trimester when associated with uterine anomaly. Early sonographic diagnosis has a major offering in workup, management and prevention of mother from grave life threatening consequences.

scholarly journals Small Cell Carcinoma of the Uterine Cervix in a Pregnant Patient Diagnosed with Liquid Based Cytology and Cell Block Immunocytochemistry

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Mawuli F. Attipoe ◽  
Charles D. Sturgis
Keyword(s):  
Cell Carcinoma ◽  
Small Cell Carcinoma ◽  
Uterine Cervix ◽  
Case Reports ◽  
Pregnant Patient ◽  
Small Cell ◽  
Tumor Type ◽  
Cell Block ◽  
Current Case ◽  
Small Series

Definitive cytomorphologic diagnosis of small cell carcinoma of the uterine cervix is possible but can be challenging in routine cervicovaginal cancer screening specimens. Several small series of reported cases of cervical small cell carcinoma have shown this uncommon malignancy to represent fewer than 2% of all invasive cervical cancers. This tumor type is associated with poor prognosis and rapid disease progression and can develop to an advanced stage in the interval between screening visits. Only rare case reports of small cell carcinoma arising in gravid cervices are known. In the current case a 29-year-old, gravida 6, para 2, pregnant (10-week gestation) female presented with postcoital bleeding. A definitive diagnosis of small cell carcinoma of the cervix was made possible by liquid based Pap testing with ancillary cell block preparation allowing for immunocytochemical characterization of the lesional cell population.

scholarly journals Valproate semisodium-induced encephalopathy: diet and polypharmacy interactions

2012 ◽  
Vol 36 (4) ◽  
pp. 137-139 ◽  
Author(s):  
Nuno Rodrigues Silva ◽  
Ângela Venâncio
Keyword(s):  
Case Reports ◽  
Adult Population ◽  
Paediatric Population ◽  
Valproate Semisodium ◽  
Bipolar I Disorder ◽  
Life Threatening ◽  
Life Threatening Complication

SummaryDespite extensive use of valproate in neurology and psychiatry, valproate-induced encephalopathy is a rarely reported complication. Although initially reported in the paediatric population, case reports are growing in the adult population.Clinicians need to be aware of this potentially life-threatening complication. We report a case in a 37-year-old woman with bipolar I disorder with previously uncomplicated valproate use, who developed encephalopathy when valproate was restarted a few years later. The patient has provided consent for publication.

HIV/AIDS and traditional healers: a blessing in disguise

2010 ◽  
Vol 50 (3) ◽  
pp. 154-155
Author(s):  
B L Meel
Keyword(s):  
Case Reports ◽  
Health Care Systems ◽  
Traditional Healers ◽  
Immunodeficiency Virus ◽  
Herbal Decoction ◽  
Care Systems ◽  
Life Threatening ◽  
Acquired Immunodeficiency ◽  
Immunodeficiency Syndrome ◽  
Hiv Aids

Traditional healers contribute significantly to the level of health-care systems in Africa. They could play an important role in the prevention and care of patients with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) in the community. The traditional healing system deals with psychosocial stress associated with HIV/AIDS as well as herbal medications. Sometimes, herbal medicine causes serious life-threatening complications. Two case reports are presented in this article. The first is a 48-year-old woman with HIV who was made to drink a large volume of a herbal decoction to stimulate vomiting in the belief that cleansing the bowel would rid the system of the disease. The second is a 25-year-old young man who had a herbal enema, which resulted in gangrene of the large bowel. The case histories, mechanism of action and causes of death are discussed.

scholarly journals Spontaneous liver rupture in a pregnant woman associated with HELLP syndrome

2019 ◽  
Vol 24 (3) ◽  
pp. 132-138
Author(s):  
T. M. Bunyatov ◽  
I. A. Kozlov ◽  
B. N. Gurmikov ◽  
Yu. A. Stepanova ◽  
V. S. Shirokov ◽  
...  
Keyword(s):  
Hellp Syndrome ◽  
Similar Case ◽  
Case Reports ◽  
Endovascular Embolization ◽  
Syndrome Patient ◽  
Liver Rupture ◽  
Right Hepatic Artery ◽  
Appropriate Treatment ◽  
Threatening Condition ◽  
Life Threatening

Spontaneous liver rupture is rare and highly dangerous, life-threatening condition occurring in 1–2% of pregnant women with preeclampsia and eclampsia. There are more than 100 similar case reports in the literature. It is believed that liver rupture is caused by HELLP syndrome as one of the signs of preeclampsia. The results of surgical treatment is still unsatisfactory. Appropriate treatment strategy is absent because of rareness of this condition. It is presented case report of a woman with spontaneous liver rupture associated with HELLP syndrome. Patient underwent perihepatic tamponade, endovascular embolization of right hepatic artery followed by right-sided hemihepatectomy.

scholarly journals Unfit for Work, Fit for Firearm or driving license - Is that Possible?

2019 ◽  
Vol 7 (17) ◽  
pp. 2864-2867
Author(s):  
Hrvoje Lalić
Keyword(s):  
Psychiatric Disorders ◽  
Occupational Medicine ◽  
Case Reports ◽  
Work Capacity ◽  
Chronic Alcoholic ◽  
Driving License ◽  
The Third ◽  
Life Threatening ◽  
Car Driving ◽  
Single Worker

BACKGROUND: Psychiatric disorders are not compatible with carrying firearms or with driving a car. Persons with such disorders are often not employed and are persistent in demanding invalidity pensions, but some of them also insist on holding on to the mentioned licenses. In such cases, where persons are already in possession of firearms and driving licences, it never occurs to them, that they should surrender their permits back. AIM Pointing to the importance of OM controlling firearm/car driving licenses. CASE REPORTS: This paper discusses the problem of three cases that should be widely recognised as it is potentially life-threatening to other people. The first is the case of a war veteran in retirement with PTSD that had his application for firearms licence rejected by the authorities. The second is the case of a labourer who suffers from a depressive disorder, temporarily incapable of work. The third is the case of a war veteran, a chronic alcoholic with toxic epilepsy, who is applying for invalidity retirement but wants to keep his driving license. CONCLUSION: Occupational medicine assess every single worker by applying advanced methods and psycho tests that enable a thorough assessment of work capacity and fitness for carriage of firearms, driving as well as the assessment of psychiatric disorders, which are the most delicate to assess.

scholarly journals Amoxicillin Induced Steven Johnson’s Syndrome: A Case Report

2020 ◽  
Vol 10 (4-s) ◽  
pp. 220-222
Author(s):  
R Mahendra Kumar ◽  
Sanatkumar Nyamagoud ◽  
Krishna Deshpande ◽  
Ankitha Kotian
Keyword(s):  
Adverse Drug Reaction ◽  
Drug Reaction ◽  
Case Reports ◽  
The Body ◽  
Stevens Johnson Syndrome ◽  
Hypersensitivity Reactions ◽  
Johnson Syndrome ◽  
Oral Consumption ◽  
Life Threatening

Stevens-Johnson syndrome (SJS) is a very rare, potentially fatal skin reaction that is typically the result of reaction to the drug. In particular, SJS is characterized by extensive skin and mucous membrane lesions (i.e. mouth, nose, esophagus, anus, and genitalia), epidermis detachment, and acute skin blisters. In 95 % of case reports, drugs were found to be an important cause for the development of SJS. This story is a case of A 42 year old male hospitalized with rashes all over the body and fever, after oral consumption of Amoxicillin drug for sore throat. This case study discusses the possibility that serious hypersensitivity reactions with Amoxicillin can rarely occur and can be extremely harmful and life-threatening Menacing. Keywords: Toxic Epidermal Necrolysis, Stevens Johnson Syndrome, Adverse drug reaction, Nikolsky’s sign

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