ABSTRACT
An incarcerated inguinal hernia is a textbook example of a basic and straightforward diagnosis. In rare cases, an incarcerated hernia may be a symptom of more complex underlying pathology. In this case report a patient with a ruptured abdominal aortic aneurysm presented with an incarcerated left inguinal hernia. Only two other cases have been reported with a stable patient at initial presentation. The diagnosis was suspected when blood seeping next to the internal inguinal ring was detected, and an urgent ultrasound in the operating room confirmed the diagnosis. Whether or not patients with an inguinal hernia are more at risk for an AAA remains unclear.
Subject(s)
Aortic Aneurysm, Abdominal/diagnosis , Diagnostic Errors , Hernia, Inguinal/diagnosis , Aged , Aortic Aneurysm, Abdominal/diagnostic imaging , Aortic Rupture , Fatal Outcome , Hernia, Inguinal/diagnostic imaging , Humans , Intra-Abdominal Hypertension/etiology , Male , Reoperation , Ultrasonography/methodsABSTRACT
These guidelines represent a consensus among experts on hypersensitivity reactions occurring after transfusion of blood components. They cover recognition, investigation, treatment, and prevention of such reactions. Implemented in France under the auspices of the French Medicines and Healthcare Products Regulatory Agency (AFSSAPS) and based on current knowledge, research, and experience, they aim to provide effective and easily teachable means of further improving the quality of hemovigilance databases, promote interest in this field, and help identify possible mechanisms and at-risk patient groups.
Subject(s)
Blood Component Transfusion/adverse effects , Blood Component Transfusion/standards , Hypersensitivity/etiology , Hypersensitivity/prevention & control , France , Health Policy , Humans , Hypersensitivity/blood , Hypersensitivity/therapy , Practice Guidelines as TopicABSTRACT
Pulmonary oedema after transfusion of blood products may be hydrostatic (transfusion-associated circulatory overload [taco]) or exsudative (transfusion-related acute lung injury [trali]). Both conditions have been recognized as major hazards to transfusion recipients. Risk characterization is necessary to improve safety and to monitor trends in the national blood transfusion system. A collaborative multidisciplinary working group of the French National Hemovigilance Committee has proposed an analysis framework for case definitions and classification. The method relies on internationally used definitions and is adapted to the codification procedures used in the french transfusion incident reports electronic data management.
Subject(s)
Acute Lung Injury/etiology , Pulmonary Edema/etiology , Transfusion Reaction , Acute Lung Injury/classification , Acute Lung Injury/diagnosis , Blood Safety , Blood Volume , Consensus Development Conferences as Topic , Decision Trees , Diagnosis, Differential , Electronic Health Records , France , Humans , Hypertension/etiology , Hypotension/etiology , International Cooperation , Pulmonary Edema/classification , Pulmonary Edema/diagnosis , Respiratory Distress Syndrome/diagnosis , Severity of Illness IndexABSTRACT
Pulmonary oedemas occurring during or after a blood transfusion appear as the most frequent serious immediate incidents in the French hemovigilance database. They include transfusion-associated circulatory overload (TACO) and transfusion-related acute lung injury (TRALI). TACO are a major cause of transfusion-related death in France. TRALI are more and more recognized and notified. In no case, pooled fresh frozen plasma (100 donations) treated with solvent-detergent were involved in French TRALI cases. A logigrame will allow hemovigilance officers to better classify pulmonary oedemas in e-fit, the French hemovigilance database.