scholarly journals Disseminated Intravascular Coagulation as the First Manifestation of Coronavirus Disease: Report of a Survived Deadly Case

2020 ◽  
pp. 1-5
Keyword(s):  
Computed Tomography ◽  
Vaginal Bleeding ◽  
Hypovolemic Shock ◽  
International Normalized Ratio ◽  
Coagulation Disorders ◽  
Spiral Computed ◽  
Case Presentation ◽  
The World ◽  
Life Threatening ◽  
Mucosal Bleeding

Introduction: Coronavirus disease 2019 (COVID-19), newly emerging in the world as a pandemic disease, can have rare extrapulmonary manifestations. Few studies have reported coagulation disorders, induced by coronavirus; however, hemorrhage is an extremely rare and life-threatening phenomenon in COVID-19. Case presentation: Herein, we present a 31-year-old woman referring with vaginal bleeding, melena, skin ecchymosis, mucosal bleeding, melena, hematuria, and hypovolemic shock. At our center, she was diagnosed as a case of severe internal hemorrhage due to ovulation site hemorrhage and underwent emergency surgery, complicated by prolonged international normalized ratio, which could be due to the presence of COVID-19 in the patient, detected by spiral computed tomography. Conclusions: This case showed the importance of examining COVID-19 in any patients referring to the hospital during the pandemic as well as paying greater attention to the effect of COVID-19 on coagulation disorders in these patients.

scholarly journals Melanosis coli in a peritoneal dialysis patient: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Nor Fadhlina Zakaria ◽  
Nurul Izah Ahmad ◽  
Elmina Mokhtar ◽  
Wan Zul Haikal Hafiz Wan Zukiman ◽  
Anim Md Shah
Keyword(s):  
Peritoneal Dialysis ◽  
Chronic Diarrhea ◽  
Histopathological Examination ◽  
Hypovolemic Shock ◽  
Peritoneal Dialysis Patient ◽  
Electrolyte Imbalance ◽  
Case Presentation ◽  
Melanosis Coli ◽  
Life Threatening ◽  
Black Discoloration

Abstract Background Patients who undergo peritoneal dialysis (PD) are at risk of gut bacteria translocation leading to peritonitis when there is chronic diarrhea. Chronic diarrhea is defined as any course of diarrhea that lasts at least 4 weeks, which can be continuous or intermittent. Chronic diarrhea of any duration may cause dehydration, electrolyte imbalance, and life-threatening hypovolemic shock. In PD patients, excessive ultrafiltration from the exchanges, combined with severe gastrointestinal loss, may cause hypovolemic shock, electrolyte imbalance, and metabolic acidosis. There are multiple causes of chronic diarrhea in PD patients including infective causes, mitotic lesions, and rarely the regular and excessive use of laxatives, which is a diagnosis of exclusion. Case presentation We report a case of Melanau lady with chronic diarrhea secondary to laxative usage in a patient being treated with automated peritoneal dialysis (APD). The patient went into hypovolemic shock, but luckily did not contract peritonitis. A colonoscopy revealed brown to black discoloration of the colon, a feature suggestive of melanosis coli. A biopsy of the intestine further confirmed the diagnosis by histopathological examination. Withdrawal of laxatives and the introduction of probiotics improved the symptoms tremendously. Conclusions The chronic use of laxatives in PD patients can potentially lead to a devastating problem; thus, the management team must monitor treatment commencement appropriately.

scholarly journals Unresectable primary hepatic adenosquamous carcinoma successfully treated with systemic and transcatheter hepatic arterial injection chemotherapies followed by conversion surgery: a case report and literature review

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yusuke Watanabe ◽  
Akihiko Osaki ◽  
Kiwamu Kimura ◽  
Shunta Yakubo ◽  
Kenichi Takaku ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Liver Tumor ◽  
Needle Biopsy ◽  
Adenosquamous Carcinoma ◽  
Conversion Surgery ◽  
Dynamic Computed Tomography ◽  
Postoperative Adjuvant Chemotherapy ◽  
Case Presentation ◽  
The World ◽  
Node Metastases

Abstract Background Primary hepatic adenosquamous carcinoma (ASC) is a type of tumor that has the features of both adenocarcinoma and squamous cell carcinoma (SCC). The prognosis for patients with ASC is poor, as the chemotherapy has been ineffective so far. Case presentation Here, we report a case of a 62-year-old male patient who presented with high fever. The tumor marker levels were high, and abdominal dynamic computed tomography showed a liver tumor and distant lymph node metastases. Upon further investigation, needle biopsy of the liver tumor showed a primary hepatic SCC. Because the SCC was unresectable, the patient was treated with tegafur/gimeracil/oteracil (S-1) and transcatheter hepatic arterial injection (TAI) of cisplatin. After chemotherapy, a surgical resection performed on the remaining liver tumor, made the patient cancer-free. After the operation, the liver tumor was confirmed as primary hepatic ASC. Subsequently, the patient was administered postoperative adjuvant chemotherapy, which prevented its recurrence. Conclusions Due to the lack of an effective treatment for primary hepatic ASC, its prognosis is poor. Here, we suggest that a chemotherapy combination of 5-fluorouracil (S-1) and cisplatin along with conversion surgery might be an effective way for treating primary hepatic ASC. Our experience from this case shall be valuable to clinicians around the world involved in the treatment of primary hepatic ASC.

scholarly journals Left coronary button aneurysm presenting with progressive enlargement after aortic root replacement

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Kimihiro Kobayashi ◽  
Yoshinori Kuroda ◽  
Masahiro Mizumoto ◽  
Atsushi Yamashita ◽  
Eiichi Ohba ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Surgical Treatment ◽  
Aortic Root ◽  
Postoperative Recovery ◽  
Aortic Root Replacement ◽  
Case Presentation ◽  
Life Threatening ◽  
Conservative And Surgical Treatment ◽  
Progressive Enlargement

Abstract Background Aneurysmal degeneration of the coronary button after aortic root replacement using the button technique is a rare but potentially life-threatening complication. However, the appropriate management of this complication, including the indications for conservative and surgical treatment, is still unknown. Case presentation Here we present a 38-year-old woman who successfully underwent surgical repair of a left coronary button aneurysm using the graft interposition technique 24 years after aortic root replacement. Because follow-up computed tomography after aortic root replacement showed a progressively enlarging left coronary button aneurysm, the patient was judged an acceptable candidate for surgical treatment, considering the potential risk of aneurysmal rupture and subsequent myocardial infarction. The postoperative recovery was uneventful. The patient is doing well 1 year after the surgery. Conclusions We believe that serial follow-up using computed tomography is mandatory for coronary button aneurysms, and surgical intervention may be considered if progressive enlargement of the aneurysm is observed, especially in younger patients.

scholarly journals Tracheoinnominate fistula: acute bleeding and hypovolemic shock due to a trachea-innominate artery fistula after long-term tracheostomy, treated with a stent-graft

2021 ◽  
Vol 4 (1) ◽  
Author(s):  
Ali Khanafer ◽  
Victoria Hellstern ◽  
Helfried Meißner ◽  
Christoph Harmening ◽  
Klaus Schneider ◽  
...  
Keyword(s):  
Stent Graft ◽  
Hypovolemic Shock ◽  
Innominate Artery ◽  
Stent Deployment ◽  
Case Presentation ◽  
Antiplatelet Medication ◽  
Brachiocephalic Trunk ◽  
Life Threatening ◽  
Stent Graft Implantation

Abstract Background A tracheo-innominate fistula is a rare but life-threatening complication of tracheostomy and has a mortality rate of 100% without therapy. The underlying cause is an acquired fistula between the brachiocephalic trunk and the trachea, induced by a tracheostomy cannula’s mechanical impact. Case presentation A 25-year-old female was admitted with pulsatile bleeding from a tracheostomy. The cause of the bleeding was a tracheo-innominate artery fistula, which was difficult to recognize. Said fistula was treated with implantation of a self-expanding stent-graft. The bleeding stopped immediately after the implantation of the stent-graft. Dual antiplatelet medication with aspirin IV and ticagrelor PO, bridged with a bolus of eptifibatide IV, was started right after the stent deployment. Conclusions Endovascular self-expanding stent-graft implantation is a viable treatment option for tracheo-innominate artery fistulae, especially in hemorrhagic emergencies.

scholarly journals Medical errors during COVID-19 pandemic: the role of emergency medicine

2020 ◽  
Vol 7 (2) ◽  
pp. 133-134
Author(s):  
Shaghayegh Rahmani ◽  
Kosar Deldar ◽  
Sara Hemati Ali
Keyword(s):  
Emergency Medicine ◽  
Healthcare Workers ◽  
Delayed Diagnosis ◽  
Health Concern ◽  
Critical Conditions ◽  
Case Presentation ◽  
Academic Center ◽  
The World ◽  
Life Threatening

Objective: Nowadays, many countries all over the world are involved with COVID-19 and the number of new cases and deaths are on a rise. The role of emergency medicine and physician-led triage is important in this period. We report some near missed cases in our academic center related to this pandemic. Case Presentation: We report 5 cases that missed triage or received delayed diagnosis because of COVID-19 suspicion. Some cases are life threatening. Conclusion: Although COVID-19 is the main health concern these days, other critical conditions should be considered. Stabilizing patients before transferring them between hospitals should be the essential goal of emergency department whether the patient is Corona virus infected or not. And before any intervention, the safety of healthcare workers must be ensured.

scholarly journals COVID-19 and Thrombosis Predisposition

2020 ◽  
Vol 5 (3) ◽  
pp. 86-90
Author(s):  
Renata Gerculy ◽  
Camelia Libenciuc ◽  
Nora Rat ◽  
Monica Chitu ◽  
Imre Benedek
Keyword(s):  
Infectious Disease ◽  
Current Knowledge ◽  
The Novel ◽  
Coagulation Disorders ◽  
Healthy Individuals ◽  
The World ◽  
Life Threatening ◽  
Thrombotic Complications ◽  
Disease Spreading ◽  
Novel Coronavirus

AbstractThe novel coronavirus disease first appeared in Wuhan (China) is an infectious disease spreading throughout the world, causing life-threatening conditions in vulnerable or even healthy individuals. The great impact of this virus on healthcare urges physicians to investigate all aspects of the disease in order to overcome its complications. A particularly investigated aspect of the SARS-CoV-2 infection is represented by the coagulation disorders among infected and critically ill patients. Several studies observed modified blood coagulation parameters such as D-dimers, fibrinogen, and coagulation times. Moreover, the severe thrombotic complications, mainly pulmonary embolism, could be responsible for the high mortality and poorer outcomes of COVID-19 infected patients. The aim of this article is to present the current knowledge related to thrombosis predisposition in patients infected with the new coronavirus.

scholarly journals Removal of hematoma due to massive hemoptysis after transbronchial biopsy: a case report

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Harushi Ueno ◽  
Hideki Tsubouchi ◽  
Keita Nakanishi ◽  
Tomoshi Sugiyama ◽  
Yuka Kadomatsu ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Case Report ◽  
Transbronchial Biopsy ◽  
Massive Hemoptysis ◽  
Lobe Bronchus ◽  
Case Presentation ◽  
Life Threatening ◽  
Life Threatening Complication ◽  
The Right

Abstract Background Massive hemoptysis is a life-threatening complication after transbronchial biopsy (TBB). Reports on massive hemoptysis occurring several days after TBB are scarce. Case presentation A 62-year-old man presented with massive hemoptysis and was admitted to hospital as an emergency on the eighth day after TBB. On the 12th day after TBB, computed tomography showed complete atelectasis of the right middle and lower lobes. The patient underwent emergent right upper lobectomy. The right upper lobe bronchus was separated with a scalpel, the hematoma was pulled out with forceps, and the bronchus subsequently sutured shut. The patient was discharged from the hospital uneventfully. Conclusions We experienced a case of massive hemoptysis on the eighth day after TBB, which required emergency surgery due to persistent bleeding into the airway and airway obstruction during follow-up. Postoperative pneumonia and atelectasis could be prevented by manual removal of the residual hematoma.

scholarly journals Chronic Uterine Inversio due to Myoma Geburt

2020 ◽  
Vol 4 (1) ◽  
pp. 110-113
Author(s):  
Bobby Indra Utama, SpOG(K)
Keyword(s):  
Severe Pain ◽  
Vaginal Bleeding ◽  
Hypovolemic Shock ◽  
Total Hysterectomy ◽  
Obstetric Emergency ◽  
Uterine Inversion ◽  
Threatening Condition ◽  
Life Threatening ◽  
Low Incidence ◽  
The Right

Background: Uterine inversion is a rare obstetric emergency but potentially serious complication of labour. This disease characterized by severe pain and can cause life threatening condition. If these not immediately identified, the massive and underestimated blood loss can lead to hypovolemic shock. There for, early diagnosis and management of this condition is desirable.Objective: Report on the management of chronic uterine inversion due to myoma geburtMethods: Case reportCase: A 46 years old patient was admitted to the gynaecology ward of Dr. M. Djamil Central General hospital with slight bleeding from vagina since 1 month ago with 2-3 pieces of underware dark-red colored, with pain. Bleeding from the vagina often recurs. There was a mass revealed from vagina with size as big  as baby’s head. The mass  had pus and necrotic tissue.Conclusion: Uterine inversion is an serious obstetric complication due to life threaten of the patient. Its low incidence leads to scarce experience in solving this kind of situation. There are some risk factors or mechanism as an underlying etiology of uterine inversion. The authors concluded that the presence of myoma geburt can be assosiated with the chronic uterine inversion. Surgical approach by eksterpation of myoma geburt with  total hysterectomy can be the right procedure. Therefore, it is essential to keep in mind this diagnosis in all cases of vaginal bleeding. Keywords: uterine inversion; myoma geburt

scholarly journals Chronic Uterine Inversion due to Myoma Geburt

2020 ◽  
Vol 8 (C) ◽  
pp. 223-225
Author(s):  
Bobby indra Utama
Keyword(s):  
Severe Pain ◽  
Vaginal Bleeding ◽  
Hypovolemic Shock ◽  
Total Hysterectomy ◽  
Obstetric Emergency ◽  
Uterine Inversion ◽  
Threatening Condition ◽  
Life Threatening ◽  
Low Incidence ◽  
The Right

BACKGROUND: Uterine inversion is a rare obstetric emergency but potentially serious complication of labor. This disease characterized by severe pain and can cause life-threatening condition. If these not immediately identified, the massive and underestimated blood loss can lead to hypovolemic shock. Therefore, early diagnosis and management of this condition is desirable. The objective of the study was to report on the management of chronic uterine inversion due to myoma geburt. CASE REPORT: A 46-year-old patient was admitted to the gynecology ward of Dr. M. Djamil Central General Hospital with slight bleeding from vagina for 1 month ago with 2–3 pieces of underwear dark red colored, with pain. Bleeding from the vagina often recurs. There was a mass revealed from vagina with size as big as baby’s head. The mass had pus and necrotic tissue.  CONCLUSION: Uterine inversion is a serious obstetric complication due to life threaten of the patient. Its low incidence leads to scarce experience in solving this kind of situation. There are some risk factors or mechanism as an underlying etiology of uterine inversion. The authors concluded that the presence of myoma geburt can be associated with the chronic uterine inversion. Surgical approach by eksterpation of myoma geburt with total hysterectomy can be the right procedure. Therefore, it is essential to keep in mind this diagnosis in all cases of vaginal bleeding.

scholarly journals Post-COVID-19 Massive Hemoptysis and Gastrointestinal Bleeding: A Case Report

2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Gholamreza Soleimani ◽  
Saeedeh Yaghoubi ◽  
Elham Shafighi Shahri
Keyword(s):  
Respiratory Symptoms ◽  
Recovery Phase ◽  
World Health ◽  
Massive Hemoptysis ◽  
Gi Bleeding ◽  
Case Presentation ◽  
Global Epidemic ◽  
The World ◽  
Life Threatening ◽  
Health Organization

Introduction: COVID-19 is a new respiratory infection caused by the coronavirus, which the World Health Organization (WHO) declared as a global epidemic in 2019. All the information obtained about this virus was different in children than in adults. Case Presentation: The case investigated in this study was a 10-year-old boy with hemoptysis and gastrointestinal (GI) bleeding in his post-COVID-19 recovery phase. Conclusions: COVID-19 can have a variety of presentations and complications beyond the classic respiratory symptoms and fever. This case is important and shows how COVID-19 can be life-threatening.

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