1/18. Postoperative retroperitoneal hemorrhage due to a bleeding ureteric artery: treatment by transcatheter embolization.We report a case of a postoperative retroperitoneal haemorrhage due to an iatrogenic perioperative injury of an ureteric artery. Transcatheter embolization using microparticles stopped the bleeding and the patient stabilized immediately. Ureteric artery injury is a very rare condition but can be managed successfully by percutaneous interventional techniques.- - - - - - - - - - ranking = 1keywords = haemorrhage (Clic here for more details about this article) |
2/18. Iatrogenic acute subdural hematoma due to drainage catheter.BACKGROUND: Insertion of a catheter for drainage of a cavity is a routine step in many surgical practices. In neurosurgery, catheters are commonly placed in the subdural, subgaleal, or epidural spaces to prevent haematoma formation. CASE DESCRIPTION: We present three cases of iatrogenic acute subdural hematoma. These were all related to the drainage catheters. In the first case, a subgaleal redivac suction catheter was used after craniotomy for brain abscess. The other two patients had ordinary ventricular catheters placed in the subdural space after burr hole drainage of chronic subdural hematoma. The drainage catheter was removed on postoperative day 5 in the first case and two days after the initial operation in the other two cases. Shortly after the removal of the drains, the conditions of the patients deteriorated rapidly due to the development of acute subdural hematoma. CONCLUSION: Although they are extremely uncommon, life-threatening complications related to a drainage catheter are a real possibility. Therefore, the procedure should not be taken lightly.- - - - - - - - - - ranking = 67.797945419735keywords = subdural, haematoma (Clic here for more details about this article) |
3/18. Coagulopathy induced spinal intradural extramedullary haematoma: report of three cases and review of the literature.In a retrospective review of patients operated for coagulopathy induced spinal intradural-extramedullary haematoma the literature regarding coagulopathy induced spinal haemorrhage is reviewed and the etiology of these rare spinal subdural and subarachnoid haemorrhages is discussed. Spinal intradural haematomas are usually related to trauma or a previous lumbar puncture. A review of the literature revealed only a handful cases of spinal intradural haemorrhages occurring secondary to an underlying haematological disorder or an iatrogenic coagulopathy. Coagulopathy induced spinal haemorrhage should be included in the differential diagnosis of acute paraparesis in patients with co-existent haematological disorders or undergoing anticoagulation therapy. Due to the often mixed subdural and subarachnoid bleeding patterns we have termed this entity spinal intradural-extramedullary haematoma.- - - - - - - - - - ranking = 63.056765321356keywords = subdural, haematoma, haemorrhage (Clic here for more details about this article) |
4/18. Reversed portal vein pulsatility on Doppler ultrasound secondary to an iatrogenic mediastinal haematoma.The Doppler ultrasound pattern of reversed pulsatile flow (RPF) of the portal vein (PV) is strongly associated with high atrial pressure. Tricuspid regurgitation is considered to be the main cause of RPF in patients with chronic heart disease, but the precise pathomechanism of this PV flow pattern has not yet been resolved. We describe for the first time a RPF of the PV in a young patient with a mediastinal haematoma after inadvertent puncture of the subclavian artery. In this patient, transcutaneous echocardiography demonstrated normal valves without any tricuspid regurgitation as well as normal diameters of the cardiac cavities. The RPF of the PV in this patient resolved spontaneously within 7 days. An increased hepatic outflow resistance with transmission of hepatic artery pulsations across arterioportal communications seems the most likely pathomechanism to explain our finding.- - - - - - - - - - ranking = 32.452048938748keywords = haematoma (Clic here for more details about this article) |
5/18. Iatrogenic injuries of renal pelvis and ureter following open surgery for urolithiasis.OBJECTIVE: To study the types of injuries of renal pelvis and ureter following open surgical procedures for urolithiasis and predisposing factors leading to such injuries and discuss various options for the management of iatrogenic injuries of the renal pelvis and ureter. patients AND METHOD: Case files and available radiographs of the patients who were managed for ureteral and renal pelvic injuries were reviewed. Initial procedure, mode of injury and clinical course were noted. RESULTS: The study consisted of 13 patients (9 males and 4 females). Age of the patients ranged from 18 to 65 years. Eight patients had injuries of renal pelvis or ureteropelvic junction and 5 patients got ureteral injuries. Primary management of ureteral and renal pelvic injuries was successful in 9 patients. Four patients required further surgery. Three out of 4 patients underwent nephrectomy and in 1 patient renal function deteriorated despite secondary pyeloplasty. Among 3 patients who had nephrectomy, one died postoperatively due to sepsis and haemorrhage. CONCLUSION: Injuries of the renal pelvis and ureter have significant morbidity and even mortality. Peroperative recognition of these injuries and appropriate management can prevent the late sequele of these injuries such as stricture formation leading to progressive renal damage.- - - - - - - - - - ranking = 1keywords = haemorrhage (Clic here for more details about this article) |
6/18. blindness following paranasal sinus surgery: a report of two cases.Two cases of blindness following paranasal sinus surgery are presented. The first patient, a 38-year old man, developed a delayed massive haemorrhage, after bilateral sphenoethmoidectomy. This hemorrhage could be stopped by electric cauterisation under endoscopical control. During this reintervention the patient developed total blindness of his right eye, and a restriction of the inferotemporal left visual field. The second patient, a 10-year old girl, developed, after bilateral spheno-ethmoidectomy for isolated sphenoiditis, total blindness of the left eye and paralysis of the ipsilateral extraocular muscles. According to the literature, blindness secondary to paranasal surgery is mainly due to retrobulbar hemorrhage. In the first case blindness was due to a direct cauterisation of the optic nerve, after perforation of the lamina papyracea. In the second case, blindness was probably due to a hemorrhage in the orbital apex.- - - - - - - - - - ranking = 1keywords = haemorrhage (Clic here for more details about this article) |
7/18. Rare fatal vascular complication of transsphenoidal surgery.We report the case of a 61-year-old man, who underwent transsphenoidal surgery for a pituitary macroadenoma. The presence of tough fibrous septa dividing the tumour permitted only a partial resection. Progressive loss of consciousness soon after surgery occurred, an emergency CT scan showed no evidence of haemorrhage. Twenty hours later, MRI revealed compression of both internal carotid arteries with arrest of arterial flow resulting in stroke by an enlarged haemorrhagic mass consistent with a pituitary apoplexy. On the second postoperative day, the patient died as a result of this extensive stroke. The mechanisms of this rare complication after transsphenoidal surgery are theorized and the sensitivity of imaging methods is discussed.- - - - - - - - - - ranking = 1keywords = haemorrhage (Clic here for more details about this article) |
8/18. Inadvertent extra-arachnoid (subdural) injection of a local anaesthetic agent during epidural anaesthesia. A case report.Profound hypotension occurring in a patient 2 hours after initiation of combined general and epidural anaesthesia for a myocutaneous free-flap graft was found to be attributable to subdural/extra-arachnoid injection of 0.5% bupivacaine. The initial diagnosis was based on a negative aspiration test, a delayed widespread sensory and sympathetic block, and the absence of any other obvious cause for the hypotension. This was confirmed by myelography, which demonstrated an extension of the contrast medium predominantly posteriorly in the spinal canal with excessive spread along the nerve roots. posture and coughing did not affect the spread.- - - - - - - - - - ranking = 34.05974201777keywords = subdural (Clic here for more details about this article) |
9/18. Non-operative management of endoscopic iatrogenic haemobilia: case report and review of literature.Haemobilia denotes an abnormal communication between a vessel of the splanchnic circulation and the biliary system. patients typically presents with the triad of abdominal pain, upper gastrointestinal haemorrhage, and jaundice. Common causes for haemobilia are iatrogenic causes secondary to hepatobiliary system instrumentation and trauma. Management of patients with haemodynamic significant haemobilia is aimed at stopping bleeding, maintaining continuous flow of biliary system, and cure of the underlying aetiology. Iatrogenic haemobilia after ERCP polyethylene biliary endoprosthesis placement is extremely uncommon. Herein we present a case of iatrogenic haemobilia triggered by biliary endoprosthesis placement and was successfully managed by non-operative treatment. The management algorithm for a rational approach to haemobilia is discussed.- - - - - - - - - - ranking = 1keywords = haemorrhage (Clic here for more details about this article) |
10/18. Iatrogenic secondary post-partum haemorrhage: apropos of two uncommon cases.In this article we would like to highlight uterine pseudoaneurysm as a cause of secondary post-partum haemorrhage following Caesarean section. We would like to stress Doppler ultrasound scan as the initial screening modality for this condition. We also describe angioembolization as the prudent treatment option for this condition rather than resorting to surgery.- - - - - - - - - - ranking = 5keywords = haemorrhage (Clic here for more details about this article) |
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