scholarly journals Spontaneous retroperitoneal hematoma in a COVID-19 patient

2021 ◽  
Vol 2 (4) ◽  
pp. 377-385
Author(s):  
Ana Sekulić ◽  
Olivera Marinković ◽  
Davor Mrda ◽  
Borislav Tošković ◽  
Marija Zdravković ◽  
...  
Keyword(s):  
Risk Factors ◽  
Case Report ◽  
Mortality Rate ◽  
Anticoagulant Therapy ◽  
Psoas Muscle ◽  
Bleeding Complications ◽  
Thromboembolic Events ◽  
Life Threatening ◽  
The Right ◽  
Radiological Examinations

Introduction: The infection caused by the SARS-CoV-2 virus is known to cause a hypercoagulable condition resulting in acute thrombotic events. Thromboembolic events occur in as many as 21.0% of cases with a mortality rate of about 74.0% in persons infected with COVID-19. Anticoagulant therapy is used in severe COVID-19 infections in order to prevent thrombosis and has been shown to reduce mortality. The use of anticoagulants is not without risks. Bleeding complications can range from mild to severe or even life-threatening, such as retroperitoneal bleeding into the psoas muscle. Case report: We present a case of a patient who developed a complication of bleeding into the retroperitoneal space during the treatment of bilateral bronchopneumonia caused by the SARS-CoV-2 virus. After the diagnosis was established, on the basis of a clinical examination, laboratory and radiological examinations, and after initial conservative treatment at the UHMC Bežanijska kosa, the patient underwent embolization of the left lumbar arteries from the right inguinal fossa, during procedural analgosedation. After the radiological procedure, the recovery was satisfactory, but due to the impossibility of resorption of an encapsulated hematoma with a zone of central necrosis, a mini left lumbotomy and evacuation of the hematoma were performed. The patient was discharged from the hospital on the 23rd day of admission in stable general condition. Conclusion: The effect of anticoagulant therapy, especially in patients with existing risk factors, early diagnosis, and prompt therapy of spontaneous retroperitoneal hematomas is imperative to reduce mortality from this severe complication, in patients with the COVID-19 infection.

Catastrophic antiphospholipid syndrome presenting with aortic barrage: case report and review of the literature

Lupus ◽  
2021 ◽  
Vol 30 (6) ◽  
pp. 1005-1009
Author(s):  
Luca Moroni ◽  
Paolo Righini ◽  
Giuseppe A Ramirez ◽  
Nicola Farina ◽  
Gaia Mancuso ◽  
...  
Keyword(s):  
Risk Factors ◽  
Case Report ◽  
Antiphospholipid Syndrome ◽  
Unusual Case ◽  
Thromboembolic Events ◽  
Review Of The Literature ◽  
Catastrophic Antiphospholipid Syndrome ◽  
Short Period ◽  
Threatening Condition ◽  
Life Threatening

Catastrophic antiphospholipid syndrome (CAPS) is a life-threatening condition characterized by multiple thromboembolic events occurring in a short period of time, frequently accompanied by significant systemic inflammation. Aortic involvement is rare in antiphospholipid syndrome and it had been never described in the context of its catastrophic variant. Here, we report an unusual case of aortic occlusion as a debut manifestation of CAPS and discuss its clinical features with an up-to-date review of the literature to identify risk factors and clues for clinical practice.

Stent Graft Placement in the Top-Down Direction for Treating Traumatic Intra-Abdominal Suprahepatic Inferior Vena Cava Rupture: A Case Report

2021 ◽  
pp. 152660282110250
Author(s):  
Yun Chul Park ◽  
Hyoung Ook Kim ◽  
Nam Yeol Yim ◽  
Byung Chan Lee ◽  
Chan Park ◽  
...  
Keyword(s):  
Case Report ◽  
Inferior Vena Cava ◽  
Stent Graft ◽  
Inferior Vena ◽  
Vena Cava ◽  
Endovascular Management ◽  
Top Down ◽  
Life Threatening ◽  
The Right ◽  
Suprahepatic Inferior Vena Cava

Purpose The treatment of suprahepatic inferior vena cava (IVC) ruptures results in high mortality rates due to difficulty in performing the surgical procedure. Here, we present a case of successful endovascular management of a life-threatening suprahepatic IVC rupture with top-down placement of a stent graft. Case Report A 33-year-old woman was involved in a traffic accident and presented to our emergency department due to unstable hemodynamics after blunt abdominal wall trauma. Computed tomography (CT) revealed massive extravasation of contrast agent from the suprahepatic IVC, which suggested traumatic suprahepatic IVC rupture. To seal the IVC, to salvage major hepatic veins, and to prevent migration of the stent graft into the right side of the heart after placement, an aortic cuff with a proximal hook was introduced in a top-down direction via the right internal jugular vein. After closure of the injured IVC, the patient’s hemodynamics improved, and additional laparotomy was performed. After 3 months of trauma care, the patient recovered and was discharged. Follow-up CT after 58 months showed a patent stent graft within the IVC. Conclusion Endovascular management with top-down placement of a stent graft is a viable option for emergent damage control in patients with life-threatening hemorrhage from IVC rupture.

scholarly journals A Case Report on VT from TV: DVT and PE from Prolonged Television Watching

2017 ◽  
Vol 2017 ◽  
pp. 1-3
Author(s):  
Alan Lucerna ◽  
James Espinosa ◽  
Lindsey Ackley ◽  
Philip Carhart ◽  
Douglas Stranges ◽  
...  
Keyword(s):  
Risk Factors ◽  
Emergency Department ◽  
Deep Vein Thrombosis ◽  
Case Report ◽  
Pulmonary Embolus ◽  
Thromboembolic Events ◽  
Television Watching ◽  
Vein Thrombosis ◽  
Deep Vein ◽  
Made In

Pulmonary embolus (PE) and deep vein thrombosis are diagnoses that are commonly made in the emergency department. Well known risk factors for thromboembolic events include immobility, malignancy, pregnancy, surgery, and acquired or inherited thrombophilias, obesity, cigarette smoking, and hypertension. We present a case of a 59-year-old female who watched TV and developed leg swelling and was found to have PE and DVT.

scholarly journals Treatment of bleeding complications in patients on anticoagulant therapy

Blood ◽  
2019 ◽  
Vol 133 (5) ◽  
pp. 425-435 ◽  
Author(s):  
Siavash Piran ◽  
Sam Schulman
Keyword(s):  
Anticoagulant Therapy ◽  
Vitamin K Antagonists ◽  
Laboratory Data ◽  
Factor Xa ◽  
Thrombin Inhibitors ◽  
Bleeding Complications ◽  
Emergency Setting ◽  
Antifibrinolytic Agents ◽  
Different Types ◽  
Life Threatening

Abstract Anticoagulant therapy is often refrained from out of fear of hemorrhagic complications. The most frequent type of major bleeding is gastrointestinal, but intracranial hemorrhage has the worst prognosis. Management of these complications in patients on anticoagulants should follow the same routines as for nonanticoagulated patients, as described here with the previously mentioned bleeds as examples. In addition, for life-threatening or massive hemorrhages, reversal of the anticoagulant effect is also crucial. Adequate reversal requires information on which anticoagulant the patient has taken and when the last dose was ingested. Laboratory data can be of some help, but not for all anticoagulants in the emergency setting. This is reviewed here for the different types of anticoagulants: vitamin K antagonists, heparins, fondaparinux, thrombin inhibitors and factor Xa inhibitors. Specific antidotes for the latter are becoming available, but supportive care and nonspecific support for hemostasis with antifibrinolytic agents or prothrombin complex concentrates, which are widely available, should be kept in mind.

Inguinal Paravascular (Lumbar Plexus) Neurolytic Block—Description of a Catheter Technique: Case Report

1998 ◽  
Vol 23 (2) ◽  
pp. 214-218
Author(s):  
Abdullah M. Kaki ◽  
Geraint W. Lewis
Keyword(s):  
Case Report ◽  
Guide Wire ◽  
Femoral Nerve ◽  
Psoas Muscle ◽  
Pathologic Fracture ◽  
Sensory Block ◽  
Lumbar Plexus ◽  
Catheter Technique ◽  
Neurolytic Block ◽  
The Right

Background and ObjectivesWe provided care for a 47-year-old female with a history of lung carcinoma and bony metastases who sustained a pathologic fracture of the right acetabulum causing severe and uncontrolled pain in the right groin. Her pain was rated as 8-10 on a 10-point visual analog scale (VAS). Her terminal disease and poor surgical risk precluded therapeutic operative intervention. Consequently, a neurolytic block of the lumbar plexus was performed as a palliative measure.MethodsA modified inguinal paravascular (lumbar plexus) block technique was used. A 17-gauge Tuohy needle was inserted in the groin area just lateral to femoral artery and 1 cm below the inguinal ligament. A guide wire was threaded through the needle and subsequently an angiogram catheter was introduced over the wire into the psoas muscle. Radiographic confirmation of the position was obtained, and the catheter was secured in place. A prognostic block using an infusion of 0.25% bupivacaine at 5 mL/h was initiated for the first 2 days. On the third day a neurolytic block with 6% phenol was performed.ResultsMarked pain relief was experienced by the patient (VAS: 0-1). Sensory block in the femoral, lateral femoral cutaneous, and obturator nerve distributions was elicited. Motor weakness in the femoral nerve was demonstrated. Narcotic use was markedly reduced, and the patient was discharged to home in a pain-free state.ConclusionsThis case report supports the feasibility of placing a catheter via a modified anterior inguinal paravascular block technique and its subsequent use for both local anesthetic infusion and neurolytic block of the lumbar plexus.

scholarly journals Acute Parotitis after Lower Limb Amputation: A Case Report of a Rare Complication

2018 ◽  
Vol 2018 ◽  
pp. 1-3
Author(s):  
Konstantinos Ioannis Avgerinos ◽  
Nikolaos Degermetzoglou ◽  
Sofia Theofanidou ◽  
Georgia Kritikou ◽  
Ioannis Bountouris
Keyword(s):  
Risk Factors ◽  
Case Report ◽  
General Anesthesia ◽  
Lower Limb ◽  
Rare Complication ◽  
Head Tilt ◽  
Lower Limb Amputation ◽  
Limb Amputation ◽  
The Right ◽  
Type Of Surgery

Background. Postoperative parotitis is a rare complication that occurs usually after abdominal surgery. Parotitis has never been described as a complication of vascular operations, in literature. In the present article, we describe a case of a postamputation parotitis along with its management and its possible pathogenesis. Case Report. An 83-year-old diabetic man was emergently admitted to hospital because of gangrene below the right ankle and sepsis. The patient underwent a lower limb amputation above the knee. On the 5th postoperative day, he was diagnosed with right parotitis probably because of dehydration, general anesthesia, and immunocompromisation. A CT scan confirmed the diagnosis. He received treatment with antibiotics and fluids. His condition gradually improved, and he was finally discharged on 15th postoperative day. Conclusions. Postoperative parotitis can possibly occur after any type of surgery including vascular. Clinicians should be aware of this complication although it is rare. Several risk factors such as dehydration, general anesthesia, drugs, immunocompromisation, head tilt during surgery, and stones in Stensen’s duct may predispose to postoperative parotitis. Treatment consists of antibiotics and hydration.

Lateral sinus thrombosis following myringoplasty: a rare complication

2012 ◽  
Vol 127 (S1) ◽  
pp. S39-S41 ◽  
Author(s):  
G Sim ◽  
F Lannigan
Keyword(s):  
Case Report ◽  
Mortality Rate ◽  
Otitis Media ◽  
High Mortality ◽  
Sinus Thrombosis ◽  
Rare Complication ◽  
Lateral Sinus ◽  
Lateral Sinus Thrombosis ◽  
Life Threatening ◽  
Life Threatening Complication

AbstractObjective:We report lateral sinus thrombosis occurring as a rare complication following a routine and uneventful otological procedure.Case report:Lateral sinus thrombosis is a rare but known complication of otitis media. It has not been documented as a complication of routine otological surgery. We present a case of this rare complication following a myringoplasty. We also discuss the presentation, investigation and treatment of lateral sinus thrombosis. It is essential to be able to recognise and treat this rare complication early, due to its high mortality rate.Conclusion:Lateral sinus thrombosis is a rare but potentially life-threatening complication. It is therefore essential for clinicians to be able to recognise and treat this condition early.

scholarly journals Case Report of Necrotizing Fasciitis Associated withStreptococcus pneumoniae

2016 ◽  
Vol 2016 ◽  
pp. 1-4 ◽  
Author(s):  
Lei Jiao ◽  
Zain Chagla ◽  
Reham Mohammedsaeed Kaki ◽  
Gabriela Gohla ◽  
Marek Smieja
Keyword(s):  
Case Report ◽  
Streptococcus Pneumoniae ◽  
Necrotizing Fasciitis ◽  
Neutrophil Infiltration ◽  
Skin Lesions ◽  
Blood Samples ◽  
Surgical Exploration ◽  
Lower Back ◽  
Life Threatening ◽  
The Right

Necrotizing fasciitis, caused byStreptococcus pneumoniae, is an extremely rare and life-threatening bacterial soft tissue infection. We report a case of early necrotizing fasciitis associated withStreptococcus pneumoniaeinfection in a 26-year-old man who was immunocompromised with mixed connective tissue disease. The patient presented with acute, painful, erythematous, and edematous skin lesions of his right lower back, which rapidly progressed to the right knee. The patient underwent surgical exploration, and a diagnosis of necrotizing fasciitis was confirmed by pathological evidence of necrosis of the fascia and neutrophil infiltration in tissue biopsies. Cultures of fascial tissue biopsies and blood samples were positive forStreptococcus pneumoniae. To our knowledge, this is the first report of necrotizing fasciitis resulting fromStreptococcus pneumoniaediagnosed at early phase; the patient recovered well without surgical debridement.

scholarly journals Case Report. Non-Obvious, Post-Traumatic, Life-Threatening Bleeding in Two Elderly Patients

2017 ◽  
Vol 3 (2) ◽  
pp. 79-83
Author(s):  
Rafael García Carretero
Keyword(s):  
Case Report ◽  
Side Effects ◽  
Elderly Patients ◽  
Anticoagulant Therapy ◽  
Vitamin K ◽  
Major Bleeding ◽  
Vitamin K Antagonist ◽  
Life Threatening ◽  
Post Traumatic ◽  
Main Complication

Abstract The main complication of anticoagulant therapy is major bleeding. Clinicians are usually aware of these side effects and are careful when managing the therapeutic range of vitamin K antagonist drugs. But major bleeding, while lifethreatening, can be overlooked if there are no visible signs of bleeding. Two cases are described in which inaccurate diagnoses lead to inadequate treatment.

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