11/15. Haemorrhagic shock encephalopathy.Three children suffered from acute onset of convulsions and progressive coma associated with hyperpyrexia, profound shock and generalized bleeding tendency. No causative agent could be identified. Despite aggressive resuscitation they all died. Post-mortem examination revealed cerebral oedema, petechial haemorrhages of the gut, lungs and kidneys, and a generalized depletion of lymphocytes in the lymphoid organs. Features were compatible with haemorrhagic shock encephalopathy, which is a highly fatal disease. The possible role of hyperpyrexia in its pathophysiology is discussed. More careful case identification and research in various possible aetiological factors may help elucidate its pathogenesis.- - - - - - - - - - ranking = 1keywords = haemorrhage (Clic here for more details about this article) |
12/15. Haemorrhagic shock and encephalopathy.Two infants are described with a fulminant disorder characterised by profound circulatory collaps and shock, generalised convulsions and unremitting coma, bleeding due to severe DIC, fever, diarrhoea, metabolic acidosis and renal and hepatic failure. Both infants died shortly after onset of the symptoms. autopsy mainly revealed haemorrhages in different organs, anoxaemic lesions in the brain and a normal structure of liver and pancreas. No causative agent could be demonstrated. We believe that both patients suffered from haemorrhagic shock and encephalopathy, a mostly fatal disorder which has recently been described. Although the clinical and biochemical features are very distinctive, this syndrome is probably heterogeneous and its differentiation from some other disorders may be difficult. Its pathogenesis is unknown but there are some indications that intravascular activity of trypsin may play a role. During a study of the two families we obtained abnormal results of immunologic tests in most members: the interpretation of this finding remains conjectural. Haemorrhagic shock and encephalopathy may occur more frequently than the restricted literature on this subject suggests. Future studies will have to deal with the question of identity and pathogenesis.- - - - - - - - - - ranking = 1keywords = haemorrhage (Clic here for more details about this article) |
13/15. plasma noradrenaline and adrenaline concentrations and dopamine-beta-hydroxylase activity in patients with shock due to septicaemia, trauma and haemorrhage.plasma adrenaline and noradrenaline concentrations and dopamine-beta-hydroxylase activities were measured in patients with septicaemic, traumatic or haemorrhagic shock. Irrespective of the type of shock plasma adrenaline and noradrenaline concentrations were increased above the normal range. This is in keeping with the clinical features of increased sympathetic nervous system and adrenal medullary activity present in these patients. plasma dopamine-beta-hydroxylase activities were within the normal limits in all forms of shock indicating the poor relationship of this measurement to sympathetic nervous system activity. In patients who died plasma noradrenaline concentrations remained persistently elevated above normal while in those who survived there was a rapid decline towards the normal range.- - - - - - - - - - ranking = 4keywords = haemorrhage (Clic here for more details about this article) |
14/15. Spontaneous rupture of the liver in severe preeclampsia. Case report.Uncontrolled haemorrhage is the most common cause of death after spontaneous rupture of the liver in pregnancy. This severe complication of pregnancy-induced hypertension is associated with a high rate of both maternal and fetal mortality, and aggressive therapy should be instituted including treatment of haemorrhagic shock, control of hepatic bleeding, and delivery.- - - - - - - - - - ranking = 1keywords = haemorrhage (Clic here for more details about this article) |
15/15. Vascular complications of lumbar disc surgery.Over a period of seven years nine patients with vascular complications after lumber discectomy received medical care at the Clinic of Vascular Surgery, University of Graz Medical School. We report five acute bleeding complications occurring during the operation and four late manifestations of vascular lesions. Five patients presented with acute life-threatening iatrogenic haemorrhages from pelvic vessels. Three patients made a complete recovery, one patient died from acute haemorrhagic shock, one further patient died from sepsis due to an associated complication-an injury to the ureter. Over a period of two to ten years after primary surgery we corrected late complications such as 1 case of posttraumatic aneurysm of the aortic bifurcation found to have eroded the body of the fifth lumbar vertebra, and three cases of arteriovenous fistula between the common iliac artery and the common iliac vein. The four cases described below are an attempt to document the vascular surgical procedures involved and to provide typical findings. The risk of injuring the pelvic vessels intra-operatively can be explained by the close anatomical relation between the retroperitoneal vessels and the vertebral column and furthermore not only by the fact that pre-existent deficiencies but also injury to the anterior longitudinal ligament give access to the retroperitoneal space.- - - - - - - - - - ranking = 1keywords = haemorrhage (Clic here for more details about this article) |
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