Thrombosis of the abdominal aorta in newborn: About two cases

Author(s):  
N. Imad ◽  
N. El Idrissi Slitine ◽  
S. Alaoui ◽  
I. Zalle ◽  
D. Boumzebra ◽  
...  

BACKGROUND: Aortic thrombosis in neonates is a rare phenomenon, and in most cases iatrogenic. An early recognition of the clinical features and an immediate intervention can offer a better prognosis, and thus preventing morbidity such as limb amputation, and even mortality. METHODS: We present two cases of full-term newborns with a thrombosis of the abdominal aorta hospitalized in the neonatal intensive care unit of Mohammed VI University Hospital in Marrakech in 2017 and 2019. RESULTS: The two patients presented swelling and cyanotic lower limbs. Doppler ultrasound revealed a pathological lower limb blood flow as a result of a thrombosis of the abdominal aorta. Both patients underwent an anticoagulant therapy, the first one benefited from a surgical thrombectomy, he developed a reperfusion syndrome with alveolar hemorrhage, and passed away as a result of a cardiorespiratory arrest. However the second patient got amputated of the right foot, his clinical evolution was favorable with a good healing of the surgical wound without recurrence of any thrombosis. CONCLUSION: Through those cases clinicians should be aware of the first clinical signs of this condition in order to offer a rapid and successful management.

2020 ◽  
Vol 99 (3) ◽  
pp. 131-135

Introduction: Abdominal emergencies occur in pregnant women with the rate of 1:500−635 pregnancies. Such conditions usually develop from full health and worsen rapidly. Symptoms are often similar to those in physiological pregnancy (abdominal pain, vomiting, constipation). The diagnostic process is thus difficult and both the mother and her child are at risk. Our aim was to evaluate the frequency of abdominal emergencies in the Department of Surgery, University Hospital in Pilsen and to consider their impact on pregnancy and on the newborn. Methods: We acquired a set of patients by retrograde collection of data. We searched for pregnant patients suspected of developing an abdominal emergency admitted to the Department of Surgery, Faculty of Medicine, Pilsen between 2004 and 2015. We evaluated a number of clinical signs to statistically describe the set. Results: The set included 121 patients; 42 of the patients underwent a surgical procedure and 79 received conservative treatment. 38 patients underwent appendectomy; 6 appendixes were with no pathologies. McBurney’s incision was an approach of choice in most cases. The most frequent symptom was pain in the right lower abdominal quadrant. The foetus has been lost in none of the cases. Conclusion: Acute appendicitis was the most frequent abdominal emergency in our set and also the most frequent reason for surgical intervention. The most specific sign was pain in the right lower abdominal quadrant. No impact of appendicitis or appendectomy on the health of the newborn has been observed. Even though abdominal emergencies in pregnancy are relatively rare, the results of the department are very good.


2012 ◽  
pp. 74-84
Author(s):  
Thi Kieu Nhi Nguyen

Objectives: 1. Estimating the ratios of clinical and paraclinical signs of post-term newborns hospitalized at Pediatric Department of Hue University Hospital. 2. Identifying the relation between clinical signs and paraclinical signs. Materials and Method: 72 post- term babies < 7 days of life hospitalized at NICU from 2010/5 to 2011/4. Classification of post - term newborn was based on WHO 2003: gestational age ≥ 42 weeks with clinical manifestations: desquamation on press with fingers or natural desquamation, withered or meconial umbilicus, meconial long finger nails (*) or geatational age still < 42 weeks with theses clinical manifestations (*). Data were recorded on a clinical record form. Per-protocol analysis of clinical outcomes was performed by using Medcalc 11.5 and Excell 2007. Analyses used the χ2 test or Fisher's exact test for categorical data; Student's t test was used for continuous data and the Mann-Whitney U test for nonparametric data. Data were presented as means or proportions with 95% CIs. Results: Clinical characteristics: Tachypnea and grasp were main reasons of hospitalisation (48.61%). Poor feeding, vomitting (16.67%). Asphyxia (8.34%). Jawndice (6.94%). Hypothermia < 36.50C (13.89%), fever (13.89%). Tachypnea (59.72%). Bradycardia (1.39%). Poor feeding (11.11%). Hypertonia (9.72%). Paraclinical characteristics: Erythrocytes < 4.5.1012/l (51.39%), Leucocytes 5 – 25.103/mm3 (81.94%), Thrombocytes 100- 400.103/mm3 (94.44%). Hemoglobinemia < 10mg/l (67.61%). Maternal characteristics: Menstrual cycles regular (75%). Primiparity (75%). Amniotic volume average (70.42%), little (29.58%). Aminiotic liquid clair (62.5%), aminiotic liquid yellow (4.17%), aminiotic meconial liquid (33.33%). Maternal manifestation of one of many risk factors consist of genital infection; urinary infection; fever before, during, after 3 days of birth; prolonged delivery; medical diseases influence the foetus (75%). The relation between clinical signs and paraclinical signs: There was significantly statistical difference: between gestationnal age based on obstetrical criteria and amniotic volume on ultrasound (p < 0.05); between birth weight and glucosemia p < 0.02). There was conversional correlation of average level between erythroctes number and respiratory rate (r = - 0.5158; p < 0,0001), concordance correlation of weak level betwwen leucocytes number and respiratory rate r = 0.3045; p = 0.0093). Conclusion: It should made diagnosis of postterm baby based on degree of desquamation. The mother who has menstrual cycles regular is still delivered of a postterm baby. A postterm baby has the individual clinical and paraclinical signs.


2011 ◽  
pp. 468-475
Author(s):  
Javier Torres ◽  
Laura Lorena Espinosa ◽  
Ángela Marcela García ◽  
Alejandra María Mideros ◽  
Enrique Usubillaga

Introduction: Necrotizing enterocolitis (NEC) is, over all newborn surgical afflictions, the most deathly, representing the main GI problem in neonatal intensive care units (NICU) and a medical/surgical emergency in which early diagnosis and opportune treatment may diminish surgical needs and mortality. Objective: To describe the features of patients with NEC attended at a third-level hospital NICU in the city of Cali in 2006. Method and materials: We conducted a pilot descriptive retrospective study that included 32 clinical records of newborns in the NICU (named CIRENA) from the Hospital Universitario del Valle (HUV) with NEC diagnosis. Finally, we made a descriptive analysis of the data by using the Epi-Info statistics program. Results: In 2006, 1555 newborns were admitted to HUV-CIRENA and 32 (2%) of them were diagnosed with NEC, a percentage that is similar to that of other countries; half of which weighed less than 1500 grams and only three pregnant women had adequate prenatal care, 17(53.1%) of these newborns were female and 15(46.9%) were male. Conclusions: Although the majority of NEC cases occurs in premature and/or very low weight children, it is outstanding the number of full-term newborns, either on gestational age and weight, that developed early NEC. There is a visible relationship among low birth weight, prematurity, and the development of NEC, especially in the higher degrees of the disease, where the tendency is the presentation of late NEC.


2021 ◽  
Vol 01 (01) ◽  
pp. 007-008
Author(s):  
Daniela Burguêz

Intravascular papillary endothelial hyperplasia or Masson’s tumor is a rare benign vascular pathology. It mainly affects the lower limbs and is not related to the gender or age of the patients. Evaluation by clinical history and imaging exams can be confused with other soft tissue tumors. The purpose of this article is to describe a case attended at a university hospital in Porto Alegre, Brazil. In the present study, the authors report a case of a 54-year-old male patient with the presence of nodulation on the back of the right foot. After inconclusive biopsy, the treatment of choice was surgical resection of the tumor with free margins. Anatomopathological study of the surgical specimen was compatible with Masson’s tumor. A 6-month follow-up did not show any recurrence of the lesion. With this case, the authors wish to highlight this pathology among the differential diagnoses for soft tissue tumors.


2021 ◽  
pp. 1098612X2110130
Author(s):  
Brittany N Schlesener ◽  
Elizabeth A Peck ◽  
Eric M Teplitz ◽  
Filipe Espinheira Gomes ◽  
Dwight D Bowman ◽  
...  

Case series summary Described are four cats diagnosed with ophthalmomyiasis externa caused by Cuterebra larvae. Medical records were retrospectively reviewed to identify cats with ophthalmomyiasis externa between 2005 and 2020 at Cornell University Hospital for Animals. Signalment, history, clinical and diagnostic findings, treatment and outcome were recorded. All cats were young (< 3 years of age), had outdoor access and were initially examined during the summer months. All cases had unilateral disease with the right eye affected. Two cases had nictitating membrane lesions and two had orbital disease. Concurrent superficial corneal ulceration was present in three cats. Two cats suffered from pyrexia, suspected secondary to inflammation from the larval infestation. Successful larval removal was performed in all cats, which resulted in improvement of discomfort and clinical signs. A corneal ulcer persisted in one cat, which was lost to follow-up prior to ulcer resolution. Parasite identification confirmed Cuterebra species infestation in all cases. Relevance and novel information To the authors’ knowledge, this is the first report of feline ophthalmomyiasis externa caused by Cuterebra species. Parasite removal was successful in restoring comfort and resolving clinical signs in all cats with adequate follow-up information.


2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Chika Kyo ◽  
Takeshi Usui ◽  
Kanako Yamada ◽  
Mizuki Torii-Hanakita ◽  
Rieko Kosugi ◽  
...  

Abstract BACKGROUND: Oversecreted catecholamines from pheochromocytoma (PCC) is responsible for a large variety of clinical signs and symptoms, including skin lesions, due to their effects on hemodynamics and metabolism, as well as the putative effects on the blood coagulation system. Livedo reticularis had been reported as the skin complications of PCC, but there was no pathological evidence. Livedoid vasculopathy, a subtype of livedo reticularis is a noninflammatory thrombotic condition. Here we firstly showed that livedo reticularis accompanying PCC. Case: A 36-year-old female with hypertension, hyperglycemia, and right adrenal mass had referred to our hospital. She had violaceous reticular lesions on bilateral lower limbs, a three-year history of recurrent ulcers around her right ankle with severe pain. She also had frequent Raynaud’s phenomenon. On admission, the blood examination showed that her hemoglobin concentration was 16.3g/dl and her platelet count was 408,000/ml. Plasma catecholamines and the metabolite levels were elevated. The abdominal CT scan showed the right adrenal mass, approximately 6.5cm in diameter, and MRI showed a heterogeneous mass with high signal intensity on T2-weighted images. MIBG scintigraphy showed uptake in the mass. We diagnosed her as PCC. A skin biopsy revealed occlusions of the lumen of small vessels in the mid dermis without vasculitis. Administration of doxazosin revealed the improvement of the clinical parameters including the pain and the ulcer of the right ankle. The laparoscopic right adrenalectomy was performed. Histopathological study of the adrenal tumor was consistent with PCC. Genetic testing and MLPA analysis for RET, VHL, SDHx, SDH-AF2, MAX, and TMEM127 showed no mutations or copy number alterations. Postoperatively, hypertension and hyperglycemia improved, and Raynaud’s phenomenon and reticular macules disappeared. Discussion: Among the various clinical signs of PCC, skin disorders are relatively rare. Limited reports showed that the livedo reticularis was a complication of PCC, but its mechanism had not been elucidated. Livedoid vasculopathy is a rare cutaneous disease manifesting as recurrent ulcers on the lower extremities, which is a noninflammatory thrombotic condition associated with hypercoagulation. The catecholamine excess could induce arterial vasospasm in addition to relative hypercoagulation tendency, which could result in livedoid vasculopathy. Conclusion: The present study showed first pathological evidence of that the livedo reticularis accompanying PCC was livedoid vasculopathy.


2019 ◽  
Vol 47 ◽  
Author(s):  
Raíssa Oliveira Leite ◽  
Viciany Erique Fabris ◽  
Elisa Sant'Anna Monteiro da Silva ◽  
Geison Morel Nogueira ◽  
Diego José Zanzarini Delfiol

Background: Osteosarcomas are common malignant bone tumors described in dogs, humans and cats. However, there are rare reports in horses. The tumor etiology has not been fully elucidated. Clinical signs are associated to the tumor size, location and growth characteristics. When located on the face, the most common findings are facial distortion, nasal discharge and inspiratory dyspnea. The aim of this study was to report an osteoblastic osteosarcoma in a horse, located on the right maxillary region with projections into the corresponding nostril.Case: A 6-year-old mixbreed saddle gelding, presenting bay coat was admitted to a University Hospital with a chronic sinusitis history. The animal was previously examined and treated by other veterinarians, who suspected of odontogenic maxillary sinusitis, and therefore a repulsion of the fourth premolar from the right maxilla hemiarcade was performed. However, an improvement of the clinical signs was not observed and subsequently the gelding was referred to a Veterinary Hospital. During physical examination the patient presented dyspnea, tachypnea and tachycardia. An increase on the face size was observed, together with a fetid and purulent nasal discharge. During oral cavity inspection, a diagonal wear was detected at the occlusal surface of the right hemiarcade; food accumulation was seen at the dental extraction site, and a communication with the rostral maxillary sinus was evidenced, from where a purulent fetid discharge was draining. At the radiographic exam, well defined margins of a tumor were observed, with adjacent bone lysis and the presence of a central nucleus showing a gross granular mineral radiopacity, distorting the frontal and nasal bones. During the endoscopic exam, a mass was partially occluding the right nasal cavity close to the nasal opening, which was blocking the progression of the endoscopy. However, during the left cavity inspection, at the end of the nasal septum a mass with irregular surface was detected emerging from the border of the right choana, which extended up to the nasopharynx region. The diagnosis was established based on clinical evaluation and histopathological findings of the tumor, which confirmed osteoblastic osteosarcoma. The animal was euthanized due to poor clinical conditions and prognosis. There was no evidence of metastasis to other organs during necropsy.Discussion: The majority of reported osteosarcoma cases in horses do not define the tumor histopathological subtype. The occurrence of metastasis in equine osteosarcoma is not well established, however it seems to be uncommon. It is important to emphasize the relevance of performing a necropsy in patients presenting osteosarcoma, in order to establish a pattern concerning the metastasis incidence in the species. The predominant osteosarcoma location is the mandible, although there are few reports in the paranasal sinuses and appendicular skeleton. The tumor usual location makes the treatment difficult because of the impossibility of performing a complete surgical resection, which leads to a euthanasia decision. Although osteosarcoma has been little reported in horses, it should be a differential diagnosis for facial alterations and paranasal sinuses abnormalities, which would contribute to an early diagnosis and increase the chances of a favorable prognostic.


2019 ◽  
Vol 13 (Supl 1) ◽  
pp. 39S
Author(s):  
Jordanna Maria Pereira ◽  
Ricardo Cardenuto Ferreira ◽  
Marco Tulio Costa ◽  
Noé De Marchi Neto ◽  
Daiana Kerry Gobbo ◽  
...  

Introduction: Congenital distal tibiofibular diastasis is an extremely rare entity of unknown etiology that compromises the feet and ankles with different degrees of deformity, although in general, the feet show equinovarus deformity, and the talus is proximally dislocated due to the separation of the distal tibial and fibular epiphyses. There are few reports of this disorder in the literature, and most describe cases that ultimately lead to limb amputation. We present the cases of 2 patients treated from birth to skeletal maturity. Methods: Two female patients with clubfoot at birth were diagnosed with congenital distal tibiofibular diastasis. One of them had the deformity of the right foot, and the other had deformity of both limbs. Both patients underwent early distal tibiofibular arthrodesis and serial stretching of the compromised feet and legs. Results: After 20 years of clinical follow-up and after reaching skeletal maturity, both patients had plantigrade feet without significant shortening of the lower limbs or pain, and both performed activities of daily living without restrictions, wearing conventional shoes. Conclusion: Early distal tibiofibular arthrodesis followed by limb stretching was effective for treating congenital distal tibiofibular diastasis and is a good alternative to amputation, which is indicated in the literature.


2018 ◽  
Vol 3 (2) ◽  

Neonatal jaundice is common in newborns affecting over half (50-60%) of all babies in the first week of life. Severe jaundice can result into significant morbidity in the form of kernicterus. Early screening along with, quick treatment of neonatal jaundice helps to reduce the risk of developing severe hyperbilirubinemia, hence Kernicterus. There is strong evidence that screening newborns with hour-specific serum bilirubin level measurements can help in identifying risk of developing hyperbilirubinemia in newborns. There is insufficient data from developing countries regarding hyperbilirubinemia and newborns with and without underlying risk factors for hyperbilirubinemia. This cross sectional study will help the physician to anticipate and manage newborns with high-intermediate zone total serum bilirubin (TSB) and will also help to established specific management guideline for these newborns to prevent bilirubin induced neurological damage (BIND). All term newborns of either gender (fulfilling inclusion criteria) with TSB level at high-intermediate risk zone at 48 hours of life, born at Aga Khan University Hospital were included in this study. Their demographics were recorded in structured proforma. Results were collected and analyzed by SPSS software, version 20.0. A total of 173 newborns were enrolled. There was a female predilection 56.6% (n=98). One-third of the newborns having TSB in high-intermediate risk zone at 48 hours of life progressed to level of significant hyperbilirubinemia requiring treatment (31.2%; n=54). Those who required phototherapy had the mean rate of rise of 5.00 mg/dL/day (0.20 mg/dL/ hr). For future implementations we recommended that early recognition, monitoring and early treatment of neonatal hyperbilirubinemia may help in reducing morbidity. Neonates with high-intermediate risk serum bilirubin level should be followed at 24 hours intervel for assessment and possible treatment.


2018 ◽  
Vol 10 (1) ◽  
pp. 142-146
Author(s):  
R. El Qadiry ◽  
F. Bennaoui ◽  
N. El Idrissi Slitine ◽  
Fmr. Maoulainine

Introduction: Newborn cellulitis is rare and often atypical disease. It is a diagnostic and therapeutic emergency and its progress leads to instant death. We report three cases of neonatal cellulitis from the Neonatal ICU Department of Mohammed VI university hospital in Marrakesh, highlighting this rare, serious and unknown disease. Case 1: 17-day-old female newborn admitted for sepsis and breast refusal since 5 days. Clinical examination revealed a hypotonic newborn, hypothermic at 34.2 °C with sclerema neonatorum. Skin examination found Erythema and edema on the left hemi-face with necrosis of the ipsilateral nostril. The blood culture had isolated coagulase-negative staphylococci. The newborn was put under triple antimicrobial therapy of 3rd Generation Cephalosporin (3GCs), gentamicin and vancomycin with good progress. Case 2: 20-day-old male newborn, was circumcised ten days before admission, had sepsis with a fever at 40 °C evolving since 24h. The clinical examination found hard, hot and very painful inflammatory lesion starting at the scrotum and extending to suprapubic region and the start of the lower limbs. Blood tests revealed strongly positive infectious status. The progress was positive when put under triple antimicrobial therapy. Case 3: 25-day-old female newborn, visited a traditional healer who gave her a mixture of unknown nature to apply on her face, hospitalized in our department for cellulitis of the right hemi-face extending to the periorbital and cervical region evolving since two days together with a fever. Infectious blood assessment was positive. The progress was favorable when put under triple antimicrobial therapy. Conclusion: Cellulitis is a rare disease in newborn and it must be diagnosed early because it can be complicated into sepsis. The search for other localizations, mainly meningeal, is essential.


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