1/12. Haematemesis and Melaena: surgical management.A prospective study of the surgical management of 100 consecutive patients with benign, non-variceal upper gastrointestinal bleeding is presented. The manner of presentation, precipitating factors, investigations and associated medical problems are discussed. Chronic duodenal ulceration was the most common cause of haemorrhage. vagotomy and drainage with oversewing or excision of the bleeding ulcer was the surgical procedure performed in 71 of the patients in the series. The incidence of recurrent bleeding was 7%; no patient in this category required further operation. The mortality rate was 6%, and there were no deaths recorded in the patients who underwent vagotomy and drainage. The reasons for the relatively low surgical mortality are discussed.- - - - - - - - - - ranking = 1keywords = haemorrhage (Clic here for more details about this article) |
2/12. Massive upper gastrointestinal haemorrhage in a young man: a case of Dieulafoy's syndrome.A 23-year-old man was admitted following a massive haematemesis. Dieulafoy's syndrome was diagnosed and the treatment was a partial proximal gastrectomy and pyloroplasty. The diagnosis and approach to surgical management of Dieulafoy's syndrome are discussed.- - - - - - - - - - ranking = 4keywords = haemorrhage (Clic here for more details about this article) |
3/12. Acute promyelocytic leukemia: an unusual cause of fatal secondary postpartum hemorrhage.INTRODUCTION: Postpartum haemorrhage can rarely be associated with an underlying coagulation or haematological disorder. We wish to discuss a case of acute promyelocytic leukemia (APL) presenting as secondary postpartum hemorrhage (PPH), its clinical and pathological features and maternal outcome. CASE REPORT: We describe a 28-year-old woman who presented with secondary PPH accompanied by bleeding from gums, marked pallor, hematemesis, ecchymotic and purpuric spots all over the body, 8 days post-partum. Investigations revealed her to be having APL, a diagnosis not suspected by the referring clinic. She was given supportive therapy but died before chemotherapy could be started. CONCLUSION: The case emphasizes the importance of suspecting, investigating and energetically treating uncommon causes such as acute leukemia when an unusually severe clinical picture in a postpartum setting suggests such a possibility. This may prove to be life saving, particularly if the leukemia happens to be APL, a cancer with a very high cure rate.- - - - - - - - - - ranking = 1keywords = haemorrhage (Clic here for more details about this article) |
4/12. Massive haemorrhage from the vallecula: a diagnostic difficulty. Case report.A case is presented of massive bleeding from a vessel in the vallecula. This was confused with haemoptysis and haematemesis. The bleeding may have resulted from trauma to the vessel during intubation for emergency surgery. 25 units of blood were transfused before the site of the bleeding was identified and controlled by diathermy coagulation.- - - - - - - - - - ranking = 4keywords = haemorrhage (Clic here for more details about this article) |
5/12. Oesophageal intramural pseudodiverticulosis--always benign?Oesophageal intramural pseudodiverticulosis is a rare condition that presents with dysphagia. The diagnosis is usually not apparent endoscopically and careful radiological evaluation is required. Previous reports suggest a benign course with good response of dysphagia to oesophageal dilatation and complications have not been described. Two cases are reported, one in whom life threatening haemorrhage developed following dilatation, and one complicated by a retro-oesophageal collection. It is possible that oesophageal intramural pseudodiverticulosis results in an increased propensity to trauma and even perforation.- - - - - - - - - - ranking = 1keywords = haemorrhage (Clic here for more details about this article) |
6/12. Gastrointestinal bleeding with influenza virus.Seven children who presented during the influenza A(H1N1) epidemic of 1988 are described. After a typical influenzal illness, they developed haematemesis of varying severity. endoscopy revealed haemorrhagic gastritis. Laboratory evidence of influenza A(H1N1) virus infection was present. Two children died as a result of their illness. The association of virus and gastrointestinal haemorrhage is explored.- - - - - - - - - - ranking = 1keywords = haemorrhage (Clic here for more details about this article) |
7/12. Pyloric obstruction caused by aspirin: case report.A case of pyloric obstruction caused by ingestion of enteric-coated aspirin tablets is presented. The patient was predisposed by previous pyloric stenosis. A barium meal study was diagnostic. The patient later had a massive gastro-intestinal haemorrhage requiring surgical repair. The hazards of aspirin ingestion in such a patient are discussed.- - - - - - - - - - ranking = 1keywords = haemorrhage (Clic here for more details about this article) |
8/12. Haematemesis from distal extracranial carotid aneurysms. Case report and literature review.A 5-year-old white boy presented with life-threatening haematemesis from spontaneous rupture of an aneurysm of the high cervical internal carotid artery (ICA). The haemorrhage was controlled by emergency trap ligation of the distal ICA in the neck. The child made an excellent recovery and 7 years later has no neurologic deficit other than an Horner's syndrome. The diagnosis of an extracranial carotid artery aneurysm without a pulsatile lump may be very deceptive.- - - - - - - - - - ranking = 1keywords = haemorrhage (Clic here for more details about this article) |
9/12. Haematemesis in Menetrier's disease.Three patients with Menetrier's disease presented with massive haematemesis. One patient died. Menetrier's disease may be associated with gastrointestinal haemorrhage and although it is rare it should be borne in mind as a cause of upper gastrointestinal bleeding. In one patient an elevated serum gastrin was found and the possible significance of this is briefly discussed.- - - - - - - - - - ranking = 1keywords = haemorrhage (Clic here for more details about this article) |
10/12. Fatal haematemesis from an aorto-oesophageal fistula of obscure aetiology: a case report.endoscopy, aortography and laparotomy failed to demonstrate a high aorto-oesophageal fistula of obscure aetiology in a woman presenting with haematemesis. Recognition of Chiari's triad: mid-thoracic pain, sentinel arterial haemorrhage, and final exsanguination after a symptom-free interval, and therapeutic embolization as a mode of therapy, are discussed.- - - - - - - - - - ranking = 1keywords = haemorrhage (Clic here for more details about this article) |
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