scholarly journals Life-Threatening Complications of Hormonal Contraceptives: A Case History

2013 ◽  
Vol 2013 ◽  
pp. 1-3
Author(s):  
Saheed Khan ◽  
Yvo M. Smulders ◽  
Johanna I. P. de Vries ◽  
Angélique M. E. Spoelstra-de Man
Keyword(s):  
Oral Contraceptives ◽  
Good Condition ◽  
Abdominal Ultrasound ◽  
Massive Pulmonary Embolism ◽  
Hormonal Contraceptives ◽  
Successful Resuscitation ◽  
Internal Bleeding ◽  
Arterial Embolisation ◽  
Heparin Anticoagulation ◽  
Life Threatening

We present a case with the rare combination of thrombotic and hemorrhagic complications of oral contraceptives. A healthy 40-year-old woman suffered from cardiac arrest due to massive pulmonary embolism, caused by oral contraceptives and immobilization during a flight. After successful resuscitation, obstructive shock necessitated thrombolysis and thereafter heparin. Anticoagulation was complicated by internal bleeding from contraceptive related hepatic adenoma. She underwent arterial embolisation, and anticoagulation was continued. On day 18, she was discharged in a good condition. Hepatic adenomas are a potential source of internal bleeding in women using oral contraceptives requiring anticoagulation. Signs of internal bleeding in such patients should prompt immediate abdominal ultrasound examination.

scholarly journals Portal Venous Thrombosis Associated with Use of Etonogestrel/ethinyl Estradiol Vaginal Ring

2020 ◽  
Vol 4 (2) ◽  
pp. 263-266
Author(s):  
Katelynn Bailey ◽  
Michael Tranovich
Keyword(s):  
Abdominal Pain ◽  
Venous Thrombosis ◽  
Oral Contraceptives ◽  
Ethinyl Estradiol ◽  
Hormonal Contraception ◽  
Vaginal Ring ◽  
Hormonal Contraceptives ◽  
Term Outcome ◽  
Life Threatening ◽  
Portal Venous Thrombosis

Introduction: Portal venous thrombosis is a life-threatening cause of abdominal pain. In younger patients, heritable thrombophilias, pregnancy, tobacco use, and oral contraceptives are associated. Case Report: A 26-year-old woman prescribed contraceptive vaginal ring presented with abdominal pain and was diagnosed with an extensive portal venous thrombosis. Management included heparin and later an oral anticoagulant with good short-term outcome. Discussion: Women using hormonal contraception are approximately four times more likely to develop thromboembolism. Risk of thromboembolism is similar between users of intravaginal and oral contraceptives. Conclusion: Portal venous thrombosis must be considered in women presenting with abdominal pain who are prescribed hormonal contraceptives, including intravaginal forms.

scholarly journals An unusual cause of recurrent pediatric vomiting (an extraluminal pyloric duplication cystic): A case report

2020 ◽  
Vol 2020 (12) ◽  
Author(s):  
Leen Jamel Doya ◽  
Naya Talal Hassan ◽  
Fareeda Wasfy Bijow ◽  
Hanin Ahmed Mansour ◽  
Sawsan Ahmad ◽  
...  
Keyword(s):  
Gastrointestinal Endoscopy ◽  
Early Recognition ◽  
Outlet Obstruction ◽  
Abdominal Ultrasound ◽  
Duplication Cyst ◽  
Common Symptom ◽  
Surgical Emergencies ◽  
Recurrent Vomiting ◽  
Life Threatening ◽  
Tomography Scan

ABSTRACT Vomiting is a common symptom of a multitude of diseases in children. It is usually part of benign illness and can occur at any age. Recurrent vomiting can be a symptom of life-threatening medical or surgical emergencies. It can be rarely caused by an extraluminal pyloric duplication cyst. Early recognition is essential for preventing delays in management and potential complications. Here we report a case of an extraluminal pyloric duplication presenting as progressive gastric outlet obstruction cyst in a 14-month-old Syrian boy. The diagnosis was made through abdominal ultrasound, gastrointestinal endoscopy and abdominal computed tomography scan.

Management of an unusual cause of life-threatening haemoptysis: a multidisciplinary approach

2021 ◽  
Vol 14 (5) ◽  
pp. e240448
Author(s):  
Kim Pramanik ◽  
Philip Webb ◽  
RanaShoaib Hamid
Keyword(s):  
Cystic Fibrosis ◽  
Interventional Radiology ◽  
Tranexamic Acid ◽  
Medical Management ◽  
Multidisciplinary Approach ◽  
Bronchial Artery ◽  
Successful Resuscitation ◽  
Emergency Medical ◽  
Life Threatening

We present to you a case of life-threatening haemoptysis secondary to non-cystic fibrosis bronchiectasis complicated by bronchial artery pseudoaneurysms. We discuss this patient’s emergency medical management using intravenous tranexamic acid, which resulted in successful resuscitation and eventual survival, and evaluate the need for urgent anaesthetic and interventional radiology input in such a case.

scholarly journals Thromboembolic complications of thyroid storm

2014 ◽  
Vol 2014 ◽  
Author(s):  
T Min ◽  
S Benjamin ◽  
L Cozma
Keyword(s):  
Atrial Fibrillation ◽  
Early Recognition ◽  
Massive Pulmonary Embolism ◽  
Clinical Findings ◽  
Favourable Outcome ◽  
Thyroid Storm ◽  
List Type ◽  
Chads2 Score ◽  
Prompt Treatment ◽  
Life Threatening

Summary Thyroid storm is a rare but potentially life-threatening complication of hyperthyroidism. Early recognition and prompt treatment are essential. Atrial fibrillation can occur in up to 40% of patients with thyroid storm. Studies have shown that hyperthyroidism increases the risk of thromboembolic events. There is no consensus with regard to the initiation of anticoagulation for atrial fibrillation in severe thyrotoxicosis. Anticoagulation is not routinely initiated if the risk is low on a CHADS2 score; however, this should be considered in patients with thyroid storm or severe thyrotoxicosis with impending storm irrespective of the CHADS2 risk, as it appears to increase the risk of thromboembolic episodes. Herein, we describe a case of thyroid storm complicated by massive pulmonary embolism. Learning points Diagnosis of thyroid storm is based on clinical findings. Early recognition and prompt treatment could lead to a favourable outcome. Hypercoagulable state is a recognised complication of thyrotoxicosis. Atrial fibrillation is strongly associated with hyperthyroidism and thyroid storm. Anticoagulation should be considered for patients with severe thyrotoxicosis and atrial fibrillation irrespective of the CHADS2 score. Patients with severe thyrotoxicosis and clinical evidence of thrombosis should be immediately anticoagulated until hyperthyroidism is under control.

(Un) conventional complicated pancreatitis

2021 ◽  
Vol 75 (1) ◽  
pp. 61-67
Author(s):  
Michal Rybár ◽  
Ivo Horný
Keyword(s):  
Acute Pancreatitis ◽  
Multidisciplinary Approach ◽  
Pancreatic Necrosis ◽  
Surgical Intervention ◽  
Secondary Infection ◽  
Abdominal Ultrasound ◽  
Stent Migration ◽  
Endoscopic Extraction ◽  
Threatening Condition ◽  
Life Threatening

Acute pancreatitis is sudden inflammatory disease of pancreas, which can vary from a mild form to severe life threatening condition. The management of pancreatitis usually consists of intensive care and multidisciplinary approach, often including surgical intervention or digestive endoscopy. In this article, we present a 68-year-old female with recidivous acute pancreatitis who underwent a series of endoscopic examinations and at the end also an unusual surgical intervention due to numerous complications. At first, it seemed that there was an idiopatic etiology because neither an anamnesis of alcohol consumption nor metabolic risks or CT signs of cholelithiasis were found. The condition was complicated by the development of acute necrotic collection, gastrointestinal bleeding and development of walled-off pancreatic necrosis (WOPN). Later, the biliary etiology was revealed after cholecystolithiasis was found on abdominal ultrasound. The WOPN was endoscopically drained because of the local compression syndrome. After the drainage, we noticed two cases of stent migration and the secondary infection of the WOPN. At the end, the migrated stents caused transient bowel obstruction and were stuck in the distal ileum. After three unsuccessful attempts to endoscopic extraction, the condition was solved by surgical intervention and double enterotomy was performed. The postoperative care was not easy anyway, being complicated by the dehiscence of the surgical wound with the need of opening the wound and use the VAC system to heal it up.

scholarly journals Effect of oral contraceptives on tear film in reproductive age group women

2018 ◽  
Vol 7 (3) ◽  
pp. 860
Author(s):  
Amita Sharma ◽  
Surabhi Porwal ◽  
Manoj Tyagi
Keyword(s):  
Oral Contraceptives ◽  
Tear Film ◽  
Reproductive Age ◽  
Hormonal Contraceptives ◽  
Control Group ◽  
Study Group ◽  
Age Group ◽  
Tear Secretion ◽  
Schirmer’S Test ◽  
Reproductive Age Group

Background: According to WHO 2009, 60-70% women use one of the method of contraception. 8.8% to 15.4% women use oral contraceptives. Objective of present study was to investigate the effect of oral contraceptives on androgen profile and tear film parameters in females within child bearing age.Methods: Present study involve 100 healthy women between 20-45 years, who presented in family planning clinic. Two groups were made according to the use of oral contraceptive pills. Study group consist of 50 women who were on OCPs (Oral contraception pills) and 50 as control group were not taking any hormonal contraceptives. Serum testosterone and DHEA levels of all subjects was done by Enzyme Immuno Assay on blood samples which were collected during 3th to 7th day of menstrual cycle. Quantitative test for tear secretion was done by Schirmer’s test. Stability of tear film was measured by Tear Breakup time (TBUT). Statistical analysis was done to determine the correlation between use of OCPs and androgen profile and tear film parameters.Results: Present results shows decreased androgen levels in women taking oral contraceptives as compared with age matched women who were not taking oral contraceptives. Tear secretion was significantly reduced in study group as indicated by decreased Schirmer’s test values in study group as compared to control group, the tear film stability was also significantly decreased in women taking oral contraceptives.Conclusions: Present study suggest that androgen profile decrease in women taking oral contraceptives. These results support that use of oral contraceptives may be an important etiological factor in pathogenesis of dry eye disease reproductive age group women.

scholarly journals Pegylated megakaryocyte growth and development factor abrogates the lethal thrombocytopenia associated with carboplatin and irradiation in mice

Blood ◽  
1995 ◽  
Vol 86 (12) ◽  
pp. 4486-4492 ◽  
Author(s):  
MM Hokom ◽  
D Lacey ◽  
OB Kinstler ◽  
E Choi ◽  
S Kaufman ◽  
...  
Keyword(s):  
Growth And Development ◽  
Granulocyte Colony Stimulating Factor ◽  
Potent Inducer ◽  
Development Factor ◽  
Internal Bleeding ◽  
Life Threatening ◽  
Stimulating Factor ◽  
Sublethal Irradiation

Megakaryocyte growth and development factor (MGDF) is a potent inducer of megakaryopoiesis in vitro and thrombopoiesis in vivo. The effects of MGDF appear to be lineage-selective, making this cytokine an ideal candidate for use in alleviating clinically relevant thrombocytopenias. This report describes a murine model of life-threatening thrombocytopenia that results from the combination treatment of carboplatin and sublethal irradiation. Mortality of this regimen is 94% and is associated with widespread internal bleeding. The daily administration of pegylated recombinant human MGDF (PEG-rMGDF) significantly reduced mortality (to < 15%) and ameliorated the depth and duration of thrombocytopenia. The severity of leucopenia and anemia was also reduced, although it was not clear whether these effects were direct. Platelets generated in response to PEG-rMGDF were morphologically indistinguishable from normal platelets. PEG-rMGDF administered in combination with murine granulocyte colony-stimulating factor completely prevented mortality and further reduced leukopenia and thrombocytopenia. These data support the concept that PEG-rMGDF may be useful to treat iatrogenic thrombocytopenias.

scholarly journals Massive pulmonary embolism at the onset of acute promyelocytic leukemia

2016 ◽  
Vol 8 ◽  
pp. 2016027 ◽  
Author(s):  
Federica Sorà ◽  
Patrizia Chiusolo ◽  
Luca Laurenti
Keyword(s):  
Pulmonary Embolism ◽  
Retinoic Acid ◽  
Acute Promyelocytic Leukemia ◽  
Massive Pulmonary Embolism ◽  
Promyelocytic Leukemia ◽  
Early Complication ◽  
Trans Retinoic Acid ◽  
All Trans Retinoic Acid ◽  
First Case ◽  
Life Threatening

Life-threatening bleeding is a major and early complication of acute promyelocytic leukemia (APL), but in the last years there is a growing evidence of thromboses in  APL. We report the first case of a young woman with dyspnea as the first symptom of APL due to massive pulmonary embolism (PE) successfully treated with thrombolysis for PE and heparin. APL has been processed with a combination of all-trans retinoic acid (ATRA) and arsenic trioxide (ATO) obtaining complete remission.

The effect of different hormonal contraceptives on plasma levels of free protein S and free TFPI

2013 ◽  
Vol 109 (04) ◽  
pp. 606-613 ◽  
Author(s):  
Frans M. Helmerhorst ◽  
Kathrin Fleischer ◽  
Anders E. A. Dahm ◽  
Frits R. Rosendaal ◽  
Jan Rosing ◽  
...  
Keyword(s):  
Venous Thrombosis ◽  
Oral Contraceptives ◽  
Acquired Resistance ◽  
Activated Protein C ◽  
Protein S ◽  
Hormonal Contraceptives ◽  
Free Protein ◽  
Routes Of Administration ◽  
Apc Resistance ◽  
Increased Risk

SummaryUse of combined oral contraceptives is associated with a three- to sixfold increased risk of venous thrombosis. Hormonal contraceptives induce acquired resistance to activated protein C (APC), which predicts the risk of venous thrombosis. The biological basis of the acquired APC resistance is unknown. Free protein S (PS) and free tissue factor pathway inhibitor (TFPI) are the two main determinants of APC. Our objective was to assess the effect of both hormonal and non-hormonal contraceptives with different routes of administration on free TFPI and free PS levels. We conducted an observational study in 243 users of different contraceptives and measured APC sensitivity ratios (nAPCsr), free TFPI and free PS levels. Users of contraceptives with the highest risk of venous thrombosis as reported in recent literature, had the lowest free TFPI and free PS levels, and vice versa, women who used contraceptives with the lowest risk of venous thrombosis had the highest free TFPI and free PS levels. An association was observed between levels of free TFPI and nAPCsr, and between free PS and nAPCsr. The effect of oral contraceptives on TFPI and PS is a possible explanation for the increased risk of venous thrombosis associated with oral contraceptives.

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