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International Journal of Surgery Case... Mar 2024We report the case of a patient who developed a severe pulmonary embolus postoperatively despite perioperative venous thromboembolism (VTE) prophylaxis as prescribed.
INTRODUCTION
We report the case of a patient who developed a severe pulmonary embolus postoperatively despite perioperative venous thromboembolism (VTE) prophylaxis as prescribed.
PRESENTATION OF CASE
A 50-year-old female patient underwent a robotic total hysterectomy for uterine fibroids. Her perioperative VTE risk was assessed as moderate, and compression and intermittent air compression stockings were used postoperatively until the morning following the surgery. The surgery was uneventful, and the patient was discharged on postoperative day 4. On postoperative day 19, the patient experienced rapid dyspnea and was diagnosed with a severe pulmonary embolus.
DISCUSSION
Heparin, a tissue-type plasminogen activator, and a catecholamine were administered, and the patient recovered well.
CONCLUSION
VTE measures in minimally invasive gynecologic surgery are not well defined, and future thrombotic risk assessments specific to minimally invasive gynecologic surgery may be necessary.
PubMed: 38367419
DOI: 10.1016/j.ijscr.2024.109396 -
Annals of African Medicine 2023Venous thromboembolism (VTE) commonly presents as either deep-vein thrombosis (DVT) or pulmonary embolism (PE). Despite rapid advances in its diagnostic and therapeutic... (Observational Study)
Observational Study
BACKGROUND
Venous thromboembolism (VTE) commonly presents as either deep-vein thrombosis (DVT) or pulmonary embolism (PE). Despite rapid advances in its diagnostic and therapeutic modalities, it still leads to significant morbidity and mortality.
OBJECTIVES
Our study predominantly aims at studying the clinical profile, risk factors, and the clinical outcomes in VTE patients presenting to a single tertiary care center to rapidly detect the disease and use appropriate thrombo-prophylaxis.
MATERIALS AND METHODS
This was an prospective observational study involving 40 patients of confirmed cases of VTE who presented to this tertiary care hospital during a period from June 2017 to May 2019. Data collected included the age, sex, clinical presentation, risk factors, diagnostic modalities, and their clinical outcomes. Descriptive analysis was carried out by mean and standard deviation for quantitative variables; frequency and proportion for the categorical variables.
RESULTS
Among the study groups, 30 (74%) had DVT, 4 (11%) had PE, and 6 (15%) had both. Major risk factors detected included smoking history (44%), recent surgery (15%), malignancy (11%), history of immobility (10%), and past history of DVT (15%). The clinical presentation mainly included leg pain (62%) and leg swelling (87%).The outcomes were predominantly re-canalization (31%), recurrent DVT (21%), recurrent PE (1%), chronic DVT (27%), chronic venous insufficiency (36%), chronic venous ulcer (7%), pulmonary hypertension (16%), and death (5%). In our study population, the most common pro-thrombotic state was found to be hyperhomocysteinemia.
CONCLUSIONS
In our study of VTE patients, we have highlighted the possible risk factors, clinical presentation, and clinical outcomes to identify the disease early and help us initiate appropriate thromboprophylaxis to reduce morbidity.
Topics: Humans; Venous Thromboembolism; Anticoagulants; Tertiary Care Centers; Venous Thrombosis; Pulmonary Embolism; Risk Factors
PubMed: 38358139
DOI: 10.4103/aam.aam_123_22 -
Cureus Jan 2024Cerebral arterial air embolism (CAE), a rare subtype of air embolism, carries a 21% mortality rate. We present a unique case involving a 69-year-old female with a...
Cerebral arterial air embolism (CAE), a rare subtype of air embolism, carries a 21% mortality rate. We present a unique case involving a 69-year-old female with a history of usual interstitial pneumonia (UIP) who suffered a transient ischemic attack (TIA) due to CAE. Unlike typical cases, CAE in this instance resulted from spontaneous pneumothorax, not the more common iatrogenic causes. Adding complexity, an unexpected discovery emerged during evaluation: a patent foramen ovale, contributing to paradoxical embolism. This underscores the vital need to consider CAE as a differential diagnosis in UIP patients with neurological symptoms, highlighting its rarity and diagnostic challenges.
PubMed: 38357055
DOI: 10.7759/cureus.52277 -
Neurocritical Care Jun 2024
Topics: Humans; Embolism, Air; Intracranial Embolism; Pneumonia, Necrotizing; Male; Middle Aged
PubMed: 38356078
DOI: 10.1007/s12028-023-01935-7 -
Circulation Reports Feb 2024
PubMed: 38344388
DOI: 10.1253/circrep.CR-23-0090 -
Radiology Case Reports Apr 2024Lung biopsy is an important interventional radiology procedure allowing the characterization of lesions with suspected malignancy. The most frequent complications are...
Lung biopsy is an important interventional radiology procedure allowing the characterization of lesions with suspected malignancy. The most frequent complications are pneumothorax and hemorrhage. Air embolism is a rare but potentially fatal occurrence. In this case report, we present an air embolism after core needle CT-guided biopsy showing CT and MRI features that radiologists should expect in the everyday clinical practice.
PubMed: 38317699
DOI: 10.1016/j.radcr.2024.01.027 -
Asian Journal of Surgery May 2024
Topics: Humans; Tachycardia, Ventricular; Embolism, Air; Myocardial Infarction; Catheter Ablation; Stroke; Male; Intraoperative Complications; Middle Aged; Female; Acute Disease
PubMed: 38302354
DOI: 10.1016/j.asjsur.2024.01.067 -
South African Family Practice :... Jan 2024This is part of a series of articles on vascular access in emergencies. The other two articles were on intra osseous lines and central venous lines. These are critical... (Review)
Review
This is part of a series of articles on vascular access in emergencies. The other two articles were on intra osseous lines and central venous lines. These are critical lifesaving emergency skills for the primary care professional. In this article, we will provide an overview of umbilical vein catheterisation highlighting its importance, the indications, contraindications, techniques, complications and nursing considerations. By familiarising healthcare providers with this procedure, we hope to enhance their knowledge and skills, ultimately leading to improved outcomes in the neonatal population.
Topics: Humans; Infant, Newborn; Catheterization; Infusions, Intraosseous; Physicians, Family; Primary Health Care; Umbilical Veins
PubMed: 38299529
DOI: 10.4102/safp.v66i1.5797 -
Neurosurgical Focus: Video Jan 2024The supracerebellar infratentorial (SCIT) approach is a well-described corridor to lesions in the quadrigeminal cistern, pineal gland, and dorsal midbrain. It can be...
The supracerebellar infratentorial (SCIT) approach is a well-described corridor to lesions in the quadrigeminal cistern, pineal gland, and dorsal midbrain. It can be performed in the prone or sitting position. The sitting position offers the benefit of gravity retraction of the cerebellum but comes at the expense of nonergonomic hand positioning and the potential risk of air embolism. The 3D exoscope is an alternative to the operating microscope and permits the SCIT approach in the prone position with excellent visualization. This video demonstrates exoscope-based SCIT approach for resection of a pineal meningioma in the prone position. The video can be found here: https://stream.cadmore.media/r10.3171/2023.10.FOCVID23155.
PubMed: 38283816
DOI: 10.3171/2023.10.FOCVID23155