ABSTRACT
Spontaneous intra-abdominal hemorrhages are uncommon in hemophilic patients. They can cause complications in patients with severe hemophilia, and are associated with a high mortality rate. To date, there is no guideline for the management of intra-abdominal hemorrhage in patients with hemophilia. Management of intra-abdominal hemorrhage ranges from conservative treatment to emergent embolization or surgery. We describe two children with hemophilia A, who were successfully treated non-operatively by administering coagulation factor concentrates and embolization, and were later discharged from the hospital. We emphasize the role of an active approach in the evaluation and management of intra-abdominal hemorrhage without any surgical intervention.
Subject(s)
Child , Humans , Blood Coagulation Factors , Hemophilia A , Hemorrhage , MortalityABSTRACT
Spontaneous intra-abdominal hemorrhages are uncommon in hemophilic patients. They can cause complications in patients with severe hemophilia, and are associated with a high mortality rate. To date, there is no guideline for the management of intra-abdominal hemorrhage in patients with hemophilia. Management of intra-abdominal hemorrhage ranges from conservative treatment to emergent embolization or surgery. We describe two children with hemophilia A, who were successfully treated non-operatively by administering coagulation factor concentrates and embolization, and were later discharged from the hospital. We emphasize the role of an active approach in the evaluation and management of intra-abdominal hemorrhage without any surgical intervention.
Subject(s)
Child , Humans , Blood Coagulation Factors , Hemophilia A , Hemorrhage , MortalityABSTRACT
Objective To investigate the cause,prevention and treatment of intra-abdominal hemorrhage after liver transplantation. Methods Clinical data of 82 patients undergoing liver transplantation were retrospectively analyzed. All participants were divided into the intra-abdominal hemorrhage (n =12)and control groups (n =70). Preoperative parameters including age,model for end-stage liver disease (MELD)score,prothrombin time (PT),prothrombin time international normalized ratio (PT-INR),fibrinogen (FIB),activated partial thromboplastin time (APTT),platelet (Plt) were statistically compared between two groups. Intraoperative hemorrhage volume,cold ischemia time of donor liver, anhepatic phase time and operation time were also compared between two groups. Postoperatively,the mortality rate was compared between two groups. Results Among 82 patients,1 2 (1 5%)presented with intra-abdominal hemorrhage and required twice surgical hemostasis. In the intra-abdominal hemorrhage group,4 cases (33%)died,and 8 (1 1%)died in the control group. No statistical significance was documented between two groups (P>0. 05 ). Age,MELD score,PT-INR, FIB,APTT and PLT did not significantly differ between two groups (all P>0. 05 ). Compared with patients in the control group,those in the intra-abdominal hemorrhage group yielded significantly more blood loss intraoperatively,longer operation time and longer cold ischemia time of donor liver (all P<0. 05 ). Anhepatic phase time did not significantly differ between two groups (P>0. 05 ). Conclusions After liver transplantation,intra-abdominal hemorrhage is associated with longer cold ischemia time of donor liver,more intraoperative blood loss and longer operation time. In order to decrease the incidence of postoperative intra-abdominal hemorrhage,coagulation function should be completely corrected prior to surgery and the surgical skills should also be enhanced.
ABSTRACT
Se describen 6 casos clínicos de mujeres con embarazo ectópico intersticial de menor incidencia entre las formas de la variedad tubárica, tratadas en el Hospital Ginecoobstétrico Docente "Tamara Bunke Bider" de Santiago de Cuba. Esta entidad clínica ha mostrado un incremento inusual en la población asistida (7,59 %) que resulta, 2,57 veces mayor que la media (2,95 %) del intervalo notificado en la bibliografía médica (1,9-4 %). Se exponen las historias individuales de las pacientes en forma tabulada y, asimismo, los autores ofrecen sus consideraciones a propósito de estas experiencias.
Six case reports of women with interstitial ectopic pregnancy of lower incidence among the forms of tubaric variety treated in "Tamara Bunke Bider" Teaching Gynecological and Obstetrical Hospital from Santiago de Cuba are described. This clinical entity has shown an unusual increase in the assisted population (7.59%), which is 2.57 times higher than the mean (2.95%) of the interval notified in the medical literature (1.9-4%). Tabulated individual medical records of the patients are exposed and, likewise, the authors offer their considerations concerning these experiences.
ABSTRACT
The clinical data of 67 patients underwent orthotopic liver transplantation, including 4 cases of early intra abdominal hemorrhage after orthotopic liver transplantation, were analyzed retrospectively.Anastomotic liver artery hemorrhage was found in 2 cases, hemorrhage of IVC in 1 case and hemorrhage of right adrenal gland in 1 case. All the 4 patients were correctly dignosed and successfully treated by operation in time. It suggests that the early intra abdominal hemorrhage after orthotopic liver transplantation is mostly due to surgical technique. The improvement of surgical technique,correct diagnosis and timely operation are very important for the treatment of intra abdominal hemorrhage.