scholarly journals Air Embolism after Endoscopic Retrograde Cholangiopancreatography in a Patient with Budd Chiari Syndrome

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Beatriz Wills-Sanin ◽  
Yenny R. Cárdenas ◽  
Lucas Polanco ◽  
Oscar Rivero ◽  
Sebastian Suarez ◽  
...  
Keyword(s):  
Endoscopic Retrograde Cholangiopancreatography ◽  
Rare Complication ◽  
Air Embolism ◽  
Care Staff ◽  
Health Care Staff ◽  
Budd Chiari Syndrome ◽  
Endoscopic Retrograde ◽  
Chiari Syndrome ◽  
History Of ◽  
Timely Fashion

Endoscopic retrograde cholangiopancreatography is a procedure commonly used for the diagnosis and treatment of various pancreatic and biliary diseases. Air embolism is a rare complication, which may be associated with this procedure. This condition can be manifested as cardiopulmonary instability and/or neurological symptoms. Known risk factors include: sphincterotomy; application of air with high intramural pressure; anatomic abnormalities; and chronic hepatobiliary inflammation. It is important for the health-care staff, including anesthesiologists, interventional gastroenterologists, and critical care specialists, amongst others, to promptly recognize air embolism and to initiate therapy in a timely fashion, thus preventing potentially fatal outcomes. We submit a brief review of the literature and a case report of air embolism which occurred in the immediate postoperative stage of an endoscopic retrograde cholangiopancreatography, performed in a woman with a history of liver transplantation due to Budd Chiari syndrome and biliary stricture.

Budd-Chiari syndrome due to segmental obstruction of the inferior vena cava successfully managed with endovascular stenting

MedPharmRes ◽  
2018 ◽  
Vol 2 (3) ◽  
pp. 22-26
Author(s):  
Uyen Vo ◽  
Duc Quach ◽  
Luan Dang ◽  
Thao Luu ◽  
Luan Nguyen
Keyword(s):  
Inferior Vena Cava ◽  
Inferior Vena ◽  
Laboratory Data ◽  
Transaminase Level ◽  
Vena Cava ◽  
Budd Chiari Syndrome ◽  
Endovascular Stenting ◽  
Massive Ascites ◽  
Chiari Syndrome ◽  
History Of

Budd–Chiari syndrome (BCS), a rare and life-threatening disorder due to hepatic venous outflow obstruction, is occasionally associated with hypoproteinemia. We herein report the first case of BCS with segmental obstruction of the intrahepatic portion of inferior vena cava (IVC) and hepatic veins (HVs) successfully treated by endovascular stenting in Vietnam. A 32-year-old female patient presented with a 2-month history of massive ascites and leg swelling. She refused history of oral contraceptives use. Hepatosplenomegaly without tenderness was noted. Laboratory data showed polycythemia, mild hypoalbuminemia and hypoproteinemia, slightly high total bilirubin and normal transaminase level. The serum ascites albumin gradient was 1.9 g/dL and ascitic protein level was 1.1 g/dL. The other data were normal. BCS was suspected because of the discrepancy between mild liver failure and massive ascites; and the presence of hepatosplenomegaly and polycythemia. On abdominal magnetic resonance imaging, the segmental obstruction of three HVs and IVC was 2-3 cm long without thrombus. Cavogram revealed the severe segmental stenosis of intrahepatic portion of IVC with no visualized HV and extensive collateral veins. A Protégé stent was deployed to IVC. Leg swelling and ascites were completely resolved within 3 days after stenting. During 1-year follow-up, edema was not recurred and repeated laboratory results were all normal.

scholarly journals Suicide by prisoners

2004 ◽  
Vol 184 (3) ◽  
pp. 263-267 ◽  
Author(s):  
Jenny Shaw ◽  
Denise Baker ◽  
Isabelle M. Hunt ◽  
Anne Moloney ◽  
Louis Appleby
Keyword(s):  
Mental Disorder ◽  
Clinical Care ◽  
National Sample ◽  
Primary Diagnosis ◽  
Care Staff ◽  
Health Care Staff ◽  
Prevention Measures ◽  
Prison Health ◽  
History Of ◽  
Clinical Survey

BackgroundThe number of suicides in prison has increased over recent years. This is the first study to describe the clinical care of a national sample of prison suicides.AimsTo describe the clinical and social circumstances of self-inflicted deaths among prisoners.MethodA national clinical survey based on a 2-year sample of self-inflicted deaths in prisoners. Detailed clinical and social information was collected from prison governors and prison health care staff.ResultsThere were 172 self-inflicted deaths: 85 (49%; 95% CI 42–57) were of prisoners on remand; 55 (32%; 95% CI 25–39) occurred within 7 days of reception into prison. The commonest method was hanging or self-strangulation (92%; 95% CI 88–96). A total of 110 (72%; 95% CI 65–79) had a history of mental disorder. The commonest primary diagnosis was drug dependence (39, 27%; 95% CI 20–35). Eighty-nine (57%; 95% CI 49–64) had symptoms suggestive of mental disorder at reception into prison.ConclusionsSuicide prevention measures should be concentrated in the period immediately following reception into prison. Because hanging is the commonest method of suicide, removal of potential ligature points from cells should be a priority.

scholarly journals Splenic Hematoma as a Rare Complication of Endoscopic Retrograde Cholangiopancreatography

2020 ◽  
Vol 6 (2) ◽  
Author(s):  
Kulvinder S Bajwa ◽  
Anirudh K Madabhushi ◽  
Nadim Jafri ◽  
Shinil K Shah ◽  
Melissa M Felinski
Keyword(s):  
Endoscopic Retrograde Cholangiopancreatography ◽  
Rare Complication ◽  
Endoscopic Retrograde ◽  
Splenic Hematoma

Hepatic artery pseudoaneurysm secondary to a cholangitic abscess and its spontaneous thrombosis

2021 ◽  
Vol 14 (11) ◽  
pp. e247304
Author(s):  
Maninder Kaur ◽  
Harsimran Bhatia ◽  
Gaurav Muktesh ◽  
Pankaj Gupta
Keyword(s):  
Hepatic Artery ◽  
Liver Abscess ◽  
Endoscopic Retrograde Cholangiopancreatography ◽  
Rare Complication ◽  
Gallstone Disease ◽  
Biliary System ◽  
Endoscopic Retrograde ◽  
Spontaneous Thrombosis ◽  
Artery Pseudoaneurysm ◽  
Hepatic Artery Pseudoaneurysm

Hepatic artery pseudoaneurysm (HAP) is mostly encountered secondary to trauma or iatrogenic causes. HAP associated with cholangitic liver abscess is a rare complication. We present a case of gallstone disease and choledocholithiasis who developed moderate cholangitis and a liver abscess. A small HAP was detected incidentally on a biphasic CT done to evaluate the biliary system. Repeat CT after management with endoscopic retrograde cholangiopancreatography and antibiotics showed resolution of cholangitic abscess with spontaneous thrombosis of HAP.

scholarly journals EUS-directed transgastric endoscopic retrograde cholangiopancreatography versus laparoscopic-assisted ERCP versus deep enteroscopy-assisted ERCP for patients with RYGB

2020 ◽  
Vol 08 (07) ◽  
pp. E877-E882 ◽  
Author(s):  
Gursimran S. Kochhar ◽  
Nabeeha Mohy-ud-din ◽  
Abhinav Grover ◽  
Neil Carleton ◽  
Abhijit Kulkarni ◽  
...  
Keyword(s):  
Endoscopic Retrograde Cholangiopancreatography ◽  
Retrospective Chart Review ◽  
Complication Rates ◽  
Success Rates ◽  
Technical Success ◽  
Endoscopic Retrograde ◽  
Technical Success Rate ◽  
Edge Group ◽  
History Of ◽  
Laparoscopic Assisted

Abstract Background and study aims Endoscopic ultrasound-directed transgastric endoscopic retrograde cholangiopancreatography (ERCP) (EDGE) is a novel technique for managing pancreaticobiliary diseases in patients with a history of Roux-en-Y Gastric Bypass (RYGB). It has shown to have high technical success rates and fewer adverse events as compared to laparoscopic-assisted ERCP (LA-ERCP). We compared the technical success and clinical outcomes of EDGE vs. LA-ERCP vs. E-ERCP. Patients and methods A retrospective chart review was performed for 56 patients, of whom 18 underwent LA-ERCP, 12 underwent E-ERCP, and 26 had EDGE, and a comparison of technical success and complication rates was done. Results Baseline demographic characteristics of patients undergoing these procedures, including age and gender, were comparable. The technical success rate for patients in the EDGE group were 100 % (n = 26), compared with 94 % (n = 17) and 75 % (n = 9) in the LA-ERCP and E-ERCP groups (P = 0.02). In the EDGE group, 8 % of patients (n = 2) had bleeding, and 4 % of patients (n = 1) had lumen-apposing metal stent migration occur during the procedure. In the LA-ERCP group 6 % (n = 1) of patient had bleeding, 6 % (n = 1) post-ERCP pancreatitis and 6 % (n = 1) were diagnosed with an intra-abdominal infection post-procedure. Time to complete the EDGE procedure was significantly shorter at 79 ± 31 mins, compared with 158 ± 50 mins for LA-ERCP and 102 ± 43 mins for E-ERCP (P < 0.001). Conclusion EDGE is a novel procedure with short procedure times and an effective alternative to LA-ERCP and E-ERCP in management of pancreaticobiliary diseases in patients with a history of RYGB.

scholarly journals An unusual experience with endoscopic retrograde cholangiopancreatography

2013 ◽  
Vol 04 (04) ◽  
pp. 114-116 ◽  
Author(s):  
Mallikarjun Patil ◽  
Keyur A. Sheth ◽  
C. K. Adarsh ◽  
B. Girisha
Keyword(s):  
Gastrointestinal Tract ◽  
Endoscopic Retrograde Cholangiopancreatography ◽  
Guide Wire ◽  
Rare Complication ◽  
Endoscopic Retrograde ◽  
Endoscopic Procedures ◽  
Hepatic Hematoma ◽  
Hemorrhagic Complications ◽  
Life Threatening ◽  
Therapeutic Utility

AbstractThe endoscopic retrograde cholangiopancreatography (ERCP) is known for its varied diagnostic and therapeutic utility for a variety of disorders. However it has greater likelihood of procedure related complications among the endoscopic procedures of gastrointestinal tract. The extraluminal hemorrhagic complications following ERCP are potentially life threatening though relatively rare. We present a 50 year patient with choledocholithiasis and cholelithiasis developing rare complication of subcapsular hepatic hematoma, following ERCP due to guide wire injury.

scholarly journals A case of antiphospholipid syndrome presenting cryptogenically as Budd-Chiari syndrome, then fulminantly as Libman-Sacks endocarditis

2019 ◽  
Vol 12 (5) ◽  
pp. e227450
Author(s):  
Hart A Goldhar ◽  
Paloma O’Meara ◽  
Lana A Castellucci
Keyword(s):  
Antiphospholipid Syndrome ◽  
Lupus Erythematosus ◽  
Vena Cava ◽  
Left Middle Cerebral Artery ◽  
Severe Thrombocytopenia ◽  
Budd Chiari Syndrome ◽  
Reactive Protein ◽  
Chiari Syndrome ◽  
History Of ◽  
New Diagnosis

A 58 year-old left-handed woman was transferred to our hospital with an evolving left middle cerebral artery stroke, severe thrombocytopenia and elevated inflammatory markers. She had a history of chronic Budd-Chiari syndrome (BCS) 16 months prior, attributed to a calcified web in the inferior vena cava that was stented. No thrombophilia testing was performed at that time. The current presentation demonstrated dense right-sided facial and arm paresis and neglect. Erythrocyte sedimentation rate and C-reactive protein were elevated, an autoimmune workup was consistent with a new diagnosis of systemic lupus erythematosus and triple-positive antiphospholipid antibodies. A transesophageal echocardiogram demonstrated a vegetation consistent with Libman-Sacks endocarditis (LSE), thought to have embolised to the brain. The patient was treated acutely with steroids, intravenous immunoglobulin and clopidogrel. This case demonstrates an atypical constellation of the antiphospholipid syndrome, with a novel presentation of BCS and LSE, and reinforces the importance of hypercoagulability screening in this population.

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