• Title/Summary/Keyword: Risk of bleeding

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A CASE OF INTRAORAL SURGICAL TREATMENT FOR CHILDREN WITH HEMOPHILIA (Hemophilia 환아의 관혈적 치과치료에 관한 증례보고)

  • Lee, Joon-Kyun;Lee, Keung-Ho;Choi, Yeong-Chul
    • Journal of the korean academy of Pediatric Dentistry
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    • v.32 no.4
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    • pp.589-594
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    • 2005
  • With the progress of medical treatment techniques of bleeding control, dental care of the patient with hemophilia has become more convenient. So many surgical treatments can be performed with out-patient. 2 cases of intraoral surgical treatment of children, one with hemophilia 3, sever, the other with hemophilia A, severe. While the former was treated under general anesthesia, the latter was treated under local anaesthesia. There are principles : 1. When a patient with hemophilia need dental treatment, the dentist must consult to his physician, pediatrician, or hematologist before dental treatment. 2. When the dentist make a treatment plan, there should be consideration of the general condition, cooperation of the patient and risk of the treatment needed. 3. Minimize the number of times of coming for dental treatment so that reduce the times that need replacement therapy of coagulation factor. And during the treatment, dentist should care for infection and bleeding.

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The Effects of Exercise Therapy and Transcutaneous Electrical Nerve Stimulation for the Alleviation of Low Back Pain After Coronary Angiography (관동맥 조영술 후 요통완화를 위한 운동요법과 경피적 전기 신경자극의 효과)

  • Hahn, Sook-Won
    • Korean Journal of Adult Nursing
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    • v.14 no.2
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    • pp.222-232
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    • 2002
  • Background and Purpose: After the coronary angiography procedure, patients are required to remain on bed rest to reduce the risk of bleeding and hematoma formation at the puncture site. This prolonged bed rest in the supine position is difficult for many patients, who frequently complain of low back pain. The purpose of the study was to determine whether a specially designed exercise therapy and transcutaneous electrical nerve stimulation (TENS) had an effect on the alleviation of low back pain. Method: Sixty-two patients were assigned to one of three groups : specially designed exercise therapy plus TENS plus general nursing care (exercise group N=21), general nursing care plus TENS (TENS group, N=23) or general nursing care (control group, N=18). The exercise therapy consisted of five movements including stretching, pelvic tilting, knee to chest, modified situps and trunk rotation with minimizing the motion of the puncture site. The severity of low back pain was assessed by a visual analogue scale(VAS) every two hours. The use of analgesic and any development of bleeding or other complications were monitored as well. The level of serum ${\beta}$-endorphin was determined before and after the three interventions. Result: The pain score of the exercise group was significantly lowered compared to that of the other groups. There was no difference in the serum ${\beta}$-endorphin level among three groups. Analgesic were less frequently taken by the exercise group. However the incidence of bleeding complications was not significantly different among the three groups. Conclusion: Exercise therapy is more effective than general care or TENS in alleviating low back pain of the patients with coronary angiography.

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A Case of Gastric Wall Hematoma and Ischemic Necrosis After Endoscopic Biopsy (상부 위장관 내시경조직검사 후 위벽에 발생한 출혈을 동반한 혈종 및 점막 괴사 1예)

  • Kim, You-Min;Lee, Jin-Sung;Kim, Dong-Hee;Sung, Young-Ho;Choi, Sun-Taek;Kim, Hyun-Tae;Lee, Hyun-Wook;Kim, Keung-Ok
    • Journal of Yeungnam Medical Science
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    • v.27 no.2
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    • pp.159-164
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    • 2010
  • Hematoma of gastric wall is very rare, and occasionally associated with coagulopathy, trauma, peptic ulcer disease, and therapeutic endoscopy. Ischemic gastric necrosis is also rare because of the abundant anastomotic supply to the stomach, and it is usually associated with surgery and disruption of the major vessels. Endoscopic submucosal injection of hypertonic saline-epinephrine (HS-E) is a safe, cost-effective, and widely used therapy for hemostasis but it may cause tissue necrosis and perforation. We describe a case of gastric wall hematoma with oozing bleeding after endoscopic gastric mucosa biopsy in 71-year old woman with chronic renal failure and angina pectoris undergoing anti-platelet medication. We injected a small dose of HS-E (7ml) for controlling oozing bleeding. Two days later, endoscopy showed huge ulcer with necrotic tissue at the site of previously hematoma. Therefore we should pay particular attention for hematoma and mucosal necrosis when performing endoscopic procedure in a patients with high bleeding and atherosclerotic risk.

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Recurrent Bleeding in Hemorrhagic Moyamoya Disease : Prognostic Implications of the Perfusion Status

  • Jo, Kyung-Il;Kim, Min Soo;Yeon, Je Young;Kim, Jong-Soo;Hong, Seung-Chyul
    • Journal of Korean Neurosurgical Society
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    • v.59 no.2
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    • pp.117-121
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    • 2016
  • Objective : Hemorrhagic moyamoya disease (hMMD) is associated with a poor clinical course. Furthermore, poorer clinical outcomes occur in cases of recurrent bleeding. However, the effect of hemodynamic insufficiency on rebleeding risk has not been investigated yet. This study evaluated the prognostic implications of the perfusion status during the clinical course of adult hMMD. Methods : This retrospective study enrolled 52 adult hMMD patients between April 1995 and October 2010 from a single institute. Demographic data, clinical and radiologic characteristics, including hemodynamic status using single photon emission computed tomography (SPECT), and follow up data were obtained via a retrospective review of medical charts and imaging. Statistical analyses were performed to explore potential prognostic factors. Results : Hemodynamic abnormality was identified in 44 (84.6%) patients. Subsequent revascularization surgery was performed in 22 (42.3%) patients. During a 58-month (median, range 3-160) follow-up assessment period, 17 showed subsequent stroke (hemorrhagic n=12, ischemic n=5, Actuarial stroke rate $5.8{\pm}1.4%/year$). Recurrent hemorrhage was associated with decreased basal perfusion (HR 19.872; 95% CI=1.196-294.117) and omission of revascularization (10.218; 95%; CI=1.532-68.136). Conclusion : Decreased basal perfusion seems to be associated with recurrent bleeding. Revascularization might prevent recurrent stroke in hMMD by rectifying the perfusion abnormality. A larger-sized, controlled study is required to address this issue.

Comparison of Recurrence Rates with Contour-Loop Excision of the Transformation Zone (C-LETZ) and Large Loop Excision of the Transformation Zone (LLETZ) for CIN

  • Boonlikit, Sathone;Srichongchai, Hemwadee
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.15
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    • pp.6005-6008
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    • 2014
  • Aim: To compare recurrence rates of large loop excision of the transformation zone (LLETZ) with those of contour-loop excision of the transformation zone (C-LETZ) in the management of cervical intraepithelial neoplasia (CIN). Materials and Methods: The medical records of 177 patients treated consecutively by LLETZ and C-LETZ for CIN at Rajavithi Hospital between 2006 and 2009 were retrospectively reviewed. Results: Of the 87 women in the C-LETZ group, 2 cases (2.30%) had recurrence compared with 13 cases (14.4%) of the 90 women in the LLETZ group, the higher recurrence rate in the latter being statistically significant (p<0.05). Median times of follow up in the C-LETZ and LLETZ groups were 12 months and 14 months respectively (p>0.05). The C-LETZ group showed less intraoperative bleeding compared to the LLETZ group, but the rate of achievement of single specimens and positive margins were similar in the two groups. Conclusions: The present study demonstrated the superiority of C-LETZ over LLETZ in terms of efficacy; C-LLETZ is associated with a lower recurrence rate and also carries a smaller risk of intraoperative bleeding than LLETZ. The rotating technique still has a potential role in treating precancerous lesions of the cervix.

Treatment of Central Hemangioma with Embolization in the Mandible

  • Hae-In Choi;Gyeong-Yun Kim;Dong-Ho Shin;Ji-Su Oh;Seong-Yong Moon;Jae-Seek You;Ji-Won Ryu
    • Journal of Oral Medicine and Pain
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    • v.48 no.4
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    • pp.169-173
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    • 2023
  • Hemangioma is a lesion characterized by vascular proliferation of endothelial origin, manifesting neoplastic features. The occurrence of central hemangioma in the oral and maxillofacial region is exceptionally rare, and in two-thirds of cases, it is predominant in the mandible rather than the maxilla. The main symptoms and signs associated with central hemangiomas include pulsation, bone expansion, bruit, teeth displacement, and root resorption of the adjacent teeth. Bleeding may manifest periodically from the sulcus surrounding the affected teeth, particularly when accompanied by hypermobility in the primary dentition. One of the most noteworthy complications is the potential for severe bleeding during tooth extraction or surgical procedures conducted in proximity to unrecognized hemangiomas. Such situations may pose a life-threatening risk. Taking this into consideration, we present two cases of central hemangiomas in adolescent patients who sought consultation, with subsequent embolization performed by the Department of Radiology in Chosun University Hospital.

When do we need more than local compression to control intraoral haemorrhage?

  • Sohn, Jun-Bae;Lee, Ho;Han, Yoon-Sic;Jung, Da-Un;Sim, Hye-Young;Kim, Hee-Sun;Oh, Sohee
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.45 no.6
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    • pp.343-350
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    • 2019
  • Objectives: The aims of this study were to determine the effectiveness of local compression in patients presenting to the emergency room with intraoral bleeding and to identify when complex haemostatic measures may be required. Materials and Methods: Five hundred forty patients who had experienced intraoral haemorrhage were retrospectively reviewed. The outcome variable was the haemostasis method used, i.e., simple (local compression with gauze) or complex (an alternative method after local compression has failed). Predictor variables were sex, age, American Society of Anesthesiologists (ASA) class, hepatic cirrhosis, bleeding disorder, use of antithrombotic agents, and site/cause of haemorrhage. Results: The mean patient age was 48.9±23.9 years, 53.5% were male, 42.8% were ASA class II or higher, and 23.7% were taking antithrombotic agents. Local compression was used most often (68.1%), followed by local haemostatic agents, sutures, systemic tranexamic acid or blood products, and electrocautery. The most common site of bleeding was the gingiva (91.7%), and the most common cause was tooth extraction (45.7%). Risk factors for needing a complex haemostasis method were use of antithrombotic agents (odds ratio 2.047, P=0.009) and minor oral surgery (excluding extraction and implant procedures; odds ratio 6.081, P=0.001). Conclusion: A haemostasis method other than local compression may be needed in patients taking antithrombotic agents or having undergone minor oral surgery.

Management of the complications occurred in/after dental treatment of the medically compromised patient (임상가를 위한 특집 3 - 전신질환자의 치과 치료 중/후 발생 가능한 합병증과 대처법)

  • Kim, Change-Hyen;Shin, Hee-Jin;Kwon, Young-Wook;Park, Je-Uk
    • The Journal of the Korean dental association
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    • v.48 no.1
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    • pp.38-44
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    • 2010
  • Nowadays, medically compromised patients who could not receive dental treatments in the past are able to go through minor oral surgeries with adequate preoperative measures. Thorough understanding of the systemic disease and its complications is needed as well as the management them. Frequent complications of surgical procedures are bleeding, infection, delayed healing, systemic reactions by stress and they can be aggravated due to the patients' systemic conditions. Therefore, understanding of the systemic disease of patient visiting dental office and treatment modification according to the systemic status is needed. Also consultation to the medical doctor is imperative, through which perioperative risk and complications can be reduced. Among the high frequency complications of dental treatment of medically compromised patients, bleeding, infection, delayed healing, systemic reactions by stress will be discussed with the management of each one.

Isolated Splenic Vein Thrombosis Associated with Acute Pancreatitis (급성 췌장염에 동반된 고립성 비정맥 혈전증 1예)

  • Song, Hyang-Soon;Yang, Noo-Ri;Jin, So-Hee;Choi, Kyeong-Dan;Jang, Young-Taek
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.12 no.2
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    • pp.221-225
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    • 2009
  • Pancreatic disease is the most frequent cause of isolated splenic vein thrombosis. Splenic vein thrombosis causes a localized form of portal hypertension known as sinistral or left-sided portal hypertension. Splenic vein thrombosis may be complicated by the formation of gastric varices, with the potential of massive upper gastrointestinal bleeding. Whereas splenectomy is considered to be the treatment of choice for symptomatic splenic vein thrombosis, the role of splenectomy in the patient with asymptomatic splenic vein thrombosis remains controversial. We report a rare case of acute pancreatitis complicated by isolated asymptomatic splenic vein thrombosis. Recognition of this disease entity is important because the risk of secondary variceal bleeding, while uncommon, can be life-threatening.

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What is the best treatment of heterotopic cervical pregnancies for a successful pregnancy outcome?

  • Kim, Ji Won;Park, Han Moie;Lee, Woo Sik;Yoon, Tae Ki
    • Clinical and Experimental Reproductive Medicine
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    • v.39 no.4
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    • pp.187-192
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    • 2012
  • Heterotopic pregnancy is rare event and the risk is increased with assisted reproductive technology procedures. Heterotopic cervical pregnancy is even more unusual. We report a rare case of heterotopic cervical pregnancy that was managed successfully. A 36-year-old women who conceived by IVF-ICSI was diagnosed with heterotopic cervical pregnancy. She visited the emergency room with vaginal bleeding at 5 weeks of gestation and underwent careful intracervical gestational sac reduction with forceps under abdominal guidance the next day. The postoperative course was uneventful and with regular check-ups, the intrauterine pregnancy (IUP) progressed unremarkably through 41 weeks with delivery of a healthy newborn. We reviewed a total of 37 cases of heterotopic pregnancy that have been reported in the English language literature. There have been many attempts to eliminate the cervical embryo while preserving the IUP, and complete cervical evacuation is important in order to avoid infection, bleeding, and premature birth.