scholarly journals Spontaneous Hemoperitoneum Masquerading Placental Abruption: A Case Report

2014 ◽  
Vol 7 (2) ◽  
pp. 50-51 ◽  
Author(s):  
S Subedi ◽  
B Banerjee
Keyword(s):  
Placental Abruption ◽  
Clinical Presentation ◽  
Acute Abdominal Pain ◽  
Fetal Distress ◽  
Third Trimester ◽  
Obstetrics And Gynaecology ◽  
Spontaneous Hemoperitoneum ◽  
Threatening Condition ◽  
Life Threatening ◽  
Pelvic Viscera

Hemoperitoneum during pregnancy is a rare but potentially life threatening condition to both mother and fetus. Spontaneous hemoperitoneum may develop from rupture of various abdominal or pelvic viscera like spleen, pancreas and also uterus from the uterine ovarian vessels and rarely from pelvic endometrial implants. It mimics placental abruption having similar clinical presentation like acute abdominal pain, peritonitis, shock and fetal distress or fetal death. We present a case of spontaneous rupture of superficial uterine vessels in third trimester of pregnancy with an objective to share our experience in managing this rare emergency condition having diagnostic dilemmas. DOI: http://www.dx.doi.org/10.3126/njog.v7i2.11145   Nepal Journal of Obstetrics and Gynaecology / Vol 7 / No. 2 / Issue 14 / July-Dec, 2012 / 50-51

scholarly journals Myelodysplastic Syndrome Clinically Presenting with the “Classic TTP Pentad”

2017 ◽  
Vol 2017 ◽  
pp. 1-6 ◽  
Author(s):  
Santiago Fabián Moscoso Martínez ◽  
Evelyn Carolina Polanco Jácome ◽  
Elizabeth Guevara ◽  
Vijay Mattoo
Keyword(s):  
Myelodysplastic Syndrome ◽  
Clinical Presentation ◽  
Renal Involvement ◽  
Medical Emergency ◽  
Complete Blood Cell Count ◽  
Blood Cell Count ◽  
Thrombocytopenic Purpura ◽  
Life Saving ◽  
Threatening Condition ◽  
Life Threatening

The clinical presentation of myelodysplastic syndrome (MDS) is not specific. Many patients can be asymptomatic and can be detected only due to an abnormal complete blood cell count (CBC) on routine exam or for other reasons while others can be symptomatic as a consequence of underlying cytopenias. Thrombotic thrombocytopenic purpura (TTP) usually is suspected under the evidence of microangiopathic hemolytic anemia (MAHA) and thrombocytopenia and because it is a life-threatening condition (medical emergency) immediate initiation of plasmapheresis could be life-saving. The following case illustrates an unusual presentation of MDS in a patient who came in to the emergency room with the classic TTP “pentad” of fever, renal involvement, MAHA, mental status changes, and thrombocytopenia. We will focus our discussion in the clinical presentation of this case.

scholarly journals Fetal Midgut Volvulus with Meconium Peritonitis Detected on Prenatal Ultrasound

2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
Emanuelle J. Best ◽  
Cecelia M. O’Brien ◽  
Wendy Carseldine ◽  
Aniruddh Deshpande ◽  
Rebecca Glover ◽  
...  
Keyword(s):  
Small Bowel ◽  
Abdominal Mass ◽  
Uneventful Recovery ◽  
Team Approach ◽  
Midgut Volvulus ◽  
Meconium Peritonitis ◽  
Third Trimester ◽  
Bowel Necrosis ◽  
Threatening Condition ◽  
Life Threatening

Background. Fetal volvulus is a rare, yet life-threatening condition that requires skilful diagnosis and management. Volvulus occurs when bowel loops become twisted and the twisting of the mesenteric artery leads to congestion, impaired venous return, and bowel necrosis. Case Description. We present a case of fetal ileal volvulus suspected on third trimester ultrasound, complicated by premature labour, small bowel necrosis, and meconium peritonitis. Progressive dilatation and decreased peristalsis of echogenic bowel were noted in the early part of the third trimester. Daily surveillance ultrasound was performed and spontaneous labour occurred at 32 weeks’ gestation. A proactive postnatal approach guided by prenatal sonographic findings allowed prompt treatment and an urgent laparotomy was performed for an ileal volvulus with necrosis and meconium peritonitis. A segment of small bowel volvulus was resected and an end-to-end anastomosis was performed with uneventful recovery. Discussion. Clinically signs of fetal midgut volvulus are not pathognomonic, such as intestinal dilatation, abdominal mass, ascites, peritoneal calcifications, or polyhydramnios; thus, the diagnosis is often challenging. Complications reported in the literature include perforation and haemorrhagic ascites, which may lead to anaemia, hypovolemia, heart failure, and fetal demise. Conclusion. This case highlights the importance of assessing the fetal bowel as a part of routine third trimester ultrasound. The case describes the complexity of diagnosis in the fetus, important considerations along with multidisciplinary team approach to management.

scholarly journals Acute ileocolitis as a presentation of Sars Cov-2 infection in children- A case report

2021 ◽  
Vol 7 (4) ◽  
pp. 218-220
Author(s):  
Raghavendra H Gobbur ◽  
Ranjima M Mahesh
Keyword(s):  
Clinical Presentation ◽  
Acute Liver Injury ◽  
Kidney Injury ◽  
Symptomatic Infection ◽  
Pain Abdomen ◽  
Asymptomatic Children ◽  
Threatening Condition ◽  
Life Threatening ◽  
Inflammatory Syndrome ◽  
The Impact

As COVID-19 continues to spread in India and other countries, the impact of the disease among children, initially considered less important, is becoming more relevant. The extent of the diversity of clinical presentation of COVID-19 in children are still unclear. We have already seen a new clinical picture of SARS-CoV-2 in children manifesting as a hyper-inflammatory syndrome, with multi-organ involvement similar to Kawasaki Disease and with potential evolution to a shock syndrome. This represented a new phenomenon affecting previously asymptomatic children with SARS-CoV-2 infection. COVID-19 may also manifest as viral hepatitis, acute pancreatitis, acute liver injury, acute kidney injury, ARDS, Sepsis, septic shock and meningo-encephalitis and cerebellar ataxia. The Multisystem Inflammatory Syndrome in Children (MIS-C) associated with SARS-CoV-2 infection occurs weeks after infection and may evolve unnoticed. MIS-Cs pathophysiology remains unclear. However, it appears to be a postinfectious hyperimmune response that may occur during or following asymptomatic or symptomatic infection. COVID-19 infection in children may lead to a potentially life threatening condition that we may not be aware of. We are in need of reporting of the diverse presentation of SARS CoV-2 virus in children. Here we describe a case of a previously normal 14-year-old boy who manifested with severe pain abdomen after SARS CoV-2 infection and was diagnosed as Acute Ileocolitis secondary to COVID-19. Child improved with steroid therapy and was asymptomatic after 3 weeks of treatment.

scholarly journals Nonspecific abdominal pain: Do I have to allocate a specific diagnosis for every patient?

2022 ◽  
Keyword(s):  
Abdominal Pain ◽  
Care Setting ◽  
Acute Abdominal Pain ◽  
Scoring Systems ◽  
Acute Care Setting ◽  
Acute Setting ◽  
The World ◽  
Threatening Condition ◽  
Chief Complaints ◽  
Life Threatening

Acute abdominal pain is one of the most common chief complaints in the acute setting all over the world. The definitive diagnoses of these patients vary depending on age, gender, geographical and sociodemographic characteristics etc. Apart from these, aging of the population, obesity, advanced diagnostic imaging modalities and changes in nutritional habits also have an impact on the rates of specific diagnoses. On the other hand, nonspecific abdominal pain constitutes almost half of all visits due to acute abdominal pain in the acute care setting. This phenomenon is the main differential diagnostic problem in the management of these patients because missing a life-threatening condition can cause enormous medicolegal problems for the caregivers. Certain diagnostic scoring systems have also been developed to facilitate recognition and management of these conditions. This article aims to review the entity and underline the challenges it can bring to the scene.

scholarly journals Gastric Pneumatosis: Emphysematous Gastritis versus Gastric Emphysema

2019 ◽  
Vol 02 (02) ◽  
pp. 151-154
Author(s):  
Amit Kumar Paliwal ◽  
Sachin Girdhar ◽  
Somali Pattanayak ◽  
Brajesh Kumar
Keyword(s):  
Abdominal Surgery ◽  
Diabetic Patient ◽  
Clinical Presentation ◽  
Favorable Outcome ◽  
Radiological Findings ◽  
Benign Condition ◽  
Emphysematous Gastritis ◽  
Threatening Condition ◽  
Life Threatening ◽  
Gastric Emphysema

AbstractPresence of air in the wall of the stomach is known as gastric pneumatosis. It may be associated with a benign condition like gastric emphysema (GE) to life threatening condition emphysematous gastritis (EG). Differentiation between two entities based on clinical presentation, predisposing factors, and radiological findings is important as EG has more complications and higher rates of mortality. The treatment in GE is conservative while treatment in EG is evolving. We present a case of a diabetic patient who developed EG following abdominal surgery and managed conservatively with favorable outcome.

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

scholarly journals Acute Fatty Liver of Pregnancy: A Life Threatening Condition

2020 ◽  
Vol 15 (1) ◽  
pp. 79-80
Author(s):  
Sarita Sitaula ◽  
Ajay Agrawal ◽  
Achala Thakur ◽  
Tara Manandhar ◽  
Babauram Dixit Thapa ◽  
...  
Keyword(s):  
Fatty Liver ◽  
Postpartum Hemorrhage ◽  
Post Partum ◽  
High Morbidity ◽  
Third Trimester ◽  
Delay In Diagnosis ◽  
Threatening Condition ◽  
Life Threatening ◽  
Acute Fatty Liver ◽  
Catastrophic Disease

Acute Fatty Liver of Pregnancy (AFLP) is a rare but catastrophic disease affecting women in pregnancy. It usually occurs in the third trimester or post-partum period. Delay in diagnosis is associated with morbid complications with high morbidity and mortality. We report a case of 24 years old female at 38 weeks period of gestation who presented with jaundice, vomiting for 3 days and deranged liver function test. She was diagnosed as acute fatty liver of pregnancy and was delivered by instrumental delivery but required cesarean hysterectomy due to postpartum hemorrhage. She started improving with supportive care and discharged after 4 weeks of hospital stay. Key words: AFLP, Hysterectomy, Postpartum hemorrhage

scholarly journals Intrapartal resection of the bicornuete uterus for placenta membranacea percreta

2007 ◽  
Vol 135 (1-2) ◽  
pp. 85-87 ◽  
Author(s):  
Radmila Sparic ◽  
Sasa Kadija ◽  
Jasmina Tadic ◽  
Milan Dokic ◽  
Vera Milenkovic
Keyword(s):  
Placental Abruption ◽  
Villous Atrophy ◽  
Breech Presentation ◽  
Uterine Wall ◽  
Uterine Horn ◽  
Uterine Anomalies ◽  
Threatening Condition ◽  
Life Threatening ◽  
Lower Segment Uterine ◽  
Live Baby

Placenta membranacea is a rare anomaly characterized by failure of villous atrophy during early gestation, and 30% of cases involve some form of placental adherence. Placenta percreta is infrequent, but life-threatening condition. Antenatal diagnosis of these placental anomalies is very difficult, but essential for reduction of the number and extent of possible complications. A 19-year-old primigravida was referred to us with 31- week pregnancy complicated by preeclampsia. Upon admission, ultrasound scan revealed eutrophic fetus in breech presentation, without any signs of retroplacental clot. At laparotomy, hemoperitoneum without any trophoblastic tissue emerging to the peritoneal cavity was found and placental abruption with uteroplacental apoplexy was suspected. In addition, unicervical symmetric bicornuate uterus with pregnancy in the left uterine horn was found. The lower segment uterine section was performed and 1800 grams live baby was delivered. Delivery of the placenta was unusually difficult. It was very large and densely adherent to the posterior uterine wall, which appeared to be composed of serosa in that area only. After removal of placenta, the hemorrhage could not be controlled, and resection of the left uterine horn was performed. Placenta accreta, increta and percreta ought to be considered in all cases of uterine anomalies in pregnancy and in cases of prenatal diagnosis of placenta membranacea.

Necrotizing Enterocolitis

2018 ◽  
Author(s):  
Jared Hylton ◽  
Sarah Deverman
Keyword(s):  
Necrotizing Enterocolitis ◽  
Neonatal Intensive Care ◽  
Clinical Presentation ◽  
Pneumatosis Intestinalis ◽  
Postoperative Management ◽  
First Line ◽  
Surgical Emergencies ◽  
Threatening Condition ◽  
Life Threatening ◽  
Ventilatory Management

Necrotizing enterocolitis (NEC) is a potentially life-threatening condition that affects mainly preterm infants. It is one of the most common surgical emergencies in the neonatal intensive care unit. While medical management is the first line of treatment, if that fails, NEC becomes a surgical emergency, and the pediatric anesthesiologist must be prepared. This chapter covers the pathogenesis, risk factors, clinical presentation and diagnosis, prevention, medical and surgical management, pre- and intraoperative anesthetic assessment, and postoperative management of NEC. Topics covered include intestinal perforation, necrotizing enterocolitis, neonatal anesthesia, pneumatosis intestinalis, prematurity, and ventilatory management. The chapter ends with review questions on the chapter’s content.

scholarly journals DRESS Syndrome due to Nevirapine Treated with Methylprednisolone

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
Henrique Pott Junior ◽  
Gisele Cristina Gosuen ◽  
Ana Cristina Gales
Keyword(s):  
Clinical Presentation ◽  
Mortality Rates ◽  
Multiple Organ ◽  
Clinical Suspicion ◽  
Significant Morbidity ◽  
Dress Syndrome ◽  
Infected Female ◽  
Threatening Condition ◽  
Life Threatening ◽  
Systemic Symptoms

Nevirapine-induced DRESS syndrome is uncommon but a potentially life-threatening condition, with significant morbidity and mortality rates due to multiple-organ involvement. The authors report a case of a 47-year-old HIV-infected female patient who presented with fever, right hypochondrium pain, jaundice, and skin rash. The Nevirapine-induced DRESS syndrome was suspected based on clinical presentation and RegiSCAR scoring system. This case highlights the need for a high index of clinical suspicion among HIV-infected patients with severe skin eruption and systemic symptoms.

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