1/29. Metastases from a regressed malignant melanoma as a cause of haemoperitoneum.We report a case of metastasis from a regressed cutaneous melanoma presenting as an acute abdomen. The patient presented with peritonitis, which at operation was found to be due to intraperitoneal haemorrhage from a bleeding metastatic melanoma lesion in the ileum. Surgical resection was performed and the patient remained well 2 years later.- - - - - - - - - - ranking = 1keywords = haemorrhage (Clic here for more details about this article) |
2/29. Fatal retroperitoneal haemorrhage: an unusual complication of percutaneous endoscopic gastrostomy.A 93-year-old lady with dementia, neurological dysphagia and aspiration pneumonia, died from massive retroperitoneal haemorrhage which developed as a rare and, it is believed, hitherto unreported, complication of percutaneous endoscopic gastrostomy (PEG), which was performed for feeding purposes. It is postulated that the initial, unsuccessful attempt at needle puncture of the stomach, under endoscopic guidance, had resulted in iatrogenic perforation and laceration of the splenic and superior mesenteric veins close to their confluence with the portal vein. It would also appear that dense fibrous adhesions between the pyloro-antral region of the stomach and the posterior hepatic surface had altered the immediate anatomical relations of the stomach in such a manner as to have predisposed to these events.- - - - - - - - - - ranking = 5keywords = haemorrhage (Clic here for more details about this article) |
3/29. Periaortic lymph node involvement by metastatic angiosarcoma and benign sinus mesothelial cells.Hyperplastic mesothelial cells involving lymph node sinuses have only been recently described. Most nodal mesothelial cells are thought to originate from mesothelial surfaces disrupted by serosal effusions. Dislodged mesothelial cells likely gain access to submesothelial lymphatics via mesothelial stomata and disseminate to draining lymph nodes. Unusual lymph node architectural patterns result when benign sinus mesothelial cells occur concurrently with a neoplastic nodal process. We describe a young man who developed diffuse metastases from a primary cardiac angiosarcoma. His periaortic lymph nodes contained metastatic angiosarcoma and hyperplastic mesothelial cells with a sinus distribution. The patient had a clinical history of progressive haemoperitoneum, exacerbated by thrombocytopaenia and disseminated intravascular coagulation. Massive haemoperitoneum of 5000 ml was confirmed at autopsy. This is the first report to suggest that multiple episodes of intraperitoneal haemorrhage and ascites may both act in the same manner to cause dislodgment and dissemination of mesothelial cells to draining lymph node sinuses.- - - - - - - - - - ranking = 1keywords = haemorrhage (Clic here for more details about this article) |
4/29. Spontaneous haemoperitoneum from surreptitious ingestion of a rodenticide.Superwarfarins have progressively replaced warfarin as rodenticides as they are more potent and have a longer anticoagulant activity. Human exposure may be complicated by spontaneous haemorrhage in various sites. We report the case of a 51-year-old woman who was admitted with spontaneous haemoperitoneum and intramural haematoma along the small intestine. After the evidence of a deficit of vitamin K1-dependent clotting factors (II, VII, IX, X), the patient admitted that she was chronically ingesting difenacoum. She was successfully treated with fresh frozen plasma and vitamin K1. Follow-up was not accepted.- - - - - - - - - - ranking = 1keywords = haemorrhage (Clic here for more details about this article) |
5/29. Fatal blunt pancreatic trauma secondary to assault and battery: a case report.The authors report on an fatal case of closed trauma of the pancreas in a context of violence. A 55-year-old man was found unconscious on the sidewalk and died a short time after being taken to the hospital. He had been hit with several punches to the face and abdomen 6 h before. The post-mortem examination showed numerous bruises over the whole body, a haemoperitoneum, a fissuration of the spleen and a massive peripancreatic haemorrhage associated with a complete dilaceration of the pancreas head. Histological examination of the pancreas revealed a massive necrosis associated with a subtotal disappearance of the acini, numerous sites of cytosteatonecrosis and a large haemorrhagic suffusion of the peripancreatic tissue. This case illustrates the possibilities of pancreatic injuries induced by blunt force aimed at the abdomen in a context of violence. Even if this occurs as an isolated injury it can result in rapid death because of the particular type of pancreatic fracture which is frequently involved. In postmortem situations, the pancreas should be systematically checked at necropsy and a histological examination should be carried out at the slightest doubt of a pancreatic lesion or suspicion of blunt force abdominal injuries.- - - - - - - - - - ranking = 1keywords = haemorrhage (Clic here for more details about this article) |
6/29. Intraperitoneal haemorrhage secondary to perforation of uterine fibroid after cystic degeneration. Unusual CT findings resembling malignant pelvic tumor: case report.Intraperitoneal haemorrhage is a rare complication of myomatous uterus. We present a case of a 37-year-old white nullipara who presented in the emergency room with acute, lower-abdominal pain which reportedly started after riding over a bump on a motorcycle. On examination, the abdomen was diffusely tender, with moderate spasm and rebound tenderness in both iliac fossae. pregnancy test was negative. Computed tomography revealed a soft-tissue mass with cystic components and inhomogeneous appearance. Free fluid in the peritoneal cavity suggested ascites. The patient underwent an exploratory laparotomy. A ruptured, actively bleeding, subserosal, nonpedunculated, cystic degenerated uterine fibroid was found, as well as approximately two liters of free, bloodstained peritoneal fluid and clots. Subtotal hysterectomy without salpingo-oophorectomy was performed, followed by evacuation of the fluid and clots. The patient's postoperative course was uneventful. In conclusion, definitive, preoperative diagnosis of a perforated, haemorrhaging, uterine fibroid is difficult; exploratory laparotomy is both diagnostic and therapeutic in this rare, life-threatening condition.- - - - - - - - - - ranking = 5keywords = haemorrhage (Clic here for more details about this article) |
7/29. Haemoperitoneum secondary to ureteric stenting.We report an unusual but catastrophic complication of 'haemo peritoneum' noted following an uneventual insertion of ureteric stent. Its management was primarily affected by the presence of a significant coexisting pathology. This case highlights two important points: (1) recognizing the most rare but real possibility of major intra peritoneal haemorrhage following simple stenting of the ureter (2) the importance of checking that the guide wire has been correctly preloaded in the spool before its placement up the ureter as inserting the wrong (nonfloppy) end may have serious implications.- - - - - - - - - - ranking = 1keywords = haemorrhage (Clic here for more details about this article) |
8/29. Splenic haemorrhage in a newborn as the first manifestation of wandering spleen syndrome.wandering spleen is an unusual condition in children and is even more rarely diagnosed in the neonatal period. A case of splenic haemorrhage after dystocic birth in a newborn is reported. Before surgery, results of imaging studies were suggestive of a ruptured spleen. On laparotomy, a big haematoma surrounding a wandering spleen was found. Haemorrhage aroused from short splenic arteria. Haemostasia and splenopexy were performed. The spleen proved later to be viable. The authors speculate that the haemorrhage was the first manifestation of the wandering spleen.- - - - - - - - - - ranking = 6keywords = haemorrhage (Clic here for more details about this article) |
9/29. Spontaneous rupture of hepatocellular carcinoma: a case report and review of literature.Hepatocellular carcinoma (HCC) has a tendency for fatal spontaneous rupture leading to massive haemorrhage. A 64-year-old man presented with sudden, severe epigastric pain for 6 h. Systolic blood pressure was 80/50 mmHg, and pulse rate was 100/min. The patient's history did not reveal any operation or disease up to date. Contrast enhancement-axial computed tomography (CT) scan showed a tumoral lesion with a necrotic centre measuring 6 x 5 cm within 6th segment of the liver and a fluid collection (haemoperitoneum) at the periphery of the liver. At exploratory laparotomy, the liver was found to be cirrhotic, and an actively bleeding tumour confirmed in 6th segment of the liver. The tumour was resected. Post-operative recovery was unremarkable, and the patient was discharged on the 14th post-operative day. Ruptured HCC should be included in the differential diagnosis of non-traumatic intra-abdominal haemorrhage.- - - - - - - - - - ranking = 2keywords = haemorrhage (Clic here for more details about this article) |
10/29. Nightmare of lumbar disc surgery: iliac artery injury.Intra-operative injuries of pelvic vessels are quite infrequent but serious complications of lumbar disc surgery. Injury may cause laceration of the vessel with acute life threatening retroperitoneal haemorrhage, formation of pseudoaneurysms or arteriovenous fistulae in the late phase. It is important for surgeons to be aware of these potentially fatal complications. Authors reported a case of major vascular injury recognised intra-operatively during posterior lumbar discectomy and repaired immediately.- - - - - - - - - - ranking = 1keywords = haemorrhage (Clic here for more details about this article) |
| | Next -> |