• Title/Summary/Keyword: bleeding

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Serious Bleeding Complication Due to the Use of Low-molecular-weight heparin to treat a Traumatic Patient with Acute Renal Failure (급성신부전이 발생한 중증 외상 환자에서 저분자량헤파린 투여 후 발생한 심각한 출혈 합병증)

  • Kyoung, Kyu-Hyouck;Kim, Woon-Won;Park, Sung-Jin;Kim, Ki-Hoon;Kim, Jin-Soo;Park, Jong-Kwon
    • Journal of Trauma and Injury
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    • v.24 no.2
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    • pp.164-167
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    • 2011
  • Trauma is an important risk factor for a pulmonary thromboembolism, and anticoagulation is essential to prevent deep vein thrombosis (DVT) in patients with trauma. Low-molecular-weight heparin (LMWH) is excreted in the kidney; therefore, using LMWH in patients with renal insufficiency may increase the risk of bleeding complication. The following case describes a 55-year-old traffic accident victim who had massive bleeding and underwent a laparotomy for bleeding control. The patient had acute renal failure, and enoxaparin was administered for the prophylaxis of DVT. Although the patient suffered from serious complications such as pericardial hematoma, the patient recovered without sequellae and was discharged at day 84.

Spinal Hemangiopericytoma Which Needed Intraoperative Embolization due to Unexpected Bleeding

  • Lee, Chang-Hyun;Kim, Ki-Jeong;Jahng, Tae-Ahn;Kim, Hyun-Jib
    • Journal of Korean Neurosurgical Society
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    • v.54 no.3
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    • pp.253-256
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    • 2013
  • Spinal intradural hemangiopericytoma is a very rare tumor and can be characterized by massive bleeding during surgeries, frequent recurrence, and metastasis. However, definite radiologic differential points of hemangiopericytoma are not known. We describe an unexpected hemangiopericytoma case with large bleeding and management of the tumor. A 21-year-old man visited complaining of progressive neck pain and tingling sensation in both hands. Magnetic resonance imaging of his spine revealed C1-2 ventral intradural mass. When the dura was opened, the intradural tumor was placed behind spinal accessary nerves. The tumor was partially exposed only after some accessary nerves had been cut. When internal debulking was performing, unexpected bleeding was noted and it was difficult to control because of narrow surgical field and hypervascularity. Intraoperative spinal angiography and embolization were performed. The tumor was completely removed after embolization. Pathological diagnosis was consistent with hemangiopericytoma. When surgeons meet a flesh-red tumor that bleeds unexpectedly during surgery, hemangiopericytoma may be considered. When feeder control is hard due to reciprocal location of spinal cord, the tumor, and feeders, intraoperative angiography and embolization may be a possible option.

The Effect of Position Change on Discomfort and Bleeding after Liver Biopsy (체위변경이 간 조직검사 환자의 불편감과 출혈에 미치는 효과)

  • Yun, Mi-Jeong;Min, Hye Sook
    • Korean Journal of Adult Nursing
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    • v.27 no.2
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    • pp.233-241
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    • 2015
  • Purpose: This study examined the effects of e position change upon reported discomfort and bleeding complications during bed rest following a liver biopsy. Methods: The research design for this study was a non-equivalent control group quasi-experimental design. Twenty-nine participants were assigned to the treatment group and twenty seven participants were in the comparison group. Following the biopsy, the treatment group participants had a position change from the supine without compression for two hours followed by compressive right lateral position for two hours. The comparison group maintained continuously the compressive right lateral position with sandbag for four hours. Results: There were statistically significant differences in reported discomfort between the treatment and comparison groups following the intervention. No significant differences were found in bleeding complications between the two groups. Conclusion: The results of the study suggest that the positional change is an effective nursing intervention in reducing discomfort without risk of bleeding following a liver biopsy.

Retroperitoneal Gauze Packing with Vacuum-Associated Closure for Pelvic Fracture with Hemodynamic Instability (혈역학적으로 불안정한 골반 골절에서 진공 폐쇄 드레싱을 병용한 후복막 거즈 충전법 치료)

  • Kim, Sung Jeep;Kim, Ji Hoon T.
    • Journal of Trauma and Injury
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    • v.27 no.2
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    • pp.29-32
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    • 2014
  • Pelvic bone fracture with hemodynamic instability is fatal and the mortality rate can range up to 40%. Despite the big advances in the treatment of massive bleeding and hemorrhagic shock, the mortality associated with hemodynamically unstable pelvic bone fractures remains high. The gold standard of treatment for pelvic bone fracture with hemodynamic instability has not yet been determined and is an issue of main discussion among many doctors. Retroperitoneal packing is not yet wide spread in Korea, but is a good modality for managing of massive bleeding from pelvic bone fractures when an angiography suite or an expert surgeon is not available. A vacuum-assisted closure (VAC) system can also be applied with retroperitoneal packing in the manner of damage control surgery and open abdomen surgery. We present the case of a 51-year-old male who had a pelvic bone fracture with massive bleeding. We performed retroperitoneal gauze packing with a VAC system for the first time. The postoperative vital signs of patient were immediately stable, the massive bleeding was easily and quickly controlled, and the amount of transfusion of blood components was reduced.

The Comparison of PTT and Systolic Blood Pressure in a hemorrhaged Rat (출혈을 일으킨 흰쥐에서의 PTT와 수축기 혈압 비교)

  • Shim, Young-Woo;Lee, Ju-Hyung;Yang, Dong-In;Kim, Deok-Won
    • Proceedings of the IEEK Conference
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    • 2009.05a
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    • pp.138-140
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    • 2009
  • Hemorrhage shock occupies high rate in trauma patient's mortality and blood pressure is the variance that judges early diagnosis and the effect of remedy. Systolic blood pressure is related to pulse transit time(PTT). PTT means the time that is required to flow from the heart to peripheral artery. PTT is influenced from the length, cross section and stiffness of the blood vessels. It is hard to evaluate the correlation between systolic blood pressure and PTT because they are variable in human body. In this paper, we evaluated the correlation between the systolic blood pressure and PTT in normal and hemorrhage states using standardized rat. PTT is defined as the time differences between the R peak and the peak of pulse wave. The analyzed time differences of ECG and blood pressure are analyzed every 5minutes for 30 seconds when there is before and after bleeding. Before bleeding, systolic blood pressure and PTT are steadily preserved but when the bleeding comes started, systolic blood pressure is declined. However PTT was increased and decreased. Under the circumstance that the standardized rat is controlled by age, the length of the blood vessels, and any disease, it shows that PTT measurement using systolic blood pressure of bleeding is impossible.

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A Case of Common Bile Duct Stone with Delayed Bleeding after Endoscopic Papillary Sphincterotomy (내시경적 유두 괄약근 절개술 후 지연성 출혈을 보인 총담관 결석 치험 1례)

  • Lee, Chang-Hee;Lee, Yoon-Kyung;Chae, Hyun-Seok;Kim, Dong-Un;Kim, Young-Hoon;Han, Seung-Hoon;Lee, Ik-Jun
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.3 no.2
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    • pp.222-226
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    • 2000
  • Common bile duct stones are an unusual occurrence in children. Endoscopic retrograde cholangiopancreaticography and endoscopic papillary sphincterotomy are excellent tool for diagnosis and therapy. Bleeding after endoscopic papillary sphincterotomy occurs in approximately 0.5~12% of procedures. We experienced a case of common bile duct stone in 5-year-old boy. After endoscopic papillary sphincterotomy, the stone was passed. 5 days after the procedure bleeding occurred, but it was controlled spontaneously.

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Newly Diagnosed Klippel-Trenaunay Syndrome Presenting with Rectal Polyposis in a Male Pediatric Patient: A Case Report

  • Jeong, Seong Hee;Joo, Donghoon;Lim, Taek Jin;Lee, Yeoun Joo
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.23 no.1
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    • pp.115-120
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    • 2020
  • Klippel-Trenaunay syndrome (KTS) is a rare disorder characterized by a triad of abnormal bone and soft tissue growth, the presence of a port-wine stain, and venous malformations. Gastrointestinal (GI) manifestations of KTS are relatively common and generally do not cause significant problems. However, persistence can lead to chronic GI blood loss or even massive bleeding in rare cases. The majority of the severe GI manifestations associated with KTS present as vascular malformations around the GI tract and exposed vessels can lead to serious bleeding into the GI tract. Herein, we report a case of a 16-year-old boy with severe iron deficiency anemia who was previously misdiagnosed as hemorrhoid due to small amount of chronic bleeding. The actual cause of chronic GI bleeding was from an uncommon GI manifestation of KTS as rectal polyposis.

DRAINAGE AS WOUND CARE AFTER ENUCLEATION OF DENTIGEROUS CYST AND EXTRACTION OF SUPERNUMERARY TOOTH IN A CEREBRAL PALSY PATIENT : REPORT OF A CASE (뇌성마비 장애환자에서 함치성 낭종 적출과 매복 과잉치 발치후 창상처치로 배액술 : 증례보고)

  • Yoo, Jae-Ha;Son, Jeong-Seog;Kim, Jong-Bae
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.8 no.2
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    • pp.134-138
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    • 2012
  • In treatment of dentigerous cyst, complete enucleation, histopathologic examination and postoperative care are important to prevent the potential complications (mural ameloblastoma, squamous cell carcinoma). On the other hand, a maxillary impacted supernumerary anterior tooth are removed surgically, owing to the possibility of the cyst formation in future. After the cyst enucleation and extraction of the involved tooth, the wound area sutured and removable resin plate is then applied. In this operation, the postoperative bleeding and infection is likely to occur owing to postoperative accumulation of hematoma & seroma, psychologic stress and other contaminated factor. So, the authors established the immediate rubber & iodoform gauze drainage into the sutured wound of cyst enucleation & tooth extraction for the prevention of postoperative bleeding and infection. The removable resin splint are not used because of the poor cooperation and economic factor. The results were more favorable without the postoperative bleeding & wound infection in a cerebral palsy patient.

A Case of Giant Papillary Thyroid Carcinoma Resection with Massive Intraoperative Bleeding (술 중 대량 출혈을 동반한 거대 갑상선유두상암종 절제술 1례)

  • Kim, Seok Hyun;Jung, Jae Hwan;Sung, Eui Suk;Lee, Jin Choon
    • Korean Journal of Head & Neck Oncology
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    • v.33 no.1
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    • pp.85-89
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    • 2017
  • A 62-year-old female patient had goiter for twenty years. She visited out-patient clinic with a hoarse voice and intermittent breathing difficulties. About protruding 15cm sized mass located the anterior neck and right vocal cord paralysis was observed. Preoperative CT scan was strongly suspected of thyroid gland cancer and cervical lymph node metastasis. Therefore, fine needle aspiration test was performed and surgical treatment was planned with the histopathologic results (papillary thyroid carcinoma). Surgery was performed with total thyroidectomy, bilateral cervical lymph node dissection, and right selective nodal lymph node dissection (level II-V). During operation right thyroid seemed to be adherent to surrounding tissue and the blood vessels were extremely engorged. There was hypotensive crisis because of intraoperative excessive bleeding. However it was managed by repetitive transfusion. The operation was completed without abnormalities. She underwent 4 times of bleeding control operation due to postoperative bleeding. After complications were improved, we are currently undergoing out-patient follow up without morbidity.

A Case of Gastro-Colic Fistula due to Ectopic Gastric Mucosa and its $^{99m}TcO_4$ Scan Findings (대장에 발생하여 대장-위 루를 형성한 이소성 위점막과 $^{99m}TcO_4$ 스캔 소견)

  • Park, Seok-Gun;Lee, Yeon-Hee;Im, Chang-Young;Cho, Jung-Hee
    • The Korean Journal of Nuclear Medicine
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    • v.32 no.2
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    • pp.172-177
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    • 1998
  • We report a case of gastro-colic fistula caused by ectopic gastric mucosa developed at transverse colon. Fistula was detected by colonofiberscopy. And fistulous tract was proved by barium enema. Meckel's diverticulum scan finding was similar to that of GI bleeding; e.g. injected radioactivity was secreted into the lumen and moved along the lumen. There was no bleeding. And there was no diverticulum in the colon. Absence of diverticular pouch may explain this unusual GI bleeding-like scan finding rather than focal collection of radioactivity, which is typical of ectopic gastric mucosa found in the Meckel's diverticulum. Ectopic gastric mucosa was confirmed by colonofiberscopic biopsy. We suggest GI bleeding-like pictures should be included in differential diagnosis of $^{99m}TcO_4$ (ectopic gastric mucosa or Meckel's diverticulum) scan.

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