1/39. Lupoid hepatitis, Rendu-Osler-Weber syndrome, clubbing cyanosis and hypertrophic osteoarthropathy.Chronic liver disease typical of chronic active 'lupoid' hepatitis together with cyanosis, clubbing and hypertrophic osteoarthropathy in a 42-year-old female is described. In addition she had severe nose bleeds, gastro-intestinal haemorrhages, syncopal attacks with generalised convulsive seizures, pulmonary arterio-venous fistulae as manifestations of Rendu-Osler-Weber syndrome. A study of the literature revealed that similar associations are far more frequent than can be attribtued to chance. Possible mechanisms of the cyanosis, clubbing and osteoarthropathy and possible common pathogenesis for these seemingly unrelated disorders are discussed.- - - - - - - - - - ranking = 1keywords = haemorrhage (Clic here for more details about this article) |
2/39. The use of the laryngeal mask airway in post-tonsillectomy haemorrhage--a case report.INTRODUCTION: The use of the laryngeal mask airway in elective adenotonsillectomy has been well described. However, there is no literature to support its use in post-tonsillectomy haemorrhage. CLINICAL PICTURE: We report a case of a patient who presented with primary post-tonsillectomy haemorrhage, which required general anaesthesia for haemostasis after undergoing bilateral functional endoscopic sinus surgery, uvulopalatopharyngoplasty and tonsillectomy. TREATMENT AND OUTCOME: The laryngeal mask airway was used successfully after an initial attempt at endotracheal intubation had failed. There were no complications. CONCLUSIONS: The laryngeal mask airway can be used to secure the airway for haemostasis for post-tonsillectomy haemorrhage if intubation is not possible.- - - - - - - - - - ranking = 7keywords = haemorrhage (Clic here for more details about this article) |
3/39. Major abdominal bleeding in chronic pancreatitis.This case report concerns a patient with chronic pancreatitis which led to extensive retroperitoneal haemorrhage from a rupture of the abdominal aorta. The rarity of this complication is emphasized, but other reported instances of bleeding in association with chronic pancreatitis are commented upon.- - - - - - - - - - ranking = 1keywords = haemorrhage (Clic here for more details about this article) |
4/39. Embolisation of a renal artery pseudoaneurysm in a patient with renal malrotation and chronic aortic dissection.INTRODUCTION: renal artery pseudoaneurysms may arise as a complication of percutaneous nephrolithotomy (PCNL). Prompt recognition and treatment is essential to arrest haemorrhage which may be life threatening. CLINICAL PICTURE: A patient with chronic aortic dissection and malrotated right kidney underwent PCNL for right renal calculus. He developed delayed gross haematuria. TREATMENT: angiography showed a pseudoaneurysm arising from one of two right renal arteries, which in turn arose from the false lumen of the aortic dissection. The supplying artery was successfully embolised. CONCLUSION: renal artery pseudoaneurysms can be successfully treated with prompt angiography and embolisation, even in the presence of renal malrotation and aortic dissection.- - - - - - - - - - ranking = 1keywords = haemorrhage (Clic here for more details about this article) |
5/39. Intraparenchymal haemorrhage after evacuation of chronic subdural haematoma. Report of three cases and review of the literature.Three cases of intracerebral haemorrhage following removal of a chronic subdural haematoma are reported and the literature on this topic reviewed. The possibility of an increase in cerebral blood flow following removal of CSH, makes slow, gradual decompression mandatory in all patients submitted to cranial trapanation.- - - - - - - - - - ranking = 5keywords = haemorrhage (Clic here for more details about this article) |
6/39. Mechanisms in cerebral lesions in trauma to high cervical portion of the vertebral artery--rotation injury.Three cases have been described illustrating the mechanisms and effects of lesions from acute rotation injury to the vertebral artery. These indicate that the portion of artery at risk is in the C1 to C2 region, where stretching and shearing strains can produce intramural dissection and haemorrhage. Such changes can radically alter flow to produce acute arterial obliteration or later cerebral embolism. Such alteration can also produce a change in relationships between artery and surrounding structures and thus cause intermittent occlusion of a vertebral artery upon cervical rotation.- - - - - - - - - - ranking = 1keywords = haemorrhage (Clic here for more details about this article) |
7/39. Haemorrhage into chronic plaque psoriasis as a consequence of disseminated intravascular coagulation.We describe a patient with chronic plaque psoriasis who developed haemorrhage into pre-existing lesions during an episode of disseminated intravascular coagulation secondary to sepsis. disseminated intravascular coagulation is a complex disorder characterized by widespread intravascular deposition of fibrin with consumption of coagulation factors and platelets and occurs as a consequence of many disorders that release procoagulant material into the circulation or cause widespread endothelial damage or platelet aggregation. As both disseminated intravascular coagulation and psoriasis occur relatively frequently in the general population we were surprised to find no previous reports of this phenomenon in the literature.- - - - - - - - - - ranking = 1keywords = haemorrhage (Clic here for more details about this article) |
8/39. Haemosuccus pancreaticus: treatment by arterial embolization.AIM: Haemosuccus pancreaticus is bleeding into the pancreatic duct from a peripancreatic artery. This condition most commonly follows pseudoaneurysm formation secondary to acute or chronic pancreatitis. It is a rare disorder, challenging in both diagnosis and therapy. We present an eight-year experience of managing these patients using endovascular embolization as the primary therapy. MATERIALS AND methods: We retrospectively reviewed the imaging, laboratory results and clinical notes of the five patients who presented to this institution between 1991-1999 with gastrointestinal bleeding subsequently found to be haemosuccus pancreaticus. RESULTS: There were four men and one women aged 38-75 years. All had a history of gastrointestinal haemorrhage and had acute (n=1) or chronic pancreatitis with a complicating pseudoaneurysm. All underwent embolization as the primary therapy for the pseudoaneurysm. There was immediate technical success in all cases without major complication. No patient required operative surgery for the pseudoaneurysm. Follow-up ranged from 18 months to 7 years. One patient died four years after embolization due to hepatic failure but the other four remain well without further gastrointestinal bleeding. CONCLUSION: Endovascular embolization is an effective and safe treatment for haemosuccus pancreaticus.- - - - - - - - - - ranking = 4.831161875609keywords = gastrointestinal haemorrhage, haemorrhage (Clic here for more details about this article) |
9/39. Chronic hyposphagma revealing primary ocular amyloidosis.BACKGROUND: amyloidosis is an extracellular accumulation of a clear substance called amyloid in different organs. Fragments of identical proteinic chains are the components of this substance. amyloidosis can be primary, secondary (chronic inflammation, multiple myeloma, tumour), senile or hereditary. history AND SIGNS: A 59-year-old healthy patient was referred with recurrent subconjunctival haemorrhages in his right eye since one year. The clinical examination disclosed the presence of yellowish subconjunctival deposits associated with haemorrhages. THERAPY AND OUTCOME: Histopathologic examination of these deposits revealed the presence of amyloid. A complete work-up to exclude a systemic disease gave negative results. CONCLUSIONS: Primary conjunctival amyloidosis is a rare clinical entity that is mainly diagnosed histopathologically. In the presence of a recurrent hyposphagma of unknown aetiology the diagnosis of amyloidosis should be excluded.- - - - - - - - - - ranking = 2keywords = haemorrhage (Clic here for more details about this article) |
10/39. Chronic eosinophilic ascites in a very young child.A case of chronic eosinophilic ascites with onset in early infancy is described. An intensive diagnostic work-up ruled out other known causes of ascites in childhood. The final diagnosis was made at 2 years of age when a large number of eosinophils was detected in the ascitic fluid. The outcome was complicated by an ex vacuo intraperitoneal haemorrhage. steroids were able to control the disease only after complete aspiration (1600 ml) of the ascitic fluid. On discontinuation of treatment, peritoneal inflammation recurred indicating steroid-dependency. CONCLUSION: eosinophilic ascites, a very rare disorder in children, should be considered in the differential diagnosis of even very young children presenting with ascites.- - - - - - - - - - ranking = 1keywords = haemorrhage (Clic here for more details about this article) |
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