Pyriform sinus rupture caused by blunt trauma

2020 ◽  
pp. 197140092097516
Author(s):  
Emil Jernstedt Barkovich ◽  
M Reza Taheri
Keyword(s):  
Blunt Trauma ◽  
Pyriform Sinus ◽  
Significant Heterogeneity ◽  
Cervical Trauma ◽  
Specific Location ◽  
Appropriate Treatment ◽  
Threatening Condition ◽  
Pharyngeal Perforation ◽  
Life Threatening ◽  
Foreign Body Impaction

Hypopharyngeal perforation (HP) is a potentially life-threatening condition most associated with iatrogenic injury and foreign body impaction. Additionally, a number of cases of posterior HP have been reported following blunt cervical trauma. We present a case of a construction accident causing lateral hypopharyngeal rupture. Visceral perforation was initially diagnosed on computed tomography (CT) imaging and managed conservatively. We speculate this region may be particularly vulnerable to injury due to an anatomic transition in adjacent fascial support. A review of 29 prior cases suggests that this may be the first reported case of blunt trauma causing rupture of the pyriform sinus. However, significant heterogeneity exists in diagnostic approach. Radiography and CT are rapid, sensitive modalities for suggesting pharyngeal perforation, while fluoroscopy and endoscopy can better assess injury size and location and monitor resolution. Early radiologic recognition of hypopharyngeal injury is essential to initiate appropriate treatment. In certain cases, including our own, both the presence and specific location of perforation may be identified on initial CT images.

scholarly journals Spontaneous liver rupture in a pregnant woman associated with HELLP syndrome

2019 ◽  
Vol 24 (3) ◽  
pp. 132-138
Author(s):  
T. M. Bunyatov ◽  
I. A. Kozlov ◽  
B. N. Gurmikov ◽  
Yu. A. Stepanova ◽  
V. S. Shirokov ◽  
...  
Keyword(s):  
Hellp Syndrome ◽  
Similar Case ◽  
Case Reports ◽  
Endovascular Embolization ◽  
Syndrome Patient ◽  
Liver Rupture ◽  
Right Hepatic Artery ◽  
Appropriate Treatment ◽  
Threatening Condition ◽  
Life Threatening

Spontaneous liver rupture is rare and highly dangerous, life-threatening condition occurring in 1–2% of pregnant women with preeclampsia and eclampsia. There are more than 100 similar case reports in the literature. It is believed that liver rupture is caused by HELLP syndrome as one of the signs of preeclampsia. The results of surgical treatment is still unsatisfactory. Appropriate treatment strategy is absent because of rareness of this condition. It is presented case report of a woman with spontaneous liver rupture associated with HELLP syndrome. Patient underwent perihepatic tamponade, endovascular embolization of right hepatic artery followed by right-sided hemihepatectomy.

scholarly journals Extra-Pericardial Tamponade due to Internal Thoracic Artery Rupture after Blunt Trauma: A Case Report

2021 ◽  
Vol 34 (3) ◽  
pp. 183-186
Author(s):  
Donsub Noh ◽  
Sung Wook Chang ◽  
Dae Sung Ma
Keyword(s):  
Case Report ◽  
Cardiac Tamponade ◽  
Blunt Trauma ◽  
Traffic Accident ◽  
Internal Thoracic Artery ◽  
Pericardial Tamponade ◽  
Sternal Fracture ◽  
Mediastinal Hematoma ◽  
Threatening Condition ◽  
Life Threatening

Cardiac tamponade is an acute life-threatening condition that predominantly involves the intra-pericardial space; however, an expanding mediastinal hematoma can also sometimes cause cardiac tamponade. Here we describe the case of a 45-year-old male driver in whom a traffic accident resulted in rupture of the left internal thoracic artery (ITA), extra-pericardial hematoma, and sternal fracture. After resuscitation, he was scheduled to undergo angio-embolization to repair the ruptured left ITA, but he suddenly developed cardiac tamponade that required a decompressive sternotomy. Nevertheless, the patient had an uncomplicated recovery, and this case suggests that extra-pericardial cardiac tamponade should be considered as a possible consequence of retro-sternal hematoma due to traumatic ITA rupture.

scholarly journals Sebészi megoldások krónikus multivisceralis arteriás elzáródások esetében

2021 ◽  
Vol 74 (3) ◽  
pp. 57-65
Author(s):  
Csaba Dzsinich ◽  
László Barta ◽  
Klaudia Bogdány ◽  
Tamás Tóth ◽  
Tibor Pataki ◽  
...  
Keyword(s):  
Severe Disease ◽  
Fatal Outcome ◽  
Adequate Treatment ◽  
Long Run ◽  
Appropriate Treatment ◽  
Slow Progression ◽  
Threatening Condition ◽  
Visceral Arteries ◽  
Clinical Consequences ◽  
Life Threatening

Összefoglaló. Bevezetés: A zsigeri artériák akut elzáródása fulmináns klinikai képpel társul, és az esetek jelentős százalékában gyorsan halálhoz vezet. Ha ezen artériák obliteratív folyamata lassan alakul ki, a zsigeri artériák gazdag kollaterális kapacitása a klinikai tüneteket sokáig elfedi. Az esetek egy részében az anatómiailag közel fekvő renalis artériák obliteratív folyamata, illetve a társuló aortoiliacalis szűkületek és/vagy elzáródások rendkívül szerteágazó klinikai képet okozhatnak. Az átfedések más hasi betegségekkel félrevezetők lehetnek, emiatt késedelmes felismerésük súlyos következményekkel járhat. Előfordulásuk nem gyakori, ismeretük azonban nélkülözhetetlen mind a diagnosztika, mind a megoldás szempontjából. Dolgozatunkban e bonyolult kórkép eseteit tárgyaljuk, és ismertetjük a megoldások lehetőségeit. Summary. Introduction: Acute occlusions of the visceral arteries result in fulminant clinical consequences and without fast and appropriate treatment may lead to fatal outcome. If the obliterative disease has slow progression the huge capacity of the collateral circulation of the visceral arteries may remain free of symptoms at long run. By progression of the obliterative disease and extension to both, the renal arteries and the aortoiliac segment the clinical picture becomes more colourful. Symptoms mimicking other abdominal disorders may easily lead to misdiagnosis and/or unnecessary delay of adequate treatment – finally to organ or life threatening condition. In the present paper we deal with this infrequent, but severe disease in order to recognize it in time, to recommend proper diagnostic workup and propose adequate treatment.

Anaphylaxis and other allergic reactions to food: a global challenge

2020 ◽  
Vol 13 (5) ◽  
pp. e231425
Author(s):  
Antonio Jose Reyes ◽  
Amanda Sheena Hosein ◽  
Kanterpersad Ramcharan ◽  
Sean Perot
Keyword(s):  
Early Recognition ◽  
Public Awareness ◽  
Successful Outcome ◽  
Allergic Reactions ◽  
Global Challenge ◽  
Link Type ◽  
Preventative Measures ◽  
Appropriate Treatment ◽  
Threatening Condition ◽  
Life Threatening

We describe a case of a biphasic anaphylactic reaction that occurred in a young woman soon after the ingestion of soy milk that led to her hospitalisation. Early recognition and appropriate treatment led to a successful outcome of this life-threatening condition. Challenges encountered in the care of this common illness are highlighted. There is a need for an increase in public awareness on dangerous allergic reactions caused by allergens present in food products in public use, thereby facilitating primary preventative measures to minimise its occurrence. Healthcare stakeholders need to implement measures of contemporary preventative medicine and efficient therapeutic protocols to safeguard the public welfare concerning this global health problem where appropriate interventions can reduce morbidity and mortality. Trial registration numbers NCT02991885 and NCT02851277.

Intracranial abscesses

2020 ◽  
pp. 6097-6100
Author(s):  
Tim Lawrence ◽  
Richard S.C. Kerr
Keyword(s):  
Developing Countries ◽  
Early Diagnosis ◽  
Supportive Care ◽  
Antimicrobial Treatment ◽  
Anatomical Location ◽  
Image Guided ◽  
Appropriate Treatment ◽  
Threatening Condition ◽  
Life Threatening

An intracranial abscess is a life-threatening condition. Although the incidence is low in countries where antimicrobial treatment for infections is widespread, they remain frequent causes of space-occupying masses in developing countries and, therefore, an important cause of death and disability. Early diagnosis and intervention is vital in reducing potential subsequent sequelae. This chapter describes how they can be broadly defined into three categories based on their anatomical location: extradural, subdural, and intraparenchymal. Aside from supportive care and (where possible) identification and treatment of any underlying cause, treatment requires (1) abscess drainage by image-guided surgical aspiration or excision by craniotomy, and (2) long-term antimicrobial therapy. Early intervention offers the best chance of recovery. Without intervention, intracranial abscesses are fatal. With appropriate treatment overall mortality is between 6.6% and 12.7%, depending on the surgical method used (aspiration compared with craniotomy, respectively). Long-term complications from neurological deficit and epilepsy remain frequent in survivors.

scholarly journals Disseminated Cryptococcosis in a Non-HIV Patient in Singapore

2019 ◽  
Vol 2019 ◽  
pp. 1-5
Author(s):  
Jonathan See ◽  
Kok Choon Raymond Fong ◽  
Humaira Shafi
Keyword(s):  
Lupus Erythematosus ◽  
Pulmonary Involvement ◽  
Tertiary Hospital ◽  
Mortality And Morbidity ◽  
Therapeutic Modalities ◽  
Appropriate Treatment ◽  
Improved Outcomes ◽  
Atypical Clinical Presentation ◽  
Threatening Condition ◽  
Life Threatening

We present a case of disseminated cryptococcosis (DC) in a 71-year-old gentleman with systemic lupus erythematosus (SLE) on long-term corticosteroids. He initially presented with right arm cellulitis in a tertiary hospital in Singapore and was subsequently diagnosed with DC involving skin, meninges, blood, and possibly pulmonary involvement. He eventually succumbed to the disease despite prolonged antifungal therapy. Through this case, we wish to highlight an atypical clinical presentation of an uncommon infection and hope to share the importance of considering DC in the differential diagnosis of nonresolving cellulitis among immunocompromised individuals. Mortality and morbidity rates for this condition remain high despite appropriate treatment. Early diagnosis and treatment are crucial for improved outcomes. More research is needed to improve the therapeutic modalities for treatment of DC and to improve the clinical outcomes for this life-threatening condition.

scholarly journals Contrast-Induced Rhabdomyolysis Occurring after ERCP in a Patient with Pancreatic Cancer: A Case Report

2020 ◽  
Author(s):  
Natassja Moriarty ◽  
Jonathan Moriarty ◽  
John Keating
Keyword(s):  
Skeletal Muscle ◽  
Pancreatic Cancer ◽  
Renal Failure ◽  
Creatine Kinase ◽  
Acute Renal Failure ◽  
Case Report ◽  
Mortality Rate ◽  
Appropriate Treatment ◽  
Threatening Condition ◽  
Life Threatening

Objective: We present a patient with pancreatic cancer who developed weakness, acute renal failure and significantly raised creatine kinase levels post-ERCP and who was assessed as having contrast-induced rhabdomyolysis. Results: The patient underwent haemofiltration and ultimately succumbed to his condition. Conclusion: Rhabdomyolysis is a potentially life-threatening condition which occurs because of damage to skeletal muscle, with release of myoglobin and electrolytes into the circulation. The mortality rate is 59% in severe cases, despite appropriate treatment.

May-Thurner syndrome – Are we aware enough?

VASA ◽  
2019 ◽  
Vol 48 (5) ◽  
pp. 381-388 ◽  
Author(s):  
Katalin Mako ◽  
Attila Puskas
Keyword(s):  
Contraceptive Use ◽  
Iliac Vein ◽  
Common Iliac Vein ◽  
Vein Thrombosis ◽  
Compression Syndrome ◽  
Threatening Condition ◽  
Life Threatening ◽  
Iliac Vein Compression ◽  
Iliac Vein Compression Syndrome ◽  
The Right

Summary. Iliac vein compression syndrome (May-Thurner syndrome – MTS) is an anatomically variable clinical condition in which the left common iliac vein is compressed between the right common iliac artery and the underlying spine. This anatomic variant results in an increased incidence of left iliac or iliofemoral vein thrombosis. It predominantly affects young women in the second or third decades of life with preponderance during pregnancy or oral contraceptive use. Although MTS is rare, its true prevalence is underestimated but it can be a life-threatening condition due to development of pulmonary embolism (PE). In this case based review the authors present three cases of MTS. All patients had been previously confirmed with PE, but despite they were admitted to hospital, diagnosed and correctly treated for PE and investigated for thrombophilia, the iliac vein compression syndrome was not suspected or investigated. With this presentation the authors would like to emphasize that MTS is mostly underdiagnosed, and it needs to be ruled out in left iliofemoral vein thrombosis in young individuals.

Severe Alveolar Hemorrhage – What’s in it for the Gastroenterologist?

2016 ◽  
Vol 25 (4) ◽  
pp. 555-558
Author(s):  
Alina Popp
Keyword(s):  
Celiac Disease ◽  
International Normalized Ratio ◽  
Gluten Free Diet ◽  
Alveolar Hemorrhage ◽  
Severe Anemia ◽  
Gluten Free ◽  
Pulmonary Infiltrates ◽  
Pulmonary Hemosiderosis ◽  
Threatening Condition ◽  
Life Threatening

Background: Alveolar hemorrhage is a potentially life-threatening condition which is usually managed by the pulmonologist. When considering its etiology, there is a rare association that sets the disease into the hands of the gastroenterologist. Case presentation: We report the case of a 48 year-old female who was admitted to the intensive care unit for severe anemia and hemoptysis. On imaging, diffuse pulmonary infiltrates suggestive of alveolar hemorrhage were detected and a diagnosis of pulmonary hemosiderosis was made. She received cortisone therapy and hematologic correction of anemia, with slow recovery. In search of an etiology for the pulmonary hemosiderosis, an extensive workup was done, and celiac disease specific serology was found positive. After confirmation of celiac disease by biopsy, a diagnosis of Lane-Hamilton syndrome was established. The patient was recommended a gluten-free diet and at 6 months follow-up, resolution of anemia and pulmonary infiltrates were observed. Conclusion: Although the association is rare, celiac disease should be considered in a patient with idiopathic pulmonary hemosiderosis. In our case, severe anemia and alveolar infiltrates markedly improved with glucocorticoids and gluten-free diet. Abbreviations: APTT: activated partial thromboplastin time; BAL: bronchoalveolar lavage; CD: celiac disease; Cd: crypt depth; GFD: gluten-free diet; GI: gastrointestinal; IEL: intraepithelial lymphocyte; INR: international normalized ratio; IPH: idiopathic pu

LAPAROSCOPIC CHOLECYSTECTOMY IN ACUTE CHOLECYSTITIS: A PROSPECTIVE STUDY.

2019 ◽  
Author(s):  
Madan Goyal ◽  
R K Goel
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Acute Cholecystitis ◽  
Open Cholecystectomy ◽  
Critical View Of Safety ◽  
Recent Onset ◽  
Conversion To Open Cholecystectomy ◽  
Threatening Condition ◽  
Life Threatening ◽  
Fluid Collections ◽  
A Prospective Study

Acute cholecystitis (AC) is a potentially life-threatening condition. LC was initially considered to be a relative contraindication for laparoscopic cholecystectomy (LC), but with increase in general expertise, early LC was recommended in selected patients1. Aprospective study of LC in grade 1 and 2 AC patients with mild to moderate inflammatory changes in the gallbladder and no significant organ dysfunction, was performed during October 2016 to July 2019. A total of 78 patients, out of 408 cholecystectomies performed during this period, were included in this study. Criteria for diagnosing AC was, recent onset of pain in right hypochondrium, fever, leucocytosis, pericholecystic fluid collections, subserosal oedema on ultrasound, pyocele and other pathological evidence of AC. Patients presented and operated within 4 days of onset of symptoms showed better results as compared to those who could be operated after 4 days and within 14 days. Five patients required conversion to open cholecystectomy because of complex adhesions in 2, critical view of safety was unachievable in 2 and in 1 for troublesome bleeding.

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