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Severe celiac trunk stenosis following blunt trauma in a patient with diabetic ketoacidosis: a diagnostic dilemma of traumatic injury versus median arcuate ligament syndrome.

INTRODUCTION: Severe proximal celiac trunk stenosis or occlusion following blunt trauma is exceedingly rare, with potential etiologies inclu … ing crushed by an approximately 400-kg object, resulting in sternal, rib, and pelvic fractures with hemoperitoneum. He developed persistent nausea, vomiting, and hyperglycemia, and was initially diagnosed with DKA. Despite correction of metabolic abnormalities with insulin therapy, fluid resuscitation, and acid-base balance, gastrointestinal symptoms persisted, …

Fatal traumatic injury patterns in free-roaming cats: an anatomopathological study of 40 cases.

BACKGROUND: Trauma is an important cause of death in domestic cats, particularly in animals with unrestricted outdoor access. However, necro … ulmonary hemorrhage, pulmonary hemorrhage, atelectasis or pulmonary collapse, fracture, hemothorax, hemoperitoneum, visceral herniation into the thoracic cavity, and diaphragmatic rupture. Compared with sharp-force trauma, blunt force trauma was associated with significantly higher EGTN values and with a greater frequency of extrapulmonary hemorrhage, fracture, …

Management of Complications of First Instance of Hepatic Trauma in a Liver Surgery Unit: Portal Vein Ligation as a Conservative Therapeutic Strategy.

BACKGROUND: According to the National Trauma Data Bank, the liver, after the spleen, is the first most injured organ in closed abdominal tra … e.In 3 cases we had to perform a right epatectomy in second instance. Two hepatectomies were due to hemoperitoneum, and the other for coleperitoneum. Two patients were treated in first instance by only doing hemostasis on the bleeding site. We observed 6 patients in first instance. Five of them underwent surgery with hepatic resection and surgical hemostasis of …

Clinical outcome and bowel function following total abdominal colectomy and ileorectal anastomosis in the Oriental population.

UNLABELLED: Total abdominal colectomy with ileorectal anastomosis is a commonly performed surgical procedure. The postoperative outcome of t … ive mortalities. Five cases required re-laparotomy, three for anastomotic complications and two for hemoperitoneum. Five patients had recurrent admissions for adhesion colic, which resolved with nonsurgical therapy. Ten patients succumbed on follow-up, six to tumor recurrence, two to unrelated cancers (stomach and bladder), and three to medical conditions. CONC …

Disappearing multiple visceral aneurysms in Vascular Ehlers-Danlos syndrome.

OBJECTIVE: To assess the complex management of arterial anomalies in Vascular Ehlers-Danlos Syndrome (vEDS). METHODS: We report the case of a 34-year-old male, diagnosed with vEDS, who presented with acute intraperitoneal hemorrhage caused by the rupture of a splenic artery aneurysm, treated in emergency with coil embolization and splenectomy. Computed Tomography (CT) scan showed the concomitant presence of right renal artery (RRA) and common hepatic artery (CHA) aneurysms. RESULTS: Both aneurysms were conservatively managed and the patient went through serial CT imaging. After 3 months, rap

Acute-onset abdominal pain in a woman in her 30s.

CLINICAL INTRODUCTION: A woman in her 30s presented to the emergency department with sudden-onset abdominal pain with hypotension and tachycardia. She gave a history of congenital heart disease for which she had previously undergone multiple operations. On examination she demonstrated right upper quadrant tenderness. She underwent an urgent multiphase CT (figure 1A-C).heartjnl;105/4/275/F1F1F1Figure 1(A) Arterial phase coronal CT. (B) Arterial phase axial CT. (C) Portal venous phase axial CT. QUESTION: What is the underlying liver pathology?Hepatocellular adenomaCholangiocarcinomaHepatocellul

Spontaneous haemoperitoneum due to a sigmoid diverticulum.

Spontaneous haemoperitoneum is rare. When it occurs it is a life-threatening condition. Common causes of this are gynaecological in nature and rarely due to colonic diverticular perforation. Diverticulitis is a common condition affecting people in western countries. This presentation of spontaneous haemoperitoneum highlights the disproportionate abdominal pain and opioid-induced constipation. Significant bloods on admission included haemoglobin of 148 g/L, C reactive protein (CRP) of 1.1 mg/L, white cell count (WCC) of 12.7×10(9)/L (neutrophils 10.9×10(9)/L). Bloods repeated 10 h later reveale

Diagnostic Peritoneal Aspiration Revisited: Its Diagnostic Accuracy for the Detection of Intraabdominal Hemorrhage.

BACKGROUND: The use of Focused Assessment with Sonography for Trauma (FAST) in combination with computed tomography (CT) has become the mainstay of diagnostic workup in patients with suspected intraabdominal hemorrhage (IAH). However, diagnostic peritoneal aspiration (DPA) can be an important adjunct in hemodynamically unstable patients. The aim of this study was to evaluate the utility and diagnostic accuracy of DPA in detecting IAH. METHODS: Retrospective analysis of all patients who presented to the LAC+USC Medical Center and underwent evaluation with DPA between January 2010 and December

[Videolaparoscopic operations in diagnosis and treatment of intraperitoneal complications after operations on the liver and bile tracts].

The results of videolaparoscopic operations on 62 patients with intraperitoneal complications after operations on the liver and bile tracts were analyzed. Intraperitoneal complications were avoided in 9 cases (14.5%), postoperative bile peritonitis was diagnosed in 38 patients (61.3%), intraperitoneal bleeding was noted in 10 (16.1%) patients, and early adhesive intestinal obstruction in 10 (26.3%) patients. In 51.6% of cases the diagnostic videolaparoscopy was transformed in a curative method. Postoperative lethality was 16.1%. Mean time of stay in hospital was 2 times less and made 7.4 days.

Resuscitation injuries complicating the interpretation of premortem trauma and natural disease in children.

Minor soft tissues injuries are common in both adults and children who have had cardiopulmonary resuscitation (CPR). Potentially life-threatening injuries are rare. The pre-arrest history in a resuscitated adult often assists the pathologist to interpret autopsy findings. In contrast, an infant or child may not have a reliable history. In this situation, it may be difficult if not impossible to distinguish resuscitation injuries from pre-existing accidental or inflicted trauma. I describe two children who had significant autopsy-documented injuries initially attributed to abuse. The State file

Rapidly Progressive Merkel Cell Carcinoma with Atypical Metastatic Pattern-A Case Report and Brief Literature Review.

Background and Clinical Significance: Merkel cell carcinoma (MCC) is a rare, aggressive neuroendocrine cutaneous malignancy with increasing incidence among elderly, immunocompromised patients or individuals exposed to ultraviolet radiation. Case Presentation: We present the case of an 84-year-old Caucasian male with no history of immunosuppression, who was admitted for asthenia, dysphagia, weight loss, and generalized weakness. Clinical and imaging investigations revealed a violaceous tumor on the right arm and disseminated metastases affecting the liver, spleen, bones and lymph nodes. A liver

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… The post-biopsy hemoperitoneum further destabilized the patient, aggravating an already fragile and preterminal clinical condition and eliminating the possibility of additional diagnostic or therapeutic measures. … The liver biopsy was obtained while the patient was hemodynamically unstable, and within hours he developed biopsy-related hemoperitoneum, shock and multiorgan failure, requiring transfer to the ICU. …

Outcomes of Laparoscopic Peritoneal Dialysis Catheter Placement Using an Optimal Placement Technique.

BackgroundPeritoneal dialysis (PD) is a widely employed renal replacement modality. A prospective study was conducted to determine the short-term and midterm outcomes and complication rates associated with a standardized optimal laparoscopic peritoneal dialysis catheter placement technique.MethodsAll patients undergoing laparoscopic PD catheter placement by one surgeon using our standardized method over a 5-year period were entered into a prospective database. Patients were evaluated preoperatively and postoperatively through office visits. Development of complications was assessed using follo

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… One patient with hemoperitoneum had their catheter removed for recurrence of hemoperitoneum beyond 30 days postop. The other patient with hemoperitoneum developed insufficient dialysis requiring eventual catheter removal. … The 23 catheter-related complications consisted of 14 (14.3%) infections either of the catheter or peritonitis, 8 (8.2%) instances of insufficient flow due to adhesions, and 1 (1.0%) case of recurrent hemoperitoneum. …

[Diffuse cavernous hemangioma of the uterus diagnosed during pregnancy. Case report].

We report the case of a pregnancy of 16 weeks with anemia and a presumptive diagnosis of partial mole. In secondary care this diagnosis was ruled out through ultrasonography and diffuse cysts were found in the myometrium. Spectral Doppler ultrasound showed no flow, but it could be observed with power angiography. Cesarean section was performed at 38 weeks and hysterectomy 24 hours after because of intra-abdominal hemorrhage. Power angiography, spectral Doppler and serum human chorionic gonadotropin are the most useful diagnostic tools in the differential diagnosis of diffuse cavernous hemangio

[The supra-acetabular pelvic clamp. Emergency treatment for unstable pelvic ring fractures].

BACKGROUND: The anatomic region on the lateral cortex of the ileum, where a palpable groove is formed by angulations of the lateral cortex of the iliac wing, is recommended as the insertion point for the pelvic emergency clamp by many authors. In our opinion this technique often leads to an incomplete closure of the anterior pelvic ring as well as to bacterial contamination of the access for the sacroiliac joint screw fixation and is accompanied by a risk for nerve and vessel injuries. To reduce these risks the pelvic clamp was placed at a supra-acetabular location. The goal of our study was t

Liver infarction produced by dual vessels occlusion due to trauma and TAE: long follow up using CT, US, and MRI.

The cause of liver infarction previously reported [1-4] are mainly due to occlusion of hepatic artery. Herein, we report the case of liver infarction resulted from simultaneous occlusion of hepatic artery and portal vein due to trauma and therapeutic transcatheter arterial embolization (TAE), and we followed up the infarcted lesion with computed tomography (CT), ultra sonography (US) and magnetic resonance imaging (MR imaging) until it disappeared.