• Title/Summary/Keyword: Massive hemorrhage

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Massive Intracerebral Hemorrhage Caused by a Cavernous Malformation

  • Kim, Young-Soo;Lee, Jae-Il;Choi, Chang-Hwa;Ko, Jun-Kyeung
    • Journal of Korean Neurosurgical Society
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    • v.51 no.1
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    • pp.37-39
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    • 2012
  • We present a rare case of massive intracerebral hemorrhage resulting from a small, superficially-located supratentorial cavernous malformation, or cavernoma. These lesions rarely lead to massive, life-threatening intracerebral hemorrhages. A 17-year-old female presented with a 3-week history of declining mental status. Brain computed tomography and magnetic resonance imaging revealed a sizable intracranial hemorrhage, within the right occipital region, associated with a small nodule at the hematoma's posterior margin. An emergency operation removed the entire hematoma and nodule. Histological examination of the nodule was compatible with a diagnosis of cavernous malformation. The patient's post-operative course was uneventful.

Direct Removal of Fourth Ventricle Hematoma in Massive Intraventricular Hemorrhage

  • Kim, You-Sub;Ryu, Han-Seung;Kim, Tae-Sun;Joo, Sung-Pil
    • Journal of Korean Neurosurgical Society
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    • v.65 no.2
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    • pp.325-330
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    • 2022
  • Various grading systems and surgical techniques have been developed for the treatment of intraventricular hemorrhage (IVH); however, little attention has been paid to the fourth ventricle hematoma. Nonetheless, hemorrhagic dilation of the fourth ventricle may lead to catastrophic consequences for patients with massive IVH. We present two cases of massive IVH accompanied by massive fourth ventricle hematoma which was successfully removed with combination of suboccipital craniotomy for fourth ventricle hematoma and intraventricular fibrinolysis for supratentorial hematoma.

A Vestibular Schwannoma Associated with Massive Intratumoral Hemorrhage (종양내 출혈을 동반한 청신경 초종)

  • Jeong, Je Hoon;Leem, Won;Lee, Ki Taeck;Lim, Young Jin;Kim, Tae Sung;Kim, Gook Ki;Rhee, Bong Arm
    • Journal of Korean Neurosurgical Society
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    • v.30 no.8
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    • pp.1028-1032
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    • 2001
  • The report of massive intratumoral hemorrhage from vestibular schwannoma is rare. A 66-year-old female who had suffered from disturbance of hearing for one year developed severe headache and dizziness. Brain MRI showed crescent shaped mass in the left cerebellopontine angle. A left suboccipital approach revealed an $3{\times}3cm$-sized encapsulated mass. The tumor was totally extirpated together with clot. Histologically the tumor was schwannoma with massive hemorrhage. Postoperative course was uneventful. The authors report the rare case of vestibular schwannoma presenting with intratumoral hemorrhage with review of possible pathophysiology and associated factor.

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Massive Intracerebral Hemorrhage Following Drainage of Subdural Hygroma

  • Kim, Sung-Soo;Kim, Choong-Hyun;Cheong, Jin-Hwan;Kim, Jae-Min
    • Journal of Korean Neurosurgical Society
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    • v.41 no.4
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    • pp.261-263
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    • 2007
  • Subdural hygromas are easily treated by trephination and drainage. Therefore, most neurosurgeons do not consider subdural hygromas seriously. However, various complications including intracerebral hemorrhage may develop after rapid drainage of subdural hygroma although rare. Postoperative intracerebral hemorrhage presents with a rapid deterioration of consciousness and focal neurological deficits occurring immediately after drainage of the subdural hygroma. The authors present an unfortunate massive intracerebral hemorrhage and pneumocephalus following drainage of the bifrontal subdural hygroma. The patient subsequently died. To prevent this disastrous complication, close neurosurgical observation and gradual drainage under a closed system seem mandatory. Possible pathogenic mechanisms for this unfavorable complication is discussed with a review of pertinent literatures.

Life-Threatening Lower Gastrointestinal Hemorrhage in Pediatric Crohn's Disease

  • Kim, Earl;Kang, Yunkoo;Lee, Mi Jung;Park, Young Nyun;Koh, Hong
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.16 no.1
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    • pp.53-60
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    • 2013
  • In Crohn's disease, mild gastrointestinal bleeding often occurs; however massive gastrointestinal hemorrhage, which can have a dramatic effect on a patient's vital sign, is rare. This could result in potentially life-threatening complications, which can lead to death. Massive hemorrhagic Crohn's disease is not well known and for this reason, they are a diagnostic and therapeutic challenge. Various diagnostic and therapeutic methods are currently being developed and used. The surgical method is often used only as a last measure since this approach has the risk of serious complications that may endanger patients. However, if massive bleeding continues even after all therapeutic methods are used, the surgical method must be implemented. In this case, all therapeutic methods were found to be ineffective; therefore, surgery was used as a last option. Ultimately, the surgical method was found to be successfully used to treat life-threatening hemorrhagic Crohn's disease.

Massive Hemorrhage Caused by a Non-Displaced Pubic Ramus Fracture from Low-Energy Trauma (저에너지 외상에 의한 비전위 치골지 골절에서 발생한 대량출혈)

  • Na, Hwa-Yeop;Shin, Keun-Young;Choe, Saehun
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.6
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    • pp.557-561
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    • 2019
  • Most low-energy pelvic ring fractures in elderly patients are treated conservatively so that an initial evaluation for complications such as vascular injury is usually overlooked. An 81-year-old female, who was taking regular aspirin, visited the emergency room and was diagnosed with a simple non-displaced pubic ramus fracture from a low-energy fall from standing, which was complicated by massive hemorrhage from the overlooked injury of the corona mortis. Elderly patients with pelvic ring fractures can have a delayed presentation of vascular injuries, regardless of the degree of displacement of the fractures, which highlights the need for a careful physical examination and close monitoring.

Gastric Duplication Cyst Presenting as Massive Gastrointestinal Bleeding

  • Youssef, Alexey;Ibrahim, Alexander;AlShehabi, Zuheir;Omran, Ammar;Sharara, Ala I.
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.22 no.2
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    • pp.189-192
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    • 2019
  • Gastric duplication cysts (GDCs) are rare congenital anomalies. Presentation of GDCs varies from an asymptomatic abdominal mass to fulminant or massive gastrointestinal (GI) bleeding. Herein, we describe a case of a GDC in a 10-month-old infant presenting with unexplained massive GI hemorrhage and hematemesis. An abdominal ultrasound was negative, while computerized tomography was, initially, inaccessible. Through a series of repeated esophagogastroduodenoscopies, we documented penetration of the GDC into the gastric cavity that was later confirmed by computerized tomography. The patient was treated successfully with surgical resection.

Severe Airway Obstruction due to Massive Retropharyngeal Hematoma in a Warfarin-Taking Patient with a Normal International Normalized Ratio

  • Cho, Hyun Young;Kim, Hyung Il
    • Journal of Trauma and Injury
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    • v.34 no.1
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    • pp.57-60
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    • 2021
  • Warfarin is used as part of the treatment of various diseases, and laboratory monitoring of its effects is required. Airway hematoma secondary to warfarin is rare, but can be fatal because of potential airway obstruction. Rapid definitive airway establishment is crucial if airway obstruction is suspected. This complication is more likely to occur in those with elevated coagulation laboratory values. However, we experienced a patient in whom a massive retropharyngeal hematoma caused airway obstruction after a non-severe motor vehicle collision. The patient had been taking warfarin, and had coagulation parameter values within the normal ranges. A major fracture or hemorrhage was not anticipated. Upon examination, a massive retropharyngeal hematoma was noted. Orotracheal intubation failed due to an airway obstruction. Emergency tracheostomy and an operation for hematoma removal were performed. Physicians must always consider the possibility of airway hematoma in warfarin-taking patients with normal coagulation values regardless of the severity of mechanism of injury.

A Clinical Review of the 100 Cases of Pneumonectomy (일측폐 전적출술 100례에 대한 임상적 고찰: 특히 합병증의 원인에 대하여)

  • 김진식;김의윤;손재현
    • Journal of Chest Surgery
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    • v.3 no.1
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    • pp.3-12
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    • 1970
  • During the last 10 years of period, one hundred patients with various pulmonary diseases were pneumonectomized upon at the Department of Chest Surgery of Pusan University Hospital. This paper is concerned with the clnical results of these patients along with the serious postoperative complications such as postoperative intrapleural infection and hemorrhage. The results were obtained as follows. 1.Left pneumonectomy was done in sixty-six of 100 patients [66 %] and the right one was done in the rest thirty-four[34 %]. The ratio between left and right was nearly 2:1. 2.Of all oostoperative complications, the intrapleural infection was most common, and these were 53 % in empyema thoracis and 12.7 % in pulmonary tuberculosis respectively. 3.More postoperative complications could be seen after right pneumonectomy than the left one. 4.It was thought that the postoperative intrapleural infection was closely correlated with the methods of pleural dissection at pneumonectomy,postoperatlve tube drainage, time of operation, massive hemorrhage during operation, prolongation of bleeding time, and dysfunction of the liver. 5.The repeated thoracenteses with infusion of neomycin into the infected thoracic cavity and intravenous administrations of the high units of penicillin were effective in treatment of the postoperative intrapleural infection, however, the refractory cases have to be cured by thoracoplasty with open window. 6.Immediate secondary open thoracotomy appears to be the method of choice in life saving who developed massive intrathoracic hemorrhage after pneumonectomy. 7.The mortality rate was 10 % in our cases and the main causes of death were postoperative respiratory insufficiency, pulmonary edema, hemorrhage and sudden cardiac arrest.

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Body mass index and massive hemorrhage after cesarean section in patients with placenta previa

  • Changrock Na;Hyun Jung Kim
    • Journal of Medicine and Life Science
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    • v.19 no.2
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    • pp.39-45
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    • 2022
  • This study was undertaken to assess the potential of body mass index (BMI) as a risk factor for massive hemorrhage (MH) after cesarean section (CS) in patients with placenta previa. We retrospectively reviewed the medical records of patients who underwent CS for placenta previa between January 2010 and December 2018. MH was defined as an estimated blood loss ≥2,000 mL during surgery. Clinical characteristics, including BMI, were compared between the groups with and without MH. Subsequently, multivariable logistic regression analysis was conducted to identify the independent risk factors for MH. A total of 189 patients were included in this study. MH was observed in 28 patients (14.8%). According to the multivariable logistic regression analysis results, the risk factors independently associated with MH were BMI at delivery (adjusted odds ratio [aOR], 1.19; 95% confidence interval [CI], 1.04-1.35; P=0.012), placenta accrete (aOR, 24.55; 95% CI, 2.75-219.02; P=0.004), and total previa degree (aOR, 9.86; 95% CI, 2.71-35.96; P=0.001). The study findings showed that maternal obesity, namely a higher BMI at delivery, was an independent risk factor for MH after CS in patients with placenta previa. Close attention should be paid to the potential risk of hemorrhage associated with maternal obesity as well as the well-known risk factors of placenta accreta and total previa degree.