• Title/Summary/Keyword: Massive bleeding

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Spontaneous Spinal Epidural Hematoma with Intraoperative Acute Massive Bleeding - Case Report - (수술중 급성 대량 출혈을 동반한 자발성 척추경막외혈종 - 증 례 보 고 -)

  • Kim, Hyoung Jong;Hwang, Soo Hyun;Park, In Sung;Kim, Eun-Sang;Jung, Jin-Myung;Han, Jong Woo
    • Journal of Korean Neurosurgical Society
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    • v.29 no.9
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    • pp.1184-1187
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    • 2000
  • Spontaneous spinal epidural hematoma is rare disease and usually presents with a progressive neurological syndrome for which surgical decompression is usually indicated. The cause of bleeding in epidural hematoma remains unknown in most of the cases. The most frequently identified risk factor is coagulopathy or treatment with anticoagulants. Recently, authors experienced a case of spontaneous spinal epidural hematoma with intraoperative profuse bleeding at the cervicothoracic location. Laboratory examination showed no evidence of coagulopathy or hepatic disease. On neurologic examination, left hemiparesis(Grade : II) and left side sensory change were noted. On MRI scan, there was a mass of high signal intensity in T2WI and isosignal intensity in T1WI compressing the cord to left side. The patients had good surgical outcome after decompressive laminectomy and hematoma removal.

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A Study on the Heating Performance of SCW Type Geothermal Heat Pump System for Residential House (지하수 이용 지열 히트펌프 시스템의 주거용 건물 적용시 난방성능 특성에 관한 연구)

  • Kim, Ju-Hwa;Kim, Ju-Young;Hong, Won-Hwa;Ahn, Chang-Hwan
    • Journal of the Korean housing association
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    • v.19 no.5
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    • pp.11-18
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    • 2008
  • Geothermal heat pump system using sanding column well type with their ground heat exchanger can be used as a highly efficient source of heating and cooling in massive buildings. But there is no case of a small scale residential house. So in the residential house this study estimated heating coefficient of performance (COP) of geothermal heat pump system using sanding column well type which is excellent in heat recovery. As a result of analysis, The COP of heat pump is over average 6 and is excellent. And in consequence of making a comparative study according to the bleeding, the COP is higher in the case of bleeding. Therefore, bleeding affects the performance of the system. This study has shown performance result that stands on actual data. Therefore, this study provides ground data that needs when a low capacity of system designs for a residence with confidence elevation.

Traumatic Rupture of a Hepatic Hemangioma (간혈관종의 외상성 파열)

  • Sung, Ji Eun;Park, Sang Jun;Nam, Chang Woo;Hwang, Jae Chol;Kim, Young Min
    • Journal of Trauma and Injury
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    • v.26 no.3
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    • pp.252-254
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    • 2013
  • A hepatic hemangioma is the most frequent benign liver tumor. Once rupture occurs, the bleeding can barely be controlled by using conservative management or endovascular treatment. We report a case of traumatic hepatic hemangioma rupture. A 60-year-old man was referred to our hospital under cardiopulmonary cerebral resuscitation (CPCR). CPCR was continued for 16 minutes after his admission to the emergency room (ER). Computed tomography (CT) showed fluid accumulation in the peritoneal cavity with active contrast extravasation in the left lateral segment of the liver. Percutaneous transarterial embolization and massive transfusion were carried out. Embolization did not stop the bleeding, we decided on an exploration and then resected the lateral segment of the liver to control the bleeding. The specimen showed a ruptured hemangioma in the liver segment.

A Case of Tracheo-Innominate Artery Fistula after Tracheostomy (기관절개술 후 발생한 기관무명동맥루 1예)

  • Lee, Jae Hun;Hong, Seok Min;Kim, Yong Bok;Park, Il-Seok
    • Korean Journal of Bronchoesophagology
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    • v.18 no.2
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    • pp.56-59
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    • 2012
  • Tracheo-innominate artery fistula (TIF) is a rare but catastrophic and almost always fatal complication of tracheostomy. TIF can occur anytime but is commonly present 3 to 24 days after tracheostomy. It can first manifest as massive bleeding around and through the tracheostomy tube, but it can also manifest as a small amount of blood with temporary spontaneous resolution. If TIF is suspicious, airway management and prompt surgical intervention are needed. In an 83-year-old man with CVA history 20 years earlier and who had recurrent aspiration pneumonia, tracheostomy was performed for respiratory management and ventilator support. On day 7 post-tracheostomy, the patient had bleeding from the tracheostoma. Immediate surgical exploration was performed to control the bleeding. A defect was seen at the post wall of the innominate artery. The erosive portion of the artery was sutured, but the patient died three weeks after the surgery due to rebleeding and respiratory failure. We present a patient who developed TIF after tracheostomy, with literature review.

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Meckel's Diverticulum Diagnosed in a Child with Suspected Small Bowel Crohn's Disease

  • Kang, Hyun Sik;Lee, Jeong Sub;Hyun, Chang Rim;Jung, In-Ho;Kang, Ki Soo
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.22 no.1
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    • pp.98-104
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    • 2019
  • We report a rare case of Meckel's diverticulum in a boy who initially presented with chronic iron deficiency anemia (IDA) without any history of gastrointestinal (GI) bleeding at 8 years-old. Isolated small bowel Crohn's disease was suspected based on findings of small bowel ulcers on capsule endoscopy. At four years from initial presentation, he developed massive GI bleeding. Abdominal computed tomographic angiography and small bowel series revealed findings suggestive of Meckel's diverticulum. Meckel's diverticulum should be suspected in children with unexplained chronic IDA even in the absence of prominent GI bleeding and negative findings on repetitive Meckel's scans. Moreover, Meckel's diverticulum should be included in the differential diagnosis of isolated small bowel Crohn's disease when the disease is limited to a short segment of the distal small bowel, as ulcers and inflammation may result as a consequence of acid secreted from adjacent heterotopic gastric mucosa constituting the Meckel's diverticulum.

A Case of Henoch-Schönlein Purpura with Fulminant Complications and Its Long-term Outcome

  • Lee, Dong Hyun;LEE, Eun-So;Hong, Jeong;Park, Kwang-Hwa;Pai, Ki Soo
    • Childhood Kidney Diseases
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    • v.23 no.2
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    • pp.128-133
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    • 2019
  • Henoch-$Sch{\ddot{o}}nlein$ purpura (HSP) is a systemic vasculitis characterized by purpura, arthritis, abdominal pain, and nephritis. Gastrointestinal involvement can manifest as pain, intussusception, intestinal bleeding, and intestinal perforation. We report a case of fulminant HSP at an age of eight in 1994, with multiple complications of intra-thoracic bleeding, massive intestinal perforation, nephritis, and various skin rashes. The brisk bleeding findings of intestinal on Technetium-99m-labeled red blood cell scan ($^{99m}Tc$ RBC scan) were well matched to those of the emergency laparotomy and the resected intestine. The patient's abdominal conditions improved gradually but nodular skin eruptions developed newly apart from improving preexisting lower limb rashes and the urine findings continued abnormal, so skin and kidney biopsy were done for the diagnosis. After cyclosporine therapy, skin eruptions and urine findings returned to normal gradually. On a follow-up after 25 years in 2019, the patient is 33-year-old, healthy without any abnormality on blood chemistries and urine examination.

Hookworm Infection Caused Acute Intestinal Bleeding Diagnosed by Capsule: A Case Report and Literature Review

  • Tan, Xia;Cheng, Meichu;Zhang, Jie;Chen, Guochun;Liu, Di;Liu, Yexin;Liu, Hong
    • Parasites, Hosts and Diseases
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    • v.55 no.4
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    • pp.417-420
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    • 2017
  • Hookworm infections are rare causes of acute gastrointestinal bleeding. We report a middle aged man with primary nephrotic syndrome and pulmonary embolism. During the treatment with steroids and anticoagulants, the patient presented acute massive hemorrhage of the gastrointestinal tract. The results of gastroscopy showed red worms in the duodenum. Colonoscopy and CT angiogram of abdomen were unremarkable. Capsule endoscopy revealed fresh blood and multiple hookworms in the jejunum and ileum. Hookworms caused the acute intestinal bleeding. The patient responded well to albendazole. Hematochezia was markedly ameliorated after eliminating the parasites. Hence, hookworm infection should be considered in the differential diagnosis of a patient with obscure gastrointestinal bleeding. Capsule endoscopy may offer a better means of diagnosis for intestinal hookworm infections.

Penetrating Chest Trauma in Autopneumonectomy Status due to Pulmonary Tuberculosis : 1 Case Report (폐결핵에 의한 전폐자가절제 환자에서의 흉부 자상 치험 1례-)

  • Hong, Yoon Joo
    • The Korean Journal of Emergency Medical Services
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    • v.9 no.1
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    • pp.89-93
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    • 2005
  • Penetrating chest trauma by stab injury may result in massive hemothorax from damage to single or multiple intrathoracic organs such as heart, aorta, internal mammary artery, intercostal artery or pulmonary parenchyme. Prognosis of massive hemothorax necessitating emergency thoracotomy is fatal especially so if there exists concomitant underlying compromise of cardiopulmonary function. A 56 year old man with destroyed left lung due to old pulmonary tuberculosis was stabbed in right parasternal lesion through third intercostal space. Intubation with cardiopulmonary resuscitation and closed thoracostomy were performed to resuscitate from cardiac asystole from hemorrhagic shock and acute respiratory distress. Midsternotomy was made to expose active bleeding foci in right mammary artery, subclavian vein, intercostal artery and anterior segment of right upper lung showing severe bullous change and pleural adhesion. Postoperative care included ventilator support, inotropic instillation and cautious, balance fluid therapy ; successful extubation was done on third postoperative day and patient was discharged on tenth postoperative day without any complication.

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Massive Hemothorax Occurring with Intramural Hematoma of the Descending Aorta in the Early Postpartum Period

  • Yun, Jeong Hee;Jeon, Yeong Jeong;Hong, Tae Hee;Byun, Joung Hun;Hwang, Sang Won;Park, Jae Hong
    • Journal of Chest Surgery
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    • v.49 no.2
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    • pp.122-125
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    • 2016
  • Postpartum aortic intramural hematoma (IMH) is a rare but potentially lethal condition. We report a case of aortic IMH with massive hemothorax in a postpartum woman. The patient was a 31-year-old woman who had delivered twins by cesarean section. Two days after delivery, she complained of sudden-onset dyspnea. Chest computed tomography revealed a massive left hemothorax. Exploratory thoracotomy was performed, and we found a defect measuring approximately 6 mm in the adventitial layer of the thoracic aorta and an IMH. We repaired the defect primarily, and no more bleeding was observed. The patient was discharged on the 19th postoperative day without any complications.

Massive hemothorax resulting from spontaneous pneumothorax (자연성 기흉으로 인한 대량의 혈흉)

  • Hong, Ji Yeon;Kim, Su Wan
    • Journal of Medicine and Life Science
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    • v.17 no.1
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    • pp.16-20
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    • 2020
  • Spontaneous hemopneumothorax is a rare disease, and it can cause life threatening condition. It is characterized by the accumulation of more than 400 mL of blood and air in the pleural cavity without any other apparent causes. A previously healthy 22-year-old female patient presented with acute chest pain and dyspnea. Chest X-ray and computed tomography revealed a massive hemopneumothorax in the left hemithorax. The images showed a completely collapsed left lung with right-sided tracheal deviation, several pleural adhesion bands, and fluid collection with air-fluid level. We emergently performed a closed thoracostomy, and then 560 mL of fresh bloods were initially drained. We considered an emergent video-assisted thoracoscopic surgery for pulmonary wedge resection and bleeding control because of the massive hemothorax. However, the patient's vital signs were stabilized after blood transfusion and supportive cares for re-expansion pulmonary edema. The patient discharged from the hospital on 11th in-hospital day after removal of the chest tube, and there had not been any recurrence of the pneumothorax for 10 months. We suggest that treatment strategy should be decided upon individually based on the patient's condition and clinical course of the disease.