scholarly journals Giant Intrahepatic Subcapsular Haematoma: A Rare Complication following Laparoscopic Cholecystectomy—A Case Report and Literature Review

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Eltaib Saad ◽  
Lauren O’Connell ◽  
Anne M. Browne ◽  
W. Khan ◽  
R. Waldron ◽  
...  
Keyword(s):  
Rare Complication ◽  
Rare Event ◽  
Decisive Role ◽  
Postoperative Monitoring ◽  
Refractory Hypotension ◽  
Life Threatening ◽  
The Right ◽  
Tomography Scan

We report on a 59-year-old female with symptomatic cholelithiasis on a background of morbid obesity who underwent an elective LC with an uncomplicated intraoperative course; however, she experienced a refractory hypotension within one hour postoperatively with an acute haemoglobin drop requiring fluid resuscitation and blood transfusion. A triphasic computed tomography scan revealed a large intrahepatic subcapsular haematoma (ISH) measuring 21   cm × 3.1   cm × 17   cm surrounding the lateral surface of the right hepatic lobe without active bleeding. She was managed conservatively with serial monitoring of haemoglobin and haematoma size. A follow-up ultrasound scan after eight weeks confirmed complete resolution of the haematoma. Giant ISH is a fairly rare, but life-threatening complication following LC which merits special attention. This case demonstrates the necessity of close postoperative monitoring of patients undergoing LC and considering the possibility of ISH, although being rare event, in those who experience a refractory postoperative hypotension. It also highlights the decisive role of diagnostic imaging in securing a timely and accurate diagnosis of post LC-ISH.

scholarly journals Case report: Recovery after large intramyocardial dissecting haematoma of the ventricular septum—a rare complication of myocardial infarction

2021 ◽  
Vol 5 (2) ◽  
Author(s):  
David Lovasz ◽  
Daniele Camboni ◽  
Judith Zeller ◽  
Christof Schmid
Keyword(s):  
Myocardial Infarction ◽  
Plaque Rupture ◽  
Rare Complication ◽  
Coronary Intervention ◽  
Ventricular Septum ◽  
Feasible Option ◽  
Life Threatening ◽  
Magnetic Resonance Imaging Mri ◽  
The Right

Abstract Background Intramyocardial dissecting haematoma is a rare and potentially life-threatening complication of myocardial infarction (MI). Only a few isolated cases have been reported so far. Case summary We report the case of a patient with a large, obstructing intramyocardial haematoma of the ventricular septum following MI due to plaque rupture of the right coronary artery (RCA) and following successful coronary intervention. The clinically inapparent haematoma was discovered during routine echocardiography and confirmed by both computed tomography (CT) and magnetic resonance imaging (MRI). With non-surgical treatment, the patient remained clinically stable. Repeated echocardiography showed gradual regression of the haematoma. Follow-up echocardiography 3 months after the initial diagnosis demonstrated no evidence of septal haematoma. Discussion This report suggests that even large intramyocardial haematoma may recede without operative intervention. Echocardiography, CT, and MRI are all helpful in quantifying the size of the haematoma. The appropriate management should be patient-oriented, depending on clinical stability and progression of the haematoma. Conservative treatment in clinically stable patients suffering from septal haematoma following MI and coronary intervention can be a feasible option.

scholarly journals A rare complication developing after delivery: septic pelvic thromboembophlebitis

2020 ◽  
Vol 28 (1) ◽  
pp. 52-55
Author(s):  
Ersin Çintesun ◽  
Denizhan Bayramoğlu ◽  
Emine Uysal ◽  
Çetin Çelik
Keyword(s):  
Emergency Service ◽  
Rare Complication ◽  
Previous History ◽  
Ovarian Vein ◽  
Anticoagulant Treatment ◽  
Vein Wall ◽  
History Of ◽  
The Right ◽  
Tomography Scan

Objective In this case report, we aimed to discuss a septic pelvic thromboembophlebitis (SPT) case detected 20 days later who had the previous history of cesarean section and had an intrauterine stillbirth vaginally at 30 weeks of gestation. Case(s) A 24-year old patient, who admitted to the emergency service with the complaints of fever and pain in the lower right abdomen and was reported to have a 4 cm formation consistent with thrombus on the right ovarian vein wall in the computed tomography (ST), was hospitalized for follow-up and treatment. The patient whose thrombus showed remission in the check-up tomography scan after the broad-spectrum antibiotherapy and anticoagulant treatment was discharged on the 10th day. The treatment of the patient who did not develop any complication in the follow-ups was completed with recover. Conclusion In conclusion, SPT is a complication which is seen rarely in both obstetric and gynecologic practices. SPT is a disease which may lead to fatal outcomes by late diagnosis but satisfying results with early diagnosis. Abdominal pain and fever symptoms should come to mind in all cases after delivery or operation.

scholarly journals 143 Massive Intra-Hepatic Subcapsular Liver Haematoma Post-Laparoscopic Cholecystectomy- A Rare Complication of a Common Procedure'

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
E Saad ◽  
L O'Connell ◽  
I Khan ◽  
K Barry
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Rare Complication ◽  
Postoperative Bleeding ◽  
Bile Leak ◽  
Decisive Role ◽  
Biliary Colic ◽  
Post Discharge ◽  
Common Procedure ◽  
Life Threatening ◽  
The Right

Abstract Laparoscopic Cholecystectomy (LC) is currently considered the gold standard for the management of symptomatic gallbladder stones disease. Specific complications remain challenging, particularly postoperative bleeding, bile leak, and bile duct injury. We report a rare case of a giant intrahepatic subcapsular haematoma (ISH) complicating LC. Case Presentation A 59-year-old female presented with symptomatic biliary colic. Her past medical history was noted for obesity (BMI>50). She underwent an elective LC with an uncomplicated intraoperative course; however, post-operatively she developed hypovolaemic shock with an acute haemoglobin drop requiring fluid resuscitation and blood transfusion. Emergency CT revealed a massive subcapsular haematoma measuring 21cm×3.1cm× 17cm at the right liver margin without evidence of ongoing bleeding. She was managed conservatively- as per a tertiary hepatobiliary surgery centre’s advice- with meticulous clinical observations, serial monitoring of haemoglobin, and repeat CT to assess for interval progressions. She progressed well with conservative management and did not require surgical or radiological intervention. A follow-up liver sonography performed eight weeks post-discharge confirmed a complete resolution. Conclusion Giant ISH is an exceedingly rare but life-threatening complication following LC which merits special attention. Our case demonstrates the necessity of close postoperative monitoring of patients undergoing LC and considering the possibility of ISH in those who experience refractory postoperative hypotension. It also highlights the decisive role of diagnostic imaging in securing a timely and accurate diagnosis of post-LC ISH.

scholarly journals Peritoneal well-differentiated papillary mesothelioma associated with infertility in a 37-year-old woman

2021 ◽  
Vol 49 (1) ◽  
pp. 030006052098668
Author(s):  
Bo Pang ◽  
Cong Hu ◽  
Qian Liu ◽  
Jinyu Yu ◽  
Zhentong Wei ◽  
...  
Keyword(s):  
Benign Tumors ◽  
Free Fluid ◽  
Adenomatoid Tumor ◽  
Cancer Antigen 125 ◽  
Immunohistochemical Markers ◽  
Serum Ca125 ◽  
Life Threatening ◽  
Well Differentiated ◽  
The Right

Well-differentiated papillary mesothelioma (WDPM) is an uncommon mesothelial tumor. The lesions may be single or multiple and usually behave in a benign or indolent fashion, sometimes persisting for many years. In the present case, a 37-year-old woman had experienced primary infertility for 12 years, and a diagnostic laparoscopy was performed. Approximately 200 mL of dark red, free fluid in the pelvis and more than 10 yellow-white nodules on the surface of the right round ligament, sacrum ligament, right fallopian tube, and both sides of the uterus were found. A lesionectomy was performed and immunohistochemical markers indicated WDPM with adenomatoid tumor. The patient was monitored by computed tomography and serum CA125 (cancer antigen 125) levels for 49 months with no recurrence. WDPM and adenomatoid tumor are both benign tumors of mesothelial origin. Because of the lack of effective radical treatment, regular follow-up is sufficient. However, the effects of estrogen and progesterone on WDPM and adenomatoid tumors during ovulation or pregnancy remains unclear. Although WDPM is not life threatening, a strategy to fulfill the fertility requirements of women with this condition is a new challenge for infertility doctors.

Intra-Peritoneal Pseudocyst as a Rare Complication After Peritoneal Dialysis: The Use of a Staged Surgical Approach in Management

2021 ◽  
pp. 000313482110474
Author(s):  
Ahmad Kharsa ◽  
Kayla Colvill ◽  
Heather Stevenson ◽  
Jeffrey Fair ◽  
Rupak Kulkarni ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Surgical Approach ◽  
Rare Case ◽  
Diagnostic Laparoscopy ◽  
Rare Complication ◽  
Cyst Excision ◽  
Neoplastic Processes ◽  
Life Threatening ◽  
Pseudocyst Formation

Despite its numerous benefits, peritoneal dialysis (PD) can rarely result in dangerous and even life-threatening complications, including peritonitis, hernias, encapsulating peritoneal sclerosis (EPS), and rarely peritoneal pseudocysts. Herein, we present a rare case of a giant intra-peritoneal pseudocyst that presented four months following the discontinuation of a 5-year course of complicated PD. Despite the initially successful drainages, the patient’s symptoms continued to recur, and the imaging findings were concerning for underlying neoplastic processes. As such, a staged surgical approach was performed, starting with a diagnostic laparoscopy and was subsequently followed with cyst excision and marsupialization to the peritoneal cavity. While previous reports of such rare pseudocyst have been documented in the literature as a complication of PD, to our knowledge, this is the second case of pseudocyst formation to occur months after the discontinuation of PD therapy. This case emphasizes the importance of close follow-up in PD patients and showcases how a staged surgical approach can be utilized to accurately diagnose and manage such complicated cases.

scholarly journals A forgotten life-threatening medical emergency: myxedema coma

2016 ◽  
Vol 12 (2) ◽  
Author(s):  
Elisa Pizzolato ◽  
Alberto Peano ◽  
Letizia Barutta ◽  
Emanuele Bernardi ◽  
Elena Maggio ◽  
...  
Keyword(s):  
Life Support ◽  
Neurological Status ◽  
Medical Emergency ◽  
Myxedema Coma ◽  
Emergency Department Stay ◽  
Life Threatening ◽  
Appropriate Therapy ◽  
Alithiasic Cholecystitis ◽  
The Right ◽  
Tomography Scan

Nowadays myxedema coma is a rare medical emergency but, sometimes, it still remains a fatal condition even if appropriate therapy is soon administered. Although physical presentation is very non-specific and diversified, physicians should pay attention when patients present with low body temperature and alteration of neurological status; the presence of precipitating events in past medical history can help in making a diagnosis. Here we discuss one such case: an 83-year-old female presented with abdominal pain since few days. Laboratory tests and abdomen computed tomography scan demonstrated alithiasic cholecystitis; she was properly treated but, during the Emergency Department stay she experienced a cardiac arrest. Physicians immediately started advance cardiovascular life support algorithm and she survived. Later on, she was admitted to the Intensive Care Unit where doctors discovered she was affected by severe hypothyroidism. Straightway they started the right therapy but, unfortunately, the patient died in a few hours.

scholarly journals Rare Case of Servelle Martorelle Syndrome

2014 ◽  
Vol 10 (4) ◽  
pp. 91-94
Author(s):  
A Bhatnagar ◽  
M Deshpande
Keyword(s):  
Soft Tissue ◽  
Upper Limb ◽  
Rare Case ◽  
Prompt Treatment ◽  
Congenital Vascular Malformation ◽  
History Of ◽  
The Right ◽  
Scapular Region

Servelle Martorelle Syndrome is a congenital vascular malformation associated with soft tissue hypertrophy and bony hypoplasia. This rarely involves whole of an extremity, with involvement of part of limbs reported in literature. We present a case of a twelve year boy who presented to the Department of Plastic Surgery SGPGIMS in April 2011 ,with history of circumferential soft tissue hypertrophy involving whole of left upper limb, scapular region and axilla since birth. The entire left upper limb length was lesser than the right upper limb. Hence this is a very rare case of Servelle Martorelle Syndrome having extensive limb involvement at a very young age. Highlighted is the role of conservative treatment and close follow-up to understand the natural history of the diseases, with prompt treatment of complications. DOI: http://dx.doi.org/10.3126/kumj.v10i4.11011 Kathmandu Univ Med J 2012;10(4):91-94

scholarly journals Ibrutinib Treatment of a Patient with Relapsing Chronic Lymphocytic Leukemia and Sustained Remission of Richter Syndrome

2017 ◽  
Vol 103 (1_suppl) ◽  
pp. S37-S40 ◽  
Author(s):  
Elisa Albi ◽  
Stefano Baldoni ◽  
Patrizia Aureli ◽  
Erica Dorillo ◽  
Beatrice Del Papa ◽  
...  
Keyword(s):  
Chronic Lymphocytic Leukemia ◽  
Kinase Inhibitor ◽  
Rare Event ◽  
Lymphocytic Leukemia ◽  
Sustained Remission ◽  
Richter Syndrome ◽  
Positron Emission ◽  
Bruton Tyrosine Kinase ◽  
Tomography Scan

Purpose Richter syndrome (RS) is a rare event in chronic lymphocytic leukemia (CLL) that is influenced by biological factors and prior CLL treatments. Ibrutinib is a Bruton tyrosine kinase inhibitor that has shown remarkable efficacy in CLL; however, little is known about its relationship to RS. We report a case of ibrutinib efficacy against CLL in a patient with prolonged remission of RS. Methods The patient was diagnosed with CLL in 2003. Biological findings at onset included absent ZAP70 expression, mutated IGVH, and NOTCH1 mutation. He was treated with FCR with partial response. In 2013, he progressed to RS, not clonally related to the underlying CLL. The patient was treated with anthracycline- and platinum-based regimens, obtaining a complete remission. After 3 years, he presented a CLL progression with worsening lymphocytosis, anemia, thrombocytopenia, increased splenomegaly, and lymphadenopathies. Positron emission tomography-computed tomography scan excluded pathologic uptake. Thus, he was started on ibrutinib. Results At 12 months’ follow-up, we observed white blood cell normalization, increased hemoglobin and platelet levels, disappearance of lymphadenopathy, and spleen size reduction. Therapy was well-tolerated with no evidence of RS. Conclusion This case demonstrates sustained RS remission in a patient with CLL under ibrutinib therapy, thus improving our knowledge on the use of this new drug in CLL and beyond.

Cyclophosphamide, methotrexate, and fluorouracil with and without doxorubicin in the adjuvant treatment of resectable breast cancer with one to three positive axillary nodes.

1991 ◽  
Vol 9 (7) ◽  
pp. 1124-1130 ◽  
Author(s):  
A Moliterni ◽  
G Bonadonna ◽  
P Valagussa ◽  
L Ferrari ◽  
M Zambetti
Keyword(s):  
Randomized Study ◽  
Menopausal Status ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
Treatment Groups ◽  
The Face ◽  
Life Threatening ◽  
Drug Treatments

In the attempt to improve current adjuvant results in patients with one to three positive axillary lymph nodes, in November 1981 we activated a prospective randomized study to assess the effectiveness of intravenous (IV) cyclophosphamide, methotrexate, and fluorouracil (CMF) for 12 courses versus CMF for eight courses followed by Adriamycin (doxorubicin; Farmitalia Carlo Erba, Milan, Italy) for four courses. The 5-year results were evaluated in a total of 486 patients entered into the study up to December 1987. CMF chemotherapy was delivered IV for a total of 12 courses when given alone and for eight courses when followed by four courses of Adriamycin. All drugs were recycled every 3 weeks. Rather than temporarily reducing doses, drug administration was delayed for 1 to 2 weeks in the face of myelosuppression on the planned day of treatment. After a median follow-up of 61 months, no significant differences were evident between the treatment groups in terms of relapse-free (CMF 74% v CMF followed by Adriamycin 72%) and total survival (CMF 89% v CMF followed by Adriamycin 86%). Drug treatments were fairly well tolerated and devoid of life-threatening toxicity. Present results, which were not influenced by menopausal status, indicate that Adriamycin given after CMF failed to improve treatment outcome over CMF alone. However, the role of Adriamycin in an adjuvant setting remains to be further clarified. Considering the good 5-year results achieved in this study at the expense of minimal toxicity, full-dose CMF remains, at present, the adjuvant chemotherapy of choice for patients with one to three positive nodes.

The Role of Temporo-parietal Cortex in Subcortical Visual Extinction

2010 ◽  
Vol 22 (9) ◽  
pp. 2141-2150 ◽  
Author(s):  
Luca Francesco Ticini ◽  
Bianca de Haan ◽  
Uwe Klose ◽  
Thomas Nägele ◽  
Hans-Otto Karnath
Keyword(s):  
Basal Ganglia ◽  
Decisive Role ◽  
Brain Structures ◽  
Cortical Lesion ◽  
Critical Aspect ◽  
Subcortical Structures ◽  
Visual Extinction ◽  
Subcortical Brain Structures ◽  
The Right

Visual extinction is an intriguing defect of awareness in stroke patients, referring to the unsuccessful perception of contralesional events under conditions of competition. Previous studies have investigated the cortical and subcortical brain structures that, when damaged or inactivated, provoke visual extinction. The present experiment asked how lesions of subcortical structures may contribute to the appearance of visual extinction. We investigated whether lesions centering on right basal ganglia may induce dysfunction in distant, structurally intact cortical structures. Normalized perfusion-weighted MRI was used to identify structurally intact but abnormally perfused brain tissue, that is, zones that are receiving enough blood supply to remain structurally intact but not enough to function normally. We compared patients with right basal ganglia lesions showing versus not showing visual extinction. In the extinction patients, the contrast revealed cortical malperfusion that clustered around the right TPJ. It seems as if malfunction of this area is a critical aspect in visual extinction not only after cortical lesion but also in the case of subcortical basal ganglia damage. Our results support the idea that a normally functioning TPJ area plays a decisive role for the attentional network involved in detecting of visual stimuli under conditions of competition.

Sign in / Sign up

Export Citation Format

Share Document