Résumé
Chest pain is a symptom observed commonly in outpatients and emergency room patients, and its causes are variable. Because treatment and prognosis of chest pain are different depending on its cause, it is more important than anything else to accurately diagnose the cause of chest pain. Most of patients complaining of chest pain undergo basic tests at a private local clinic or at the Internal medicine or chest surgery department of a general hospital and, they are referred to the pain clinic, with a note stating no particular finding. However, if they have sustained severe neuropathic pain in spite of nerve block, accurate diagnosis for chest pain is essential. We experienced rapidly developing spine breakdown and cord compression caused by metastatic spinal tumor in an inpatient who was being treated for chest pain, and thus, we report here in the case with literature review.
Sujets)
Humains , Douleur thoracique , Urgences , Hôpitaux généraux , Patients hospitalisés , Médecine interne , Bloc nerveux , Névralgie , Patients en consultation externe , Centres antidouleur , Pronostic , Rachis , ThoraxRésumé
Airway management is important during general anesthesia. Difficulties with a direct laryngoscopy can be managed successfully in a routine manner using a laryngeal mask airway. A 65-year-old woman was scheduled to undergo gynecologic surgery. After injecting the intravenous induction agents and muscle relaxants, intubation was attempted with a direct laryngoscope. However, the vocal cords could not be observed with only the epiglottis being slightly visible. Although intubation was re-attempted by another anesthesiologist, it failed. Intubation was successfully performed via an intubating laryngeal mask airway (ILMA) after additional 100% oxygen mask ventilation. We report a case of vocal cord palsy subsequent to tracheal extubation after endotracheal intubation via ILMA.
Sujets)
Sujet âgé , Femelle , Humains , Extubation , Prise en charge des voies aériennes , Anesthésie générale , Épiglotte , Procédures de chirurgie gynécologique , Enrouement , Intubation , Intubation trachéale , Masques laryngés , Laryngoscopes , Laryngoscopie , Masques , Muscles , Oxygène , Ventilation , Paralysie des cordes vocales , Plis vocauxRésumé
Placenta accreta is a rare complication of pregnancy with high rates of maternal morbidity and mortality.It is usually discovered when removal of the placenta after delivery is difficult or there is substantial postpartum bleeding.Placenta accreta can be complicated by disseminated intravascular coagulation (DIC) and this increases maternal morbidity and mortality.DIC is characterized by the widespread activation of coagulation, which results in the intravascular formation of fibrin and ultimately thrombotic occlusion of small and midsize vessel.We report a 24-year-old woman with DIC, who developed severe pre- and intraoperative bleeding and massive transfusion during emergent cesarean section.
Sujets)
Femelle , Humains , Grossesse , Jeune adulte , Dacarbazine , Coagulation intravasculaire disséminée , Fibrine , Hémorragie , Placenta , Placenta accreta , Période du postpartumRésumé
Placenta accreta is a rare complication of pregnancy with high rates of maternal morbidity and mortality.It is usually discovered when removal of the placenta after delivery is difficult or there is substantial postpartum bleeding.Placenta accreta can be complicated by disseminated intravascular coagulation (DIC) and this increases maternal morbidity and mortality.DIC is characterized by the widespread activation of coagulation, which results in the intravascular formation of fibrin and ultimately thrombotic occlusion of small and midsize vessel.We report a 24-year-old woman with DIC, who developed severe pre- and intraoperative bleeding and massive transfusion during emergent cesarean section.