scholarly journals Retroperitoneal Paraganglioma-Induced Cardiogenic Shock Rescued by Preoperative Arterial Embolization

2018 ◽  
Vol 2018 ◽  
pp. 1-5
Author(s):  
N. Houari ◽  
S. Touzani ◽  
H. Salhi ◽  
M.-Y. Alaoui Lamrani ◽  
K. Ibnmajdoub ◽  
...  

Background. Catecholamine-induced cardiogenic shock is a rare manifestation of paragangliomas. The high mortality rate of this condition makes the immediate, multidisciplinary approach mandatory. Case Report. We report a case of an 18-year-old woman with a retroperitoneal secreting paraganglioma, complicated with a cardiogenic shock and an acute adrenergic myocarditis, requiring hemodynamic support and emergency arterial embolization prior to surgical excision, with a favorable outcome. Conclusion. Paraganglioma-induced myocarditis is rare but can be dramatic. Management requires appropriate and immediate hemodynamic support. Embolization may be an alternative to stabilize the patient prior to surgery.

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Daniel Ardian Soeselo ◽  
Wirawan Hambali ◽  
Sandy Theresia

Abstract Background In patients who are critically ill with COVID-19, multiple extrapulmonary manifestations of the disease have been observed, including gastrointestinal manifestations. Case presentation We present a case of a 65 year old man with severe COVID-19 pneumonia that developed hypercoagulation and peritonitis. Emergent laparotomy was performed and we found bowel necrosis in two sites. Conclusions Although rare, the presentation of COVID-19 with bowel necrosis requires emergency treatments, and it has high mortality rate.


Author(s):  
Ankitha Peetha ◽  
Nahida Farheen Shaik ◽  
Spandana Ayela

Myocardial infarction can be complicated by Ventricular septal rupture which is a rare fatal grim mechanical complication of MI which is a surgical emergency due to its incredibly high mortality rate. We depict a case of Anterior wall MI which was complicated by Ventricular septal rupture post fibrinolytic therapy.


2012 ◽  
Vol 127 (S1) ◽  
pp. S39-S41 ◽  
Author(s):  
G Sim ◽  
F Lannigan

AbstractObjective:We report lateral sinus thrombosis occurring as a rare complication following a routine and uneventful otological procedure.Case report:Lateral sinus thrombosis is a rare but known complication of otitis media. It has not been documented as a complication of routine otological surgery. We present a case of this rare complication following a myringoplasty. We also discuss the presentation, investigation and treatment of lateral sinus thrombosis. It is essential to be able to recognise and treat this rare complication early, due to its high mortality rate.Conclusion:Lateral sinus thrombosis is a rare but potentially life-threatening complication. It is therefore essential for clinicians to be able to recognise and treat this condition early.


2020 ◽  
Vol 8 (C) ◽  
pp. 121-124
Author(s):  
Darmadi Darmadi ◽  
Riska Habriel Ruslie ◽  
Carolus Trianda Samosir

BACKGROUND: Gallstone ileus (GI) is a mechanical obstruction in the intestinal lumen due to gallstones. Its prevalence is very low, but it possesses a high mortality rate. It is commonly found in older female population. CASE REPORT: We reported a case of GI in a 61-year-old Chinese female, who presented with acute onset of abdominal pain, nausea, and intermittent vomiting. On water-soluble contrast follow-through examination, she showed total bowel obstruction on the level of terminal ileum due to suspected gallstone. Exploratory laparotomy with procedure of enterolithotomy and stone removal by milking the bowel distal to the stone were performed. Post-operative course was uneventful, but the patient was discharged at post-operative day 8. Furthermore, the patient underwent cholecystectomy and fistula repair in the following days (two-stage surgery). She was followed up in the clinic for 12 months and the patient remained asymptomatic. CONCLUSION: GI is a rare medical condition with a high mortality rate, commonly affecting females and elder population. It must be considered in a patient with bowel obstruction, especially with a history of cholelithiasis. Many clinicians prefer enterolithotomy alone, followed by cholecystectomy at later date, because of its lower morbidity and report high spontaneous fistula closure.


Author(s):  
Benjamin D Sarkodie ◽  
Dorothea A Anim ◽  
Bashiru B Jimah

Renal angiomyolipomas (AML) are the commonest benign renal neoplasms. They are composed of blood vessels, adipose tissue, and smooth muscle in varying amounts. It is quite rare to find AML in a horseshoe kidney, although there is at least one such reported case discovered in pregnancy and managed by resection. Spontaneous hemorrhage which could be fatal is the most feared sequelae of AML. The first-line of management for AMLs was previously surgical excision. However, advances in minimally invasive techniques that have a lower risk of complications have broadened treatment options for reducing tumour size and preventing hemorrhage. One of such effective techniques is selective arterial embolization (SAE) of renal AMLs > 4cm. Patients not requiring any immediate intervention maybe followed up with active surveillance. In this case report, we present a case of AML in a horseshoe kidney that was successfully treated with transfemoral embolization as well as a review of the literature.


2019 ◽  
pp. 43-47
Author(s):  
Juliana C Ferreira ◽  
Maria Lucia B Santos ◽  
Marcia A Souza ◽  
Gisele M Silva ◽  
Ana Cristina S Monteiro ◽  
...  

Toxic epidermal necrolysis is a rare and severe skin reaction with a high mortality rate. This case report describes a case of toxic epidermal necrolysis in a 7-year-old patient caused by an adverse drug reaction.


2007 ◽  
Vol 122 (12) ◽  
pp. 1389-1391 ◽  
Author(s):  
O Obanor ◽  
H O Osazuwa ◽  
J E O Amadasun

AbstractBackground:Tetanus is a fatal infection caused by the neurotoxin tetanospasmin released by the vegetative spores of Clostridium tetani. The high mortality rate is related to frequent tetanic fits with laryngeal spasm and airway obstruction. Numerous anticonvulsants are in use, with varying efficacy in controlling fits. This case report highlights the use of ketamine as adjunctive therapy in the management of tetanus.Case report:A 20-year-old woman was admitted with a history of recurrent left ear pain, with bloody, purulent discharge, following a self-inflicted injury. She developed tetanic spasms 24 hours after admission. She had received no immunisations. A tracheostomy was established to relieve airway obstruction, and ketamine was added to the medication when breakthrough seizures were refractory to diazepam.Conclusion:Ketamine is of proven safety as an anaesthetic agent, especially in cases in which an anaesthetist is not readily available. Its effectiveness in this case, in combination with diazepam, warrants further evaluation.


2020 ◽  
pp. 194187442095784
Author(s):  
Rizwan Sabir ◽  
McNeill Kirkpatrick ◽  
Jonathan Watts ◽  
Jindong Xu

Cavernous sinus thrombosis (CST) is rare and can present with various nonspecific symptoms. The high mortality rate of this disease is largely due to delayed recognition and treatment. We report a case who presented with unrelenting headache and was diagnosed with temporal arteritis (TA) but did not respond to steroids. Imaging helped make the CST diagnosis and the patient responded well to treatment. This case reiterates the importance of early recognition and treatment of CST, and reminds physicians to include CST as an essential differential diagnosis of TA.


2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
A Venuti ◽  
M Gramegna ◽  
L Baldetti ◽  
F Calvo ◽  
V Pazzanese ◽  
...  

Abstract Background Despite progresses in the reperfusion strategies, the prognosis of patients with cardiogenic shock (CS) remains poor with a high in-hospital mortality rate. Percutaneous mechanical circulatory support systems (pMCS) reducing afterload, preload and myocardial oxygen demand, preventing compensatory tachycardia and increasing mean arterial pressure, lead to improve end-organ perfusion. Since CS progression to a refractory shock state is deleterious, timing of treatment represents a crucial issue in these patients. Purpose The aim of our study was to assess whether a multidisciplinary approach and an early use of pMCS could be safe and effective in improving CS patients' outcome. Methods We examined the outcome in terms of one-month survival of 62 patients (75.8% males, mean age 67.7±12.2 years) admitted between January and December 2018 to our Cardiac Intensive Care Unit (CICU) with cardiogenic shock due to acute coronary syndrome (ACS), acute heart failure (AHF) and other causes in 43.5%, 21.6%, 35.4% of cases respectively. For each patient, a Multidisciplinary Shock Team (CS-Team) including critical care specialists, interventional cardiologists and advanced heart failure specialists, was involved and the early use of pMCS was considered. Results Overall, 52 (83.9%) CS patients underwent pMCS implant, including intra-aortic ballon pump counterpulsation (IABP), Impella system (Impella), venous-arterial extracorporeal membrane oxygenation (VA ECMO) in 67.7%, 46.7%, 11.3% of cases respectively. Median time from the first CS-Team contact to the pMCS implantation was 32.5 (30–60) minutes. Among ACS-CS group, AHF-CS group and CS-due to other causes group, pMCS were implanted in 25 (92.5%), 12 (92.3%) and 15 (68.1%) patients respectively. Lower extremities ischemia, gastrointestinal/intracerebral and life-threatening bleeding and ischemic stroke were observed as pMCS related adverse events in 9.7%, 6.4%, 1.6%, 3.2%, 6.4% of cases respectively. At one month, 56 (90.3%) CS patients were discharged alive while 6 (9.7%) CS patients died during the CICU stay. Conclusion A multidisciplinary approach of CS patients, contemplating an early and extensive use of pMCS, may be effective in the reduction of in-hospital mortality rate with a low and acceptable occurrence of pMCS related adverse events. Funding Acknowledgement Type of funding source: None


Author(s):  
Jose Sanchez-Perez ◽  
Gabriel Rivera-Rivera ◽  
Mario Gonzalez ◽  
Shayanne Lajud ◽  
Mario Corona-Ruiz ◽  
...  

Tracheobronchial injuries following blunt trauma have a low incidence due to the high mortality rate before reaching hospitals. This case report advocates for conservative management in a hemodynamic patient with a large longitudinal tracheal laceration with no signs of acute complication.


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