1/8. Recurrent haemoperitoneum in a mild von Willebrand's disease combined with a storage pool deficit.Haemoperitoneum secondary to haemorrhagic corpus luteum has been described in severe bleeding disorders such as afibrinogenaemia, type 3 von Willebrand's disease and patients under oral anticoagulation. We have studied one patient who presented three episodes of severe bleeding at ovulation, requiring surgery twice, with the diagnosis of mild von Willebrand's disease and mild storage pool deficiency. Mild von Willebrand's disease (associated with other thrombopathies or coagulopathies) should be considered in this pathology, although physicians would prefer to find a severe haemorrhagic disorder as the underlying condition in these cases.- - - - - - - - - - ranking = 1keywords = coagulation (Clic here for more details about this article) |
2/8. Ruptured giant liver cyst: a rare cause of acute abdomen in a haemodialysis patient with autosomal dominant polycystic kidney disease.Autosomal dominant polycystic kidney disease (ADPKD) is a common hereditary disorder. Although liver involvement is the most frequent extra-renal manifestation, serious complications due to liver cysts are very rare. We report the occurrence of an acute abdomen caused by massive haemoperitoneum resulting from rupture of a giant liver cyst in ADPKD. Data suggest that chronic anticoagulation therapy should be avoided where possible in the presence of a giant liver cyst.- - - - - - - - - - ranking = 1keywords = coagulation (Clic here for more details about this article) |
3/8. Spontaneous hematoma of the rectus abdominis muscle: a rare cause of acute abdominal pain in the elderly.A rectus abdominis sheath hematoma (RSH) is uncommon. It may mimic other acute abdominal disorders. The underlying conditions are trauma, coagulation disorders, or anticoagulant therapy, complications related to operations, subcutaneous injections to the abdominal wall, although it can also develop spontaneously. Acute abdominal pain and a palpable mass after muscular strain such as coughing, sneezing, and twisting were features highly suggestive of RSH. The diagnostic means of choice is computerized tomography. The treatment is usually conservative, but surgery may be needed in cases with large or progressing hematomas or with severe symptoms. We herein report an elderly woman presenting with an acute painful abdominal mass, without any underlying conditions, which was diagnosed as spontaneous RSH. She needed an operation. We concluded that RSH should be considered in the differential diagnosis of acute abdominal pain in the elderly, even in the absence of underlying conditions.- - - - - - - - - - ranking = 48.958497073087keywords = coagulation disorder, coagulation (Clic here for more details about this article) |
4/8. Omental infarction: an unusual cause of acute abdomen in children.Acute abdomen is caused by a wide variety of etiologies, many of which require surgical intervention. Two boys were hospitalized for acute abdominal pain and low-grade fever. physical examination revealed epigastric and right upper abdominal fullness, and laboratory studies showed elevated erythrocyte sedimentation rates, with normal leukocyte counts and coagulation profiles. Abdominal ultrasound and computerized tomography revealed pseudotumor in both cases. Symptomatic treatment and cefazolin were administered, and pain and fever subsided after 6 to 10 days. Pseudotumor due to omental infarction can present as acute abdomen in children. A high index of suspicion and the use of both ultrasonography and computerized tomography will help avoid unnecessary surgical intervention in such cases.- - - - - - - - - - ranking = 1keywords = coagulation (Clic here for more details about this article) |
5/8. Management of the acute abdomen complicating oral anticoagulation therapy.Acute abdominal pain in the patient receiving oral anticoagulants poses a difficult diagnostic and therapeutic challenge. We describe two cases of peritonitis requiring laparotomy in anticoagulated patients, and review 49 similar case reports from the world literature. These patients were usually explored for signs of bowel obstruction. At operation, the intestine often appeared infarcted, but pathologic examination commonly revealed intramural hematomata. In contrast, we present microscopic evidence of hemorrhagic cecal infarction complicating oral anticoagulation therapy in one patient. Intramural intestinal hemorrhage is the most common cause of acute abdominal pain in the anticoagulated patient who undergoes laparotomy. In addition to intramural hemorrhage, 14 per cent of patients had coexistent volvulus, appendicitis, intestinal wall disruption or intestinal infarction. We conclude that anticoagulated patients with suspected intramural intestinal hemorrhage may have severe intraabdominal pathology requiring operation. Therefore, operation is mandatory for patients who fail to improve after a short course of expectant management.- - - - - - - - - - ranking = 5keywords = coagulation (Clic here for more details about this article) |
6/8. Lupus anticoagulant masquerading as an acute abdomen with multiorgan involvement.A 45-yr-old male patient developed acute abdominal pain, ileus, and microscopic hematuria with biochemical evidence of pancreatitis and a marked increase in liver alkaline phosphatase; CT demonstrated swelling of the pancreas, bilateral adrenal hemorrhage, and a suggestion of renal hemorrhage. ERCP was negative and renal arterial and venous blood flow normal. A coagulation profile demonstrated the presence of lupus anticoagulant, but tests for anticardiolipin antibodies and collagen vascular diseases were negative. Treatment with corticosteroids and anticoagulation resulted in improvement in clinical and all biochemical indices. Thus, lupus anticoagulant syndrome may masquerade as an acute abdominal illness with multiorgan involvement.- - - - - - - - - - ranking = 2keywords = coagulation (Clic here for more details about this article) |
7/8. Mesenteric venous thrombosis due to coagulation deficiencies - a case report.Mesenteric venous thrombosis is a rather rare condition posing diagnostic problems and very often with an obscure etiology. Recently, various coagulation deficiencies were found as the main etiologic factor. A case of a 75-year-old man with acute abdomen is presented. Exploratory laparotomy revealed a 250 cm necrosis of the small intestine. Patient was successfully treated by resecting the entire involved segment of the bowel. After a complete coagulation profile examination, deficiencies of protein c and anti-thrombin III were found and were considered as the main cause of the disease. In cases with known coagulation deficiencies the presence of an acute abdomen should raise suspicion of mesenteric venous thrombosis.- - - - - - - - - - ranking = 7keywords = coagulation (Clic here for more details about this article) |
8/8. Agnogenic venous mesenteric thrombosis.One of the most difficult diagnoses to establish is that of agnogenic venous mesenteric thrombosis (AVMT). This disorder occurs chiefly in elderly patients and, unless diagnosed promptly, leads to death in most instances. AVMT may follow surgical operations or occur during a prolonged illness. In the past five years at St. Clare's Hospital and health Center in new york city, this diagnosis was established in five patients. In reviewing these cases, it was noted that some of the signs and symptoms such as those due to hypotension and shock with marked leukocytosis, were out of proportion to those usually observed when the preoperative diagnosis is being considered. The pathologic and radiologic characteristics of this disorder are outlined, and the recommended operative procedure for treatment is discussed. The importance is stressed of prompt, vigorous and prolonged anticoagulation therapy in order to minimize the chance of recurrence in the early postoperative period. Anticoagulant therapy is also effective preoperatively, if the disease is diagnosed sufficiently early. As greater numbers of elderly patients are being treated in hospitals, this dire complication should be uppermost in the minds of physicians and surgeons if a fatal outcome is to be avoided following a successful operative procedure.- - - - - - - - - - ranking = 1keywords = coagulation (Clic here for more details about this article) |