Bleeding Liver Tumor in a Patient on Anticoagulation Therapy – Case Report

2015 ◽  
Vol 87 (12) ◽  
Author(s):  
Łukasz Migdalski ◽  
Krzysztof Kuzdak
Keyword(s):  
Hepatocellular Carcinoma ◽  
Case Report ◽  
Elderly Patients ◽  
Anticoagulant Therapy ◽  
Liver Tumor ◽  
Tumor Resection ◽  
Anticoagulation Therapy ◽  
Haemorrhagic Shock ◽  
Surgical Team ◽  
Intraabdominal Bleeding

AbstractIntraabdominal bleeding is a serious surgical problem, particularly in elderly patients following an anticoagulant therapy. It occurs, that abdominal haemorrhage is the first symptom of hepatocellular carcinoma, mostly in Asians and Africans, occasionally in Europeans. The article's author shows a case of an elderly man, treated by Acenocumarolum, in a haemorrhagic shock. During an operation a bleeding liver tumor was revealed. The surgical team performed an effectual tumor resection and stoped the bleeding.

scholarly journals Case Report: Laparoscopic hepatectomy in an elderly patient with major comorbidities

F1000Research ◽  
2017 ◽  
Vol 6 ◽  
pp. 1286
Author(s):  
Georgios C. Sotiropoulos ◽  
Nikolaos Machairas ◽  
Ioannis D. Kostakis
Keyword(s):  
Hepatocellular Carcinoma ◽  
Elderly Patient ◽  
Case Report ◽  
Elderly Patients ◽  
Liver Tumor ◽  
Transarterial Chemoembolization ◽  
Laparoscopic Resection ◽  
Laparoscopic Hepatectomy ◽  
Postoperative Course ◽  
Medical Status

Surgeons have been hesitant to proceed to hepatectomy in elderly patients, due to the higher rate of comorbidities and the reduced reserves. An 81-year-old male with hepatocellular carcinoma in the segment VI of the liver and several major cardiovascular, pulmonary and metabolic comorbid illnesses was referred to our department for treatment. He underwent transarterial chemoembolization of the liver tumor and afterwards he underwent laparoscopic resection of the hepatic segment VI, with an uneventful postoperative course. This case indicates that laparoscopic liver resections could be applied even to elderly patients with major comorbidities after optimization of their medical status.

scholarly journals Case Report. Non-Obvious, Post-Traumatic, Life-Threatening Bleeding in Two Elderly Patients

2017 ◽  
Vol 3 (2) ◽  
pp. 79-83
Author(s):  
Rafael García Carretero
Keyword(s):  
Case Report ◽  
Side Effects ◽  
Elderly Patients ◽  
Anticoagulant Therapy ◽  
Vitamin K ◽  
Major Bleeding ◽  
Vitamin K Antagonist ◽  
Life Threatening ◽  
Post Traumatic ◽  
Main Complication

Abstract The main complication of anticoagulant therapy is major bleeding. Clinicians are usually aware of these side effects and are careful when managing the therapeutic range of vitamin K antagonist drugs. But major bleeding, while lifethreatening, can be overlooked if there are no visible signs of bleeding. Two cases are described in which inaccurate diagnoses lead to inadequate treatment.

scholarly journals Anticoagulation therapy in the elderly with non-valvular atrial fibrillation: a double-edged sword

2017 ◽  
Vol 3 (2) ◽  
Author(s):  
Francesco Vetta ◽  
Gabriella Locorotondo ◽  
Giampaolo Vetta
Keyword(s):  
Atrial Fibrillation ◽  
Elderly Patients ◽  
Anticoagulant Therapy ◽  
Vitamin K ◽  
Vitamin K Antagonists ◽  
Oral Anticoagulants ◽  
Anticoagulation Therapy ◽  
Treatment Strategies ◽  
The Elderly ◽  
Hemorrhagic Events

Prevalence of non-valvular atrial fibrillation is increasing over time. Particularly in elderly population, treatment strategies to reduce the rate of stroke are challenging and still represent an unsolved cultural question. Indeed, the risk of thromboembolism increases in the elderly in parallel with the risk of bleeding. The frequent coexistence of several morbidities, frailty syndrome, polypharmacy, chronic kidney disease and dementia strengthens the perception that risk-benefit ratio of anticoagulant therapy could be unfavorable, and explains why such treatment is underused in the elderly. Recently, the introduction of non-vitamin K oral anticoagulants (NOACs) has allowed us to overcome the large number of limitations imposed by the use of vitamin K antagonists. In this manuscript, the benefits of individual NOACs in comparison with warfarin in elderly patients are reviewed. Targeted studies on complex elderly patients are needed to test usefulness of a geriatric comprehensive assessment, besides the scores addressing risk of thromboembolic and hemorrhagic events. In the meantime, it is mandatory that use of anticoagulant therapy in most elderly people, currently excluded from randomized controlled trials, is prudent and responsible.

scholarly journals A case report of hybrid surgical resection of a giant dumbbell neurinoma in the thoracic spine

2020 ◽  
pp. 43-47
Author(s):  
I. V. Basankin ◽  
N. V. Naryzhnyi ◽  
A. A. Giulzatyan ◽  
S. B. Malakhov
Keyword(s):  
Computed Tomography ◽  
Case Report ◽  
Clinical Case ◽  
Tumor Resection ◽  
Functional Results ◽  
Neurological Complications ◽  
Thoracic Cavity ◽  
Dorsal Part ◽  
Surgical Team ◽  
Intrathoracic Mass

We report the clinical case of treating a female patient with a giant dumbbell neurinoma arising from the Th1 nerve root. For the treatment of neoplasm, a hybrid surgical tactic was chosen, including Th1 hemilaminectomy, mobilization of the dorsal part of the tumor and video-assisted thoracoscopy in order to remove its intrathoracic mass. The patient developed no neurological complications after surgery. A gross total tumor resection was documented by control computed tomography. Thus, well-coordinated work of the multidisciplinary surgical team provided good oncological and functional results in the treatment of a giant neurinoma with extension into the thoracic cavity.

Anticoagulant therapy in elderly patients and cardiac implantable electronic devices

2020 ◽  
Vol 2 (55) ◽  
pp. 29-34
Author(s):  
Marcin Wełnicki ◽  
Aleksandra Kurek ◽  
Zuzanna Stemplewska
Keyword(s):  
Atrial Fibrillation ◽  
Elderly Patients ◽  
Anticoagulant Therapy ◽  
Perioperative Complications ◽  
Electronic Devices ◽  
Anticoagulation Therapy ◽  
Review Article ◽  
Anticoagulation Treatment ◽  
Cardiac Implantable Electronic Devices

The number of implantations of cardiac implantable electronic devices (CIED), as well as the prevalence of atrial fibrillation (AF), is on the rise as the population ages. At the same time, regardless of the need for CIED implantation, many elderly patients require long-term anticoagulation therapy to prevent stroke. Those patients are considered a group of higher risk of perioperative complications of CIED implantation. This review article provides a summary of the indications, possibilities, and challenges of anticoagulation treatment in elderly patients with indications for CIED implantation.

scholarly journals Case Report: Laparoscopic hepatectomy in an elderly patient with major comorbidities

F1000Research ◽  
2017 ◽  
Vol 6 ◽  
pp. 1286 ◽  
Author(s):  
Georgios C. Sotiropoulos ◽  
Nikolaos Machairas ◽  
Ioannis D. Kostakis
Keyword(s):  
Hepatocellular Carcinoma ◽  
Elderly Patient ◽  
Case Report ◽  
Elderly Patients ◽  
Older Patients ◽  
Therapeutic Strategy ◽  
Laparoscopic Resection ◽  
Laparoscopic Hepatectomy ◽  
Careful Planning ◽  
Postoperative Course

Surgeons have been hesitant to proceed to hepatectomy in elderly patients, due to the higher rate of comorbidities and the reduced reserves. An 81-year-old male with hepatocellular carcinoma in the segment VI of the liver and several major cardiovascular, pulmonary and metabolic comorbid illnesses was referred to our department for treatment. He underwent transarterial chemoembolization of the liver tumor and afterwards he underwent laparoscopic resection of the hepatic segment VI, with an uneventful postoperative course. This case indicates the safety and feasibility of laparoscopic liver resections in older patients, even when major comorbidities are present, provided that there is a careful planning of therapeutic strategy and operation.

The characteristics and surgical results of hepatocellular carcinoma in elderly patients

2011 ◽  
Vol 29 ◽  
pp. 119-122
Author(s):  
Yuko Takami ◽  
Masaki Tateishi ◽  
Tomoki Ryu ◽  
Yoshiyuki Wada ◽  
Hideki Saitsu
Keyword(s):  
Hepatocellular Carcinoma ◽  
Elderly Patients ◽  
Surgical Results

Transcatheter Chemoembolization of a Hepatocellular Carcinoma Utilizing Lipiodol through the Pancreaticoduodenal Arcade: A Case Report

2018 ◽  
Vol 2 ◽  
pp. 5
Author(s):  
Scott P Patterson ◽  
Richard G Foster
Keyword(s):  
Hepatocellular Carcinoma ◽  
Case Report ◽  
Vascular Anatomy ◽  
Left Gastric Artery ◽  
Target Lesion ◽  
Celiac Artery ◽  
Small Hepatocellular Carcinoma ◽  
Gastric Artery ◽  
Variant Anatomy ◽  
Pancreaticoduodenal Arcade

This case report describes the chemoembolization of a small hepatocellular carcinoma employing a lipiodol drug delivery system utilizing a novel arterial pathway. Because the target lesion was precariously located adjacent to the inferior heart border and the diaphragm, it was unsuitable for imaging-guided microwave ablation. To achieve chemoembolization, several intraprocedural adaptations were necessary, given the variant anatomy encountered and difficulty accessing the left gastric artery through a celiac artery approach. The left gastric artery was selected from a superior mesenteric artery approach through the pancreaticoduodenal arcade (Rio Branco’s arcade). This case illustrates the importance of a mastery of the vascular anatomy and variants of hepatic arterial flow.

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