RESUMO
Hereditary hemorrhagic telangiectasia (HHT) is a hereditary, autosomal dominant, vascular dysplasia characterized by mucocutaneous telangiectasia, epistaxis, gastrointestinal bleeding, and iron deficiency anemia. Epistaxis in HHT is a recurrent and debilitating symptom, which is difficult to manage. Many methods have been tried with little success. Bevacizumab (Avastin®), a VEGF inhibitor, has been recently tried intranasally or systemically to control the recurrent epistaxis. We report three patients with HHT who were treated with intranasal bevacizumab application together with cauterization. In all three patients, recurrent epistaxis decreased considerably with improvement in quality of life. Here we describe the application methods, treatment results, and complications with literature review. We believe that this is the first report of treating epistaxis in HHT with intranasal application of bevacizumab in South Korea.
Assuntos
Humanos , Anemia Ferropriva , Bevacizumab , Cauterização , Epistaxe , Hemorragia , Coreia (Geográfico) , Qualidade de Vida , Telangiectasia Hemorrágica Hereditária , Telangiectasia , Fator A de Crescimento do Endotélio VascularRESUMO
Arthroscopic shoulder surgery has become a common and routine procedure because it provides several advantages for the diagnosis and therapy of shoulder injuries. However, shoulder arthroscopy is not a technique that's void of complications. We describe here a unique case of a patient who experienced pleural effusion caused by extravasation of irrigation fluid during arthroscopic shoulder surgery, and this surgery was done under general anesthesia.
Assuntos
Humanos , Anestesia Geral , Artroscopia , Derrame Pleural , OmbroRESUMO
The severe bradycardia and asystole are uncommon complications of epidural anesthesia but can be life threatening if not managed properly. A 73-year-old, ASA class 3, male patient was admitted for a total knee replacement under epidural anesthesia. Approximately 10 minutes after epidural anesthesia, the heart rate decreased significantly to 20 beats/min with asystole. The heart rate returned to 80 beats/min after administering atropine, ephedrine, and external cardiac compression. Severe bradycardia and asystole may be induced by vagal activation as a result of the low venous return and sympathetic blockade.