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1/39. fertility following ligation of internal iliac arteries for life-threatening obstetric haemorrhage: case report.

    Bilateral ligation of internal iliac (hypogastric) arteries (BIL) is a life-saving operation in cases of massive obstetric haemorrhage. This operation preserves reproductive function as opposed to the more commonly performed emergency hysterectomy in such situations. We report on effectiveness and future fertility in 12 women who had internal iliac ligation to control severe obstetric haemorrhage: in 10 out of the 12 women, BIL was successful. Of the two women who subsequently needed emergency hysterectomy, one woman died of disseminated intravascular coagulation. Of the eight women we were able to follow-up to assess reproductive performance, two did not desire future fertility. Three had subsequent pregnancies (50%), of whom two proceeded to term. We conclude that BIL is a safe and effective procedure for treating life-threatening obstetric haemorrhage with preservation of future fertility. This technique should be performed more often when indicated.
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keywords = haemorrhage
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2/39. Respiratory failure after liver transplantation.

    A rapidly growing haemangioendothelial sarcoma of the liver in a twenty-two year old woman was treated by liver transplantation. disseminated intravascular coagulation resulted in massive blood loss during surgery, and contributed to the death of the patient from respiratory failure on the fourth post-operative day, despite continuous post-operative intermittent positive-pressure ventilation. Other factors leading to her respiratory failure are discussed. There was no evidence of dysfunction in the transplanted liver.
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ranking = 0.26351424318679
keywords = blood loss
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3/39. A novel use of ultrasound in pulseless electrical activity: the diagnosis of an acute abdominal aortic aneurysm rupture.

    We report a case of a patient who presented to the Emergency Department with pulseless electrical activity. A rapid diagnosis of ruptured abdominal aortic aneurysm was made by emergency medicine bedside ultrasonography. On arrival, the patient was without palpable pulses and bradycardic. Therapy with epinephrine, fluids, and atropine was initiated. A bedside ultrasound was immediately performed and revealed coordinated cardiac motion with empty ventricles. A rapid search for signs of blood loss in the abdomen revealed a large abdominal aortic aneurysm. Pulses were restored with fluid, blood, and epinephrine and surgical intervention was begun within 30 min of patient arrival.
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ranking = 0.26351424318679
keywords = blood loss
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4/39. Haemorrhage into chronic plaque psoriasis as a consequence of disseminated intravascular coagulation.

    We describe a patient with chronic plaque psoriasis who developed haemorrhage into pre-existing lesions during an episode of disseminated intravascular coagulation secondary to sepsis. disseminated intravascular coagulation is a complex disorder characterized by widespread intravascular deposition of fibrin with consumption of coagulation factors and platelets and occurs as a consequence of many disorders that release procoagulant material into the circulation or cause widespread endothelial damage or platelet aggregation. As both disseminated intravascular coagulation and psoriasis occur relatively frequently in the general population we were surprised to find no previous reports of this phenomenon in the literature.
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ranking = 0.14285714285714
keywords = haemorrhage
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5/39. Postoperative extracorporeal membrane oxygenation for severe intraoperative SIRS 10 h after multiple trauma.

    A 34-yr-old male suffered multiple trauma in a road traffic accident. He required right thoracotomy and laparotomy to control exanguinating haemorrhage, and received 93 u blood and blood products. Intraoperatively, he developed severe systemic inflammatory response syndrome (SIRS) with coagulopathy and respiratory failure. At the end of the procedure, the mean arterial pressure (MAP) was 40 mm Hg, arterial blood gas analysis showed a pH of 6.9, Pa(CO(2)) 12 kPa, and Pa(O(2)) 4.5 kPa, and his core temperature was 29 degrees C. There was established disseminated intravascular coagulation. The decision was made to stabilize the patient on veno-venous extracorporeal membrane oxygenation (ECMO) only 10 h after the accident, in spite of the high risk of haemorrhage. The patient was stabilized within 60 min and transferred to the intensive care unit. He was weaned off ECMO after 51 h. He had no haemorrhagic complications, spent 3 weeks in the intensive care unit, and has made a good recovery.
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ranking = 0.28571428571429
keywords = haemorrhage
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6/39. Intravascular lymphomatosis.

    Intravascular lymphomatosis (IVL) is a rare angiotrophic large cell lymphoma producing vascular occlusion of arterioles, capillaries, and venules. Antigenic phenotyping shows that these lymphomas are mostly of B cell type, and less commonly T cell or Ki-1 lymphomas. The central nervous system and skin are the two most commonly affected organs; patients usually present with progressive encephalopathy with mental status changes and focal neurological deficits and skin petechia, purpura, plaques, and discolouration. Other involved organs include adrenal glands, lungs, heart, spleen, liver, pancreas, genital tract, and kidneys. bone marrow, blood, cerebrospinal fluid, and lymph nodes are typically spared. fever of unknown origin is another common presentation. Only one case of IVL presenting with disseminated intravascular coagulation and anasarca (generalised oedema) has been reported in the literature. This report describes a postmortem case of a patient with IVL who initially presented with disseminated intravascular coagulation complicated by intracerebral haemorrhage.
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ranking = 0.14285714285714
keywords = haemorrhage
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7/39. Postabortal haemorrhage and disseminated intravascular coagulation due to placenta accreta.

    We describe the case of a second trimester placenta accreta presenting as postabortal haemorrhage complicated by disseminated intravascular coagulation, requiring hysterectomy.
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ranking = 0.71428571428571
keywords = haemorrhage
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8/39. Pulmonary haemorrhage causing rapid death after bothrops jararacussu snakebite: a case report.

    A 36-year old woman was bitten on the left ankle by a bothrops jararacussu, and died 45 min after the bite. At necropsy, there were local signs of envenoming with haemorrhage, thrombosis and necrosis of the subcutaneous and muscular tissue. Multiple fibrin and platelet thrombi were found in the microcirculation of the heart and lungs, suggesting the occurrence of disseminated intravascular coagulation. Pulmonary haemorrhage probably secondary to the action of haemorrhagins, consumption coagulopathy and disseminated intravascular coagulation was the immediate cause of death. Intravenous inoculation of the venom could have occurred in the present case, which would explain the rapid onset of coagulation disorders, haemorrhage and death.
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keywords = haemorrhage
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9/39. Preoperative angioembolisation for life-threatening haemorrhage from Wilms' tumour: a case report.

    Wilms' tumour is one of the most common abdominal tumours of childhood. Severe perirenal bleeding resulting in consumptive coagulopathy and colonic obstruction are rare complications of Wilms' tumour. We present a case report of one patient with these two complications, their successful management with preoperative angioembolisation and emergency nephrectomy, and a review of the relevant literature.
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ranking = 0.57142857142857
keywords = haemorrhage
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10/39. Orbital haemorrhage with loss of vision in a patient with disseminated intravascular coagulation and prostatic carcinoma.

    A 65-year-old man with sudden profound loss of vision in his right eye due to sub-periosteal orbital haemorrhage was found to have disseminated intravascular coagulation (DIC) secondary to metastatic prostatic carcinoma. CT-scan did not reveal any orbital metastases. A lateral canthotomy did not help to restore the vision. Orbital haemorrhage is known to occur with DIC due to different causes. To the best of our knowledge this is the first report of orbital haemorrhage with DIC related to prostatic carcinoma. This case emphasises the importance of considering systemic factors in cases of non-traumatic haemorrhage, along with imaging studies to rule out any co-existing vascular anomaly.
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ranking = 1.1428571428571
keywords = haemorrhage
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