scholarly journals Acute Cytomegalovirus infection as a cause of venous thromboembolism

2014 ◽  
Vol 6 (1) ◽  
pp. e2014041 ◽  
Author(s):  
Raffaella Lissandrin ◽  
Francesco Mojoli ◽  
Fausto Baldanti ◽  
Enrico Brunetti ◽  
Michela Pascarella ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Venous Thromboembolism ◽  
Vascular Endothelium ◽  
Cytomegalovirus Infection ◽  
Hcmv Infection ◽  
Thrombus Formation ◽  
Threatening Condition ◽  
Life Threatening ◽  
Endothelium Damage ◽  
Acute Cytomegalovirus

Acute Human Cytomegalovirus (HCMV) Infection  is an unusual cause of venous thromboembolism, a potentially life-threatening condition. Thrombus formation can occur at the onset of the disease or later during recovery and may also occur in the absence of acute HCMV hepatitis. It is likely due to both vascular endothelium damage caused by HCMV and impairment of the clotting balance caused by the virus itself. Here we report on two immunocompetent women with splanchnic thrombosis that occurred during the course of acute HCMV infection. Although the prevalence of venous thrombosis in patients with acute HCMV infection is unknown, physicians should be aware of its occurrence, particularly in immune-competent patients presenting with fever and unexplained abdominal pain referred to the splanchnic region.

scholarly journals Atraumatic Splenic Rupture in a SARS-CoV-2 Patient: Case Report and Review of Literature

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Marcello Agus ◽  
Maria Elena Ferrara ◽  
Paola Bianco ◽  
Cristina Manieli ◽  
Paolo Mura ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Splenic Rupture ◽  
Delayed Diagnosis ◽  
Caucasian Woman ◽  
Threatening Condition ◽  
Life Threatening ◽  
Atraumatic Splenic Rupture ◽  
Rupture Of The Spleen ◽  
Delay Of Diagnosis ◽  
Possible Cause

Splenic rupture in the absence of trauma or previously diagnosed disease is rare. Due to the delay of diagnosis and treatment, this is a potentially life-threatening condition. We report a case of atraumatic splenic rupture in a SARS-CoV-2 patient. This report is of particular interest as it first identifies SARS-CoV-2 infection as a possible cause of spontaneous rupture of the spleen. A 46-year-old Caucasian woman presented at the emergency department pale and sweaty, complaining of syncopal episodes, tachycardia, hypotension, diarrhea, intense abdominal pain, diffuse arthromyalgia, and fever from the day before. RT-PCR was positive for SARS-CoV-2 infection. CT scan demonstrated extensive hemoperitoneum due to rupture of the splenic capsule. The patient required an emergency open splenectomy because of an unresponsive hemorrhagic shock. At the end of the surgery, the patient was relocated to a COVID-19 dedicated facility. COVID-19 is a new disease of which all manifestations are not yet known. Inpatients affected by SARS-CoV-2 infection with abdominal pain and spontaneous splenic rupture should be considered to avoid a delayed diagnosis.

scholarly journals Endoscopic follow-up of cyanoacrylate obliteration of gastric varices

2009 ◽  
Vol 46 (1) ◽  
pp. 81-84 ◽  
Author(s):  
Fernanda Prata Martins ◽  
Erika Pereira de Macedo ◽  
Gustavo Andrade de Paulo ◽  
Frank Shigueo Nakao ◽  
José Celso Ardengh ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Portal Hypertension ◽  
Gastric Varices ◽  
Study Endpoint ◽  
Mild Abdominal Pain ◽  
Threatening Condition ◽  
Life Threatening ◽  
Related Mortality ◽  
Overall Mortality

Bleeding from gastric varices is a life-threatening condition. We report our experience with cyanoacrylate injection. Twenty three patients with portal hypertension and gastric varices underwent intra-variceal injection of a cyanoacrylate/lipiodol solution (1:1). Study endpoint was variceal obliteration. Mean follow-up was 25.3 months. Variceal obliteration was achieved in 87% of patients. Recurrence occurred in one patient (4.3%) and rebleeding in another case (4.3%). Mild abdominal pain was described in 13% of patients. Overall mortality was 21.7% and rebleeding related mortality rate was 4.3%. Our results confirm that cyanoacrylate injection is effective and safe to eradicate gastric varices.

Vascular endothelium damage from catheter-induced mechanical stimulation causes catheter sleeve formation in a rabbit model

2019 ◽  
Vol 21 (3) ◽  
pp. 379-386
Author(s):  
Hidenori Tanabe ◽  
Naoto Takemura ◽  
Hisako Terao ◽  
Hitomi Hagiwara ◽  
Yasunobu Zushi ◽  
...  
Keyword(s):  
Endothelial Cells ◽  
Mechanical Stimulation ◽  
Vascular Endothelium ◽  
Cell Damage ◽  
Thrombus Formation ◽  
Rabbit Model ◽  
Critical Factor ◽  
External Jugular Vein ◽  
Endothelium Damage

Background: Intravenous catheters are widely used but are often removed due to complications associated with catheter sleeve formation. A catheter sleeve can develop from a thrombus, and catheter-induced vascular endothelium damage may be a critical factor for thrombus formation. We investigated the effect of catheter-induced mechanical stimulation on venous endothelial cells and catheter sleeve formation and the efficacy of anti-thrombogenic technology for preventing catheter sleeve formation in vivo. Methods: We surgically implanted poly(2-methoxyethyl acrylate)-coated and uncoated catheters with and without a stylet into the right external jugular vein of a rabbit model for 14 days. Catheter sleeve formation and the ratio of residual venous endothelial cells were compared using histological examination and immunostaining with an anti-CD31 antibody, respectively. Results: Stiffening an uncoated catheter with a stylet induced catheter sleeve formation along more than two-thirds of the length of the catheter. The ratios of residual venous endothelial cells at the tip of uncoated catheters with and without a stylet were 3% and 36%, respectively. While poly(2-methoxyethyl acrylate) coating also reduced the ratio of venous endothelial cells at the tip of the stiffened catheter (12%), it prevented external thrombus and catheter sleeve formation. Conclusion: High levels of mechanical stimulation can affect catheter-related thrombosis and promote catheter sleeve formation, and anti-thrombogenic technology such as a poly(2-methoxyethyl acrylate) coating reduces thrombus formation and can prevent catheter sleeve formation on stiffened catheters. Further studies are required to determine the maximum degree of venous endothelial cell damage before catheter sleeve formation and to compare other anti-thrombogenic technologies with poly(2-methoxyethyl acrylate) for preventing catheter sleeve formation.

scholarly journals Acute Gastric Volvulus and Atrial Fibrillation with RVR: A Coincidence or Association

2017 ◽  
Vol 2017 ◽  
pp. 1-3
Author(s):  
Omar Nadhem ◽  
Omar Salh ◽  
Faisal Khasawneh
Keyword(s):  
Atrial Fibrillation ◽  
Abdominal Pain ◽  
Diaphragmatic Hernia ◽  
Gastric Volvulus ◽  
Shortness Of Breath ◽  
Threatening Condition ◽  
Acute Gastric Volvulus ◽  
Ventricular Response ◽  
Life Threatening ◽  
Upper Abdominal

Gastric volvulus is a rare and life-threatening condition that involves the abnormal rotation of the stomach around its axis by more than 180°. The association between acute gastric volvulus and atrial fibrillation with rapid ventricular response is rare with only few cases that have been reported. Our patient was an 86-year-old female who presented with upper abdominal pain, distension, nausea, and shortness of breath. Clinical and laboratory workup revealed acute gastric volvulus with diaphragmatic hernia. On presentation, she was also in atrial fibrillation with rapid ventricular response. She was successfully treated by laparotomy with reduction of the gastric volvulus and repair of the diaphragmatic hernia, with significant improvement.

scholarly journals Nonspecific abdominal pain: Do I have to allocate a specific diagnosis for every patient?

2022 ◽  
Keyword(s):  
Abdominal Pain ◽  
Care Setting ◽  
Acute Abdominal Pain ◽  
Scoring Systems ◽  
Acute Care Setting ◽  
Acute Setting ◽  
The World ◽  
Threatening Condition ◽  
Chief Complaints ◽  
Life Threatening

Acute abdominal pain is one of the most common chief complaints in the acute setting all over the world. The definitive diagnoses of these patients vary depending on age, gender, geographical and sociodemographic characteristics etc. Apart from these, aging of the population, obesity, advanced diagnostic imaging modalities and changes in nutritional habits also have an impact on the rates of specific diagnoses. On the other hand, nonspecific abdominal pain constitutes almost half of all visits due to acute abdominal pain in the acute care setting. This phenomenon is the main differential diagnostic problem in the management of these patients because missing a life-threatening condition can cause enormous medicolegal problems for the caregivers. Certain diagnostic scoring systems have also been developed to facilitate recognition and management of these conditions. This article aims to review the entity and underline the challenges it can bring to the scene.

On-Scene and Final Assessments and Their Interrelationship Among Patients Who Use the EMS on Multiple Occasions

2017 ◽  
Vol 32 (5) ◽  
pp. 528-535 ◽  
Author(s):  
Julia Tärnqvist ◽  
Erik Dahlén ◽  
Gabriella Norberg ◽  
Carl Magnusson ◽  
Johan Herlitz ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Abdominal Pain ◽  
Chest Pain ◽  
Pulmonary Disease ◽  
Final Diagnosis ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Threatening Condition ◽  
Life Threatening ◽  
Age Range

AbstractIntroductionThe use of Emergency Medical Services (EMS) is increasing. A number of patients call repeatedly for EMS. Early studies of frequent callers show that they form a heterogenous group.ProblemThere is a lack of research on frequent EMS callers. There is furthermore a lack of knowledge about characteristics and the prehospital assessment of the patients who call for EMS on several occasions. Finally, there is a general lack of knowledge with regard to the association between the prehospital assessment by health care providers and the final diagnosis.MethodPatients in Skaraborg in Western Sweden, who used the EMS at least four times in 2014, were included, excluding transport between hospitals. Information on the prehospital assessment on-scene and the final diagnosis was collected from the EMS and hospital case records.ResultsIn all, 339 individual patients who used the EMS on 1,855 occasions were included, accounting for five percent of all missions. Fifty percent were women. The age range was 10-98 years, but more than 50.0% were in the age range of 70-89 years.The most common emergency signs and symptoms (ESS) codes on the scene were dyspnea, chest pain, and abdominal pain. The most common final diagnosis was chronic obstructive pulmonary disease (eight percent).Thirteen percent of all cases had a final diagnosis defined as a potentially life-threatening condition. Among these, 22.0% of prehospital assessments were retrospectively judged as potentially inappropriate.Forty-nine percent had a defined final diagnosis not fulfilling the criteria for a potentially life-threatening condition. Among these cases, 30.0% of prehospital assessments were retrospectively judged as potentially inappropriate.Conclusion:Among patients who used EMS on multiple occasions, the most common symptoms on-scene were dyspnea, chest pain, and abdominal pain. The most common final diagnosis was chronic obstructive pulmonary disease. In 13.0%, the final diagnosis of a potentially life-threatening condition was indicated. In a minority of these cases, the assessment on-scene was judged as potentially inappropriate.TärnqvistJ, DahlénE, NorbergG, MagnussonC, HerlitzJ, StrömsöeA, AxelssonC, Andersson HagiwaraM. On-scene and final assessments and their interrelationship among patients who use the EMS on multiple occasions. Prehosp Disaster Med. 2017;32(5):528–535.

scholarly journals A life-threatening condition – ruptured ectopic pregnancy with negative urine pregnancy test: A case report

2021 ◽  
Vol 16 (1) ◽  
pp. 121-123
Author(s):  
Fadzilah Mohamad ◽  
Ahmad Shuib Yahya ◽  
Aneesa Abdul Rashid ◽  
Navin Kumar Devaraj ◽  
Abdul Hadi Abdul Manap
Keyword(s):  
Abdominal Pain ◽  
Emergency Management ◽  
Ectopic Pregnancy ◽  
Case Reports ◽  
Rare Occurrence ◽  
Pregnancy Test ◽  
Threatening Condition ◽  
Life Threatening ◽  
Rule Out ◽  
Urine Pregnancy Test

Ectopic pregnancy is an extra-uterine pregnancy and is a potentially life-threatening condition that can lead to death from intra-peritoneal hemorrhage. This case reports a rare occurrence of ruptured tubal pregnancy in which the patient presented early with abdominal pain and a negative urine pregnancy test but subsequently presented again with evidence of intra-peritoneal hemorrhage. A negative urine pregnancy test is often used to rule out pregnancy, but it is not 100% sensitive. Complete assessment is critical in this important diagnosis in order to plan for the appropriate emergency management.

scholarly journals Multiply Recurrent Episodes of Gastric Emphysema

2011 ◽  
Vol 2011 ◽  
pp. 1-3 ◽  
Author(s):  
Eric M. Pauli ◽  
Jonathan M. Tomasko ◽  
Vishal Jain ◽  
Charles E. Dye ◽  
Randy S. Haluck
Keyword(s):  
Abdominal Pain ◽  
Chronic Abdominal Pain ◽  
Diagnostic Challenge ◽  
First Case ◽  
Threatening Condition ◽  
Life Threatening ◽  
Gastric Emphysema ◽  
Serial Episodes ◽  
Arterial Anatomy ◽  
Precipitating Factor

Introduction. Gastric emphysema can present both a diagnostic challenge and a life-threatening condition for patients and has only once been reported as being recurrent.Background. A 64-year-old male presented with chronic abdominal pain and was found to have gastric pneumatosis on CT scan. The patient was successfully managed conservatively. The cause was attributed to aberrant arterial anatomy and atherosclerosis along with hypotension. The patient has since had 3 episodes of recurrent gastric emphysema, all managed nonoperatively.Discussion. To our knowledge, this is the first case of both serial episodes of gastric pneumatosis and gastric mucosal ischemia as a precipitating factor for the development of gastric emphysema.

scholarly journals Spontaneous Isolated Celiac Artery Dissection: A Case Report

2020 ◽  
Vol 4 (3) ◽  
pp. 414-416
Author(s):  
Clifford Freeman ◽  
Aaron Lacy ◽  
Aubrey Miner ◽  
Devin Rogers ◽  
Austin Smith ◽  
...  
Keyword(s):  
Emergency Department ◽  
Abdominal Pain ◽  
Case Report ◽  
Celiac Artery ◽  
Chief Complaint ◽  
Diagnostic Tools ◽  
Artery Dissection ◽  
Emergency Physicians ◽  
Threatening Condition ◽  
Life Threatening

Introduction: Abdominal pain is a common chief complaint that can represent a wide breadth of diagnoses, ranging from benign to life-threatening. As our diagnostic tools become more sophisticated, we are able to better identify more causes of potentially life-threatening diseases. One such disease that is relatively unfamiliar to clinicians is spontaneous isolated celiac artery dissection (SICAD). Case Report: We describe a case of a 46-year-old man who presented to our emergency department with a chief complaint of abdominal pain and was found to have a SICAD and was successfully treated with anticoagulation, antihypertensives, and observation. Conclusion: It is important for emergency physicians to keep this potentially life-threatening condition in mind and to know the appropriate first steps once identified.

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