1/99. survival without surgical repair of acute rupture of the right ventricular free wall.rupture of the myocardial free wall is an infrequent complication of acute myocardial infarction. Unless it occurs in a space confined by pericardial adhesions, only surgical emergency repair of ruptured myocardium can prevent death. In this paper we report the case of an 81-year-old woman who was admitted to the emergency room with cardiac tamponade, resulting from inferolateral acute myocardial infarction and a subsequent rupture of the right ventricular free wall, with the formation of pericardial thrombus and effusion. The patient refused to undergo any surgical or invasive intervention, and therefore she was only treated conservatively. Nevertheless, her condition improved dramatically, as her blood pressure increased and echocardiography abnormalities almost disappeared. Follow-up echocardiography 7 months post discharge was unremarkable. We believe that this rare case emphasizes that in special circumstances, such as creation of a thrombus that prevents more blood from extravasating, free-wall rupture without surgical repair is compatible with long-term survival.- - - - - - - - - - ranking = 1keywords = effusion (Clic here for more details about this article) |
2/99. Spontaneous intrahepatic hemorrhage and hepatic rupture in the hellp syndrome: four cases and a review.Subcapsular hemorrhage and hepatic rupture are unusual catastrophic complications of the HELLP (hemolysis, elevated liver enzymes, and low platelets) syndrome. A high index of suspicion and prompt recognition are keys to proper diagnosis and management of affected patients. The optimal management of these patients is evolving. An aggressive multidisciplinary approach has considerably improved the morbidity and mortality associated with these complications. We present our experience with four cases of hepatic hemorrhage occurring in association with the hellp syndrome and review the literature on this subject. All of our patients were multiparous, and three had a history of eclampsia/preeclampsia in a previous pregnancy. All four patients developed intrahepatic hemorrhage; two developed hepatic rupture requiring surgical intervention. Three patients developed disseminated intravascular coagulation and acute renal failure. Two patients developed pericardial effusion, pleural effusions, and ascites. One patient died of septic complications after multiple surgical interventions.- - - - - - - - - - ranking = 2keywords = effusion (Clic here for more details about this article) |
3/99. Sudden death in an infant caused by rupture of a basilar artery aneurysm.Ruptured aneurysms of the cerebrovasculature in infancy and early childhood, except for "giant" aneurysms and arteriovenous malformations, are rare. seizures, loss of consciousness, and apnea are the usual presenting signs in infancy; symptoms such as headache or visual disturbances and signs such as cranial nerve compression or meningeal irritation commonly found in older children or adults are absent in infants. However, the morphologic findings (i.e., subarachnoid and retinal hemorrhage, and occasionally subdural hemorrhage) may be mistaken for inflicted trauma, especially if the aneurysm is not identified. Sudden death caused by rupture of a cerebral aneurysm has not been previously described in an infant. This report outlines the investigation and autopsy findings in a 7-month-old infant who died unexpectedly as a result of rupture of a complex basilar artery aneurysm.- - - - - - - - - - ranking = 16.104264218664keywords = subdural (Clic here for more details about this article) |
4/99. Ruptured giant intrathoracic lipoblastoma in a 4-month-old infant: CT and MR findings.BACKGROUND: We describe a 4-month-old infant with a ruptured intrathoracic lipoblastoma arising from the parietal pleura and associated with a pleural effusion. OBJECTIVE: The clinical presentation was rapidly evolving respiratory distress. The chest radiograph showed a large mass and a pleural effusion in the right thoracic cavity. CT demonstrated an inhomogeneous low-attenuation mass which was 7 cm in diameter and which showed areas of enhancement after intravenous contrast medium. MRI showed a fatty intrathoracic mass with intratumoral streaks and whorls, which were attributed to loose fibrovascular connective tissue on pathological examination. RESULTS: thoracotomy and pathological examination revealed a ruptured intrathoracic lipoblastoma arising from the parietal pleura. CONCLUSION: The pleural effusion might have suggested rupture of the tumour.- - - - - - - - - - ranking = 3keywords = effusion (Clic here for more details about this article) |
5/99. Ruptured intracranial dermoid cyst.Intradural dermoids are rare congenital tumors representing approximately 0.05% of all intracranial lesions. These benign tumors have a typical appearance on CT and MR due to their lipid components. The complication caused by rupture are the spillage of the fatty material into the cerebrospinal fluid. We report a case of a ruptured dermoid cyst showing fat/fluid levels in both side ventricles and fatty material in the subarachnoid space on CT and MR-imaging and the follow-up over four years after incomplete resection of the tumor.- - - - - - - - - - ranking = 0.17114829163084keywords = cerebrospinal (Clic here for more details about this article) |
6/99. Arachnoid cyst rupture with concurrent subdural hygroma.arachnoid cysts (ACs) are relatively common intracranial mass lesions, which occur most often in the middle cranial fossa. While these lesions can present as a mass lesion, many are asymptomatic. Rarely, posttraumatic or spontaneous rupture of ACs can result in intracystic hemorrhage, subdural hematoma or subdural hygroma. We have encountered two cases of ruptured arachnoid cysts that resulted in subdural hygromas. Both patients harbored middle cranial fossa cysts and suffered mild closed head injuries. The presentation, radiographic findings and surgical management of these patients as well as the association between ACs and subdural hygromas are described.- - - - - - - - - - ranking = 130.88858623073keywords = subdural, hygroma (Clic here for more details about this article) |
7/99. Spontaneous esophageal rupture treated by conservative therapy.The prognosis of spontaneous esophageal rupture of the esophagus worsens over time from disease onset to treatment and, in severe cases, may require surgery to save the patient's life. patients appearing at the hospital considerably after esophageal perforation have no appropriate surgical alternatives and face poor prospects. We conservatively treated a severe case following 2-day lapse of after disease onset, managing a favorable outcome. A 58-year-old man who developed upper abdominal and back pain after vomiting from drinking was transferred to our institute in an emergency due to pain intensifying 2 days after the symptom onset. Chest X-ray revealed a large quantity of bilateral pleural effusion similar to gastrointestinal content, which we withdrew through intrathoracic drainage. Esophagography showed perforation of the esophagus. The patient's poor general condition, including septic shock and adult respiratory distress syndrome, contraindicated radical surgery, so we instituted conservative therapy such as continuous thoracic drainage hyperalimentation. Oral intake was started in month 4 after admission. The patient was discharged in good general condition 7 months after onset.- - - - - - - - - - ranking = 1keywords = effusion (Clic here for more details about this article) |
8/99. Pure acute subdural haematoma without subarachnoid haemorrhage caused by rupture of internal carotid artery aneurysm.A 52-year-old female presented with disturbance of consciousness and clinical signs of tentorial herniation. Computed tomography showed a pure acute subdural haematoma (SDH) over the left convexity without subarachnoid haemorrhage. cerebral angiography showed a saccular aneurysm at the junction of the left internal carotid artery and the posterior communicating artery. Surgery to remove the haematoma and clip the aneurysm showed the rupture point was located in the anterior petroclinoid fold (subdural space). The patient recovered without neurological deficits. Pure SDH caused by ruptured aneurysm is rare. rupture of an aneurysm adhered to either the dura or falx and located in the subdural space may cause pure SDH. Therefore, ruptured intracranial aneurysm should be considered as a cause of non-traumatic SDH. Immediate removal of the SDH and aneurysmal clipping is recommended in such patients, even those in poor neurological condition.- - - - - - - - - - ranking = 112.72984953064keywords = subdural (Clic here for more details about this article) |
9/99. Tetraventricular hydrocephalus due to ruptured intracranial dermoid cyst.We present the MR imaging findings in a patient who developed tetraventricular hydrocephalus after massive rupture of dermoid cysts with generalized subarachnoid and ventricular spread of cyst contents. The development of tetraventricular hydrocephalus due to ruptured dermoid is a very unusual complication, and was attributed to cyst contents interfering with passage of cerebrospinal fluid through the arachnoid granulations and fourth ventricular outlet foramina.- - - - - - - - - - ranking = 0.17114829163084keywords = cerebrospinal (Clic here for more details about this article) |
10/99. Two-stage operation for treatment of a large dissecting popliteal cyst after failed total knee arthroplasty.A symptomatic popliteal cyst after total knee arthroplasty (TKA) is rare, occurring most frequently as a result of intra-articular knee pathology. We present a case of a large dissecting popliteal cyst 7 years after TKA with symptoms of severe calf pain and functional disability. The symptomatic cyst was excised completely in a first-stage operation, and the severely worn TKA was corrected by a second-stage surgical procedure. The patient in this report was pain free and had satisfactory range of knee motion 5 years after the index revision TKA, without recurrence of effusion or popliteal cyst formation.- - - - - - - - - - ranking = 1keywords = effusion (Clic here for more details about this article) |
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