Life-threatening perianaesthetic complications in five cats undergoing biliary tract surgery: case series and literature review

2016 ◽  
Vol 19 (6) ◽  
pp. 717-722
Author(s):  
Paolo Monticelli ◽  
Thaleia Rengina Stathopoulou ◽  
Karla Lee ◽  
Chiara Adami
Keyword(s):  
Biliary Tract ◽  
Case Series ◽  
Biliary Tree ◽  
Common Finding ◽  
Biliary Surgery ◽  
Biliary Tract Surgery ◽  
Alternative Treatment Option ◽  
Life Threatening ◽  
Surgical Manipulation ◽  
Queen Mother

Case series summary The aim of this case series was to describe the intra- and early postanaesthetic complications occurring in five cats undergoing major surgeries involving the gallbladder and the biliary tree. The five cases of this series were admitted to the Queen Mother Hospital for Animals between June and December 2015, and were all overseen by the same senior anaesthesist. Pre-existing pancreatitis was a common finding. Observed life-threatening events were persistent, unresponsive hypotension in the absence of major blood loss, which occurred mainly during surgical manipulation of the biliary tract, and postoperative renal failure. Relevance and novel information Biliary surgery carries the potential for life-threatening complications in cats. The pathogenesis of such morbidities is likely to be multifactorial. The perianaesthetic use of haemoglobin-based oxygen-carrying solution may be considered as an alternative treatment option when hypotension is unresponsive to fluids and traditional positive inotropes and vasopressors.

scholarly journals BILIARY TRACT SURGERY

2007 ◽  
Vol 14 (04) ◽  
pp. 689-696
Author(s):  
UMAR ALI ◽  
M. YUSUF SHAH ◽  
PAN CHENG'EN MA QINGYONG ◽  
Yu Lian
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Biliary Tract ◽  
Surgical Complication ◽  
Optimization Technique ◽  
Bile Leakage ◽  
Biliary Surgery ◽  
Bile Duct Injuries ◽  
Biliary Tract Surgery ◽  
Life Threatening ◽  
Effective Drainage

Surgical complication after biliary tract injury are serious complications of Hepatobiliary surgery. Theincidence of iatrogenic bile duct injuries has increased significantly since the number of cholecystectomy operationshave increased, laparoscopic cholecystectomy became the "gold standard", mini-cholecystectomy established for thetreatment of cholelithiasis. Intraoperative hemorrhage can be life-threatening or may lead the death. The common usesof laparoscopic cholecystectomy and mini-cholecystectomy have made the young surgeons less familiar with opencholecystectomy procedure and the approaches to manage the biliary tract injuries. Uncommonly the patient had toundergo hepatic transplantation secondary to biliary tract surgery with several vessel injuries or biliary cirrhosis.Postoperative bile leakage can be managed by effective drainage as soon as possible. These complications uncommonwith the expert surgeons, but common with comparatively inexperienced surgeons. There is no substitute of experienceand caution in biliary surgery for optimization technique.

scholarly journals BILIARY TRACT SURGERY

2007 ◽  
Vol 14 (04) ◽  
pp. 689-696
Author(s):  
UMAR ALI ◽  
M. YUSUF SHAH ◽  
PAN CHENG'EN MA QINGYONG ◽  
Yu Lian
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Biliary Tract ◽  
Surgical Complication ◽  
Optimization Technique ◽  
Bile Leakage ◽  
Biliary Surgery ◽  
Bile Duct Injuries ◽  
Biliary Tract Surgery ◽  
Life Threatening ◽  
Effective Drainage

Surgical complication after biliary tract injury are serious complications of Hepatobiliary surgery. Theincidence of iatrogenic bile duct injuries has increased significantly since the number of cholecystectomy operationshave increased, laparoscopic cholecystectomy became the "gold standard", mini-cholecystectomy established for thetreatment of cholelithiasis. Intraoperative hemorrhage can be life-threatening or may lead the death. The common usesof laparoscopic cholecystectomy and mini-cholecystectomy have made the young surgeons less familiar with opencholecystectomy procedure and the approaches to manage the biliary tract injuries. Uncommonly the patient had toundergo hepatic transplantation secondary to biliary tract surgery with several vessel injuries or biliary cirrhosis.Postoperative bile leakage can be managed by effective drainage as soon as possible. These complications uncommonwith the expert surgeons, but common with comparatively inexperienced surgeons. There is no substitute of experienceand caution in biliary surgery for optimization technique.

scholarly journals Clinical Diversity in Biliary Pancreatitis — Classification of Two Types

HPB Surgery ◽  
1993 ◽  
Vol 6 (4) ◽  
pp. 263-276 ◽  
Author(s):  
Masatoshi Isogai ◽  
Kitao Hachisuksa ◽  
Akihiro Yamaguchi ◽  
Satoshi Nakano
Keyword(s):  
Biliary Tract ◽  
Necrotizing Pancreatitis ◽  
Biliary Tract Disease ◽  
Supportive Therapy ◽  
Biliary Pancreatitis ◽  
Biliary Surgery ◽  
Group I ◽  
Life Threatening ◽  
Extent Of Surgery ◽  
Tract Disease

One hundred and seven patients with biliary pancreatitis undergoing operation from 1976 to 1989 were reviewed. To clarify the reason for failure to respond to conventional supportive therapy, 73 patients (68%) who underwent emergency surgery were retrospectively divided into two groups according to the severity of the pancreatitis evaluated at laparotomy and compared. Sixty-two had minimal or mild pancreatitis (Group I), among whom 44 (71%) had life-threatening acute biliary tract disease. All underwent biliary surgery and 4 (6%) subsequently died, 2 due to acute obstructive suppurative cholangitis. Eleven had hemorrhagic necrotizing pancreatitis (Group II), among whom 7 had complications of acute pancreatitis such as pancreatic ascites or abscess. These underwent pancreatic and/or biliary surgery and 3 (27%) died of multi-organ failure.There appears to be two types of biliary pancreatitis refractory to conventional supportive therapy, which differ in the extent of surgery required and in mortality: (1) minimal or mild pancreatitis with persistent life-threatening acute biliary tract disease (biliary type), and (2) more severe pancreatitis (pancreas type) early in the course of the disease.

scholarly journals Case Series of Three Patients with Rifampicin-Induced Thrombocytopenia

2020 ◽  
Author(s):  
Chandramouli M.T
Keyword(s):  
Pulmonary Tuberculosis ◽  
Adverse Reactions ◽  
Rare Complication ◽  
Case Series ◽  
Tuberculosis Treatment ◽  
Effective Drug ◽  
Antitubercular Drugs ◽  
Short Course ◽  
Life Threatening

AbstractLife-threatening adverse reactions of antitubercular drugs are uncommon; however, thrombocytopenia is one such rare complication encountered with rifampicin, isoniazid, ethambutol, and pyrazinamide. Rifampicin is the most effective drug and its use in the tuberculosis treatment led to the emergence of modern and effective short-course regimens. I am reporting case series of three patients with pulmonary tuberculosis presented with rifampicin-induced thrombocytopenia.

scholarly journals Treatment and therapeutic strategies for pituitary apoplexy in pregnancy: a case series

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Yuya Kato ◽  
Yoshikazu Ogawa ◽  
Teiji Tominaga
Keyword(s):  
Pituitary Apoplexy ◽  
Clinical Symptoms ◽  
Case Series ◽  
Optimal Timing ◽  
Presenting Symptoms ◽  
Pathological Evaluation ◽  
Mother And Child ◽  
Life Threatening ◽  
In Pregnancy

Abstract Background Pregnancy is a known risk factor for pituitary apoplexy, which is life threatening for both mother and child. However, very few clinical interventions have been proposed for managing pituitary apoplexy in pregnancy. Case presentation We describe the management of three cases of pituitary apoplexy during pregnancy and review available literature. Presenting symptoms in our case series were headache and/or visual disturbances, and the etiology in all cases was hemorrhage. Conservative therapy was followed until 34 weeks of gestation, after which babies were delivered by cesarean section with prophylactic bolus hydrocortisone supplementation. Tumor removal was only electively performed after delivery using the transsphenoidal approach. All three patients and their babies had a good clinical course, and postoperative pathological evaluation revealed that all tumors were functional and that they secreted prolactin. Conclusions Although the mechanism of pituitary apoplexy occurrence remains unknown, the most important treatment strategy for pituitary apoplexy in pregnancy remains adequate hydrocortisone supplementation and frequent hormonal investigation. Radiological follow-up should be performed only if clinical symptoms deteriorate, and optimal timing for surgical resection should be discussed by a multidisciplinary team that includes obstetricians and neonatologists.

scholarly journals Macrophage Activation Syndrome in Adults: A Retrospective Case Series

2021 ◽  
Vol 9 ◽  
pp. 232470962110264
Author(s):  
Taylor Warmoth ◽  
Malvika Ramesh ◽  
Kenneth Iwuji ◽  
John S. Pixley
Keyword(s):  
Macrophage Activation Syndrome ◽  
Macrophage Activation ◽  
Pediatric Patients ◽  
Inflammatory Diseases ◽  
Systemic Juvenile Idiopathic Arthritis ◽  
Case Series ◽  
Adult Patients ◽  
Retrospective Case ◽  
Life Threatening ◽  
Activation Syndrome

Macrophage activation syndrome (MAS) is a form of hemophagocytic lymphohistocytosis that occurs in patients with a variety of inflammatory rheumatologic conditions. Traditionally, it is noted in pediatric patients with systemic juvenile idiopathic arthritis and systemic lupus erythematous. It is a rapidly progressive and life-threatening syndrome of excess immune activation with an estimated mortality rate of 40% in children. It has become clear recently that MAS occurs in adult patients with underlying rheumatic inflammatory diseases. In this article, we describe 6 adult patients with likely underlying MAS. This case series will outline factors related to diagnosis, pathophysiology, and review present therapeutic strategies.

scholarly journals Autoimmune Hemolytic Anemia as a Complication of Congenital Anemias. A Case Series and Review of the Literature

2021 ◽  
Vol 10 (15) ◽  
pp. 3439
Author(s):  
Irene Motta ◽  
Juri Giannotta ◽  
Marta Ferraresi ◽  
Kordelia Barbullushi ◽  
Nicoletta Revelli ◽  
...  
Keyword(s):  
Hemolytic Anemia ◽  
Autoimmune Hemolytic Anemia ◽  
Case Series ◽  
Intravenous Immunoglobulins ◽  
Point Of View ◽  
First Line ◽  
Human Erythropoietin ◽  
Immune Mediated ◽  
Hemolytic Crisis ◽  
Life Threatening

Congenital anemias may be complicated by immune-mediated hemolytic crisis. Alloantibodies are usually seen in chronically transfused patients, and autoantibodies have also been described, although they are rarely associated with overt autoimmune hemolytic anemia (AIHA), a serious and potentially life-threatening complication. Given the lack of data on the AIHA diagnosis and management in congenital anemias, we retrospectively evaluated all clinically relevant AIHA cases occurring at a referral center for AIHA, hemoglobinopathies, and chronic hemolytic anemias, focusing on clinical management and outcome. In our cohort, AIHA had a prevalence of 1% (14/1410 patients). The majority were warm AIHA. Possible triggers were recent transfusion, infection, pregnancy, and surgery. All the patients received steroid therapy as the first line, and about 25% required further treatment, including rituximab, azathioprine, intravenous immunoglobulins, and cyclophosphamide. Transfusion support was required in 57% of the patients with non-transfusion-dependent anemia, and recombinant human erythropoietin was safely administered in one third of the patients. AIHA in congenital anemias may be challenging both from a diagnostic and a therapeutic point of view. A proper evaluation of hemolytic markers, bone marrow compensation, and assessment of the direct antiglobulin test is mandatory.

scholarly journals Neurological manifestations and neuroimaging findings in patients with SARS-CoV2—a systematic review

2021 ◽  
Vol 57 (1) ◽  
Author(s):  
Nikita Mohan ◽  
Muhammad Ali Fayyaz ◽  
Christopher del Rio ◽  
Navpreet Kaur Rajinder Singh Khurana ◽  
Sampada Sandip Vaidya ◽  
...  
Keyword(s):  
Neurological Diseases ◽  
Case Reports ◽  
Healthcare Providers ◽  
Case Series ◽  
Altered Mental Status ◽  
Common Finding ◽  
Cochrane Library ◽  
Neurological Manifestations ◽  
The Cochrane Library ◽  
Ct And Mri

Abstract Background The COVID-19 pandemic has drastically affected everyone in a hit or miss manner. Since it began, evidence of the neuro-invasive potential of the virus has been intensifying significantly. Several pathways have been hypothesized to elucidate the neurotropic nature of SARS-CoV2. It is the need of the hour to collect vital information. Objective To evaluate and correlate the neuro-radiological and neurological manifestations in patients diagnosed with SARS-CoV2. To identify neuro-invasive pathways of COVID infection. Methods Relevant studies were identified through four databases—the Cochrane Library, PubMed, Science Direct, and Web of Science. These were searched using relevant keywords—“COVID-19,” “SARS-CoV2,” “neurological manifestations,” “neuroimaging,” “CT,” and “MRI.” Relevant articles were screened according to a pre-defined inclusion and exclusion criteria from December 2019 to August 2020. Results Our review included a total of 63 full text publications with 584 patients, composed mainly of observational studies, case reports, and case series. The most common neurological manifestations associated with COVID-19 were altered mental status, stroke, and paralysis. About 17.85% patients who underwent neuroimaging were found to be having ischemic changes suggestive of a stroke. This was followed by hemorrhagic changes as the second most common finding. The most commonly involved vessel was the Middle Cerebral Artery. Besides stroke, we found that SARS-CoV2 could be the cause for new-onset seizures, Guillain-Barre Syndrome, encephalitis, and many other severe neurological diseases. Conclusion The information that we have obtained so far will prove dynamic to healthcare providers working against the COVID-19 pandemic. It is necessary to be aware of these atypical neurological findings for the early diagnosis and treatment of COVID-19 infected patients. However, to completely understand the connection between SARS-CoV2 and the nervous system, further research is necessary.

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