scholarly journals A case of rectus sheath haematoma related to severe coughing in a patient with acute exacerbation of chronic obstructive pulmonary disease

2018 ◽  
Vol 26 (6) ◽  
pp. 371-374 ◽  
Author(s):  
Ching Hin Kevin Wong ◽  
Ho Kai Patrick Tsang ◽  
Oi Fung Wong ◽  
Hing Man Ma ◽  
Chau Hung Albert Lit
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Abdominal Pain ◽  
Pulmonary Disease ◽  
Acute Exacerbation ◽  
Abdominal Mass ◽  
Rectus Sheath ◽  
Rare Condition ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
History Of

Introduction: Rectus sheath haematoma is a rare condition which is often misdiagnosed. Apart from abdominal trauma and anticoagulation, severe coughing is an uncommon precipitating cause of this rare condition. Case presentation: An elderly gentleman with history of ischaemic heart disease on aspirin developed rectus sheath haematoma due to severe coughing during an episode of acute exacerbation of chronic obstructive pulmonary disease. He developed severe abdominal pain and was noted to have epigastric bruising extending to bilateral loins. Ultrasound abdomen and computed tomography of the abdomen with contrast revealed haematoma over bilateral upper rectus abdominis muscles, which subsided with conservative management. Discussion and conclusion: Rectus sheath haematoma can be related to severe coughing. In patients, especially those with predisposing factors, presenting with abdominal pain and palpable painful abdominal mass, clinicians should raise the suspicion of this uncommon cause so that timely and appropriate management can be provided.

scholarly journals Organisms isolated in induced sputum samples in acute exacerbation of severe and very severe chronic obstructive pulmonary disease

2017 ◽  
Vol 5 (3) ◽  
pp. 25-31
Author(s):  
S K Shrestha ◽  
S Adhikari ◽  
M Karki ◽  
U R Mohsin ◽  
R Khunjeli ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Acute Exacerbation ◽  
Bacterial Culture ◽  
Induced Sputum ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Gram Negative ◽  
History Of ◽  
Gram Negative Organisms

Acute exacerbations pose a very high economic burden on Chronic Obstructive Pulmonary Disease (COPD) patients and are commonly infective in nature. Gram’s staining and bacterial cultures are baseline investigations for sputum examination for COPD. This study evaluated these techniques for characterization and identification of various organism involved in acute infective exacerbations of COPD. Sodium Chloride (3%) induced sputum samples from 122 severe and very severe COPD subjects presenting in acute exacerbation who had history of frequent exacerbations and frequent antibiotics use were evaluated. The sputum samples were evaluated by Gram’s staining and bacterial culture from January 2013 to March 2014. Induction technique was able to obtain adequate samples from 86 (70.48% of 122) subjects. Gram’s stain showed 30 samples of Gram positive cocci (34.88%), 23 samples (26.74%) of Gram Negative Cocci and 50 samples (58.13%) of Gram Negative Bacilli. Bacterial culture showed predominant growth of Gram negative organisms including Pseudomonas sp, Acinetobacter sp, Klebsiella pneumoniae and Citrobacter Freundii. Gram negative bacilli are the most common isolated pathogens responsible for the acute exacerbation in severe and very severe COPDs with history of frequent exacerbations and hospital visits.

Invasive-noninvasive Sequential Ventilation for the Treatment of Acute Exacerbation of Chronic Obstructive Pulmonary Disease

2019 ◽  
Vol 22 (3) ◽  
pp. 160-168
Author(s):  
Jian-Da Huang ◽  
Tong-Jie Gu ◽  
Zhi-Lin Hu ◽  
Dan-Fei Zhou ◽  
Jun Ying
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Length Of Stay ◽  
Pulmonary Disease ◽  
Acute Exacerbation ◽  
Relevant Literature ◽  
Total Duration ◽  
Chronic Obstructive ◽  
Invasive Ventilation ◽  
Obstructive Pulmonary Disease ◽  
Relative Risks

Background: The study aimed to evaluate the efficacy and safety of invasivenoninvasive sequential ventilation versus invasive ventilation in the treatment of Acute Exacerbation of Chronic Obstructive Pulmonary Disease (AECOPD). Method: PubMed, Cochrane, Embase, Wanfang, CNKI, VIP database were searched by the index words to identify the qualified RCTs, and relevant literature sources were also searched. The latest research was conducted in June 2017. Relative Risks (RR), and Mean Difference (MD) along with 95% confidence interval (95% CI) were used to analyze the main outcomes. Result: Twenty-nine RCTs were involved in this analysis of 1061 patients in the invasivenoninvasive sequential ventilation group (In-non group) and 1074 patients in the invasive ventilation group (In group). The results indicated that compared with the invasive ventilation, invasive-noninvasive sequential ventilation would significantly decrease the incidence of VAP (RR:0.20, 95%CI: 0.16-0.26), mortality (RR:0.38, 95%CI: 0.26-0.55), reintubation (RR:0.39, 95%CI: 0.27-0.55); and statistically reduced the duration of invasive ventilation (MD:-9.23, 95%CI: -10.65, -7.82), the total duration of mechanical ventilation (MD:-4.91, 95%CI: -5.99, -3.83), and the length of stay in the ICU (MD:-5.10, 95%CI: -5.43, -4.76). Conclusion: The results demonstrated that the application of noninvasive sequential ventilation after invasive ventilation at the pulmonary infection control window has a significant influence on VAP incidence, mortality, and the length of stay in the ICU, but further well-designed, adequately powered RCTs are required to validate the conclusion.

Sign in / Sign up

Export Citation Format

Share Document