ABSTRACT
La hemofilia es una enfermedad hemorrágica grave con gran heterogeneidad fenotípica. Los sangramientos músculo-articulares constituyen la manifestación clínica más frecuente y significativa por las secuelas crónicas que originan. Sin embargo, existen otros sitios de sangramiento menos reiterados que pueden ser graves e invalidantes, y la posibilidad de reconocerlos tempranamente evita las consecuencias adversas. Se presentan dos pacientes de edad pediátrica que acudieron al servicio de urgencias por eventos hemorrágicos en sitios poco usuales: mediastinal, pulmonar y de rectos anteriores. A todos se les realizó un diagnóstico temprano del proceso patológico basado en un interrogatorio y examen físico detallados, apoyado con estudios imagenológicos (radiografía y ultrasonido) que permitieron manejar estas hemorragias de forma adecuada con terapia sustitutiva oportuna, sin complicaciones ulteriores. De esta forma se evidencia que el diagnóstico precoz es elemento fundamental en el seguimiento de los pacientes con hemofilia para evitar complicaciones de esta enfermedad(AU)
Hemophilia is a serious hemorrhagic disease with marked phenotypic heterogeneity. Muscle and joint bleedings are the most common clinical manifestation and they stand out by the resultant chronic sequelae. However, there are other less frequent types of bleeding disorders that can be severe and disabling and the possibility to recognize them early avoids adverse consequences. We present two pediatric patients who attended the emergency service with bleeding events in unusual places: mediastinal, pulmonary and rectus. These patients were early diagnosed based on a detailed interview and physical examination supported by imaging studies such as radiography and ultrasound which enabled the appropriate handling of these bleedings with opportune replacement therapy and without further complications. It is evident that early diagnosis is the key element in monitoring patients with hemophilia to prevent complications of the disease(AU)
Subject(s)
Humans , Male , Child, Preschool , Child , Early Diagnosis , Gastrointestinal Hemorrhage/complications , Hemophilia A/diagnosis , Hemophilia A/prevention & control , Hemorrhage/diagnostic imaging , Hemothorax/diagnosis , Rectal Diseases/bloodABSTRACT
Central venous catheterization has been widely used in the anesthetic management. Unfortunately, the use of central venous catheter may be associated with adverse events that are hazardous to patients. We experienced a lethal hemomediastinum following subclavian venous catheterization and we discussed the facts that should be kept in mind to prevent the serious complications.
Subject(s)
Humans , Catheterization , Catheters , Central Venous CathetersABSTRACT
Numerous complications may accompany the central venous catheterization. The followings have been reported after central venous catheterization as complications: thrombophlebitis, air embolism, pneumothorax or hydrothorax, subcutaneous emphysema, cardiac tamponade and perforation of a major structure. Late perforation of vascular structures by central venous catheter tips are unusual, but potentially lethal complication. We report a case of lethal hemomediastinum after catheterization with a central venous catheter.