1/4. Intraventricular haemorrhage in a fetus with cerebral cytomegalovirus infection.cytomegalovirus (CMV) is the leading infectious cause of prenatal neurological damage, which is particularly severe when primary maternal infection occurs during the first 16 weeks of gestation, at the time of organ development and neuronal migration. Vascular involvement has been suggested to be among the possible pathogenic mechanisms of virus-induced pathology, in addition to direct viral effects. We report on a fetus with cerebral CMV infection, which had intraventricular haemorrhage, together with oligohydramnios and hyperechogenic bowel, following maternal primary CMV infection.- - - - - - - - - - ranking = 1keywords = haemorrhage (Clic here for more details about this article) |
2/4. Acute intestinal obstruction due to intramural haemorrhage in small intestine in a patient with severe haemophilia A and inhibitor.patients with severe haemophilia A usually present with joint, gastrointestinal and urinary tract haemorrhage. Bleeding elsewhere is often precipitated by pre-existing pathology or trauma. We report a patient with severe haemophilia A, who presented with symptoms of acute intestinal obstruction. He has a factor viii inhibitor and receives recombinant factor viia on demand at home. The CT scan of abdomen showed dilated small intestine with fluid filled loops and a long segment in the jejunum with marked transmural thickening. There was no other pathology in the small intestine. These appearances were consistent with intramural haemorrhage in the small intestine as the cause of acute obstruction. He was managed conservatively with recombinant factor viia and this resulted in resolution of his symptoms. This case highlights an unusual presentation of bleeding in a haemophilia patient. intestinal obstruction due to haemorrhage in the small intestinal wall is extremely rare and only previously reported in a few haemophilia patients. It also highlights the effectiveness of conservative management with recombinant factor viia as opposed to immediate exploratory surgery.- - - - - - - - - - ranking = 1.4keywords = haemorrhage (Clic here for more details about this article) |
3/4. Recurrent gastrointestinal bleeding of obscure origin: report of 17 cases and a guide to logical management.Seventeen patients with chronic obscure gastrointestinal bleeding presenting over a 5-year period are described. While representing only 6 per cent of the total number of admissions due to gastrointestinal haemorrhage they required a disproportionate amount of medical attention, including 67 admissions, 73 radiological and 56 endoscopic procedures and transfusion of a total of 198 units of blood. The diagnoses included 5 cases of recurrent acute upper gastrointestinal erosions, 7 small bowel abnormalities and 4 colonic lesions, with 1 patient undiagnosed. Eight arteriovenous malformations (AVM) were demonstrated angiographically and one Meckel's diverticulum identified by a 99Tcm pertechnetate scan. There were 5 cases in which laparotomy yielded the final diagnosis and in one of these peroperative endoscopy of the small bowel was required. On the basis of our experience and a review of other series, a logical plan of investigation is described for such difficult cases.- - - - - - - - - - ranking = 8.2032097206754keywords = gastrointestinal haemorrhage, haemorrhage (Clic here for more details about this article) |
4/4. Gastro-intestinal haemorrhage unrelated to gastric mucosa diagnosed on 99Tcm pertechnetate scans.Small-bowel bleeding due to an anastomotic ulcer in one patient and a haemangioma in another were diagnosed by 99Tcm pertechnetate scans. Multiple views of the abdomen during the scan proved essential. The rationale of this technique for imaging in cases of haemorrhage from the gastro-intestinal tract is described.- - - - - - - - - - ranking = 1keywords = haemorrhage (Clic here for more details about this article) |