1/18. Tracheocarotid artery fistula infected with methicillin-resistant staphylococcus aureus.Massive life-threatening haemorrhage from a fistula between the trachea and a major blood vessel of the neck is a rare complication of the tracheostomy procedure, well-recognized by anaesthetists and otolaryngologists. Although the lesion is likely to be encountered at autopsy, it is not described in histopathological literature. The possible causes are discussed together with the macroscopic and microscopic appearances of the lesion. Suitable procedures for its identification and for obtaining appropriate histopathological blocks are suggested. Presence of methicillin-resistant staphylococcus aureus (MRSA) has not been documented before and might have contributed to the genesis of the fistula in this case.- - - - - - - - - - ranking = 1keywords = haemorrhage (Clic here for more details about this article) |
2/18. Aorto-oesophageal fistula complicating tuberculous aortitis. A case report.A case of massive upper gastro-intestinal haemorrhage in a Black woman owing to tuberculous aorto-oesophageal fistula is reported. The literature is reviewed and the clinical presentation discussed. This possibly represents only the second case of aorto-oesophageal fistula complicating postprimary tuberculosis to appear in medical literature.- - - - - - - - - - ranking = 1keywords = haemorrhage (Clic here for more details about this article) |
3/18. Cerebellar haemorrhage and tension pneumocephalus after resection of a Pancoast tumour.We present an unusual case of cerebellar haemorrhage followed by tension pneumocephalus several days after thoracotomy for resection of a Pancoast tumour. The postoperative course of the 32-year-old patient was complicated by a cerebellar haemorrhage and hydrocephalus caused by compression of the fourth ventricle. Immediate surgical evacuation of the haemorrhage and placement of an external ventricular drain was performed. Respirator ventilation maintaining a continuous positive airway pressure was required. Following weaning and extubation the patient rapidly deteriorated and became comatose. A cranial CT scan revealed a dilated ventricular system filled with air, and air in the subarachnoid space. Recovery of consciousness was observed after aspiration of intracranial air through the ventricular drainage. Recurrent deterioration of consciousness after repeated air aspiration indicated rapid refilling of the ventricles with air.The patient underwent emergency surgical re-exploration of the thoracic resection cavity: dural lacerations of the cervico-thoracic nerve roots C8 and Th1 were identified. Subarachnoid-pleural fistula, cerebellar haemorrhage and tension pneumocephalus after discontinuation of continuous positive airway pressure respiration are unusual complications of thoracic surgery. We discuss the putative pathomechanisms and present a brief review of the literature.- - - - - - - - - - ranking = 8keywords = haemorrhage (Clic here for more details about this article) |
4/18. Arterioenteric fistulae: diagnosis and treatment by angiography.Two cases of massive gastrointestinal haemorrhage caused by arterioenteric fistulae are presented. In both cases, bleeding was controlled by interventional angiography. In the first case, a fistula between an aberrant right subclavian artery and a reconstructed oesophagus was temporarily occluded with a balloon catheter as a pre-surgical measure. In the second case a communication between the external iliac artery and the colon in a patient with invasive cervical cancer was treated by embolization. An arterioenteric fistula should be considered as a possible cause of acute gastrointestinal haemorrhage in post-operative or cancer patients and aortography or pelvic arteriography may be required to make the diagnosis.- - - - - - - - - - ranking = 108.91520432526keywords = gastrointestinal haemorrhage, haemorrhage (Clic here for more details about this article) |
5/18. Sudden death from perforation of a benign oesophageal ulcer into a major blood vessel.Two cases of sudden death due to perforation of a benign oesophageal ulcer into a major blood vessel are reported. In one man, anaemia and aspiration pneumonitis dominated the clinical picture. He had an oesophageal stricture and a chronic peptic ulcer associated with an incarcerated hiatus hernia. death was due to haemorrhage caused by perforation of the ulcer into the thoracic aorta. The second patient presented with confusion and falls, backache and indigestion. She had a hiatus hernia and a large benign chronic oesophageal ulcer. death was due to perforation of the ulcer into the left pulmonary vein. The cases are presented for their rarity, to illustrate the complex and late presentation of problems in geriatric medicine, and as a reminder that reflux oesophagitis can be dangerous.- - - - - - - - - - ranking = 1keywords = haemorrhage (Clic here for more details about this article) |
6/18. Innominate artery rupture. A fatal complication of tracheostomy.Tracheo-innominate artery fistula is an uncommon but frequently fatal complication of tracheostomy. The case histories of three patients with tracheo-innominate artery fistula are presented, and one is a longterm survivor. The haemorrhage can be controlled by hyperinflation of the cuff of the tracheostomy tube or by direct digital compression of the artery. The damaged segment of the eroded artery should be resected and the ends oversewn. Measures to prevent this complication are described.- - - - - - - - - - ranking = 1keywords = haemorrhage (Clic here for more details about this article) |
7/18. Major gastrointestinal haemorrhage as a complication of cholecystoduodenal fistula in gallstone disease. Report of three cases.Three patients with cholecystoduodenal fistulae due to gallstone penetration, resulting in major gastrointestinal haemorrhage are presented. diagnosis and treatment of this condition are discussed.- - - - - - - - - - ranking = 272.28801081315keywords = gastrointestinal haemorrhage, haemorrhage (Clic here for more details about this article) |
8/18. Arterio-intestinal fistula as a complication following insertion of an aorto-iliac bifurcation graft. A case report.A patient who had been treated with insertion of an aorto-iliac bifurcation dacron prosthesis for atherosclerosis 6 years previously, developed a fistulous communication between a false aneurysm at the distal anastomosis to the left iliac artery and an ileal loop. Intestinal haemorrhage and signs of infection were the main symptoms. Successful surgical treatment consisted of suturing the intestinal defect, removal of the left limb of the graft and vascular reconstruction by means of a subcutaneous femorofemoral vein bypass.- - - - - - - - - - ranking = 1keywords = haemorrhage (Clic here for more details about this article) |
9/18. Oesophageal bleeding from aortoesophageal fistula due to aortic aneurysm.From pathology data it appears that aortic aneurysm may be the commonest cause of aorto-oesophageal fistula (AOF), but this entity is rarely diagnosed clinically. We report 6 patients, seen during a 5-year period, with aneurysms which initially caused chest pain and minor oesophageal bleeding. The diagnosis of AOF was made before death in only 1 case; surgery was not attempted. This patient and 4 others died when rupture into the oesophageal lumen or wall caused exsanguinating haemorrhage. The 6th patient, who died after prostatectomy without a major haemorrhage, had oesophageal fibrosis localized at the aneurysm; this type of lesion occurs in the development of a fistula. The therapeutic ideal is to forestall fatal rupture by prompt diagnosis and immediate surgery when mild oesophageal bleeding gives warning of fistula formation.- - - - - - - - - - ranking = 2keywords = haemorrhage (Clic here for more details about this article) |
10/18. Ruptured abdominal aortic aneurysm associated with an aorto-enteric fistula. A case report.A patient with a ruptured abdominal aortic aneurysm and a primary aortoduodenal fistula is reported on. Treatment included aneurysmectomy, suture of the duodenal fistula, closure of the proximal and distal abdominal aortic stumps, and construction of an axillobifemoral bypass. The postoperative course was complicated by spinal cord ischaemia and pataplegia, Gram-negative septicaemia, secondary intra-abdominal haemorrhage and multiple abscess formation.- - - - - - - - - - ranking = 1keywords = haemorrhage (Clic here for more details about this article) |
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