scholarly journals Bleeding after Hysterectomy: Recommendations and What to Expect

2022 ◽  
Author(s):  
Eugen Ancuța ◽  
Radu Zamfir ◽  
Gabriel Martinescu ◽  
Eduard Crauciuc ◽  
Dumitru Sofroni ◽  
...  
Keyword(s):  
Risk Factors ◽  
Incidence Rate ◽  
Surgical Management ◽  
Postoperative Hemorrhage ◽  
Gynecological Surgery ◽  
Knowledge And Skills ◽  
Treatment Practice ◽  
Life Threatening ◽  
Management Techniques ◽  
Life Threatening Complication

Bleeding after gynecological surgery remains an infrequent life-threatening complication, demanding appropriate medical and surgical management. Classified as early/“reactionary” and delayed/secondary, unexpected postoperative hemorrhage may arise regardless of the route or subtype of hysterectomy. Timely recognition and prompt intervention to arrest bleeding are essential strategies for the suitable outcome of the patient. The present chapter presents an overview on different aspects of bleeding after hysterectomy such as incidence rate, risk factors, mechanisms, and management techniques aiming to expand knowledge and skills in recognizing and treating this unpredicted potentially serious problem. Furthermore, we intend to offer a guide toward standardizing treatment practice across bleeding issues following hysterectomy considering clear recommendations and algorithms.

scholarly journals Management of Total Transection of Nasoendotracheal Tube during LeFort I Osteotomy

2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
Miles Somers ◽  
Peter Tsakiris ◽  
Peter Isert ◽  
Samuel Kim
Keyword(s):  
Orthognathic Surgery ◽  
Life Threatening ◽  
Management Techniques ◽  
Life Threatening Complication

Transection of the nasoendotracheal tube during orthognathic surgery is a rare, but life-threatening complication. We present a case of complete nasoendotracheal tube transection during a LeFort 1 osteotomy and discuss appropriate preventative and management techniques.

scholarly journals Risk factors for mortality of diffuse alveolar hemorrhage in systemic lupus erythematosus: a systematic review and meta-analysis

2021 ◽  
Vol 23 (1) ◽  
Author(s):  
Mengdi Jiang ◽  
Ruxuan Chen ◽  
Lidan Zhao ◽  
Xuan Zhang
Keyword(s):  
Risk Factors ◽  
Mechanical Ventilation ◽  
Lupus Erythematosus ◽  
Disease Duration ◽  
Meta Analysis ◽  
Diffuse Alveolar Hemorrhage ◽  
Concurrent Infection ◽  
Systemic Lupus ◽  
Life Threatening ◽  
Life Threatening Complication

AbstractBackgroundDiffuse alveolar hemorrhage (DAH) is a rare but life-threatening complication of systemic lupus erythematosus (SLE). The current knowledge of the prognostic factors for SLE-associated DAH is controversial. This meta-analysis was undertaken to investigate the relevant risk factors for mortality in SLE-associated DAH.MethodsStudies were searched from PubMed, EMBASE, and Web of Science databases published up to May 27, 2020, and were selected or removed according to the inclusion and exclusion criteria. Two reviewers extracted data independently from the enrolled studies, and the odds ratios (OR) or the standardized mean difference (SMD) was utilized to identify and describe the prognostic factors for mortality.ResultsEight studies encompassing 251 patients with SLE-associated DAH were included in the meta-analysis. No significant publication bias was shown. Age at the diagnosis of DAH (SMD = 0.35, 95% confidence interval (CI) (0.08, 0.61),P = 0.01,I2 = 0.0%) was found to be an independent risk factor of mortality. Longer lupus disease duration (SMD = 0.28, 95% CI (0.01, 0.55),P = 0.042,I2 = 0.0%), concurrent infection (OR = 2.77, 95% CI (1.55, 4.95),P = 0.001,I2 = 37.5%), plasmapheresis treatment (OR = 1.96, 95% CI (1.04, 3.70),P = 0.038,I2 = 14.6%), and mechanical ventilation (OR = 6.11, 95% CI (3.27, 11.39),P < 0.0001,I2 = 23.3%) were also related to poor survival, whereas no noticeable relationships were revealed between survival and concurrent lupus nephritis (OR = 5.45, 95% CI (0.52, 56.95),P = 0.16,I2 = 58.4%) or treatment of cyclophosphamide (CTX) (OR = 0.74, 95% CI (0.16, 3.41),P = 0.70,I2 = 75.5%).ConclusionsOlder age at the diagnosis of DAH, longer disease duration of SLE, concurrent infection, plasmapheresis treatment, and mechanical ventilation were found related to increased mortality in patients with SLE-associated DAH according to our meta-analysis. However, due to limited studies with heterogeneity, these results should be interpreted cautiously. Notably, severe diseases rendered the requirement of plasmapheresis treatment and mechanical ventilation are themselves associated with poor outcome. Randomized trials of therapeutics are needed to determine the most efficacious strategies for SLE-associated DAH for better management of this life-threatening complication.

scholarly journals Conservative management of bronchopulmonary artery perforation without associated haemothorax occurring at thoracentesis: a case report

2010 ◽  
Vol 92 (5) ◽  
pp. e69-e72
Author(s):  
Yao-Tsung Chuang ◽  
Teng-Fu Tsao ◽  
Chun-Hung Su ◽  
Ming-Cheng Lin
Keyword(s):  
Case Report ◽  
Pulmonary Artery ◽  
Surgical Management ◽  
Conservative Management ◽  
Unusual Case ◽  
Surgical Intervention ◽  
Arterial Embolisation ◽  
Life Threatening ◽  
Life Threatening Complication ◽  
Pulmonary Artery Perforation

Puncture or laceration of the pulmonary, intercostal, or peripheral vessels is an uncommon, but potentially life-threatening, complication of thoracentesis, which has been reported to result in severe haemothorax in 75% of patients. Damage to these vessels typically requires surgical intervention or intra-arterial embolisation. We report the successful non-surgical management of an unusual case of pulmonary artery perforation without concomitant haemothorax in an 82-year-old man who underwent thoracentesis.

scholarly journals Risk factors of preoperative Hirschsprung-associated enterocolitis

2019 ◽  
Vol 13 (S11) ◽  
Author(s):  
Dicky Yulianda ◽  
Andy Indra Sati ◽  
Akhmad Makhmudi ◽  
Gunadi
Keyword(s):  
Risk Factors ◽  
Medical Records ◽  
Maternal Education ◽  
Neonatal Period ◽  
Hirschsprung Disease ◽  
Albumin Level ◽  
Distended Abdomen ◽  
Life Threatening ◽  
Life Threatening Complication ◽  
Early Late

Abstract Background Hirschsprung-associated enterocolitis (HAEC) is a life-threatening complication of Hirschsprung disease (HSCR), that might occur preoperatively. We investigated the risk factors of preoperative HAEC. Method We retrospectively reviewed all medical records of HSCR patients admitted at Dr. Sardjito Hospital, Indonesia from March 2012 until March 2015. Diagnosis of HAEC was determined using the Delphi scoring system. Results Sixty-one HSCR patients were involved in this study, of whom 48 were males and 13 females. Eighteen percent (11/61) patients had a preoperative HAEC. The most common findings of the HAEC score found in our patients were distended abdomen (100%) and dilated loops of bowel (100%), followed by lethargy (72.7%), cut-off sign in rectosigmoid with absence of distal air (72.7%), leukocytosis (72.7%), and shift to left (63.6%). There was no association between gender, age of HSCR diagnosis, early/late diagnosis during neonatal period, aganglionosis type, albumin level nor body mass index with preoperative HAEC (p = 0.69, 0.76, 0.33, 1.0, 0.86, and 0.50, respectively). In addition, the maternal age, gestational age, and maternal education level also did not correlate with the development of preoperative HAEC (p = 0.71, 0.59, and 0.32, respectively). Conclusion The incidence of preoperative HAEC in our hospital is considered relatively moderate, with the most common findings of distended abdomen and dilated loops of bowel. None of the identified risk factors have an association with the development of HAEC in our patients.

Suppurative Thrombophlebitis in Childhood

PEDIATRICS ◽  
1981 ◽  
Vol 68 (5) ◽  
pp. 630-632
Author(s):  
Nicholas Sears ◽  
Jay L. Grosfeld ◽  
Thomas R. Weber ◽  
Martin B. Kleiman
Keyword(s):  
Surgical Management ◽  
Inflammatory Reaction ◽  
Early Recognition ◽  
Intravenous Therapy ◽  
Intravenous Catheter ◽  
Life Threatening ◽  
Life Threatening Complication

Thrombophlebitis in children is almost always related to intravenous therapy. In most cases the inflammatory reaction is self-limited and resolves when the intravenous catheter or needle is removed. In some cases contamination may result in suppurative thrombophlebitis, a potentially life-threatening complication of intravenous therapy. This report describes two 6-year-old children with suppurative thrombophlebitis that was successfully treated by drainage of periphlebitic abscess and excision of the infected vein. Early recognition and prompt surgical management should reduce morbidity and prevent mortality in these cases.

Tension Pneumoperitoneum Following Attempted Pneumatic Reduction of Intussusception

2020 ◽  
pp. 000313482097336
Author(s):  
Rajavi S. Parikh ◽  
Timothy Weiner ◽  
Jeffrey Dehmer
Keyword(s):  
Surgical Management ◽  
Rare Complication ◽  
Hemodynamic Instability ◽  
Positive Outcome ◽  
Pneumatic Reduction ◽  
Tension Pneumoperitoneum ◽  
Life Threatening ◽  
Life Threatening Complication ◽  
High Index Of Suspicion ◽  
Emergent Laparotomy

Tension pneumoperitoneum is a life-threatening complication of pneumatic reduction for intussusception if not immediately recognized and treated. We describe a 3-month-old woman who presented with intussusception, underwent attempted pneumatic reduction, and subsequently developed tension pneumoperitoneum with associated hemodynamic instability requiring emergent laparotomy. This is a known, rare complication of pneumatic reduction which highlights the need to have a high index of suspicion for early surgical management to obtain a positive outcome.

scholarly journals Manejo nutricional em pacientes com risco de síndrome de realimentação

2020 ◽  
Vol 34 (4) ◽  
pp. 414-417
Author(s):  
Matheus Horta Sad ◽  
Bruna Fernanda Camargo Silva Parra ◽  
Ricardo Ferrer ◽  
Antônio Valério da Silva Júnior ◽  
Flávia Julie do Amaral Pfeilsticker ◽  
...  
Keyword(s):  
Risk Factors ◽  
Body Mass Index ◽  
Nutrition Therapy ◽  
Refeeding Syndrome ◽  
Magnesium Supplementation ◽  
Electrolyte Disturbances ◽  
Life Threatening ◽  
History Of ◽  
Low Body Mass Index ◽  
Life Threatening Complication

Refeeding syndrome (RS) is a life-threatening complication that occurs after prolonged starvation in malnourished patients or after severe catabolic events. It usually happens in the first 72 hours after the beginning of either enteral or parenteral nutrition and can affect one third of the patients. The most important risk factors are low body mass index (BMI), unintentional weight loss, none or low caloric supply for at least 5 days, history of alcohol or drug abuse and baseline electrolyte disturbances. Thiamine and electrolyte (phosphate, potassium and magnesium) supplementation is mandatory. The initiation and progression of nutrition therapy must be gradual with low amount of calories in the first days, with daily electrolyte monitoring. In the case of low electrolyte levels, especially hypophosphatemia, diet infusion should be reduced and slowly increased over 48 hours. RS deserves special attention the nutrition team to be prevented, identified and treated early.

Postpartum depression and its risk factors in women with a potentially life‐threatening complication

2020 ◽  
Author(s):  
Deepthi Nayak ◽  
Dhamotharan Karuppusamy ◽  
Dilip Kumar Maurya ◽  
Sitanshu Sekhar Kar ◽  
Balaji Bharadwaj ◽  
...  
Keyword(s):  
Risk Factors ◽  
Postpartum Depression ◽  
Life Threatening ◽  
Life Threatening Complication

scholarly journals Etiologies and risks of splenic decapsulation after endoscopic retrograde cholangiopancreatography: case report and literature review

2018 ◽  
Vol 06 (03) ◽  
pp. E271-E273 ◽  
Author(s):  
Vijeta Pamudurthy ◽  
Raju Abraham ◽  
Thomas Betlej ◽  
Ashish Shah ◽  
Dong Kim ◽  
...  
Keyword(s):  
Risk Factors ◽  
Literature Review ◽  
Endoscopic Retrograde Cholangiopancreatography ◽  
Severe Pain ◽  
Splenic Injury ◽  
Interventional Procedure ◽  
Endoscopic Retrograde ◽  
Life Threatening ◽  
Life Threatening Complication ◽  
High Index Of Suspicion

Abstract Background and study aims Endoscopic retrograde cholangiopancreatography (ERCP) is an invasive diagnostic and interventional procedure used in conditions related to the pancreas and biliary tract. It has a complication rate ranging from 4 % to 10 %. Severe complications are few with the most common of them being post-ERCP pancreatitis, post-sphincterotomy bleeding, and perforation. A rare, but potentially life-threatening complication of ERCP is splenic injury. We report the case of a 60-year-old female with choledocholithiasis who sustained splenic decapsulation following ERCP. The exact causes of splenic injury are unknown, although several mechanisms are postulated. A literature review of splenic injuries post-ERCP shows that there are only 3 cases with post-ERCP splenic decapsulation. Our patient is the first one in whom splenic decapsulation occurred without any risk factors or technical difficulties during the procedure. A high index of suspicion for splenic injury is required in any patient who has severe pain, anemia, or hemorrhagic shock after ERCP.

scholarly journals Methadone, Metoclopramide and Metronidazole Interaction Causing Torsades de Pointes

2021 ◽  
Vol 11 (1) ◽  
pp. 101-105 ◽  
Author(s):  
Karthik Gnanapandithan ◽  
Nishrutha Karthik ◽  
Jaime Gerber
Keyword(s):  
Risk Factors ◽  
Emergency Department ◽  
Torsades De Pointes ◽  
Qtc Interval ◽  
Hospital Personnel ◽  
Qtc Prolongation ◽  
Continuous Reinforcement ◽  
Iatrogenic Complication ◽  
Life Threatening ◽  
Life Threatening Complication

There are several classes of medications that can cause prolongation of the corrected QT (QTc) interval and potentially Torsades de Pointes (TdP). Most of these medications are commonly used in the emergency department, and interaction between these medications increases the risk of this iatrogenic complication. We describe a patient on methadone therapy who developed TdP after she received metoclopramide and metronidazole. Interaction between different classes of medications can increase the risk of QTc prolongation and TdP. Awareness of this condition and its risk factors need continuous reinforcement among all hospital personnel to reduce the risk of this life-threatening complication.

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