scholarly journals The breast necrosis caused by oral anticoagulant therapy

2020 ◽  
Vol 148 (5-6) ◽  
pp. 372-375
Author(s):  
Aleksandar Guzijan ◽  
Radoslav Gajanin ◽  
Bozana Babic ◽  
Vesna Gajanin ◽  
Bojan Jovanic
Keyword(s):  
Anticoagulant Therapy ◽  
Breast Tissue ◽  
Oral Anticoagulant Therapy ◽  
Pectoral Muscle ◽  
Left Breast ◽  
Limited Mobility ◽  
Small Vessels ◽  
The Right ◽  
Two Stages ◽  
First Time

Introduction. Described in 1943 for the first time, breast necrosis during anticoagulant therapy is only rarely encountered in clinical practice. The objective of the article is to describe a patient who underwent anticoagulant therapy and developed breast necrosis during it. Case outline. A 57-year-old female patient was admitted to hospital with pain in her left breast, which upon examination showed to be erythematous, swelled, and hard. She had started experiencing the symptoms a few days earlier, and denied having had a fever. Over the previous four weeks she had received anticoagulant treatment (acenocoumarol) as popliteal embolectomy prophylaxis. The breast was firm, edematous, of limited mobility, and with no pectoral muscle infiltration. The breast ultrasound showed a homogeneous mass, with no signs of fluid retention or suspicious lesions. Upon admission, the patient began receiving intravenous antibiotic treatment and underwent blood tests. The second day upon admission, the patient?s breast revealed a clearly demarcated area of necrotic skin. Surgical treatment was indicated. The surgery was performed in two stages, the first of which included a partial resection of the necrotic breast tissue, and the second simplex mastectomy. Histological analysis showed severe superficial necrosis, with underlying diffuse deep venous thrombosis and marked arteritis of medium and small vessels. Focal areas of extensive necrosis were found deep in the breast parenchyma. Conclusion. Considering that breast necrosis is extremely rare, it is usually not suspected initially. Learning about the patient?s undergoing anticoagulant therapy is of crucial importance for reaching the right diagnosis. Breast abscesses should also be ruled out. Surgery is the treatment of choice, as changes to the breast tissue are usually irreversible.

scholarly journals Pectoral muscle deletion on a mammogram to aid in the early diagnosis of breast cancer

2020 ◽  
Vol 12 (3) ◽  
pp. 57-65
Author(s):  
Pascal Vagssa ◽  
Nafissatou Mallam Doudou ◽  
Tchoning Jolivo ◽  
Olivier Videme ◽  
Dina Taïwé Kolyang
Keyword(s):  
Breast Cancer ◽  
Hough Transform ◽  
Pectoral Muscle ◽  
Left Breast ◽  
Risk Assessments ◽  
Morphological Filters ◽  
Diagnose Breast Cancer ◽  
The Third ◽  
Mammography Image ◽  
The Right

Mammograms are the images used by radiologists to diagnose breast cancer. In this diagnosis, the pectoral muscle appears in mammograms in  oblique mediolateral views (MLO) of the right breast and another in the left breast appears in cranio-caudal views which are marked with (CC). Considering that the pectoral muscle has the same density as the small, suspicious masses in the image, its presence in the image being processed could also require detection procedures. In this paper, we present a new general framework for pectoral muscle suppression which is the first work in the analysis of a mammography image. As a result, we proceed to four stages of image processing. The first step is to orient the image if necessary, then use a pre-processing which is to enhance the contrast of the image, and remove the digital lines of the image by morphological filters, apply a filter median. The third step involves segmenting all of the pectoral muscles, which involves threshold the entire image. The final step is to perform a pectoral muscle removal according to the orientation of the muscle in the image, which will be based on the development of the Hough transform for the recognition of borderline detections of the pectoral muscle. Some results obtained on the different images are discussed and compared with other methods (risk assessments). Evaluation of our method shows a significant improvement in performance in removing the pectoral muscle. Keywords: Breast cancer, Mammogram, Pectoral muscle, Hough transform.

scholarly journals Warfarin Induced Necrosis of The Breast: A Case Report

2018 ◽  
pp. 189-191
Author(s):  
Sanaz Zand ◽  
Roghayye Jalili ◽  
Seyed Hasan Emami Razavi ◽  
Massoome Najafi ◽  
Ahmad Kaviani
Keyword(s):  
Breast Tissue ◽  
Rare Complication ◽  
Oral Anticoagulant Therapy ◽  
Left Breast ◽  
Advancement Flap ◽  
Case Presentation ◽  
Vein Thrombosis ◽  
Simple Mastectomy ◽  
Antithrombin Iii Deficiency ◽  
Deep Vein

Background: Warfarin induced breast necrosis is a rare complication of oral anticoagulant therapy. Although it can be related to protein C, S, and antithrombin III deficiency; the pathogenesis of necrosis is still unknown. Case presentation: We report a case of a 38-year-old woman with extensive left breast necrosis after receiving warfarin for treatment of deep vein thrombosis. Simple mastectomy was performed and the wound was closed secondarily with an abdominal advancement flap. Rivaroxaban was prescribed after discontinuation of warfarin. Conclusion: Although breast necrosis following warfarin usage is uncommon, it should be considered in women presenting with breast symptoms after initiation of warfarin. Early diagnosis and appropriate management are essential to prevent extensive loss of breast tissue.

scholarly journals Hemorrhagic Complications and Dental Management of Patients with Anticoagulant Therapy: Case Report.

2019 ◽  
Vol 6 (2) ◽  
pp. 55-59
Author(s):  
Claudio Bravo ◽  
Victor Rivas
Keyword(s):  
Anticoagulant Therapy ◽  
Oral Anticoagulant Therapy ◽  
Hemorrhagic Complication ◽  
Oral Surgical Procedures ◽  
Blood Tests ◽  
Dental Management ◽  
Mandibular Region ◽  
The Right ◽  
Anticoagulated Patients ◽  
Carious Teeth

Introduction: There are different protocols for the management of anticoagulated patients that can be used when performing oral surgical procedures. Objective: To report the previous evaluation and management of a hemorrhagic complication in the maxillofacial region in a patient undergoing oral anticoagulant therapy and the recommendations described in the literature for these patients. Clinical Case: Sixty-eight year old male patient, hospitalized in the cardiology unit due to heart failure, pending surgery for valve replacement. Treating physician requests evaluation for dental infection foci by a maxillofacial surgeon. Prior to medical examination and corresponding blood tests, four carious teeth are extracted, controlling hemostasis with local measures. During the night of the same day, the patient is referred again to the dental unit because of an alveolorrhagia, being treated and controlled with new local measures; new standard blood tests are performed. Forty-eight hours later the patient presents an increase of volume in the right mandibular region compatible with hematoma and ecchymosis. It is decided to perform treatment, removing sutures, collagen and draining through the alveolus. Subsequently, new local measures are performed and the anticoagulant is suspended for 24 hrs. Conclusion: There are different care protocols for patients undergoing anticoagulant treatment in the literature, so each patient should be studied in advance to define what is the best therapeutic procedure to prevent complications.

scholarly journals Warfarin Induced Necrosis of The Breast: A Case Report

2018 ◽  
pp. 187-189
Author(s):  
Sanaz Zand ◽  
Roghayye Jalili ◽  
Seyed Hasan Emami Razavi ◽  
Massoome Najafi ◽  
Ahmad Kaviani
Keyword(s):  
Breast Tissue ◽  
Rare Complication ◽  
Oral Anticoagulant Therapy ◽  
Left Breast ◽  
Advancement Flap ◽  
Case Presentation ◽  
Vein Thrombosis ◽  
Simple Mastectomy ◽  
Antithrombin Iii Deficiency ◽  
Deep Vein

Background: Warfarin induced breast necrosis is a rare complication of oral anticoagulant therapy. Although it can be related to protein C, S, and antithrombin III deficiency; the pathogenesis of necrosis is still unknown. Case presentation: We report a case of a 38-year-old woman with extensive left breast necrosis after receiving warfarin for treatment of deep vein thrombosis. Simple mastectomy was performed and the wound was closed secondarily with an abdominal advancement flap. Rivaroxaban was prescribed after discontinuation of warfarin. Conclusion: Although breast necrosis following warfarin usage is uncommon, it should be considered in women presenting with breast symptoms after initiation of warfarin. Early diagnosis and appropriate management are essential to prevent extensive loss of breast tissue.

Controlled Trial of the Sequential Use of Streptokinase and Ancrod in the Treatment of Deep Vein Thrombosis of Lower Limb

1977 ◽  
Vol 37 (02) ◽  
pp. 222-232 ◽  
Author(s):  
D. A Tibbutt ◽  
C. N Chesterman ◽  
E. W Williams ◽  
T Faulkner ◽  
A. A Sharp
Keyword(s):  
Deep Vein Thrombosis ◽  
Clinical Improvement ◽  
Anticoagulant Therapy ◽  
Lower Limb ◽  
Oral Anticoagulant ◽  
Controlled Trial ◽  
Oral Anticoagulant Therapy ◽  
Control Group ◽  
Vein Thrombosis ◽  
Deep Vein

SummaryTreatment with streptokinase (‘Kabikinase’) was given to 26 patients with venographically confirmed deep vein thrombosis extending into the popliteal vein or above. Treatment was continued for 4 days and the patients were allocated randomly to oral anticoagulant therapy or a course of treatment with ancrod (‘Arvin’) for 6 days followed by oral anticoagulant therapy. The degree of thrombolysis as judged by further venographic examination at 10 days was not significantly different between the 2 groups. The majority of patients showed clinical improvement but there was no appreciable difference between the groups at 3 and 6 months. Haemorrhagic complications were a more serious problem during the period of treatment with ancrod than during the equivalent period in the control group.

Relationship Between Total Prothrombin, Native Prothrombin and the International Normalized Ratio (INR)

1992 ◽  
Vol 68 (02) ◽  
pp. 160-164 ◽  
Author(s):  
P J Braun ◽  
K M Szewczyk
Keyword(s):  
Anticoagulant Therapy ◽  
Oral Anticoagulant ◽  
Inverse Relationship ◽  
Low Dose ◽  
Oral Anticoagulant Therapy ◽  
International Normalized Ratio ◽  
Antigen Assay ◽  
Dose Oral ◽  
Anticoagulated Patients ◽  
Sensitive Method

SummaryPlasma levels of total prothrombin and fully-carboxylated (native) prothrombin were compared with results of prothrombin time (PT) assays for patients undergoing oral anticoagulant therapy. Mean concentrations of total and native prothrombin in non-anticoagulated patients were 119 ± 13 µg/ml and 118 ± 22 µg/ml, respectively. In anticoagulated patients, INR values ranged as high as 9, and levels of total prothrombin and native prothrombin decreased with increasing INR to minimum values of 40 µg/ml and 5 µg/ml, respectively. Des-carboxy-prothrombin increased with INR, to a maximum of 60 µg/ml. The strongest correlation was observed between native prothrombin and the reciprocal of the INR (1/INR) (r = 0.89, slope = 122 µg/ml, n = 200). These results indicated that native prothrombin varied over a wider range and was more closely related to INR values than either total or des-carboxy-prothrombin. Levels of native prothrombin were decreased 2-fold from normal levels at INR = 2, indicating that the native prothrombin antigen assay may be a sensitive method for monitoring low-dose oral anticoagulant therapy. The inverse relationship between concentration of native prothrombin and INR may help in identification of appropriate therapeutic ranges for oral anticoagulant therapy.

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