1/31. amniotic fluid embolism and isolated coagulopathy: atypical presentation of amniotic fluid embolism.A 41-year-old multigravida presented at 32 weeks of gestation with polyhydramnios and an anencephalic fetus. Abnormal bleeding as a result of disseminated intravascular coagulation complicated an emergency Caesarean section for severe abdominal pain thought to be due to uterine rupture. Massive transfusion with blood products was necessary and the abdomen packed to control bleeding. The patient was transferred to the intensive care unit where she made a slow but complete recovery. amniotic fluid embolism with atypical presentation of isolated coagulopathy is the likely diagnosis in this case. The case serves to demonstrate that amniotic fluid embolism may present with symptoms and signs other than the classical pattern of dyspnoea, cyanosis and hypotension.- - - - - - - - - - ranking = 1keywords = embolism (Clic here for more details about this article) |
2/31. Widespread hematogenous metastases and Trousseau's syndrome in gastric adenocarcinoma.A case of widespread hematogenous metastases and Trousseau's syndrome is reported in a 40 year-old white housewife with gastric cancer, presenting subdural hematoma, ecchymoses, epistaxis, stomach and uterine bleeding. After undergoing hematoma drainage, she was unsuccessfully treated with platelets, red blood cells, plasma cryoprecipitate transfusions, and antibiotics. Necropsy disclosed gastric ring-signet adenocarcinoma invading the serous layer, with massive disseminated intravascular coagulation and systemic neoplastic embolism. Multiple old and recent hyaline (rich in fibrin and platelets) microthrombi, and tumor emboli were observed in the bone marrow, meninges, liver, lungs, kidneys, lymph nodes, adrenals, thyroid, heart, pancreas, and ovaries (krukenberg tumor).- - - - - - - - - - ranking = 0.1keywords = embolism (Clic here for more details about this article) |
3/31. Mixed arterial and venous thromboembolism in a person with hiv infection.People with human immunodeficiency virus (hiv) infection are more susceptible to thromboembolic events. venous thromboembolism (VTE) occurs frequently in hiv infected persons but arterial thrombosis has only rarely been reported. We describe a case of a person with hiv infection who developed an arterial thrombosis and 3 months later an extensive VTE. Several non-hiv and hiv related thrombogenic factors were identified.- - - - - - - - - - ranking = 33.673482622108keywords = thromboembolism, embolism (Clic here for more details about this article) |
4/31. Paradoxical arterial and pulmonary embolism in a patient with a thrombus between atrial septum and patent foramen ovale.We describe a 50-year-old woman with an incident of systemic and pulmonary embolism in whom transoesophageal examination (TEE) with the aid of contrast echocardiography (CE) identified a patent foramen ovale (PFO) with a residual thrombus between atrial septum and PFO valve suggesting paradoxical systemic embolization. The patient was diagnosed as heterozygous for prothrombin G20210A mutation. Control TEE performed after fibrinolysis, 2 months of heparin treatment followed by oral anticoagulation did not show any embolic material within the PFO.- - - - - - - - - - ranking = 1.330121699484keywords = pulmonary embolism, embolism (Clic here for more details about this article) |
5/31. amniotic fluid embolism with haemostasis complications: primary fibrinogenolysis or disseminated intravascular coagulation?amniotic fluid embolism (AFE) is characterized by the passage of amniotic fluid (AF) into the maternal circulation during or just after childbirth. AFE is a rare disorder occurring in 1/8,000 to 1/80,000 deliveries but with a maternal morbidity ranging from 26% in a recent report to 86% in earlier ones. In patients who survive, AFE may affect coagulation resulting in severe bleeding. While disseminated intravascular coagulation (DIC) is usually seen in such cases, we reported a case of AFE in which the hemostatic abnormalities were compatible with primary fibrinogenolysis rather than with DIC.- - - - - - - - - - ranking = 0.5keywords = embolism (Clic here for more details about this article) |
6/31. amniotic fluid embolism during caesarean section.amniotic fluid embolism occurs rarely but is a leading cause of maternal mortality. A high index of clinical suspicion is necessary to make an early diagnosis to reduce morbidity and mortality. We report a non-fatal case of amniotic fluid embolism occurring during a caesarean section, with special emphasis on the mode of development and diagnosis. The initial presentation of this syndrome was a coagulopathy, followed by the usual complications of massive bleeding. Although non-specific, the diagnosis of amniotic fluid embolism was supported by the observation of amniotic fluid in the central venous blood as well as in the broncho-alveolar fluid.- - - - - - - - - - ranking = 0.7keywords = embolism (Clic here for more details about this article) |
7/31. stroke as a first manifestation of ovarian cancer.BACKGROUND: Gynaecologic neoplasms are reported to have the highest potential for developing of ischemic stroke. OBJECTIVES: The history of a female patient, in whom recurrent cerebral embolism was the first clinical sign of occult ovarian neoplasm is described and the casuistic literature to characterise this clinical phenomenon reviewed. RESULTS: Among a large spectrum of neoplasms complicating with ischemic stroke, ovarian carcinoma is one of the most frequently reported in the casuistic literature. The source of systemic microembolisation is endocardits of non-infectious origin; the characteristic diagnostic findings are thrombocytopenia, elevated D-dimers level, and a specific stroke pattern in magnetic resonance imaging. CONCLUSION: Meticulous diagnosis in female, otherwise 'healthy' patients with ischemic stroke, to detect the underlying neoplastic disease is of paramount importance, as early surgical intervention on cancer promises successful therapy for both, cancer and thromboembolism.- - - - - - - - - - ranking = 6.8346965244216keywords = thromboembolism, embolism (Clic here for more details about this article) |
8/31. Recurrent embolism in the course of marantic endocarditis.Marantic or nonbacterial thrombotic endocarditis (NBTE) associated with systemic embolism is usually a complication of advanced or terminal malignancies. We report on the case of a 46-year-old woman in whom nonbacterial thrombotic endocarditis (NBTE)-related cerebral embolism was the first clinical sign of ovarian neoplasm, which was diagnosed after cardiac surgery. Marantic endocarditis should alert the physician to make every effort to diagnose the possible background of this clinical phenomenon. Early identification of NBTE, treatment of the underlying disease, and the associated coagulopathy could possibly prevent cardiac surgery.- - - - - - - - - - ranking = 0.6keywords = embolism (Clic here for more details about this article) |
9/31. High titers of CA-125 may be associated with recurrent ischemic strokes in patients with cancer.In addition to etiologies common in the general population, strokes in cancer patients may be caused by hypercoagulable states, hyperviscosity, cardiogenic embolism, and neoplastic vessel infiltration. Intravascular mucins were reported in patients with recurrent thromboembolism. The authors report four patients with metastatic cancer, brain infarcts, and other thromboembolic disease with markedly elevated levels of the tumor marker CA-125 and explore possible associations between this mucinous protein and strokes.- - - - - - - - - - ranking = 6.8346965244216keywords = thromboembolism, embolism (Clic here for more details about this article) |
10/31. life-threatening hypercoagulable state following splenectomy in ITP: successful management with aggressive antithrombotic therapy and danazol.A life-threatening hypercoagulable state (HCS) is reported that developed after splenectomy in idiopathic thrombocytopenic purpura (ITP). A 50-year-old active male was rejected for blood donation because of an incidental finding of low platelet counts, 40,000/uL. The diagnosis was ITP. Although asymptomatic, he underwent splenectomy because of poor response to steroids and intravenous (IV) gamma globulin. One month after splenectomy, he suffered pulmonary emboli without deep venous embolism (DVT), followed by bilateral DVT, threatening amputation of the legs. Emergency thrombolysis, insertion of stent, and IV heparin saved his legs. Extensive workup for HCS was negative. IV heparin was withheld for colonoscopy for possible gastrointestinal neoplasm, at which time DVT recurred, necessitating another thrombolysis and heparin infusion. He was discharged on enoxaparin, antiplatelet therapy, and danazol. Platelet hyperactivation, characterized by high platelet microparticles (PMP) and CD62P, was present throughout his course of active ITP, resolving when ITP went into remission with danazol therapy. ITP has remained in remission for 4 years after stopping enoxaparin and danazol. in vitro, his plasma in active ITP induced activation of normal platelets, generating PMP and inducing CD62p-positive platelets and platelet aggregates; his plasma from remission had no effect. This indicates the presence of a platelet activating factor, possibly anti-platelet antibodies. splenectomy may have allowed procoagulant PMP to accumulate to high levels resulting in HCS. We advise awareness of thrombotic complications post-splenectomy in the subset of ITP patients who are largely asymptomatic and exhibit persisting platelet activation.- - - - - - - - - - ranking = 0.1keywords = embolism (Clic here for more details about this article) |
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