1/5. Acute abdomen and lupus enteritis: thrombocytopenia and pneumatosis intestinalis as indicators for surgery.Bowel symptoms occur often in systemic lupus erythematosus (SLE), but enteric complications in patients on steroid therapy are rare. We report a case of a 14-year-old Mexican girl with SLE on high-dose steroid therapy complicated by abdominal vasculitis and small bowel perforation. Accompanying this serious complication were thrombocytopenia and radiographic changes of pneumatosis intestinalis. These findings suggested necrotizing enteritis and prompted urgent surgery. Four jejunal perforations, pneumatosis intestinalis, and submucosal vasculitis were present in the resected specimen. Persistent SLE activity responded to cyclophosphamide, which is indicated in patients with digestive symptoms who fail to respond to high-dose steroids.- - - - - - - - - - ranking = 1keywords = thrombocytopenia (Clic here for more details about this article) |
2/5. Acute abdomen as first symptom of acute leukemia.CASE REPORT: The authors presented a rare case of acute abdomen syndrome caused by the rupture of the corpus rubrum as the first symptom in a 35-years-old woman with the acute lymphatic leukemia. During the laparotomy is notice diffuse bleeding from under skin blood vessels and muscles. The blood was electrocoagulated and was sewn with catgut sutures. The right ruptured corpus rubrum was found from which fresh blood was leaking. The right ovary was carefully resected and sutured, and each ligature was bleeding. At the beginning of the surgery laboratory analysis results arrived which showed a high leukocytosis (28.0 x 10(9)/l) with sever thrombocytopenia (10 x 10(9)/l) and afibrinogenemia (0.1 g/l) with anemia (1.9 x 10(12)/l erythrocyte, haematocrit 0.24), which indicated leukemia with disseminated intravascular coagulopathy (antithrombin iii levels 0.9 g/l, D-dimers 1989 micro g/l). RESULT. A year later she died with the picture of severe disseminated intravascular coagulopathy, agranulocytosis and septic condition with multiorganic failure.- - - - - - - - - - ranking = 0.2keywords = thrombocytopenia (Clic here for more details about this article) |
3/5. wandering spleen as a cause of acute abdomen: a case report.We report a case of acute abdomen due to torsion of the long vascular pedicle of a wandering spleen, displaced in the abdominal cavity, and caused by partial infarction of the spleen. The 46-year-old patient presented to the casualty department with piercing abdominal pain, fever, vomiting, leukocytosis, thrombocytopenia, and a palpable mass in the mesogastric region. US and CT scan revealed the presence of a mass compatible with an ectopic spleen in the mesohypogastric region, featuring necrotic-haemorrhagic areas, a long, contorted vascular pedicle twisted on its axis, and an empty splenic space. We performed an emergency laparoscopic splenectomy. Conservative surgery (splenopexy) could not be done because of the severe impairment of the vascular supply to the organ. Nowadays, conservative surgery is preferred in cases without vascular impairment, especially in children, by creating an omental or synthetic pouch after fixing the organ in the splenic space.- - - - - - - - - - ranking = 0.2keywords = thrombocytopenia (Clic here for more details about this article) |
4/5. Emergency surgery and refractory immune thrombocytopenic purpura. A case report.A 35-year-old woman with post-splenectomy refractory immune thrombocytopenia presented with an acute abdominal emergency requiring laparotomy. Her platelet count was raised from 10 to 96 X 10(9)/l using a combination of high-dose methylprednisolone, plasma exchange against fresh-frozen plasma, infusion of gammaglobulin and a single mega-unit of platelets. The surgical procedure was uneventful, and with no further therapy the platelet count rose to a peak of 244 X 10(9)/l, but over the following 7 days fell back slowly to 10 X 10(9)/l, at which time the patient was discharged well.- - - - - - - - - - ranking = 0.2keywords = thrombocytopenia (Clic here for more details about this article) |
5/5. Acute surgical abdomen caused by thrombocytopenia in patients with acute leukemia and multiple myeloma.One patient with multiple myeloma and four patients with acute leukemia presented with severe abdominal pain. Pertinent findings included numerous petechiae in the skin and buccal cavity, and diffuse abdominal guarding and tenderness, suggesting peritoneal involvement. Severe thrombocytopenia was found in all patients. laparotomy was performed in the patient with multiple myeloma, and revealed numerous petechiae throughout the peritoneum. All five patients responded to platelet transfusions with disappearance of the abdominal signs and symptoms. Severe thrombocytopenia should be considered among the causes of acute surgical abdomen in patients with malignant hematological disorders, and platelet transfusions should be administered before any surgical intervention.- - - - - - - - - - ranking = 1.2keywords = thrombocytopenia (Clic here for more details about this article) |