Cases reported "Rupture, Spontaneous"

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11/2461. Spontaneous rupture of the spleen in infectious mononucleosis.

    Two cases of spontaneous rupture of the spleen as a complication of infectious mononucleosis are reported. The literature is briefly reviewed and emphasis placed on the need for awareness of this rare complication.
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12/2461. Transesophageal echocardiography and concurrent coronary angiography for the rapid assessment of papillary muscle rupture.

    echocardiography with color flow imaging is valuable for identifying mechanical complications of myocardial infarction. Transesophageal echocardiography is useful for critically ill patients in whom transthoracic imaging is often insufficient. A case of papillary muscle rupture is presented in which transesophageal echocardiography was performed concurrently with coronary angiography. The detailed information obtained from two-dimensional and color flow imaging eliminated the need for diagnostic right heart catheterization and left ventriculography. Transesophageal echocardiography used in this manner can facilitate expeditious surgical management.
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13/2461. diagnosis of ruptured sinus of valsalva aneurysms: potential value of transesophageal echocardiography.

    Two patient cases are reported in which an aneurysm of the right coronary sinus of valsalva ruptured into the right ventricular outflow tract, near the crux of the heart. Transthoracic two-dimensional echocardiography and transesophageal echocardiography using Doppler color flow mapping allowed accurate preoperative assessment of the left-to-right shunt, which was subsequently confirmed by contrast aortography and surgery.
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14/2461. Chordal rupture: a common complication of myxomatous degeneration of the mitral valve.

    In two patients with a clinical picture of acute mitral insufficiency, the presence of chordal rupture secondary to myxomatous degeneration of the mitral valve was disclosed during surgery. There was no evidence of previous rheumatic valvulitis, subacute bacterial endocarditis or other etiologies. It appears from the literature and from the cases described that ruptured chorda tendinea is a not uncommon complication of myxomatous transformation of the mitral valve. While this fact has been mentioned in anatomophological reports, clinicians are less aware of the association. In the absence of supportive evidence for a rheumatic or arteriosclerotic etiology, a clinical picture of acute mitral insufficiency should suggest ruptured chorda tendinea secondary to myxomatous degeneration of the mitral apparatus. This is particularly true in older patients, especially among those followed for a midsystolic click-late systolic murmur or an apical pansystolic murmur of pure mitral regurgitation.
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15/2461. Spontaneous bladder rupture: rare cause of peritonitis.

    Spontaneous rupture of the urinary bladder is an uncommon, but important, cause of generalized peritonitis. It is a surgical emergency which may be rapidly fatal if diagnosis and treatment are delayed. Bladder disease or obstruction, coupled with a sudden increase in intra-abdominal pressure usually accounts for the rupture. Characteristic symptoms are acute lower abdominal pain followed by generalized peritonitis. In most cases, the rupture is intra-peritoneal.
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16/2461. Post-infarction cardiac rupture.

    Three allied conditions are described in this paper: (i) haemopericardium with cardiac rupture (5 cases); (ii) haemopericardium without rupture (2 cases); (iii) pseudoaneurysm (1 case). In the first 2 of these, the significant features were clinical deterioration with shock 3 or more days after infarction, recurrent cardiac pain, cardiac tamponade, and immediate or later ineffectiveness of counterpulsation. An additional feature in the second group was the development of haemopericardium after heparin therapy. In the third group, infarction followed by left ventricular failure and progressive cardiac enlargement was the significant feature. An apical systolic murmur was not present, as a false sac had not been formed. Ante-mortem diagnosis depends upon an appreciation of these features. Without it successful surgery is impossible. There were 4 survivors in this group of 8 patients.
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17/2461. Imperforate hymen and ruptured hematosalpinx: a case report with a review of the literature.

    The imperforate hymen is a common genital disorder, but a ruptured hematosalpinx is a fairly rare complication. This article presents one case with an imperforate hymen as well as a bilateral hematosalpinx, with unilateral ruptured hematosalpinx, giving a picture of acute abdomen. The pathology, diagnosis, treatment, and complications of these rare cases are discussed. The most important factor for the clinician to remember is the history; a simple inspection provides the diagnostic clue.
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18/2461. Spontaneous rupture of a bladder with invasive bladder carcinoma.

    Spontaneous bladder perforation associated with bladder tumour is extremely rare. Such patients generally present with the clinical symptoms of an acute abdomen, and in these settings the mortality rate is very high.
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19/2461. survival without surgical repair of acute rupture of the right ventricular free wall.

    rupture of the myocardial free wall is an infrequent complication of acute myocardial infarction. Unless it occurs in a space confined by pericardial adhesions, only surgical emergency repair of ruptured myocardium can prevent death. In this paper we report the case of an 81-year-old woman who was admitted to the emergency room with cardiac tamponade, resulting from inferolateral acute myocardial infarction and a subsequent rupture of the right ventricular free wall, with the formation of pericardial thrombus and effusion. The patient refused to undergo any surgical or invasive intervention, and therefore she was only treated conservatively. Nevertheless, her condition improved dramatically, as her blood pressure increased and echocardiography abnormalities almost disappeared. Follow-up echocardiography 7 months post discharge was unremarkable. We believe that this rare case emphasizes that in special circumstances, such as creation of a thrombus that prevents more blood from extravasating, free-wall rupture without surgical repair is compatible with long-term survival.
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20/2461. Management of splenic artery aneurysm rupture during trial of scar with epidural analgesia.

    We report a case of ruptured splenic artery aneurysm during labor in which the clinical signs were masked by epidural analgesia. A high index of clinical suspicion must be maintained in cases of atypical epidural breakthrough pain, and attending clinicians must be prepared for the unexpected when faced with a maternal collapse.
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