1/19. pancreatic pseudocyst: heparin-induced haemorrhage through the ampulla of vater.Bleeding from a pancreatic pseudocyst through the ampulla of vater is a rare cause of overt gastrointestinal haemorrhage. Previously described mechanisms of such haemorrhage are reviewed. We report a case of a 74-year-old female with a pancreatic pseudocyst that bled into the gastrointestinal tract following the administration of heparin. We believe that this is the first reported case of its kind.- - - - - - - - - - ranking = 1keywords = haemorrhage (Clic here for more details about this article) |
2/19. Spontaneous subcapsular renal haemorrhage presenting with pleuritic chest pain.We present an unusual case of spontaneous renal subcapsular haematoma in a normal kidney presenting with pleuritic chest pain and mimicking pulmonary embolism. The literature suggests that the majority of these cases occur in association with renal tumours and that the diagnosis can best be made by computed tomographic scanning. Treatment is expectant but because of the high incidence of tumours, nephrectomy is usually necessary.- - - - - - - - - - ranking = 0.66666666666667keywords = haemorrhage (Clic here for more details about this article) |
3/19. Severe postoperative haemorrhage and airway obstruction following high-dose enoxaparin.Unfractionated heparin infusion may be a more suitable choice of anticoagulant treatment in patients with venous thromboembolism in the immediate postoperative period.- - - - - - - - - - ranking = 0.66666666666667keywords = haemorrhage (Clic here for more details about this article) |
4/19. Caval filter placement for pulmonary embolism in a patient with a deep vein thrombosis and primary intracerebral haemorrhage.Treatment of deep vein thrombosis and pulmonary embolic disease when full anticoagulation is absolutely or relatively contraindicated is difficult. We report on a case where the chosen treatment proved unsuccessful. Our patient had a primary intracerebral haemorrhage, complicated by a proximal deep vein thrombosis and despite placement of a vena caval filter, had multiple pulmonary emboli and died.- - - - - - - - - - ranking = 0.83333333333333keywords = haemorrhage (Clic here for more details about this article) |
5/19. candida endocarditis with mycotic pulmonary emboli following re-do Rastelli operation.A case of a 19 year old patient with candida endocarditis complicated by pulmonary infarction and pulmonary mycotic abscesses following replacement of a right ventricle to pulmonary artery homograft conduit is presented. Despite preceding hospital admissions with probable septic pulmonary emboli, diagnosis was made only after massive pulmonary haemorrhage that ultimately proved fatal. This case highlights that candida endocarditis should be considered in patients with symptoms and signs compatible with bacterial endocarditis when blood cultures are negative, especially in the setting of congenital cardiac malformations, and illustrates the high mortality associated with delayed diagnosis.- - - - - - - - - - ranking = 0.16666666666667keywords = haemorrhage (Clic here for more details about this article) |
6/19. Pulmonary haemangiosarcoma with main pulmonary artery thrombosis imitating subacute pulmonary embolism with infarction.We report a patient with subacute pulmonary hypertension caused by unilateral massive pulmonary artery thrombosis due to a pulmonary haemangiosarcoma of the lower lobe with pulmonary arterial and bronchial invasion. The patient was misdiagnosed as having subacute pulmonary embolism and underwent thrombolytic therapy complicated by severe pulmonary haemorrhage. The imaging features of pulmonary artery thrombosis with underlying malignancy and their differential diagnosis are discussed.- - - - - - - - - - ranking = 0.16666666666667keywords = haemorrhage (Clic here for more details about this article) |
7/19. Two cases of complications of the thrombolysis of right heart free-floating thrombi with pulmonary embolism: important role of echocardiographically based management.We present two cases where successful thrombolysis of right heart thrombi and pulmonary embolism was accompanied by serious adverse events. In patient 1 with massive pulmonary thromboembolism, transesophageal ultrasound revealed large right atrial thrombus entrapped in a patent foramen ovale. Initial treatment with heparin was substituted with thrombolysis, which resulted in clinical improvement and dissolution of right heart thrombus but was followed by fatal intracerebral haemorrhage. In patient 2, thrombolysis caused mobilisation of thrombotic mass as evidenced by disappearance of thrombus on ultrasound. Massive pulmonary thromboembolism resulted in circulatory collapse. Short cardiopulmonary resuscitation restored spontaneous circulation and the patient recovered completely.- - - - - - - - - - ranking = 0.16666666666667keywords = haemorrhage (Clic here for more details about this article) |
8/19. Unusual hypersensitivity to warfarin in a critically ill patient.A patient was admitted to the intensive care unit because of respiratory failure, and warfarin therapy was started at 2 mg/day for the treatment of pulmonary embolism, together with other medications. Despite the low dosage of warfarin, international normalized ratio (INR) was markedly elevated from 1.15 to 11.28 for only 4 days, and bleeding symptoms concurrently developed. Vitamin K2 was infused along with discontinuation of warfarin. One day later, the INR was found to have decreased, and bleeding was also improved. An objective causality assessment indicated a probable relationship between clotting abnormality and warfarin administration, although the degree of elevation of the INR was unusual in the light of the daily warfarin dose and duration of its exposure. Based on the clinical status of the patient, it was suspected that several conditions contributed to the abnormal hypersensitivity to warfarin. Contributory factors probably included pharmacokinetic interactions with co-administrated drugs, vitamin k deficiency caused by decreased dietary intake, reduced gut bacterial production, impaired intestinal absorption and hepatic synthetic capacity, and increased consumption of clotting factors. In view of our experience in the present case, it should be stressed that close monitoring of coagulation capacity is necessary in critically ill patients in order to avoid fatal haemorrhage after initiating warfarin therapy regardless of the dosage.- - - - - - - - - - ranking = 0.16666666666667keywords = haemorrhage (Clic here for more details about this article) |
9/19. Pulmonary arteriovenous malformation masquerading as massive pulmonary thromboembolus.We present a case of a 78-year-old male with hereditary haemorrhagic telangiectasia and severe hypoxia incorrectly diagnosed as pulmonary embolism following a false positive ventilation/perfusion scan. Anti-coagulation and thrombolysis was complicated by an upper gastro-intestinal haemorrhage. Pulmonary arteriovenous malformations resulted in a clinically significant right-left shunt and created an apparent perfusion defect evident upon radionuclide imaging, leading to diagnostic uncertainty and a potentially dangerous treatment modality.- - - - - - - - - - ranking = 0.16666666666667keywords = haemorrhage (Clic here for more details about this article) |
10/19. pulmonary embolism in a patient with severe congenital deficiency for factor V during treatment with fresh frozen plasma.thrombosis is a rare complication in patients with congenital clotting factor deficiencies. In most cases, it is related to inherited procoagulant factors, use of central venous catheters or administration of coagulation factor concentrates. There are only a few case reports about thrombotic events during treatment with fresh frozen plasma (FFP). We report the case of a patient with homozygous inherited factor v deficiency, who developed a pulmonary embolism at a time of treatment with methylene blue treated FFP (MBFFP). The patient had only two other factors predisposing to thrombosis and both were acquired: obesity and bed rest. He started anticoagulant treatment with low molecular weight heparin (LMWH) while the deficient factors were replaced with MBFFP. After 8 days of treatment the patient developed a severe respiratory insufficiency. Pulmonary haemorrhage was considered among the differential diagnosis and LMWH was stopped. An inferior vena cava filter was placed without any further thrombotic complications. To our knowledge, there are no reports about patients with clotting factor deficiencies who developed a thrombotic event during treatment with MBFFP.- - - - - - - - - - ranking = 0.16666666666667keywords = haemorrhage (Clic here for more details about this article) |
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