1/68. Postpartum haemolytic-uraemic syndrome.In a young woman a twin pregnancy and uneventful labour were complicated by the development of the postpartum haemolytic-uraemic syndrome. A number of unusual features of this syndrome were present, including early onset, accompanying hepatocellular necrosis, hepatic encephalopathy and bleeding diathesis. Early institution of heparin therapy combined with coagulation factor replacement was followed by cessation of haemorrhage and complete recovery from acute renal failure.- - - - - - - - - - ranking = 1keywords = hepatic (Clic here for more details about this article) |
2/68. Endovascular thrombolysis for symptomatic cerebral venous thrombosis.OBJECT: The authors sought to treat potentially catastrophic intracranial dural and deep cerebral venous thrombosis by using a multimodality endovascular approach. methods: Six patients aged 14 to 75 years presented with progressive symptoms of thrombotic intracranial venous occlusion. Five presented with neurological deficits, and one patient had a progressive and intractable headache. All six had known risk factors for venous thrombosis: inflammatory bowel disease (two patients), nephrotic syndrome (one), cancer (one), use of oral contraceptive pills (one), and puerperium (one). Four had combined dural and deep venous thrombosis, whereas clot formation was limited to the dural venous sinuses in two patients. All patients underwent diagnostic cerebral arteriograms followed by transvenous catheterization and selective sinus and deep venous microcatheterization. Urokinase was delivered at the proximal aspect of the thrombus in dosages of 200,000 to 1,000,000 IU. In two patients with thrombus refractory to pharmacological thrombolytic treatment, mechanical wire microsnare maceration of the thrombus resulted in sinus patency. Radiological studies obtained 24 hours after thrombolysis reconfirmed sinus/vein patency in all patients. All patients' symptoms and neurological deficits improved, and no procedural complications ensued. Follow-up periods ranged from 12 to 35 months, and all six patients remain free of any symptomatic venous reocclusion. Factors including patients' age, preexisting medical conditions, and duration of symptoms had no statistical bearing on the outcome. CONCLUSIONS: patients with both dural and deep cerebral venous thrombosis often have a variable clinical course and an unpredictable neurological outcome. With recent improvements in interventional techniques, endovascular therapy is warranted in symptomatic patients early in the disease course, prior to morbid and potentially fatal neurological deterioration.- - - - - - - - - - ranking = 3.2073553719008keywords = vein (Clic here for more details about this article) |
3/68. A case report of acute pelvic thrombophlebitis missed by magnetic resonance imaging of the pelvic veins.A 29-year-old woman presented post-natally with pulmonary hypertension. Peripheral venous thrombosis was not detected by duplex ultrasound or conventional MRI. Despite anticoagulation, the patient arrested. autopsy revealed right iliac vein thrombosis. The ability of conventional MRI to detect acute pelvic thrombophlebitis depends on obtaining appropriate views.- - - - - - - - - - ranking = 16.036776859504keywords = vein (Clic here for more details about this article) |
4/68. Postpartum ovarian vein thrombosis.OBJECTIVE: Ovarian vein thrombosis (OVT) is known as a rare but serious postpartum complication. The condition is often clinically not distinguishable from endometritis, appendicitis or pyelonephritis. OVT may cause sepsis, septic pulmonary thromboembolism, and thrombosis of the inferior vena cava and the renal veins, and is potentially fatal. The objective of this study was to report the clinical findings and outcome of two patients with diagnosed ovarian vein thrombosis after delivery managed at this institution. METHOD: Two patients fit the study criteria of documented ovarian vein thrombosis after delivery. An imaging diagnosis (CT) of ovarian vein thrombosis was required for final study inclusion. RESULTS: We present two patients with ovarian vein thrombosis. The symptoms of one patient disappeared two days after beginning heparin and antibiotic therapy. The control-CT 93 days after the diagnosis of POVT showed unsuspected ovarian veins. The other patient suffered from POVT 13 days after spontaneous delivery. Because of lethal embolisms she died during the operation for embolectomy. CONCLUSION: On the basis of our series and other recent series, OVT may likely be more common than previously thought and may become clinically apparent only when complicated by infection, expansion of the thrombus or pulmonary embolism. POVT is a potentially fatal condition most commonly seen as a complication of pelvic surgery or inflammatory disease.- - - - - - - - - - ranking = 35.280909090909keywords = vein (Clic here for more details about this article) |
5/68. Postpartum headache after epidural blood patch: investigation and diagnosis.Use of an epidural blood patch to treat spinal headache after accidental dural puncture is well recognized. The high success rate associated with this practice has been questioned and it is not uncommon for patients to suffer recurring headaches after a supposedly successful blood patch. We describe a patient in labour who suffered accidental dural puncture, and whose headache was treated twice with an epidural blood patch. Despite this, the headache persisted. The case highlights the difficulty in the diagnosis of headache in the postnatal period in patients who have had regional analgesia and the importance of considering an alternative pathology, even if epidural blood patching has been successful. In this case, a diagnosis of cortical vein thrombosis was made. The incidence, presentation, aetiology and treatment of this rare condition is described.- - - - - - - - - - ranking = 3.2073553719008keywords = vein (Clic here for more details about this article) |
6/68. Late-onset puerperal ovarian vein thrombophlebitis treated laparoscopically.Puerperal ovarian vein thrombophlebitis is an uncommon condition that usually develops in the immediate postpartum period. Computed tomography, magnetic resonance imaging, Doppler ultrasound, and exploratory laparotomy may be performed to diagnose it. A woman developed worsening abdominal pain 6 weeks postpartum. Laparoscopic intervention allowed treatment of late-onset, left-sided puerperal ovarian vein thrombophlebitis. The disorder may develop much later after delivery than expected and can be successfully treated laparoscopically.- - - - - - - - - - ranking = 19.244132231405keywords = vein (Clic here for more details about this article) |
7/68. Vena cava thrombosis associated with nephrotic syndrome in the puerperal gestational cycle.CONTEXT: The puerperal gestational cycle is accompanied by a state of physiological hypercoagulability. Thromboembolic phenomena may occur at this time. OBJECTIVE: To report on a clinic case involving a patient that presented a family history of thromboembolism and developed deep vein thrombosis in a lower limb and vena cava thrombosis during the puerperal gestational cycle, displaying nephrotic syndrome as the main complication. DESIGN: Case report.- - - - - - - - - - ranking = 3.2073553719008keywords = vein (Clic here for more details about this article) |
8/68. Post-partum ovarian vein thrombosis.Post-partum ovarian vein thrombosis (POVT) is uncommon, but the true incidence is not known. Ninety per cent of cases present as right iliac fossa pain within 10 days of delivery. Anti-coagulation and intravenous antibiotics are the mainstay of treatment. We report three cases that were referred to our unit. These cases illustrate the difficulty in the clinical diagnosis of POVT and highlight the importance of its inclusion in the differential diagnoses of an acute abdomen in post-partum patients. POVT can be accurately diagnosed by appropriate noninvasive investigations and a laparotomy avoided.- - - - - - - - - - ranking = 16.036776859504keywords = vein (Clic here for more details about this article) |
9/68. A diagnostic dilemma of fever and back pain postpartum.A 26-year-old woman presented with fever, chills, and back pain 6 weeks postpartum. An infused CT scan of the abdomen and pelvis with IV contrast confirmed septic pelvic vein thrombophlebitis as the diagnosis. To the best of our knowledge, this is the first case report describing such a massive thrombophlebitis extending from the superior vena cava to the femoral vein inferiorly responsive to conventional anticoagulation therapy. This exceptional case reminds us to entertain septic pelvic thrombophlebitis in the differential of any patient who presents with fever and back pain of unknown etiology.- - - - - - - - - - ranking = 6.4147107438017keywords = vein (Clic here for more details about this article) |
10/68. Postpartum ovarian vein thrombosis: an unpredictable event: two case reports and review of the literature.Ovarian vein thrombosis (OVT) is a rare but serious postpartum complication that, in most cases, occurs in the right ovarian vein. Certain diagnosis, following clinical suspect because of lower quadrant tenderness and fever that alone does not respond to adequate broad-spectrum antibiotics, is now based on computed tomography (CT), although other imaging techniques, such as color Doppler ultrasonography and magnetic resonance (MR) imaging, are useful. heparin and intravenous antibiotics are the mainstay of treatment so as to avoid laparotomy. We report on the management of two cases of postpartum OVT.- - - - - - - - - - ranking = 19.244132231405keywords = vein (Clic here for more details about this article) |
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