Ischemia of the glans 24 hours after circumcision: A case report and therapeutic solution

2018 ◽  
Vol 85 (4) ◽  
pp. 174-176 ◽  
Author(s):  
Irene Mittino ◽  
Mattia Sangalli ◽  
Fabio Fabbri ◽  
Francesco Sozzi ◽  
Massimo Ghezzi ◽  
...  
Keyword(s):  
Molecular Weight ◽  
Low Molecular Weight Heparin ◽  
Major Complication ◽  
Acute Ischemia ◽  
Low Molecular Weight ◽  
Emergency Setting ◽  
Case Description ◽  
Dorsal Penile Nerve Block ◽  
Dorsal Penile Nerve

Introduction: Circumcision is a common surgical procedure, typically performed under local anesthesia and somehow also as outpatient clinic. Although complications are rare and most frequently related to the procedure itself, ischemia of the glans may occur as a major complication and can be related to local ischemia following dorsal penile nerve block. Case description: We describe the case of a 33-year-old patient who underwent circumcision at our institution and, 24 h after the procedure, developed an acute ischemia of the glans; a re-intervention was performed in emergency setting to ensure a large, not-tightened circular suture under the glans, and low-molecular-weight heparin and antiplatelet therapy was introduced to achieve anti-coagulative/antiaggregant effects. After 48 h, the skin returned to its normal color and in 7 days the penile glans achieved complete remission of the ischemic aspect. A 6-month follow-up confirmed regular outcomes with normal erectile functions. Conclusion: The treatment we proposed to treat acute post-circumcision ischemia of the glans is a simple and effective one, with a perfect aesthetic and functional outcome observed within 4 weeks and confirmed at 6-month follow-up.

Rezidivierende isolierte Unterschenkelmuskelvenenthrombose bei Soleusvenenaneurysma

VASA ◽  
2002 ◽  
Vol 31 (4) ◽  
pp. 277-279 ◽  
Author(s):  
Schwarz ◽  
Zimmermann ◽  
Hänig ◽  
Schröder ◽  
Schellong
Keyword(s):  
Molecular Weight ◽  
Low Molecular Weight Heparin ◽  
Rare Case ◽  
Calf Muscle ◽  
Venous Aneurysm ◽  
Low Molecular Weight ◽  
Therapeutic Dosage ◽  
Follow Up Study ◽  
Short Course

A rare case of venous aneurysm involving the soleal muscle vein in an 18-year-old woman is presented. The patient showed three episodes of ultrasonographically proven calf muscle thrombosis within 2 years. After a short course of low-molecular-weight heparin at a therapeutic dosage, complete thrombus recanalization was achieved. To prevent further thrombotic episodes, surgery including ligation and resection of the aneurysm was performed. At the 3-month follow-up study the patient had completely recovered.

A retrospective single-center evaluation of the safety and efficacy of direct oral anticoagulants versus low molecular weight heparin in patients with cancer-associated thrombosis.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e24102-e24102
Author(s):  
Melissa McShane ◽  
Jordan Senchak ◽  
Anthony Stack ◽  
Justina Frimpong ◽  
Van T Hellerslia ◽  
...  
Keyword(s):  
Molecular Weight ◽  
Major Bleeding ◽  
Low Molecular Weight Heparin ◽  
Oral Anticoagulants ◽  
Direct Oral Anticoagulants ◽  
Low Molecular Weight ◽  
Safety And Efficacy ◽  
The Past ◽  
Cancer Associated Thrombosis

e24102 Background: Over the past decade, there has been an increase in the use of direct oral anticoagulants (DOACs) in the cancer population despite limited data comparing its use against low molecular weight heparin (LMWH), the standard of care in cancer patients. Increasing data supporting DOACs in cancer-associated thrombosis has emerged over the past few years. Nonetheless, this study will evaluate the relative safety and efficacy of DOACs versus LMWH in cancer-associated thrombosis within an urban setting associated with low socioeconomic status. Methods: This is a retrospective chart review of medical records from patients treated at an urban academic medical center from October 2010 through October 2018. Patients met study inclusion if they had a diagnosis of venous thromboembolism occurring after the date of diagnosis of active cancer and were prescribed a direct oral anticoagulant (rivaroxaban, apixaban, dabigatran, edoxaban) or a low molecular weight heparin (dalteparin, enoxaparin, or fondaparinux) as monotherapy for the treatment of venous thromboembolic disease. Patients were excluded if they had less than 6 months of follow up data for reasons other than death. The primary outcomes were recurrent venous thromboembolism, major bleeding and death. Results: Of the 914 patients who met inclusion criteria, 286 were excluded due to lack of follow up data. The remaining patients included 472 in the LMWH arm and 156 in the DOAC arm. At 6 months, recurrent thromboembolism occurred in 5 of the 472 patients (1.1%) in the LMWH group as compared with 4 of the 156 patients (2.6%) in the DOAC group (p = 0.170). Major bleeding occurred in 36 patients (7.6%) in the LMWH group and 11 patients (7.0%) in the DOAC group (p = 0.813). Death within 6 months of starting anticoagulation occurred in 76 patients (16.1%) in the LMWH group and 16 patients (9.6%) in the DOAC group (p = 0.046). Discontinuation before 6 months of treatment occurred in 241 patients (51.2%) in the LMWH group and 46 patients (29.5%) in the DOAC group. Conclusions: The LMWH and DOAC groups had similar rates of recurrent thromboembolism and major bleeding. The mortality rate within 6 months of starting anticoagulation was significantly higher in the LMWH group and this difference requires further evaluation. These results help support the continued use of DOACs for the treatment of cancer-associated thrombosis and demonstrate that DOACs are as safe and effective as LMWH in this patient population.

scholarly journals Analysis of Age and Prevention Strategy on Outcome after Cerebral Venous Thrombosis

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Xiuli Chu ◽  
Jianlin Zhang ◽  
Bin Zhang ◽  
Yuwu Zhao
Keyword(s):  
Molecular Weight ◽  
Functional Outcome ◽  
Neurological Deficit ◽  
Low Molecular Weight Heparin ◽  
Thrombotic Event ◽  
Prevention Strategy ◽  
Low Molecular Weight ◽  
Neck Infection ◽  
Presenting Symptoms

Object. Cerebral venous sinus thrombosis (CVST) mainly affects middle-aged individuals. However, the association between age or prevention strategy with the functional outcome remains poorly investigated. Method. We identified adult CVST patients in our centers. Functional outcome and prevention strategy were extracted from medical records. Modified Rankin Scale mRS ≤ 1 is considered a good functional outcome. Results. A total of 113 patients were identified. The most common presenting symptoms were headache (86.72%) and nausea/vomiting (56.63%); the top two identified risk factors were local head/neck infection (27.43%) and pregnancy/puerperal period (19.47%). The medical encounter lag time was 0.04 d-120 d. Four enrolled patients were diagnosed as CVST again, and the interval time was 3-8 years from the first time. Thrombus was most frequently seen at superior sagittal sinus (53.10%) and sigmoid sinus (50.44%). 94 (83.19%) of the patients had good outcomes. In the acute phase, 91 (80.53%) patients received low molecular weight heparin, 29 (25.66%) took aspirin, 7 (6.19%) patients were put on low molecular weight heparin and aspirin together. During our follow up (6-24 m), there were 10 (8.85%) patients who suffered from thrombotic event recurrence. For the patients > 40 years old, they tended to suffer from neurological deficit (25.00%) and stupor/coma (16.67%) ( p > 0.05 ), with a higher rate of hemorrhage (20.83%) and death (4.16%) when compared with the younger patients (10.77% and 1.53%, separately) ( p > 0.05 ). Conclusion. Functional outcome after CVST appears good. For the patients over 40-year-old, neurological deficit and altered consciousness were more common, accompanied by a higher rate of hemorrhage and mortality. The recurrent rate of CVST was low, longer-term follow up needed. The prevention strategy after CVST was uncertain, further studies needed.

Spontaneous Left Renal Subcapsular Hematoma and Right Hip Hematoma in a Hemodialysis Patient: A Case Report and Review of the Literature

2016 ◽  
Vol 42 (2) ◽  
pp. 100-103 ◽  
Author(s):  
Muyao Ye ◽  
Yinghong Liu ◽  
Letian Zhou ◽  
Chang Wang ◽  
Xiao Fu ◽  
...  
Keyword(s):  
Molecular Weight ◽  
Case Report ◽  
Low Molecular Weight Heparin ◽  
Hemodialysis Patient ◽  
Maintenance Hemodialysis ◽  
Low Molecular Weight ◽  
Review Of The Literature ◽  
Puncture Site ◽  
Kidney Rupture

For maintenance hemodialysis (MHD) patients, the blood is in low hypercoagulable state due to the use of heparin or low molecular weight heparin during dialysis. It is not rare to see hematoma in the puncture site. In recent years, several cases have been reported of spontaneous kidney rupture, but no hip hematoma, let alone both occurred in succession. There was one MHD patient with spontaneous kidney bleeding and hip hematoma in our hospital in 2014, and we provided effective treatment and follow-up.

scholarly journals Use of Rivaroxaban for Prevention of Venous Thromboembolic Complications in Elderly Patients after Hip Arthroplasty

2016 ◽  
pp. 74-77
Author(s):  
A. P. Afanas’Ev ◽  
A. A. Kardanov ◽  
A. S. Karandin ◽  
A. V. Korolev
Keyword(s):  
Molecular Weight ◽  
Elderly Patients ◽  
Hip Arthroplasty ◽  
Low Molecular Weight Heparin ◽  
Low Molecular Weight ◽  
Thromboembolic Complications ◽  
Low Molecular Weight Heparins ◽  
Heparin Group ◽  
Venous Thromboembolic

Results of retrospective analysis of the efficacy and safety of venous thromboembolic complications prevention using anticoagulants (low-molecular-weight heparins and rivaroxaban) in elderly (over 75 years) patients after hip arthroplasty are presented. Ninety four patients were divided into 2 groups (n=47) depending on the applied anticoagulant. Follow up period was 6 months after hospitalization. Asymptomatic thrombosis was diagnosed by duplex ultrasonography only in 1 (2.1%) patient from low-molecular-weight heparin group. No one case of either bleeding or hemorrhage was recorded. It is stated that rivaroxaban ensured effective thromboprophylaxis and safety after hip arthroplasty in elderly patients when no restrictions related to the use of low-molecular-weight heparin injections are present.

Outcomes of Anticoagulant Therapy with Low-Molecular-Weight Heparin (LMWH) and Warfarin for Thromboangiitis Obliterans (TAO)

2021 ◽  
Vol 19 ◽  
Author(s):  
Jiangping Gao ◽  
Liuhuan Huang ◽  
Jianli Wang
Keyword(s):  
Molecular Weight ◽  
Anticoagulant Therapy ◽  
Low Molecular Weight Heparin ◽  
Thromboangiitis Obliterans ◽  
Medium Size ◽  
Low Molecular Weight ◽  
Monocyte Count ◽  
Rest Pain ◽  
The Difference

Background: Thromboangiitis obliterans (TAO) is a chronic, non-atherosclerotic, progressive inflammatory vascular disease affecting the small- and medium-size arteries and veins of the extremities. Objective: To evaluate whether long-term anticoagulation with low-molecular-weight heparin (LMWH) and warfarin is beneficial for treating the inflammation and symptoms associated with TAO. Methods: Patients with TAO who underwent anticoagulation as the mainstay of treatment were included in this prospective study. Rest pain relief and healing of trophic lesions (as the primary and secondary endpoint) were investigated at day 14 and after 6 months of follow-up. High sensitivity C-reactive protein (hsCRP), monocyte count, and ankle-brachial index (ABI) were recorded and the difference compared before and after 2-week anticoagulation. The Chi-square test was used to compare the difference between anticoagulant and aspirin groups (based on the literature). Results: From 2014 to 2019, 18 patients were included. Only 1 patient with wet gangrene received endo-therapy for a failing stent at the start of treatment. After ~14 days, 12 of 13 (92%) patients showed complete ulcer healing and 17 of 18 (94%) patients showed complete relief from rest pain. Monocyte-counts and hsCRP levels decreased significantly (p<0.001) after a 2-week period of anticoagulation with LMWH. The mean follow-up was 2.6 years (range 0.5-5 years). At 6 months, all patients showed relief of rest pain and complete healing of trophic lesions. All endpoints were significantly improved compared with the aspirin group (p<0.01), and no rest pain or ulcer/gangrene recurred during follow-up. Conclusion: Anticoagulant therapy may alleviate the inflammation and symptoms of TAO.

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