1/8. Gas embolism during hysteroscopy.PURPOSE: Gas embolism during hysteroscopy is rare but sometimes fatal. A fatal case of gas embolism during diagnostic hysteroscopy using carbon dioxide (CO2) is presented. CLINICAL FEATURES: A 68 yr old woman was admitted for treatment of myoma and cancer of the uterus. hysteroscopy using CO2 was performed without monitoring or anesthesia on the ward. At the end of the examination, just after the hysteroscope was removed, she developed tonic convulsions, lost consciousness, and her pulse was impalpable. Cardiac massage was started, anesthesiologists were called and the trachea was intubated. She was transferred to the intensive care unit with continuous cardiac massage. Cardiac resuscitation was successful. A central venous line was inserted into the right ventricle under echocardiography in an attempt to aspirate gas with the patient in the Trendelenberg position, but the aspiration failed. Positive end expiratory pressure and heparin for emboli, midazolam for brain protection, and catecholamines were administered. Fifteen hours after resuscitation, the pupils were enlarged and she died 25 hr after resuscitation. CONCLUSION: Gas embolism is a rare complication of hysteroscopy. The procedure should be performed with monitoring of blood pressure, heart rate, oxygen saturation and end-tidal CO2 concentration.- - - - - - - - - - ranking = 1keywords = embolism (Clic here for more details about this article) |
2/8. Effectiveness of an inferior vena caval filter as a preventive measure against pulmonary thromboembolism after abdominal surgery.In three patients with a previous history of pulmonary thromboembolism, inferior vena caval filters were inserted before elective laparotomies to prevent a recurrent pulmonary thromboembolism. Two patients had colon cancer and underwent colectomies, while the other had myoma uteri, which might have been the cause of deep vein thrombosis, and thus a hysterectomy was performed. In spite of their poor risks, their postoperative courses were fairly good owing to perioperative management including anticoagulant therapy, and no recurrence has been observed since the operation in every case. A pulmonary thromboembolism is a fatal complication which follows deep vein thromboses. In patients with such a previous history, the risk is much higher after a laparotomy because of long-term bed rest, hypercoagulability, and so on. The mortality rate after a recurrence of pulmonary thromboembolism is reported to reach 30% without adequate therapy, whereas it is reduced to 8% with anticoagulant therapy, and to 0.8% with additional inferior vena caval filter placement. Considering the feasibility of insertion and the low incidence of complications, preoperative inferior vena caval filter placement is thus recommended for patients having a previous history of either pulmonary thromboembolism or deep vein thrombosis.- - - - - - - - - - ranking = 2127.6264782143keywords = pulmonary thromboembolism, thromboembolism, embolism (Clic here for more details about this article) |
3/8. Deep venous thrombosis and pulmonary thromboembolism associated with a huge uterine myoma--a case report.A 51-year-old woman with a large uterine myoma suffered from acute pulmonary thromboembolism. Venography revealed thrombosis in the right common iliac vein and almost complete obstruction of the left common iliac vein. The ascending lumbar vein showed collateral drainage. Treatment was initiated with continuous intravenous heparin sodium, and a Greenfield filter was inserted to prevent the extension of the pulmonary embolism during and after hysterectomy. After a total hysterectomy, venography revealed restoration of patency in the bilateral common iliac veins, and no flow was seen in the ascending lumbar vein. Thorough clinical examinations failed to identify any other prothrombotic conditions. These results suggest that a large uterine myoma compressed veins in the pelvis, and the resulting impaired blood flow caused deep venous thrombosis and pulmonary thromboembolism.- - - - - - - - - - ranking = 1420.6258576226keywords = pulmonary thromboembolism, thromboembolism, pulmonary embolism, embolism (Clic here for more details about this article) |
4/8. hemoperitoneum secondary to exophytic leiomyoma: report of a case.We report herein the case of a 63-year-old male with hemoperitoneum secondary to exogastric leiomyoma. The patient had been receiving anticoagulation therapy for a cerebral embolism and complained of sudden, severe abdominal pain. A sonogram and computed tomography scan showed an exogastric mass and massive ascites. A peritoneal puncture proved the presence of an intraperitoneal hemorrhage. An emergency laparotomy revealed a pedunculated bleeding tumor, thus confirming the preoperative diagnosis of a ruptured exogastric tumor. A microscopic analysis of the excised tumor demonstrated gastric leiomyoma. Other authors have reported hemoperitoneum secondary to gastric myogenic tumors, but no cases of leiomyomas could be found in the literature.- - - - - - - - - - ranking = 0.14285714285714keywords = embolism (Clic here for more details about this article) |
5/8. Venous thromboembolic diseases associated with uterine myomas diagnosed before hysterectomy: a report of two cases.Large uterine myomas (compressed veins in the pelvis), and the resulting impaired blood flow have been associated with deep vein thrombosis and pulmonary embolism. Careful detection of the preoperatively formed thrombi and strict perioperative management, such as in the following cases we report, may reduce lethal pulmonary embolism and may positively affect patient prognosis.- - - - - - - - - - ranking = 4.4164109595193keywords = pulmonary embolism, embolism (Clic here for more details about this article) |
6/8. Echocardiographic study of an intravenous leiomyoma: case report and review of the literature.Intravenous leiomyoma is a rare tumor of smooth muscle with invasion to veined channels that affects women at reproductive age. The case of a 45-year-old woman is described, with history of oophorectomy and hysterectomy, in addition to abdominal surgery due to mesenteric tumor. Several months later, the patient developed syncope and dyspnea secondary to pulmonary embolism. Echocardiographic study reported a mass in right side of heart proceding from inferior vena cava. The patient underwent tumor surgical resection from left iliac vein and histologic study concluded intravascular leiomyomatosis.- - - - - - - - - - ranking = 2.2082054797597keywords = pulmonary embolism, embolism (Clic here for more details about this article) |
7/8. Massive pulmonary embolism in a woman with leiomyomatous uterus causing pelvic deep venous thrombosis.Deep venous thrombosis (DVT) is a serious illness sometimes causing death due to acute pulmonary thromboembolism (PTE). Blood stasis of the pelvic vein is a major etiologic factor for DVT. Occasionally a large myomatous uterus can cause compression of the pelvic venous system leading to DVT. We describe a very rare case of massive pulmonary embolism in a 39-year-old woman with multiple uterine myomas and no other recognized risk factors for PTE and DVT. The patient was successfully treated with thrombolytic and anticoagulation therapy associated with total hysterectomy.- - - - - - - - - - ranking = 247.44396942261keywords = pulmonary thromboembolism, thromboembolism, pulmonary embolism, embolism (Clic here for more details about this article) |
8/8. A case of fluid embolism from transcervical endometrial resection.Hysteroscopic transcervical endometrial resection (TCER) using a urological resectoscope offers an alternative to hysterectomy for some women with menorrhagia. The advantages of this technique are a shorter operating time and a rapid recovery and discharge. However, this procedure is not without risk of complications and one of them is related to dilutional hyponatraemia from absorption of the irrigation solution. This report describes a patient who experienced such a problem.- - - - - - - - - - ranking = 0.57142857142857keywords = embolism (Clic here for more details about this article) |