scholarly journals Gangrena Fournier i rekonstrukcija nastalih defekata

2006 ◽  
Vol 53 (3) ◽  
pp. 95-99 ◽  
Author(s):  
N. Sretenovic ◽  
M. Colic ◽  
R. Lazic ◽  
S. Bosic ◽  
N. Stojadinovic
Keyword(s):  
Early Recognition ◽  
Skin Flaps ◽  
Large Defect ◽  
Local Skin ◽  
Anatomical Region ◽  
First Case ◽  
Number Of Patients ◽  
Threatening Condition ◽  
Life Threatening ◽  
Cutaneous Flap

Fournier?s gangrene is remarkably rare but severe, life threatening condition. Thanks to better early recognition of disease in past few years, the percentage of patients which survive this condition is considerable, but consequence of this fact is large number of patients with defects of cutis and subcutis in perineal and scrotal regions. Reconstruction of this defects is complicate and require healthy, well vascularised tissue from another anatomical region which is not involved in gangrenous process. Authors present two cases of reconstruction of defects in perineal and scrotal regions. First case is large defect which is covered by transposition of musculus gracilis musculo-cutaneous flap. Second case is lesser defect which is enclosed by mobilization of local skin flaps. .

Alcohol Related Non-traumatic Rhabdomyolysis and Compartment Syndrome

2007 ◽  
Vol 6 (1) ◽  
pp. 33-34
Author(s):  
JPL Ong ◽  
◽  
LA Thomas ◽  
Keyword(s):  
Skeletal Muscle ◽  
Renal Failure ◽  
Acute Renal Failure ◽  
Lower Extremity ◽  
Compartment Syndrome ◽  
Early Recognition ◽  
Clinical Entity ◽  
Threatening Condition ◽  
Life Threatening ◽  
Renal Support

Rhabdomyolysis is a serious and life-threatening condition in which skeletal muscle is damaged, commonly resulting in acute renal failure. The causes of this clinical entity can be traumatic and non-traumatic. In the latter group, alcohol is the commonest cause. This report describes the case of a 25 year old man who presented with rhabdomyolysis leading to acute renal failure after an alcohol binge. He presented with painful legs and lower extremity compartment syndrome. The patient recovered with surgical fasciotomy and renal support. This case illustrates the importance of early recognition and treatment of alcohol related non-traumatic rhabdomyolysis and compartment syndrome.

Assessment and care of the patient with sepsis

2020 ◽  
pp. 225-257
Author(s):  
Kevin Barrett
Keyword(s):  
Septic Shock ◽  
Early Recognition ◽  
Scoring Systems ◽  
Cardiovascular Responses ◽  
Physiological Changes ◽  
Assessment Framework ◽  
Threatening Condition ◽  
Life Threatening ◽  
Support Mechanisms ◽  
Sepsis And Septic Shock

There has been considerable recent focus on sepsis in both the clinical arena and within the general public to raise awareness of the importance of early recognition of this potentially life-threatening condition. The early recognition of sepsis by ward nurses can both reduce progression of this lethal disease and improve survival for patients in hospital. This chapter focuses on definitions of sepsis and septic shock, physiological changes associated with inflammatory and cardiovascular responses to sepsis, and a clinical assessment framework to guide practice. There is also a discussion of the use of scoring systems and how to escalate support mechanisms for patients with sepsis and septic shock.

scholarly journals Acute Aortic Dissection Mimicking STEMI in the Catheterization Laboratory: Early Recognition Is Mandatory

2012 ◽  
Vol 2012 ◽  
pp. 1-3
Author(s):  
Alessio Arrivi ◽  
Gaetano Tanzilli ◽  
Paolo Emilio Puddu ◽  
Giovanni Truscelli ◽  
Marcello Dominici ◽  
...  
Keyword(s):  
Aortic Dissection ◽  
Early Recognition ◽  
Type A ◽  
Type A Aortic Dissection ◽  
Catheterization Laboratory ◽  
Arterial Complication ◽  
Threatening Condition ◽  
Life Threatening ◽  
Previously Treated ◽  
Pathophysiologic Mechanisms

Coronary malperfusion due to type A aortic dissection is a life-threatening condition where timely recognition and treatment are mandatory. A 77-year-old woman underwent an acute evolving type A aortic dissection mimicking acute myocardial infarction. Two pathophysiologic mechanisms are discussed: either thrombosis migrating from a previously treated giant aneurism of proximal left anterior descending or a local arterial complication due to left main stenting. Recognition of these occurrences in the catheterization laboratory is important to look immediately for surgery.

scholarly journals Endoscopic Retrograde Cholangiopancreatography Scope‑induced Duodenojejunal Flexure Perforation: The World’s First Case

2017 ◽  
Vol 08 (03) ◽  
pp. 145-147
Author(s):  
Jignesh A. Gandhi ◽  
Pravin H. Shinde ◽  
Basavaraj K. Nagur ◽  
Rohan D. Digarse
Keyword(s):  
Endoscopic Retrograde Cholangiopancreatography ◽  
Primary Closure ◽  
Early Recognition ◽  
Emergency Laparotomy ◽  
Significant Morbidity ◽  
Endoscopic Retrograde ◽  
The Third ◽  
First Case ◽  
Duodenojejunal Flexure ◽  
Life Threatening

ABSTRACTDuodenojejunal (DJ) flexure perforation is very rare. DJ flexure perforation following endoscopic retrograde cholangiopancreatography (ERCP) has not be documented till date. They are associated with significant morbidity and mortality. We present an ERCP‑induced DJ flexure perforation which has been treated with primary closure in two layers at our institution. To the best of our knowledge, this is the world’s first case. Such site of ERCP‑induced perforation has not been reported in literature till date. A 75‑year‑old female patient underwent repeated ERCP for obstructive jaundice. There was perforation during the third ERCP while removing the larger stone. Emergency laparotomy was performed with primary closure of perforation in two layers. ERCP‑induced DJ flexure perforation has not yet been documented. It is potentially life‑threatening. Early recognition may lead to a better prognosis through earlier intervention.

scholarly journals Hypercalcemic Crisis

2001 ◽  
Vol 12 (suppl 1) ◽  
pp. S3-S9
Author(s):  
REINHARD ZIEGLER
Keyword(s):  
Primary Hyperparathyroidism ◽  
Serum Calcium ◽  
Fatal Outcome ◽  
Humoral Hypercalcemia Of Malignancy ◽  
Hypercalcemia Of Malignancy ◽  
Hypercalcemic Crisis ◽  
Humoral Hypercalcemia ◽  
First Case ◽  
Threatening Condition ◽  
Life Threatening

Abstract. Hypercalcemia may decompensate from a more or less chronic status into a critical and life-threatening condition, hypercalcemic crisis. In the majority of cases, primary hyperparathyroidism is the cause; humoral hypercalcemia of malignancy or rarer conditions of hypercalcemia will decompensate less often. The leading symptoms that characterize the crisis are oliguria and anuria as well as somnolence and coma. After a hypercalcemic crisis is recognized, an emergency diagnostic program has to be followed either to prove or to exclude primary hyperparathyroidism. In the first case, surgical neck exploration is the only way to avoid fatal outcome. The diagnostic program should be performed within hours; during this time, serum calcium should be lowered. Treatment of choice is hemodialysis against a calcium-free dialysate. Bisphosphonates could be useful as adjuvant drugs.

scholarly journals Maternal and foetal outcome of eclampsia in a referral hospital

2017 ◽  
Vol 6 (3) ◽  
pp. 1021
Author(s):  
Mousumi Das Ghosh ◽  
Vinita Singh ◽  
Alokananda Ray
Keyword(s):  
Antenatal Care ◽  
Early Recognition ◽  
Mode Of Delivery ◽  
Ventilatory Support ◽  
Adequate Treatment ◽  
Mortality And Morbidity ◽  
Foetal Mortality ◽  
Threatening Condition ◽  
Life Threatening ◽  
Foetal Outcome

Background: Eclampsia is a life-threatening condition, common in developing countries with high fatality rate. It is a cause of maternal and foetal mortality and morbidity. The aim of the study is to determine the maternal and foetal outcome in Tata Main Hospital, Jamshedpur, Jharkhand, India.Methods: All cases of eclampsia were analysed from January 2012 to December 2014 from admission to discharge or death of the patient.  Age, parity, antenatal care, interval between attack and admission, blood pressure on admission, gestational age and mode of delivery were  taken into account. There were 135 cases of eclampsia out of 14572 deliveries. Only singleton pregnancies were analysed.Results: The incidence of antepartum eclampsia was 84.4%, intrapartum 3% and postpartum 12.5 %. 83% patients were primigravida, 33% less than 20 yrs,42% had no antenatal checkup and 45% had < 4 visits. Only 15% patients received magnesium sulphate before referral to the hospital. There were four maternal deaths and twenty-one perinatal deaths. Eleven patients needed ventilatory support, four developed pulmonary oedema,  two patients had respiratory depression and three patients had renal failure.Conclusions: Hypertensive disease in pregnancy requires proper antenatal care, early recognition and referral, adequate treatment and timely delivery.

Abacavir Hypersensitivity Reaction: The First Case Report in Thailand and Literature Review

2021 ◽  
Vol 104 (1) ◽  
pp. 159-163
Keyword(s):  
Developing Countries ◽  
Case Report ◽  
Hypersensitivity Reaction ◽  
Screening Test ◽  
Blood Test ◽  
Clinical Presentation ◽  
Health Security ◽  
First Case ◽  
Threatening Condition ◽  
Life Threatening

Abacavir-related hypersensitivity reaction (ABC-HSR) is a life-threatening condition. The incidence is low since it could have been prevented by screening with blood test for HLA-B*5701, which is strongly associated with this reaction. However, the affordability for the HLA-B*5701 screening test is still a challenging issue in many developing countries. Thai National Health Security Office (NHSO) recommends either using HLA-B*5701 as a screening test or monitoring clinical presentation for ABC-HSR after using it. Therefore, the clinical presentation of ABC-HSR should be acknowledged for the diagnosis of this condition and death prevention. This was the first reported case and literature reviewed of ABC-HSR associated with the presence of the HLA-B*5701 allele in Thailand. Keywords: Abacavir, Hypersensitivity reaction, HLA-B*5701, Clinical presentation, Thailand

Atraumatic splenic rupture in chronic pancreatitis with successful embolization

2020 ◽  
Vol 21 (2) ◽  
pp. 58-68
Author(s):  
Anooja Abdul Salam ◽  
Ben Pearch ◽  
Lisa Sorger
Keyword(s):  
Chronic Pancreatitis ◽  
Splenic Artery ◽  
Splenic Rupture ◽  
Early Recognition ◽  
Hypovolemic Shock ◽  
Artery Embolization ◽  
Splenic Artery Embolization ◽  
Threatening Condition ◽  
Life Threatening ◽  
Atraumatic Splenic Rupture

Atraumatic splenic rupture is uncommon but it is a life threatening condition because of hypovolemic shock. Early recognition and treatment are the keys to asuccessful outcome. We report a case of atraumatic splenic rupture secondary to chronic pancreatitis treated successfully by splenic artery embolization.

scholarly journals Life threatening abscess in the visceral space with penicillin and metronidazole resistant Prevotella Denticola following use of a laryngeal mask airway: case report

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hervé Vanden Eede ◽  
Elizabeth Norris ◽  
Michaël Torfs ◽  
Olivier Vanderveken
Keyword(s):  
Early Recognition ◽  
Laryngeal Mask ◽  
Pharyngeal Wall ◽  
Case Presentation ◽  
Respiratory Problems ◽  
First Case ◽  
Amoxicillin Clavulanate ◽  
Life Threatening ◽  
Single Use ◽  
Day Care Centre

Abstract Background Laryngeal mask airways (LMA) are commonly used for airway management. Complications with this device are rare. However, when they do occur, there is a high risk for respiratory problems, necessitating early diagnosis and treatment. We present the first case of a life-threatening abscess spreading in the visceral space caused by a penicillin and metronidazole resistant Prevotella Denticola after the use of an LMA. Case presentation A female patient was admitted to our day care centre for bunion surgery. A single use LMA size 3 (Solus®, intersurgical, Wokingham, Berkshire, United Kingdom) was successfully inserted. After surgery, the patient complained of a sore throat and amoxicillin was prescribed by the general practitioner. Three days after surgery the patient was admitted to the Intensive Care Unit (ICU) for obstructive breathing, due to an abscess in the visceral space. Retropharyngeal and certainly parapharyngeal abscesses in adults are already rare. This case however, is unique because it is the first case of abscess spreading into the visceral space after the use of an LMA. Amoxicillin/clavulanate and vancomycin were started. The abscess was incised 5 days later and microbiology showed 3 positive cultures of the anaerobe Prevotella denticola, resistant for penicillin and metronidazole, but sensitive for amoxicillin/clavulanate. The patient fully recovered. Conclusion LMA’s are easy to use and are established, safe tools to support ventilation of the airway. In this case, the authors hypothesise a small wound in the lateral pharyngeal wall probably created an opening into the visceral space causing infection with Prevotella denticola, supporting the idea that the pharyngeal mucosal space must be part of the visceral space. Additionally, early recognition and treatment of an LMA induced abscess is necessary to prevent evolution of complications leading to airway obstruction.

Acute Edema of the Tongue: A Life-Threatening Condition

2003 ◽  
Vol 112 (7) ◽  
pp. 651-653 ◽  
Author(s):  
Hussein Gadban ◽  
Yoav Talmon ◽  
Peter Gilbey ◽  
Alvin Samet
Keyword(s):  
Airway Obstruction ◽  
Upper Airway ◽  
Upper Airway Obstruction ◽  
Emergency Intervention ◽  
First Case ◽  
Threatening Condition ◽  
Life Threatening

Acute macroglossia is rare, but may cause upper airway obstruction requiring emergency intervention. The cause of the problem is often obscure. Edema of the tongue may be due to angioedema or to allergy. We present several cases of acute edema of the tongue, in 3 cases causing life-threatening airway obstruction. Among these, we present the first case of acute enlargement of the tongue due to the ingestion of artichoke.

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