scholarly journals Delayed presentation of diaphragmatic hernia in a young and fit patient requiring emergency management

1970 ◽  
Vol 6 (3) ◽  
pp. 50-51
Author(s):  
SM Tuladhar ◽  
VK Sharma
Keyword(s):  
Peptic Ulcer ◽  
Early Diagnosis ◽  
Emergency Management ◽  
Diaphragmatic Hernia ◽  
Tension Pneumothorax ◽  
Peptic Ulcer Perforation ◽  
Delayed Presentation ◽  
Medical Sciences ◽  
Life Threatening ◽  
Life Threatening Complication

Diaphragmatic hernia, when they do present in adults, can manifest as a life threatening complication. Symptoms might initially be minimal in young and fit patients. They can also easily mimic complications like peptic ulcer perforation or tension pneumothorax and early pathophysiological correlation is required to reach an early diagnosis and treatment. DOI: 10.3126/jcmsn.v6i3.4077Journal of College of Medical Sciences-Nepal, 2010, Vol. 6, No. 3 pp.50-51

NSAIDS: A RISK FACTOR AFFECTING PEPTIC ULCER PERFORATION

2021 ◽  
pp. 9-9
Author(s):  
Neelkamal Gupta ◽  
Mangtani Jitendra K ◽  
Khandelwal Dheeraj K
Keyword(s):  
Peptic Ulcer ◽  
Statistical Correlation ◽  
Duodenal Perforation ◽  
Peptic Ulcer Perforation ◽  
Muscularis Mucosa ◽  
Time Duration ◽  
Ulcer Perforation ◽  
Medical College ◽  
Life Threatening ◽  
Gandhi Medical College

INTRODUCTION:Apeptic ulcer is a defect in the upper gastrointestinal mucosa that extends through the muscularis mucosa into deeper layers of the gut wall. Non-steroidal anti-inammatory drugs (NSAIDs) are the major risk factors for peptic ulcer disease.Long-term use of NSAIDs, however, can cause gastrointestinal (GI) ulcers and potentially life-threatening ulcer complications. MATERIALAND METHOD: The present study was conducted on 100 patients of peptic ulcer of either sex in Department of Surgery, Mahatma Gandhi Medical College & Hospital, Jaipur. History of any other co morbid illness and any drug being taken with its time duration were recorded in detail. RESULT AND DISCUSSION: From this study, it was observed that among the 69 patients of duodenal perforation, 73.91% were taking NSAID. Similarly among the 31 patients of gastric perforation 80.64% were taking NSAID. Overall total 76% patients were taking these drugs. CONCLUSION: It is concluded from this study that a strong statistical correlation was found between use of NSAIDs and peptic ulcer perforation.

scholarly journals Efficiency and safety of single dose Magnesium sulphate in eclamptic convulsion

2017 ◽  
Vol 6 (7) ◽  
pp. 3058
Author(s):  
Vinaya Goudar ◽  
Rashmi Naganagoudaru
Keyword(s):  
Single Dose ◽  
Magnesium Sulphate ◽  
Urban Areas ◽  
Low Dose ◽  
Post Partum ◽  
Efficacy And Safety ◽  
Medical Sciences ◽  
Life Threatening ◽  
Clonic Seizures ◽  
Life Threatening Complication

Background: An acute and life-threatening complication of pregnancy is characterized by the appearance of tonic clonic seizures, in a patient with pre-eclampsia. Objective of the study was to study the efficacy and safety of a ‘single dose’ of magnesium sulphate in treatment of eclamptic convulsions.Methods: The present prospective study was undertaken among women aged between 18-35 years outpatient’s Department of gynecology in Karnataka Institute of Medical Sciences (KIMS) Hubli, Karnataka, India. The study was undertaken during December 2009 to November 2010.Results: The incidence of eclampsia in our study was 2.12%. Eclapmsia is more common in patients from rural (89%) as compared to urban areas (11%) in our study. In our study eclampsia is more common in unbooked cases (80%). Majority of patients (72%) in our study group were illiterates. 61%, 28% of patients had antepartum and intrapartum eclampsia respectively in our study. We had only 11 post-partum convulsions Table 2. 80% of patients in our study were more than 28 weeks of gestations. 65% of the patients had <5 episodes of convulsions. The number of convulsions did not affect the recurrence, and 35% had >5 episodes. In present study 5 Patients had Systolic Blood Pressure less than 140 mmHg. Majority (52) had more than 160 mmHg 42 had in between 140 and 160 mmHg. Diastolic arterial pressure was >110 in 81% of cases. The convulsions were controlled in 75% of women. Recurrence of convulsions occurred in 25% of women after receiving the single dose magnesium sulphate regime. In our study 75% of cases, there was no recurrence of convulsions and in 25% of cases, there was recurrence of convulsions, out of which 20 cases received low dose magnesium sulphate regime and the other 5 cases received Phenytoin regime as 2nd line of treatment.Conclusions: Hence the single dose Magnesium sulphate is safe and effective in controlling convulsions.

scholarly journals Jejunogastric Intussusception: An Unusual Cause of Hematemesis

2005 ◽  
Vol 19 (12) ◽  
pp. 735-736 ◽  
Author(s):  
Inian Samarasam ◽  
Sudhakar Chandran ◽  
Uday Shankar ◽  
Biju George ◽  
Ashok Chacko ◽  
...  
Keyword(s):  
Case Report ◽  
Early Diagnosis ◽  
English Literature ◽  
Rare Complication ◽  
Jejunogastric Intussusception ◽  
Life Threatening ◽  
Life Threatening Complication

Jejunogastric intussusception is an uncommon but potentially life-threatening complication of a previous gastrojejunal anastamosis. Although jejunogastric intussusception was first described in 1914, fewer than 200 cases have been reported in the English literature thus far. Awareness of this rare complication would help in early diagnosis and appropriate management. Described here is a case report of a patient who presented with hematemesis due to an acute jejunogastric intussusception associated with gangrene of the intussuscepted jejunum.

scholarly journals Traumatic Diaphragmatic Hernia: Management and Review

2021 ◽  
pp. 1-3
Author(s):  
Sweety kumari ◽  
Keyword(s):  
Early Diagnosis ◽  
Blunt Trauma ◽  
Diaphragmatic Hernia ◽  
Diagnosis And Treatment ◽  
Therapeutic Tool ◽  
Penetrating Injuries ◽  
Traumatic Diaphragmatic Hernia ◽  
Delay In Diagnosis ◽  
Life Threatening ◽  
Suspicion Index

Traumatic diaphragmatic injury (TDI) is a fairly uncommon with incidence of 0.8 and 1.6 %, commonest fallowing blunt trauma abdomen. Right-side have higher mortality rate compared to left side and penetrating injuries. It present as occult to obvious. Laparoscopy offers diagnostic and therapeutic tool of care. Lack of awareness of the condition may delay in diagnosis, results life threatening complications. Missed hernia is a known complication of blunt trauma as acute diagnosis can be difficult to ascertain. An early diagnosis and treatment lead to better outcome. In present study CECT revealed acute diaphragmatic hernia, bilateral pleural effusion and hair line fracture of right tibia on skiagram limb. Because of uncertainty in diagnosis of acute diaphragmatic hernia or rupture surgeons faces challenges for the management, high suspicion index required to diagnose the cases. An early diagnosis and treatment lead to better outcome

scholarly journals Normotensive HELLP syndrome in the midst of Dengue fever

2018 ◽  
Vol 9 (2) ◽  
pp. 40-42
Author(s):  
Robin George Manappallil ◽  
Sithara Surendran ◽  
Anoop Kumar ◽  
Ganga Prasad
Keyword(s):  
Blood Pressure ◽  
Risk Factor ◽  
Dengue Fever ◽  
Hellp Syndrome ◽  
Liver Enzymes ◽  
Elevated Blood ◽  
Medical Sciences ◽  
Elevated Liver Enzymes ◽  
Life Threatening ◽  
Life Threatening Complication

HELLP syndrome is a life threatening complication of pregnancy, characterized by haemolysis, elevated liver enzymes and low platelet counts. Preeclampsia is a risk factor for developing HELLP. However, some patients can have HELLP in the absence of elevated blood pressure. Dengue fever is a mosquito-borne viral infection characterized by fever, leucopenia and thrombocytopenia, and bleeding manifestations. This is a case of a young primigravida who presented with dengue fever and was found to have an associated normotensive HELLP syndrome.Asian Journal of Medical Sciences Vol.9(2) 2018 40-42

scholarly journals Acquired diaphragmatic hernia in an adult male: A diagnostic challenge

2013 ◽  
Vol 2 (2) ◽  
pp. 194-196 ◽  
Author(s):  
R Sachdeva ◽  
S Sachdeva ◽  
S Solanki
Keyword(s):  
Early Diagnosis ◽  
Diaphragmatic Hernia ◽  
Adult Male ◽  
Rare Case ◽  
Weight Lifting ◽  
Initial Presentation ◽  
Medical Sciences ◽  
Diagnostic Challenge ◽  
Male Farmer ◽  
Middle Aged Adult

A rare case of acquired diaphragmatic hernia in a middle aged adult male farmer following occupation related weight lifting is described which was missed at initial presentation. High index of suspicious in conjunct with related investigation can clinch early diagnosis. Nepal Journal of Medical Sciences | Volume 02 | Number 02 | July-December 2013 | Page 194-196 DOI: http://dx.doi.org/10.3126/njms.v2i2.8977  

scholarly journals Tension Pneumothorax, Pneumoperitoneum, and Cervical Emphysema following a Diagnostic Colonoscopy

2013 ◽  
Vol 2013 ◽  
pp. 1-3 ◽  
Author(s):  
Ali Pourmand ◽  
Hamid Shokoohi
Keyword(s):  
Rare Case ◽  
Tension Pneumothorax ◽  
Colonic Perforation ◽  
Tube Thoracostomy ◽  
Diagnostic Colonoscopy ◽  
Rare Case Report ◽  
Initial Injury ◽  
Life Threatening ◽  
Life Threatening Complication ◽  
Anatomical Connection

Colonoscopy is currently a widespread procedure used in screening for colorectal cancer. Iatrogenic colonic perforation during colonoscopy is a serious and potentially life-threatening complication that can cause significant morbidity and mortality. “Triple pneumo” (a combination of pneumothorax, pneumomediastinum, and pneumoperitoneum) following colonoscopy is a rare but a serious condition requiring immediate diagnosis and emergent intervention. In majority of these cases a colonic perforation is the initial injury that is followed by pneumothorax and pneumomediastinum through the potential anatomical connection with retroperitoneal and mediastinal spaces. In this rare case report we are presenting a case of “triple pneumo” with no evidence of colonic perforation. This patient developed a simultaneous pneumoperitoneum, pneumomediastinum, and a tension pneumothorax requiring immediate tube thoracostomy. This case may raise the awareness on the likelihood of these serious complications after colonoscopy.

Early diagnosis of Wolf-Hirschhorn syndrome triggered by a life-threatening event: Congenital diaphragmatic hernia

2004 ◽  
Vol 127A (2) ◽  
pp. 194-196 ◽  
Author(s):  
M.F. van Dooren ◽  
A.S. Brooks ◽  
A.J.M. Hoogeboom ◽  
T.L. van den Hoonaard ◽  
J.E.M.M. de Klein ◽  
...  
Keyword(s):  
Early Diagnosis ◽  
Congenital Diaphragmatic Hernia ◽  
Diaphragmatic Hernia ◽  
Life Threatening ◽  
Life Threatening Event

Early Diagnosis of Neutropenic Enterocolitis by Ultrasound Sonography.

Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 4742-4742 ◽  
Author(s):  
Edoardo Benedetti ◽  
Federico Simonetti ◽  
Francesco Caracciolo ◽  
Federico Papineschi ◽  
Benedetto Bruno ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Early Diagnosis ◽  
Medical Treatment ◽  
Gram Positive ◽  
Acute Leukemias ◽  
Neutropenic Enterocolitis ◽  
Gram Negative ◽  
Life Threatening ◽  
Neutropenic Patients ◽  
Life Threatening Complication

Abstract Abstract 4742 Introduction Neutropenic enterocolitis (NEC) is a life threatening complication of chemotherapy in leukemic and solid tumor patients with an incidence ranging from 2.6% to 33%. It is a necrotizing inflammatory disease that most commonly involves the ileo-cecal region. The cecum is almost invariably affected likely due to its distensibility and limited blood supply. Macroscopically the involved bowel segments show oedematous and thickened walls, with varying degrees of ulceration and haemorrhage. Perforation occurs in 5%-10% of cases. Early diagnosis is crucial to start conservative medical treatment which appears the optimal strategy. Criteria for prompt surgical treatment have also been proposed (Shamberger RC et al, 1986) so that a careful clinical evaluation by both the physician and the surgeon is mandatory (Davila ML et al, 2004). NEC should be always suspected in neutropenic patients with abdominal pain, fever and diarrhea. Ultrasound (US) has been used to evaluate bowel-wall thickening (BWT). One study correlated BWT with clinical outcome: 60% of patients with BWT > 10 mm died from NEC as compared with 4.2% of those with BWT < 10 mm (Cartoni C. et al, 2001). Overall, despite aggressive treatment, mortality rate is up to 21-48% and patients may die within hours from the onset of acute symptoms. Because of the risk of early death, a swift diagnosis is imperative. We investigated if US could detect early signs of NEC and lead to prompt treatment. We analyzed two patients cohorts (A and B). In cohort A US was performed later in the course of the disease whereas, in cohort B US was immediately performed at the onset of a single symptom (diarrhea and/or abdominal pain whichever occurred first with/without fever). Underlying haematological diagnoses were Hodgkin Disease (N=10), acute leukemias (N=9), multiple myeloma (N=3) and non-Hodgkin lymphomas (N=10). Treatments consisted of standard chemotherapy (N=10), myeloablative allografting after busulfan/cytoxan (N=1) and cytoxan/total body irradiation (N=1); autografting after busulfan/cytoxan (N=1), BEAM (N=16) and melphalan (N=3). Results All 32 patients showed grade 4 neutropenia at the onset of symptoms. Thirty-one/32 (97%) complained of abdominal pain whereas diarrhea was present in 30/32 (94%). Positive stool (for Clostridium Difficilis and Escherichia Coli) and blood cultures (62% Gram negative and 38% Gram positive bacteria) were found in 4/32 (12.5%) and 8/32 (25%) respectively. Trans-abdominal real-time US scanning of the bowel was performed using a 3.5-5 MHz convex probe and a 7 MHz linear transducer. A portable sonographer (Esaote model My Lab 25) was used for bed-side US. Both trans-abdominal axial and transverse US scans were performed on the colon. US signs of NEC were defined as thickening or dilation of small and/or large intestine. The intestinal involved areas were ileum, 21%, last terminal ileum, 21%, cecum 7%, ascending colon, 16%, transverse colon, 16%, descending colon, 14% and jejunum, 4%. US revealed signs of NEC in 8/14 in cohort A and 18/18 in cohort B. In cohort B, early US detected signs of NEC in 7 patients with abdominal pain and diarrhea without fever. Complete response to prompt medical treatment occurred in 6. Three/7 patients developed fever 48 hours after the US-guided diagnosis of NEC. Two patients, at risk of wall rupture by US imaging (confirmed by CT scans), underwent successful colon surgery within 12 hours from diagnosis. Except for these 2, all patients received medical treatment (broad spectrum antibiotics for gram-negative, gram-positive and anaerobic coverage, and antifungal drugs, granulocyte transfusions, bowel rest and granulocyte colony stimulating factor as per internal protocol). Overall 3/32 patients died. Conclusions Early bed-side intestinal US in neutropenic patients performed at the onset of a single symptom suggestive of NEC led to timely and successful treatment of this life threatening complication even before the development of fever. Disclosures: No relevant conflicts of interest to declare.

Axillary Artery Pseudoaneurysm following Severely Displaced Proximal Humerus Fracture: Delayed Presentation and Management

2010 ◽  
Vol 2 (2) ◽  
pp. 100-102
Author(s):  
Thomas Kurien ◽  
Amol Tambe ◽  
David I. Clark
Keyword(s):  
Proximal Humeral Fracture ◽  
Proximal Humerus Fracture ◽  
Proximal Humerus ◽  
Axillary Artery ◽  
Humeral Fracture ◽  
Delayed Presentation ◽  
Artery Pseudoaneurysm ◽  
Novel Approach ◽  
Life Threatening ◽  
Life Threatening Complication

Delayed presentation of axillary artery injuries after displaced proximal humeral fractures are rare. We present a report on an 88 year old female who developed a pseudoanersym of the axillary artery 3 weeks after a proximal humeral fracture and a novel approach to the management of this potentially limb and life threatening complication.

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