Accidental Falls ; Adult ; Brain Injuries ; diagnosis ; Female ; Glasgow Coma Scale ; Head Injuries, Closed ; diagnosis ; etiology ; Hematoma, Subdural ; diagnosis ; physiopathology ; therapy ; Humans ; Male ; Middle Aged

Esophageal and gastric varix, portal hypertensive gastropathy, Mallory-Weiss tear and gastric ulcer are common causes of bleeding in patients with liver cirrhosis. However, spontaneous arterial bleeding without a history of trauma is a rare cause of bleeding which can be fatal. We report a case of a 55-year-old woman with alcoholic liver cirrhosis who developed spontaneous bleeding of multiple right lumbar arteries and died in spite of repetitive transfusion and embolization.
Arteries ; Female ; Gastrointestinal Hemorrhage/*etiology/therapy ; Hematoma/diagnosis ; Humans ; Liver Cirrhosis/complications/*diagnosis ; Lung Injury/pathology ; Middle Aged ; Tomography, X-Ray Computed

Complications associated with an intramural hematoma of the bowel, is a relatively unusual condition. Most intramural hematomas resolve spontaneously with conservative treatment and the patient prognosis is good. However, if the symptoms are not resolved or the condition persists, surgical intervention may be necessary. Here we describe internal incision and drainage by endoscopy for the treatment of an intramural hematoma of the duodenum. A 63-yr-old woman was admitted to the hospital with hematemesis. The esophagogastroduodenoscopy (EGD) showed active ulcer bleeding at the distal portion of duodenal bulb. A total of 10 mL of 0.2% epinephrine and 2 mL of fibrin glue were injected locally. The patient developed diffuse abdominal pain and projectile vomiting three days after the endoscopic treatment. An abdominal computed tomography revealed a very large hematoma at the lateral duodenal wall, approximately 10X5 cm in diameter. Follow-up EGD was performed showing complete luminal obstruction at the second portion of the duodenum caused by an intramural hematoma. The patient's condition was not improved with conservative treatment. Therefore, 21 days after admission, endoscopic treatment of the hematoma was attempted. Puncture and incision were performed with an electrical needle knife. Two days after the procedure, the patient was tolerating a soft diet without complaints of abdominal pain or vomiting. The hematoma resolved completely on the follow-up studies.
Drainage ; Duodenal Diseases/*diagnosis/pathology/surgery ; Endoscopy, Digestive System ; Female ; Gastrointestinal Hemorrhage/*etiology/therapy ; Hematoma/*diagnosis/pathology/surgery ; Humans ; Intestinal Obstruction/*etiology/therapy ; Middle Aged ; Tomography, X-Ray Computed

Hemorrhagic fever with renal syndrome (HFRS) is an acute viral disease characterized by fever, hemorrhage, and renal failure. Among the various hemorrhagic complications of HFRS, the spontaneous rupture of an arteriovenous malformation of the testicular vessels with a retroperitoneal hematoma is a rare finding. Here, we report a case of HFRS complicated by a massive retroperitoneal hematoma that was treated with transcatheter arterial embolization.
Adult ; Arteriovenous Malformations/*complications ; Embolization, Therapeutic ; Hematoma/diagnosis/*etiology/therapy ; Hemorrhagic Fever with Renal Syndrome/*complications ; Humans ; Kidney Cortex/blood supply ; Male ; Retroperitoneal Space ; Rupture, Spontaneous ; Testis/blood supply

Paracentesis is a diagnostic, therapeutic procedure performed in patients with ascites. It is generally thought to be a safe procedure and transfusion of platelet concentrate or fresh frozen plasma is not recommended before the procedure, because the incidence of clinically significant bleeding is very low. We report a case of lateral abdominal wall hematoma due to the injury of the deep circumflex iliac artery after paracentesis in patient with alcoholic liver cirrhosis who was treated with transcatheter arterial embolization.
Abdominal Wall/*blood supply ; Embolization, Therapeutic ; Hematoma/etiology/*therapy ; Humans ; Iliac Artery/injuries ; Liver Cirrhosis, Alcoholic/diagnosis ; Male ; Middle Aged ; Paracentesis/adverse effects

No abstract available.
Acute Disease ; Aged ; Anticoagulants/therapeutic use ; Antihypertensive Agents/therapeutic use ; Aortic Diseases/diagnosis/*etiology/physiopathology/therapy ; Aortography/methods ; Arterial Pressure ; Female ; Fibrinolytic Agents/*adverse effects ; Hematoma/diagnosis/*etiology/physiopathology/therapy ; Humans ; Pulmonary Embolism/diagnosis/*drug therapy ; Recombinant Proteins/adverse effects ; Thrombolytic Therapy/*adverse effects ; Tissue Plasminogen Activator/*adverse effects ; Tomography, X-Ray Computed ; Treatment Outcome ; Vena Cava Filters

Scurvy is very rare disease in industrialized societies. Nevertheless, it still exists in higher risk groups including economically disadvantaged populations with poor nutrition, such as the elderly and chronic alcoholics. The incidence of scurvy in the pediatric population is very low. This study reports a case of scurvy in a 5-year-old girl with cerebral palsy and developmental delay based on MRI findings.
Ascorbic Acid/blood/therapeutic use ; Bone Diseases, Metabolic/etiology ; Cerebral Palsy/complications ; Child, Preschool ; Cholecalciferol/blood ; Developmental Disabilities/complications ; Drainage ; Female ; Femur/pathology/radionuclide imaging/surgery ; Fever/etiology ; Follow-Up Studies ; Hematoma/diagnosis/etiology/surgery ; Humans ; Knee/radiography ; Magnetic Resonance Imaging/*methods ; Muscle Weakness/etiology ; Rare Diseases ; Scurvy/complications/*diagnosis/drug therapy ; Thigh/pathology ; Vitamins/therapeutic use

Therapeutic paracentesis is considered to be a relatively safe procedure and is performed commonly for the control of massive ascites in patients with liver cirrhosis. The commonest puncture site, approximately 4 or 5 cm medial of left anterior superior iliac spine, can be located across the route of the inferior epigastric artery, which is one of the sites of potential massive bleeding. In a 46-year-old woman with liver cirrhosis and refractory ascites, a huge abdominal wall hematoma developed after therapeutic paracentesis. The patient was not stabilized by conservative treatment, and inferior epigastric artery injury was confirmed on angiography. Angiographic coil embolization of the inferior epigastric artery was conducted, after which the bleeding ceased and the hematoma stopped growing. This case indicates that physicians performing paracentesis should be aware of the possibility of inferior epigastric artery injury and consider early angiographic coil embolization when a life-threatening abdominal wall hematoma develops.
Abdominal Wall ; Angiography ; Ascites/surgery ; Embolization, Therapeutic ; Epigastric Arteries/*injuries ; Female ; Hematoma/*etiology/radiography/therapy ; Humans ; Liver Cirrhosis/*diagnosis ; Middle Aged ; Paracentesis/*adverse effects ; Tomography, X-Ray Computed ; Wounds, Nonpenetrating/complications