• Title/Summary/Keyword: bleeding complication

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Retroperitoneal Hemorrhage after Thrombolysis in ST Elevation Myocardial Infarction (ST분절 상승 심근경색증에서 혈전용해술 후 발생한 후복강 출혈 1예)

  • Moon, Min Young;Lee, Jong Young;Won, Sung Hyun;Kim, Jeong Seok;Nam, Kwang Woo;Kim, Chang Lae;Lee, Jin Seo;Ji, Won Jun
    • Journal of Yeungnam Medical Science
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    • v.29 no.2
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    • pp.125-128
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    • 2012
  • Bleeding is the most common and serious complication of thrombolysis in ST elevation myocardial infarction. Most bleeding cases are associated with an intervention or operation, but spontaneous bleeding such as gastro-intestinal bleeding or intracranial hemorrhage can happen. This is a report on the case of a 76-year-old female patient with retroperitoneal hemorrhage due to spontaneous right colic artery branch bleeding after thrombolysis in ST elevation myocardial infarction.

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Is stopping of anticoagulant therapy really required in a minor dental surgery? - How about in an endodontic microsurgery?

  • Cho, Yong-Wook;Kim, Euiseong
    • Restorative Dentistry and Endodontics
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    • v.38 no.3
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    • pp.113-118
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    • 2013
  • Nowadays, oral anticoagulants are commonly prescribed to numerous patients for preventing cardiovascular accident such as thromboembolism. An important side effect of anticoagulant is anti-hemostasis. In a major surgery, the oral anticoagulant therapy (OAT) regimen must be changed before the surgery for proper post-operative bleeding control. However, in a minor dental surgery and endodontic surgery, the necessity for changing or discontinuing the OAT is open to debate. In this study, risks of the consequences were weighed and analyzed. In patients who stop the OAT, the occurrence of thromboembolic complication is rare but the result is fatal. In patients who continuing the OAT, post-operative bleeding can be controlled well with the local hemostatic measures. In the endodontic surgery, there are almost no studies about this issue. The intra-operative bleeding control is particularly important in the endodontic surgery because of its delicate and sensitive procedures such as inspection of resected root surface using dental microscope and retrograde filling. Further studies are necessary about this issue in the viewpoint of endodontic surgery.

Balloon-Occluded Retrograde Transvenous Obliteration versus Transjugular Intrahepatic Portosystemic Shunt for the Management of Gastric Variceal Bleeding

  • Gimm, Geunwu;Chang, Young;Kim, Hyo-Cheol;Shin, Aesun;Cho, Eun Ju;Lee, Jeong-Hoon;Yu, Su Jong;Yoon, Jung-Hwan;Kim, Yoon Jun
    • Gut and Liver
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    • v.12 no.6
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    • pp.704-713
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    • 2018
  • Background/Aims: Gastric varices (GVs) are a major cause of upper gastrointestinal bleeding in patients with liver cirrhosis. The current treatments of choice are balloon-occluded retrograde transvenous obliteration (BRTO) and the placement of a transjugular intrahepatic portosystemic shunt (TIPS). We aimed to compare the efficacy and outcomes of these two methods for the management of GV bleeding. Methods: This retrospective study included consecutive patients who received BRTO (n=157) or TIPS (n=19) to control GV bleeding from January 2005 to December 2014 at a single tertiary hospital in Korea. The overall survival (OS), immediate bleeding control rate, rebleeding rate and complication rate were compared between patients in the BRTO and TIPS groups. Results: Patients in the BRTO group showed higher immediate bleeding control rates (p=0.059, odds ratio [OR]=4.72) and lower cumulative rebleeding rates (logrank p=0.060) than those in the TIPS group, although the difference failed to reach statistical significance. There were no significant differences in the rates of complications, including pleural effusion, aggravation of esophageal varices, portal hypertensive gastropathy, and portosystemic encephalopathy, although the rate of the progression of ascites was significantly higher in the BRTO group (p=0.02, OR=7.93). After adjusting for several confounding factors using a multivariate Cox analysis, the BRTO group had a significantly longer OS (adjusted hazard ratio [aHR]=0.44, p=0.01) and a longer rebleeding-free survival (aHR=0.34, p=0.001) than the TIPS group. Conclusions: BRTO provides better bleeding control, rebleeding-free survival, and OS than TIPS for patients with GV bleeding.

Tracheoinnominate Artery Fistula after Tracheal Reconstruction and Tracheostomy (기관재건술 및 기관절개술 후 발생한 기관무명동맥루)

  • 김동원
    • Korean Journal of Bronchoesophagology
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    • v.8 no.1
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    • pp.57-60
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    • 2002
  • Tracheoinnominate artery fistula is a rare but a catastrophic complication after tracheostomy or tracheal reconstruction. We experienced two cases of tracheoinnominate artery fistula after tracheal reconstruction and tracheostomy. The first patient was a 11 year old girl with cerebral arteriovenous malformation who maintained tracheostomy for 6 months before undergoing tracheal reconstruction. Three days after tracheal reconstruction, massive bleeding occurred through the intubation tube. She underwent emergency reoperation of repair the innominate artery with 5-0 Prolene and reconstruction of trachea. She died of bleeding 3 days after the reoperation. The second patient was a 68 year old man who underwent right upper lobectomy due to lung cancer. After operarion MRSA Pneumonia was developed and tracheostomy was performed 10 days after intubation. Twelve days after tracheostomy, massive bleeding occurred and emergency operation of ligation of innominate artery was performed. He died of sepsis 7 days after reoperation.

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Right Sleeve Pneumonectomy using Femoro-femoral Bypass - A Case Report - (Femoro-femoral bypass를 이용한 우측 sleeve pneumonectomy 치험 1례)

  • 최필조
    • Journal of Chest Surgery
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    • v.25 no.10
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    • pp.1132-1136
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    • 1992
  • We report a successful right,sleeve pneumonectomy using femoro-femoral bypass on a 26-year-old woman with severe carinal and lower tracheal stenosis of tuberculous origin. Omental graft on the anastomotic site was added, There was no specific postoperative complication and postoperative bleeding was minimal.

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A prospective randomized trial of xylometazoline drops and epinephrine merocele nasal pack for reducing epistaxis during nasotracheal intubation

  • Patel, Sonam;Hazarika, Amarjyoti;Agrawal, Prachi;Jain, Divya;Panda, Naresh Kumar
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.20 no.4
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    • pp.223-231
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    • 2020
  • Background: The most frequent complication of nasotracheal intubation (NTI) is epistaxis. Epinephrine nasal gauze packing has been used conventionally as a pre-treatment for reducing epistaxis, but it carries a disadvantage of pain and anxiety in patients. However, xylometazoline drops are easier to administer and more convenient for patients. We aimed at comparing the effectiveness of xylometazoline drops and epinephrine merocele packing in reducing bleeding and postoperative complications in our population. Methods: Our study enrolled 120 patients in a double-blind randomized controlled trial. We randomly allocated ASA1 or 2 adult patients into 2 groups: Group X and Group E. Group X received 0.1% xylometazoline nasal drops, and epinephrine (1:10,000) merocele nasal packing was used in Group E. The primary outcome was the incidence of bleeding during NTI; the severity of bleeding, navigability, bleeding during extubation, and postoperative complications were secondary outcomes. We used IBM SPSS and Minitab software for statistical analysis, and P < 0.05 was considered statistically significant. Results: We analyzed the data of 110 patients: 55 in Group X and 55 in Group E. The two groups did not have different bleeding incidence (56.4% vs 60.0%; P = 0.70); however, the incidence of severe bleeding was less with xylometazoline than with epinephrine (3.63% vs 14.54%; P < 0.05). We also observed less bleeding during extubation (38.2% vs 68.5%; P < 0.05) with xylometazoline. Other secondary outcomes were akin to both groups. Conclusion: The incidence of severe and post-extubation bleeding was significantly less with xylometazoline. Hence, it may be an effective alternative for reducing the incidence and severity of epistaxis during NTI.

Renal Artery Pseudoaneurysm after Blunt Renal Trauma (신손상 후 발생한 신장동맥 거짓동맥류)

  • Jung, Eun-Hong;Kim, Eun-Seok;Park, Hyeong-Cheol;Mun, Geun-Bae;Jang, Seok-Heun;Kim, Jae-Il;Son, Jung-Hwan;Ha, Yeong-Rok
    • Journal of Trauma and Injury
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    • v.22 no.2
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    • pp.260-263
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    • 2009
  • Renal artery pseudoaneurysm after blunt renal trauma is an uncommon complication of delayed hemorrhage, and diagnostic difficulties are experienced due to its rarity. Delayed hemorrhage after renal trauma is a life-threatening complication. Angiography is considered the gold standard to diagnose a traumatic renal artery pseudoaneurysm. We report here a case of delayed bleeding from a renal artery pseudoaneurysm that was diagnosed at 17 days after the injury and that was managed successfully with selective renal artery embolization without medical complication.

An Epidemiological Study on the Complications caused by the Sterilization Program (불임시술의 합병증에 관한 역학적 연구)

  • Hong, Myung-Sun
    • Research in Community and Public Health Nursing
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    • v.7 no.1
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    • pp.138-153
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    • 1996
  • Intending to offer basic information for a prospective health services in Korea, this study is to investigate the complication caused by sterilization in goverment family planning program from 1962 to 1995. The results are as follows: 1. Total number of sterilization performed during the period from 1962 to 1995 were 1.367,772 cases of male sterilization and 2,889,635 cases of female sterilization. 2. Incidence of the complication caused by sterilization operation from 1980 to 1995 were 1,883(0.20%) out of 925,801 cases in vasectomies and 15,866(0.70%) out of 2,256,020 cases in tubal sterilizations. 3. Major complications in vasectomy were epididymities of 658 cases (34.9%), vas recanalization of 326 cases(17.3%), hematoma of 266 cases(14.1%), scrotal abscess of 184 cases(9.8%), sperm granuloma of 76 cases(4.0%),and other of 373 cases(19.8%). On the other hand, in tubal sterilization, ectopic pregnancy was the most significant complication of 15,078 cases (95.0%) among 15,866 total complications, followed by pelvic inflammatory diseases of 155 cases(0.9%), peritonities of 96 cases(0.6%), ovarian & tubal bleeding of 31 cases(0.2%), intestinal perforation of 16 cases (0.1%), uterine bleeding of 14 cases(0.1%), uterine cervix laceration of 1 case (0.1%), and other of 271 cases(1.7%), while 161 pregnancies(0.1%) were terminated and 43 cases(0.3%) with normal delivery. 4. The occurrence rate of the complication for each period showed that most of the complication cases by vasectomy occurred in a year after the operation -the cases were 1,256 (66.7%). 254 cases(13.5%) occurred between the next year and the 2nd year, 138 cases (7.3%) between the 2nd year and the 3rd year, 73 cases(3.9%) between the 3rd year and the 4th year, 52 cases(2.8%) between the 4th year and the 5th year, 31 cases(1.6%) between the 5th year and the 6th year, 79 cases(4.2%) over the 6th year. Tubal sterilization indicated that the occurred complication cases in a year were 2,175 cases(13.7%), 2,113 cases(13.3%) occurred between the next year and the 2nd year, 2,082 cases(13.1%) between the 2nd year and the 3rd year, 2,049 cases (12. 9%) between the 3rd year and the 4th year, 1,819 cases(11.5%) between the 4th year and the 5th year, 621 cases(10.2%) between the 5th year and the 6th year, 4,007 cases(25.3%) over the 6th year. 5. For the cost of complication treatment, total \7,928,229,000 were paid as medical expenditure in which \609,438,000 for vasectomy and \7,318,791,000 for tubal sterilization. Accordingly per capita expenses were \345,000 for vasectomy and \467,000 for tubal sterilization. As the proportion of government sterilization program was decreased after 1988, that of private sterilization program would be increased. So it is recommended to set a guideline for the private sterilization program and to continue government sterilization program for the lower class.

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Complications amd Mortality After Coronary Artery Bypass Graft Surgery; Collective Review of 61 Cases (관상동맥우회수술후 합병증과 사망율에 대한 임상적 고찰;61례 보고)

  • 조건현
    • Journal of Chest Surgery
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    • v.26 no.7
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    • pp.526-531
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    • 1993
  • Sixty-one consecutive patients with coronary artery bypass graft for myocardial revascularization were retrospectively reviewed to analyze various pattern of postoperative complication and death during hospital stay from Nov. 1988 to Oct. 1992. Fortytwo of the patients were male and nineteen female. The mean age was 56 and 51 years in male and female. Preoperative diagnosises were unstable angina in 14 of patients, stable angina in 28, postmyocardial infarction state in 15, and state of failed percutaneous transluminal coronary angioplasty in 4. 141 stenosed coronary arteries were bypassed with use of 20 pedicled internal mammary artery and 124 reversed saphenous vein grafts. Postoperative complications and perioperative death were as follows: 1. Of 61 patients undergoing operation, peri and postoperative over all complication occured in 15 patients [ 25% ]; newly developed myocardial infarction in 4, intractable cardiac arrhythmia including atrial fibrillation and frequent ventricular premature contraction in 3, bleeding from gastrointestinal tract in 2, persistent vegetative state as a sequele of brain hypoxia in 1, wound necrosis in 1, left hemidiaphragmatic palsy in 3 and poor blood flow through graft in 2. 2. Operative mortality was 8%[5 patients]. 3 out of these died in operating room; 1 patient by bleeding from rupture of calcified aortic wall, 1 by air embolism through left atrial vent catheter, 1 by low cardiac output syndrome. 2 patients died during hospital stay; 1 by acute respiratory distress syndrome with multiuple organ failure, 1 by brain death after delayed diagnosis of pericardial tamponade.

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Experience of Hemophilic Pseudotumor Developed at the Fracture Site of the Proximal Phalanx of the Hand (수부 근위지골 골절 수술 후 발생한 혈우병성 가성종양의 치험례)

  • Park, Ji Ung;Kim, Chang Yeon;Shin, Jong In;Cho, Sang Hun
    • Archives of Plastic Surgery
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    • v.34 no.4
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    • pp.516-519
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    • 2007
  • Purpose: Hemophilia is one of the most common bleeding disorder, and circulating levels of factor VIII or IX are closely related to the severity and frequency of the bleeding. The severity of hemophilia is classified to be severe, moderate, and mild when the factor level is less than 1%, between 1% and 5%, and between 5% and 25%, respectively. Hemophilic pseudotumor is a rare complication occurring in 1 - 2% of patients with factor VIII or IX deficiency. If the treatment is delayed, it would cause disabling and life threatening results. Methods: We experienced hemophilic pseudotumor developed at the fracture site of the proximal phalanx of the hand in a hemophilic B patient. Hemophilic pseudotumor was successfully treated with perioperative factor replacement and surgical intervention included excision and autologous bone graft. Results: Hemophilic pseudotumor was healed with complete regression, and no specific complication was developed. Conclusion: When we accounter hematoma like lesion after surgery unpredictably, we must consider hemophilic pseudotumor and make a accurate diagnosis with preoperative hematologic screening and various imaging study. Subsequently, adequate perioperative supplement of concentrate and surgical intervention brings to the satisfactory result without recurrence.