[Spontaneous retroperitoneal hemorrhage].

A 50-year old male presented to our emergency department with sudden abdominal pain. Upon arrival he was diaphoretic, pale and tachycardic. A CT showed retroperitoneal hemorrhage with suspected tumor at the left adrenal gland. He was quickly stabilized with intravenous fluids and blood transfusion. Rebleed occurs roughly a week after discharge and a new CT showed a visceral pseudoaneurysm from the left middle adrenal artery. The pseudoaneurysm was embolized and the patient discharged in good condition. Follow-up MRI depicted reabsorption of the hematoma and no adrenal tumor. Thus, the etiology of the previous retroperitonal hemorrhage is considered spontaneous.

[The incidence and mortality of ARDS at Landspítali - The National University Hospital of Iceland 2004-2008]. / Brátt andnaudarheilkenni á gjörgæsludeildum Landspítala 2004-2008.

OBJECTIVE: A retrospective study of the incidence, causes, mortality and treatment of patients with ARDS at Landspítali The National University Hospital of Iceland during the five year period 2004-2008 and comparing the results with an earlier study for the period 1988-1997. MATERIALS AND METHODS: All ICU admissions during the period 2004-2008 were reviewed, selecting patients according to the American-European consensus criteria for ARDS. Data were collected on age, gender, causes, length of stay, ventilator treatment and survival. RESULTS: A total of 6413 patients were admitted to the ICUs at Landspítali during the study period and 120 patients were found to have ARDS giving an incidence of 7,9/100.000 inhabitants. Average age was 55 years, 55% were males, length of stay was 13 days and hospital stay 24 days. ICU mortality was 30% and 90 day mortality was 39%. CONCLUSION: The incidence of ARDS seems to have increased some-what during the period 1988-1997. Mortality has decreased significantly probably due to improvements in intensive care treatment, especially ventilator treament with the use of lung protective ventilation, high frequency oscillation, prone position and ECMO.