DEVASTATING RESULTS OF UNMET NEEDS OF TERMINATION OF PREGNANCY

Uterine perforation is a rare life threatening complication due to unsafe abortion by unqualified or untrained person. CASE: A 20 year old primigravida with 6 months ANC was referred to our hospital with the USG of uterine rupture and with a history of Dilation and curettage i/v/o anomalous baby, was in septic shock. There was also evidence of Sigmoid colon perforation. As a life saving measure Obstetric hysterectomy with colostomy done. Unsafe CONCLUSION: abortions are still in practice which has led to increased rate of mortality and morbidity. surgical intervention on a uterus of more than 20 weeks can be hazardous and should be terminated wisely.

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Broken metallic tracheostomy tube migrating into the tracheobronchial tree

Surgical Techniques Development ◽

10.4081/std.2016.6466 ◽

2016 ◽

Vol 6 (1) ◽

Author(s):

Nilam U. Sathe ◽

Ratna Priya ◽

Sheetal Shelke ◽

Kartik Krishnan

Keyword(s):

Foreign Body ◽

Tracheostomy Tube ◽

Main Bronchus ◽

Tracheobronchial Tree ◽

Life Saving ◽

Wear And Tear ◽

Life Threatening ◽

History Of ◽

The Right ◽

Periodic Replacement

Foreign body aspiration can be a life-threatening emergency. Broken tracheostomy tube in tracheobronchial tree is one of the rarest types of foreign body reported. Here we report two cases of fracture of metallic tracheostomy tube, leading to foreign body in tracheobronchial tree. A 14-year-old girl presented to our Emergency Department with history of respiratory distress and violent bouts of cough since 2 days. Chest X-ray showed that the broken part of the tube was lodged in the right main bronchus. The presence of Parkinson’s disease in the patient and restricted neck flexion offered a challenge both for the anaesthetist and the surgeon. We were successful in removing the broken tube in 13 small pieces. Check bronchoscopy was clear and the procedure went uneventful. We would like to conclude that broken tracheostomy tube presenting as foreign body bronchus is infrequent but it is a preventable complication of tarcheostomy. The patient must be kept on regular follow up to check for signs of wear and tear. Timely and periodic replacement of tracehostomy tube should also be done, otherwise such life-saving surgery can become lifethreatening.

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Infratentorial subdural empyemas mimicking pyogenic meningitis

Journal of Neurosciences in Rural Practice ◽

10.4103/0976-3147.112773 ◽

2013 ◽

Vol 04 (02) ◽

pp. 213-215 ◽

Cited By ~ 1

Author(s):

Anurag Gupta ◽

Suman S Karanth ◽

A Raja

Keyword(s):

Surgical Intervention ◽

Treatment Options ◽

Rare Condition ◽

Pyogenic Meningitis ◽

Suppurative Otitis Media ◽

Life Threatening ◽

History Of ◽

Associated Risk Factors ◽

High Degree ◽

Delay In Treatment

ABSTRACTInfratentorial subdural empyema is an extremely rare condition which unfortunately mimics pyogenic meningitis in 75% of cases. While an ill‑planned lumbar puncture in these cases may be fatal, an inadvertent delay in treatment may be detrimental to the outcome for the patient. We present a case of a young boy with long standing history of chronic suppurative otitis media (CSOM) presenting with an infratentorial empyema with features suggestive of pyogenic meningitis. We also review the available literature to further define the condition in terms of clinical features, treatment options, and outcome. A misdiagnosis of this condition with failure to institute appropriate surgical intervention and antibiotic therapy is potentially life threatening. We highlight this rare condition which requires a high degree of suspicion especially in the presence of associated risk factors.

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A rare case scenario: spontaneous diaphragmatic rupture during labor

International Surgery Journal ◽

10.18203/2349-2902.isj20212748 ◽

2021 ◽

Vol 8 (7) ◽

pp. 2241

Author(s):

Shambhu Nath Agrawal ◽

Amit Verma ◽

Sunil Kedia ◽

Amol Padegaonkar ◽

Hari Shankar Mahobia

Keyword(s):

Surgical Intervention ◽

Hepatic Flexure ◽

Diaphragmatic Rupture ◽

Prior History ◽

Case Scenario ◽

Term Delivery ◽

Life Threatening ◽

History Of ◽

Full Term Delivery ◽

Complications And Mortality

Diaphragmatic rupture during labor is not a very common presentation and usually occurs in patients with prior history of traumatic chest or abdominal injury or any congenital abnormality. We presented a case of a 29 year old woman who presented with sudden breathing difficulty two days after a full-term delivery by caesarean section. e-FAST scan suggested the presence of a massive pleural effusion over right side. CT scan of chest revealed large rent in right diaphragm with superior migration of liver and hepatic flexure. Patient was taken for emergent surgical intervention, inter coastal drainage (ICD) tube was placed and surgical repair was performed, patient was further treated in critical care unit, the patient recovered well and was discharged. Though diaphragmatic hernia rupture during labor are not reported often it is life threatening complication that requires immediate surgical intervention to prevent major complications and mortality.

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Under the Radar: A Case Report of a Missed Aortoenteric Fistula

Clinical Practice and Cases in Emergency Medicine ◽

10.5811/cpcem.2021.4.51791 ◽

2021 ◽

Vol 5 (3) ◽

pp. 312-315

Author(s):

Blake Briggs ◽

David Manthey

Keyword(s):

Case Report ◽

Surgical Intervention ◽

Imaging Modality ◽

Aortic Surgery ◽

Aortoenteric Fistula ◽

Prior History ◽

Gi Bleeding ◽

Life Threatening ◽

History Of ◽

Widespread Availability

Introduction: An aortoenteric fistula (AEF) is an abnormal connection between the aorta and the gastrointestinal tract that develops due to a pathologic cause. It is a rare, but life-threatening, cause of gastrointestinal (GI) bleeding. Although no single imaging modality exists that definitively diagnoses AEF, computed tomography angiography (CTA) of the abdomen and pelvis is the preferred initial test due to widespread availability and efficiency. Case Report: Many deaths occur before the diagnosis is made or prior to surgical intervention. We describe a case of a patient with a history of aortic graft repair who presented with active GI bleeding. Conclusion: Although CTA can make the diagnosis of AEF, it cannot adequately rule it out. In patients with significant GI bleeding and prior history of aortic surgery, vascular surgery should be consulted early on, even if CTA is equivocal.

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The Challenge of the Non-Compliant Patient: A Case of Caesarean Section Scar Ectopic Pregnancy

Surgery Case Reports ◽

10.31487/j.jscr.2021.02.01 ◽

2021 ◽

pp. 1-3

Author(s):

Jessica Audet ◽

Brittany Noel Robles ◽

Nicolle M Arroyo Lluberas ◽

Jessica Audet ◽

Daniel Faustin ◽

...

Keyword(s):

Ectopic Pregnancy ◽

Emergency Laparotomy ◽

Pharmacological Management ◽

Compliant Patient ◽

Life Saving ◽

Close Observation ◽

Life Threatening ◽

History Of ◽

Ruptured Uterus

Ectopic pregnancy is a quite common and life-threatening pregnancy. The most common site of ectopic implantation of a fertilized embryo is the fallopian tube. In extremely rare situations, the embryo can implant in other locations, which makes the diagnosis and management even more complex. Although close observation of a new pregnancy is key in the diagnosis and treatment of an ectopic pregnancy, there is still a major risk of life-threatening outcomes. This is a case report of a 31-year-old patient with a history of multiple pregnancies who presented to a community hospital in the spring of 2021 with an ectopic caesarean scar pregnancy. A diagnosis of ectopic pregnancy was on a timely basis, and surgical management was advised. Upon refusal of treatment and admission, pharmacological management was initiated, but patient compliance challenged the success of the therapy. Patient non-compliance to close follow-up resulted in a ruptured uterus. Emergency laparotomy with supracervical hysterectomy was performed as a life-saving procedure.

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Musculoskeletal Deterioration and Hemicorporectomy After Spinal Cord Injury

Physical Therapy ◽

10.1093/ptj/83.3.263 ◽

2003 ◽

Vol 83 (3) ◽

pp. 263-275 ◽

Cited By ~ 19

Author(s):

Richard K Shields ◽

Shauna Dudley-Javoroski

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Chronic Wounds ◽

Physical Therapists ◽

Skin Breakdown ◽

Life Saving ◽

Cord Injury ◽

History Of ◽

Saving Measure

Abstract Background and Purpose. The long-term management following an hemicorporectomy (HCP) is not well documented in the scientific literature. The purpose of this case report is to describe the 25-year history of a man with a spinal cord injury who experienced severe musculoskeletal deterioration and hemicorporectomy. Case Description. The client sustained T10 complete paraplegia at age 18 years, developed severe decubitus ulcers, and required an HCP as a life-saving measure 13 years later. The authors describe the chronology of several rehabilitation and prosthetic strategies and speculate on factors that may have contributed to their successes and failures. Outcomes. The client survived 12 years after the HCP and returned to independent mobility, self-care, and schooling despite complications with continued skin breakdown. Over the 12 years following discharge from the hospital after the spinal cord injury, he spent 749 days in the hospital. During the 12 years he lived after discharge from the hospital following the HCP, he was hospitalized 190 days. Discussion. The authors discuss factors contributing to the client's musculoskeletal deterioration including chronic wounds, postural deviations, and incomplete adherence to pressure-relief recommendations and raise considerations for physical therapists who treat patients after HCP.

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Peripartum Cardiomyopathy: The Hidden Enemy

10.5772/intechopen.97610 ◽

2021 ◽

Author(s):

Fatima Zahra Merzouk ◽

Sara Oualim ◽

Mohammed Sabry

Keyword(s):

Heart Failure ◽

Left Ventricular ◽

Peripartum Cardiomyopathy ◽

Lv Function ◽

Close Monitoring ◽

Mortality And Morbidity ◽

Life Threatening ◽

History Of ◽

The Brain ◽

In Pregnancy

Peripartum cardiomyopathy (PPCM) is the most common cardiomyopathy in pregnancy. It is potentially life-threatening. It is, diagnosed in women without a history of heart disease 1 month before delivery or within 5 months. It is marked by heart failure and left ventricular dyshfunction. The evolution is favorable. LV function improves within 6 months in the majority of patients, but long-lasting mortality and morbidity are not infrequent. Recent work suggests the critical toxic role for late-gestational hormones on the maternal vasculature and the genetic underpinnings of PPCM. Complications include different types of supraventricular and ventricular arrhythmias, heart failure and ischemic stroke. The brain natriuretic peptide (BNP) can be used to risk stratify women for adverse events. Management of peripartum cardiomyopathy is based on treatment of heart failure. The addition of bromocriptine seemed to improve LVEF. Close monitoring of pregnant women with cardiomyopathy by multidisciplinary team is recommended.

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Management of spontaneous intra parenchymal hematomas: a cohort study

International Surgery Journal ◽

10.18203/2349-2902.isj20212702 ◽

2021 ◽

Vol 8 (7) ◽

pp. 2037

Author(s):

Girish K. Madhavan ◽

Philip Issac ◽

Balakrishnan P. Kunjan ◽

Ajax John ◽

Tom Jose

Keyword(s):

Cohort Study ◽

Multidisciplinary Approach ◽

Surgical Intervention ◽

Control Group ◽

Mortality And Morbidity ◽

Hematoma Evacuation ◽

The Status ◽

Life Threatening ◽

And Control ◽

Surgical Group

Background: Management of intra parenchymal hematoma is a dilemma for neuroscientists, still a life-threatening entity which needs multidisciplinary approach.13% of all strokes constitutes hemorrhagic. Mortality and morbidity of patients depends on the status of initial presentation. Prognosis of the surgeries may vary from person to person and according to the comorbidities. The aim of the study was to determine effectiveness of decompressive craniectomy (DC) with hematoma evacuation in reducing the mortality.Methods: Patients with spontaneous intra parenchymal hematomas were selected and those having herniation syndrome were considered for surgery. Patients were evaluated after 30 days and 6 months and mortality was calculated.Results: 126 patients were selected for surgery, in that 102 patients underwent DC with hematoma evacuation and 24 patients who were not willing for surgery were considered as control group. Mortality of patients at 30 days of surgical group was 19.6% and 58.3% respectively, while 6 months mortality was 31.3% and 70.8% for surgical and control group.Conclusions: Surgical intervention can effectively reduce the mortality in spontaneous intra parenchymal hematomas.

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Repeated Duodenal Stump Perforation Using a Stapling Device Following Subtotal Gastrectomy With Roux-en-Y Reconstruction for Advanced Gastric Cancer: Lessons From a Rare Case

International Surgery ◽

10.9738/intsurg-d-14-00266.1 ◽

2015 ◽

Vol 100 (4) ◽

pp. 726-732

Author(s):

Tadashi Furihata ◽

Makoto Furihata ◽

Naoki Satoh ◽

Masato Kosaka ◽

Kunibumi Ishikawa ◽

...

Keyword(s):

Subtotal Gastrectomy ◽

Lessons Learned ◽

Wall Thickening ◽

Duodenal Stump ◽

Stapling Device ◽

Life Saving ◽

Life Threatening ◽

History Of ◽

Considerable Morbidity ◽

Reconstruction After Gastrectomy

Closure of the duodenal stump using a stapling device is commonly applied in Roux-en-Y reconstruction after gastrectomy. However, serious and possibly fatal duodenal stump perforation can develop in extremely rare cases. We describe a case of subtotal gastrectomy with Roux-en-Y reconstruction followed by repeated duodenal stump perforations. A 79-year-old man with a long history of diabetes and hypertension was admitted to our institution with epigastralgia and right hypochondralgia. Computed tomography and an upper gastrointestinal imaging series revealed remarkable wall thickening of the gastric antrum and corpus. Upper endoscopy also showed a giant ulcerative lesion in the same area. The lesion was confirmed by histology to be poorly differentiated adenocarcinoma. The patient underwent open subtotal gastrectomy with Roux-en-Y reconstruction. However, duodenal stump perforation occurred repeatedly on postoperative days 1, 3, and 19, which caused peritonitis. The patient was kept alive through duodenal stump repair, an additional resection using a stapling device, and repeated drainage treatments; but he suffered considerable morbidity due to these complications. We report a case of a life-threatening duodenal stump perforation after subtotal gastrectomy, highlighting lessons learned from the profile and clinical course. Abdominal surgeons should be aware of the possibility of this serious complication of duodenal stump perforation, and be able to perform immediate interventions, including life-saving reoperation.

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Refractory pneumothorax and hemothorax associated with metastatic scalp angiosarcoma

Surgical Case Reports ◽

10.1186/s40792-020-01001-w ◽

2020 ◽

Vol 6 (1) ◽

Author(s):

Masahide Isowa ◽

Satona Tanaka ◽

Ryo Nakanobo ◽

Yoshito Yamada ◽

Hiroshi Date

Keyword(s):

Surgical Intervention ◽

Thoracoscopic Surgery ◽

Pathological Diagnosis ◽

Parietal Pleura ◽

Surgical Biopsy ◽

Bullous Lesion ◽

Life Threatening ◽

History Of ◽

Previously Treated ◽

Video Assisted Thoracoscopic Surgery

Abstract Background Pulmonary metastasis of scalp angiosarcoma (SA) is a rare, but life-threatening disease, challenging to diagnose and manage. We report two cases of pneumothorax and hemothorax with pathologically proven metastasis of SA in the parietal pleura, which was not predictable from images and difficult to manage. Patient A A 73-year-old man with SA underwent chemoradiotherapy and surgical resection for primary skin lesion, was sent to our department to treat right empyema, which was developed during chest tube drainage for pneumothorax. Computed tomography (CT) showed multiple bullous lesions. We performed repetitive video-assisted thoracoscopic surgery (VATS) for the debridement and hemostasis; however, hemothorax was uncontrollable. The repeated cytology of pleural effusion showed no malignancy. We eventually performed fenestration and metastatic SA was pathologically diagnosed by the biopsy of parietal pleura. The patient developed respiratory failure and uncontrolled anemia, which were fatal. Patient B A 71-year-old man with SA previously treated with chemoradiotherapy was referred to our department for left pneumothorax. CT showed multiple bullous lesions at apex without any changes at parietal pleura. VATS was performed and the apex bullous lesion with air leakage was resected. The parietal pleura showed several dark-red spots and the biopsy was undertaken. The pathological diagnosis was a metastasis of SA along with visceral pleura and parietal pleura. The patient then developed right pneumothorax and left hemopneumothorax. Bilateral pleurodesis was ineffective and the patient died due to deteriorating general condition. Conclusions In patients with a history of SA who develop pneumothorax and hemothorax, metastatic SA to visceral and parietal pleura should be always considered. Surgical biopsy, not cytology, is needed for pathological diagnosis. Lesions in the parietal pleura prior to hemothorax were thoracoscopically observed in one case. Surgeons must recognize that conventional surgical intervention or pleurodesis will have unsatisfactory results.

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