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1.
Clín. investig. ginecol. obstet. (Ed. impr.) ; 47(1): 22-24, ene.-mar. 2020. ilus
Artigo em Espanhol | IBECS | ID: ibc-187069

RESUMO

El embarazo abdominal es una modalidad extremadamente rara de embarazo ectópico (EE) extratubárico, con muy pocos casos documentados en la literatura. La mortalidad materna es mayor que en los EE tubáricos por la demora en el diagnóstico y las complicaciones. Presentamos un caso de EE abdominal que se complicó con la aparición de hemoperitoneo severo en el primer trimestre de gestación. En nuestro caso, fueron necesarias 2 laparoscopias de urgencia en menos de 24 h hasta poder dar con el diagnóstico definitivo, lo cual demuestra lo dificultoso que puede llegar a ser la identificación de esta enfermedad en estadios precoces


Abdominal ectopic pregnancy is an extremely rare type of extratubal ectopic (EE) pregnancy, with very few cases documented in the literature. Maternal mortality is higher than in tubal EE because of the delay in diagnosis and complications. The case is presented of a patient with an abdominal EE that was complicated by the appearance of severe haemoperitoneum in the first trimester of pregnancy. In this case, two emergency laparoscopies were needed in less than 24 hours, until the definitive diagnosis could be found. This demonstrates how difficult it can be to identify this pathology in its early stages


Assuntos
Humanos , Feminino , Gravidez , Adulto , Hemoperitônio/etiologia , Gravidez Ectópica/diagnóstico , Gravidez Ectópica/cirurgia , Laparoscopia , Dor Abdominal/etiologia , Ultrassonografia , Cavidade Abdominal/fisiopatologia , Escavação Retouterina/lesões , Escavação Retouterina/cirurgia
2.
Am J Case Rep ; 20: 1492-1496, 2019 Oct 10.
Artigo em Inglês | MEDLINE | ID: mdl-31597909

RESUMO

BACKGROUND First described in 1863 by French surgeon Victor-Auguste-François Morel-Lavallee, the Morel-Lavallee lesion (MLL) is a closed traumatic soft-tissue degloving injury. These lesions most commonly occur following motor vehicle collisions (MVCs). The pathophysiology stems from a shearing force that causes separation of the soft tissue from the fascia underneath, which disrupts the vasculature and lymphatic vessels that perforate between the tissue layers. Timely diagnosis and treatment are imperative, as a delayed diagnosis can lead to complications. However, at present there is no universally accepted treatment algorithm. CASE REPORT A 60-year-old morbidly obese woman presented after being involved in an MVC. She complained of abdominal tenderness in the right lower quadrant, with no evidence of peritonitis. Cross-sectional imaging revealed hemoperitoneum and a traumatic posterior abdominal wall/lumbar hernia on the right, with multiple contusions in the subcutaneous abdomen. The patient was taken to the operating room and underwent an exploratory laparotomy that revealed a large abdominal Morel-Lavallee lesion (MLL) along with a traumatic abdominal wall hernia (TAWH). There was also a mesenteric avulsion injury with an associated ileocecal injury. The patient underwent resection of the involved bowel, with primary anastomosis, debridement of the abdominal wall degloving injury, and expectant management for the hernia defect. She recovered from the injuries and was doing well when followed up in the clinic, with follow-up to repair the hernia in the near future. CONCLUSIONS More research is needed to provide surgeons with evidence-based standardized therapies for dealing with these rare pathologies to ensure optimal patient outcomes.


Assuntos
Traumatismos Abdominais/etiologia , Acidentes de Trânsito , Desenluvamentos Cutâneos/etiologia , Hérnia Ventral/etiologia , Traumatismos Abdominais/diagnóstico por imagem , Desenluvamentos Cutâneos/diagnóstico por imagem , Feminino , Hemoperitônio/diagnóstico por imagem , Hemoperitônio/etiologia , Hérnia Ventral/diagnóstico por imagem , Humanos , Pessoa de Meia-Idade , Obesidade Mórbida/complicações , Tomografia Computadorizada por Raios X
4.
Korean J Parasitol ; 57(4): 405-409, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31533407

RESUMO

In malaria, splenic rupture is a serious complication potentially leading to death. Subcapsular hemorrhage of spleen is thought to be an impending sign of splenic rupture; however, the characteristics of subcapsular hemorrhage are not well known. We report 3 cases of subcapsular hemorrhage of the spleen in vivax malaria, with varying degrees of severity. Case 1 showed subcapsular hemorrhage without splenic rupture, was treated by antimalarial drug without any procedure. The healing process of the patient's spleen was monitored through 6 computed tomography follow-up examinations, over 118 days. Case 2 presented subcapsular hemorrhage with splenic rupture, treated only with an antimalarial drug. Case 3 showed subcapsular hemorrhage with splenic rupture and hypotension, treated using splenic artery embolization. They all recovered from subcapsular hemorrhage without any other complications. These 3 cases reveal the process of subcapsular hemorrhage leading to rupture and a potentially fatal outcome. The treatment plan of subcapsular hemorrhage should be determined carefully considering the vital signs, changes in hemoglobin, and bleeding tendency.


Assuntos
Hemorragia/etiologia , Malária Vivax/complicações , Esplenopatias/etiologia , Adulto , Angiografia , Hemoperitônio/diagnóstico por imagem , Hemoperitônio/etiologia , Hemorragia/diagnóstico por imagem , Humanos , Masculino , Baço/diagnóstico por imagem , Esplenopatias/diagnóstico por imagem , Tomografia Computadorizada por Raios X
5.
Cir Cir ; 87(S1): 53-57, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31501625

RESUMO

There are few reported cases of small bowel injury due to blunt abdominal trauma. We describe the clinical presentation and surgical management of these lesions. This is the clinical case of a polytraumatized male with a duodenal injury IIID3 according to AAST, who underwent resection of the intestinal segment with duodeno-duodenum anastomosis with favorable results. The infrequent presentation of injuries to the small intestine due to blunt trauma may lead the clinician to overlook the need for intentional interrogation about the kinematics of the trauma, while at the same time neglecting the taking of complementary diagnostic imaging studies, this because of a lack of clinical suspicion. It is important to analyze the patient's context, which will allow us to assess the need to delve into diagnostic studies in order to optimize their treatment.


Assuntos
Traumatismos Abdominais/cirurgia , Duodeno/lesões , Ferimentos não Penetrantes/cirurgia , Traumatismos Abdominais/diagnóstico por imagem , Traumatismos Abdominais/etiologia , Acidentes de Trânsito , Adulto , Colectomia , Duodeno/irrigação sanguínea , Duodeno/cirurgia , Gastrostomia , Hematoma/classificação , Hemoperitônio/etiologia , Humanos , Íleo/irrigação sanguínea , Isquemia/etiologia , Isquemia/cirurgia , Jejunostomia , Lacerações/classificação , Fígado/lesões , Masculino , Mesentério/lesões , Nutrição Parenteral , Pneumoperitônio/diagnóstico por imagem , Pneumoperitônio/etiologia , Ferimentos não Penetrantes/etiologia
6.
BMJ Case Rep ; 12(9)2019 Sep 16.
Artigo em Inglês | MEDLINE | ID: mdl-31527205

RESUMO

Simple hepatic cysts are usually asymptomatic but can rarely result in life-threatening complications such as haemoperitoneum secondary to rupture. A 70-year-old woman with known simple hepatic cyst presented with acute chest pain and dyspnoea. The initial diagnosis was pulmonary embolism, and anticoagulation was commenced. However, she subsequently collapsed with haemodynamic instability. CT revealed a large hepatic cyst haematoma with rupture into the peritoneal cavity. The patient underwent emergency laparotomy, haemostasis and partial deroofing of the cyst. Retrospective review of CT scans suggested that the bleed had begun on presentation but was exacerbated by anticoagulation. To our knowledge, this is the first report of haemorrhagic hepatic cyst associated with acute anticoagulation. We discuss several important clinical lessons including cyst rupture as a possible cause of chest pain, the need for careful review of imaging and the choice of anticoagulation in patients with known simple hepatic cyst.


Assuntos
Anticoagulantes/efeitos adversos , Hemoperitônio/etiologia , Ruptura Espontânea/induzido quimicamente , Idoso , Dor no Peito , Cistos/diagnóstico por imagem , Cistos/cirurgia , Diagnóstico Diferencial , Dispneia , Feminino , Hemoperitônio/diagnóstico por imagem , Hemoperitônio/cirurgia , Humanos , Hepatopatias/diagnóstico por imagem , Hepatopatias/cirurgia , Ruptura Espontânea/diagnóstico por imagem , Ruptura Espontânea/cirurgia
8.
BMJ Case Rep ; 12(8)2019 Aug 15.
Artigo em Inglês | MEDLINE | ID: mdl-31420424

RESUMO

An 18-year-old male patient presented to our regional referral hospital postcollapse at home. This was about 48 hours following a 2 m fall from a mountain bike. CT scan at presentation showed a grade 3/4 laceration at the splenic lower pole with some haemoperitoneum. He was managed conservatively. However, on day 4 he developed increasing abdominal pain which prompted repeat CT abdominal angiography. This scan did not show any further active bleeding from the spleen, however, a coeliac artery dissection was discovered, which was not evident on the first scan. After liaison with the vascular surgery team at a tertiary hospital, this was treated conservatively. Coeliac artery dissection following blunt trauma is an extremely rare occurrence, with fewer than 10 cases described in the literature. To our knowledge, this is the first case of concurrent splenic injury and coeliac artery dissection following blunt trauma to be reported.


Assuntos
Artéria Celíaca/lesões , Hemoperitônio/etiologia , Baço/lesões , Lesões do Sistema Vascular/complicações , Ferimentos não Penetrantes/complicações , Adolescente , Humanos , Masculino
9.
Medicine (Baltimore) ; 98(35): e16300, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31464889

RESUMO

We aim to investigate the diagnosis, treatment, and prognosis of intraperitoneal hemorrhage during pregnancy and parturition.Three cases with intraperitoneal hemorrhage during pregnancy and parturition admitted to our hospital from Jan. 2008 to Jan. 2018 were included in this study. One case showed fetal distress. Abdominal ultrasonography and abdominal CT showed pyoperitoneum in 2 cases. Abdominal puncture was performed in 2 patients, and noncoagulant blood was collected. The indications of emergency caesarean section in 3 cases were intraperitoneal hemorrhage. The etiology included rupture of posterior wall of uterus, rupture of blood vessel on uterine surface, and rupture of inflammatory vessel on uterine surface, respectively. The average volume of intraperitoneal bleeding was 2630 ml, and the average transfusion volume was 1530 ml. Caesarean section, and suture hemostasis were performed in 3 cases. The gestational age of delivery were 40 weeks, 40 weeks, and 25 weeks, respectively. There were 1 stillborn fetus and 2 live infants. All the puerperas were cured and discharged.Intraperitoneal hemorrhage in pregnancy is rare and is easily misdiagnosed. The mortality of pregnant women and perinatal infant is high. Therefore, early diagnosis, and timely operation is important.


Assuntos
Sofrimento Fetal/etiologia , Hemoperitônio/diagnóstico , Hemoperitônio/cirurgia , Adulto , Cesárea , Feminino , Hemoperitônio/etiologia , Humanos , Idade Materna , Parto , Gravidez , Segundo Trimestre da Gravidez , Terceiro Trimestre da Gravidez , Prognóstico , Tempo para o Tratamento
10.
BMJ Case Rep ; 12(7)2019 Jul 12.
Artigo em Inglês | MEDLINE | ID: mdl-31302618

RESUMO

Colonoscopy is a common procedure that gastroenterologists perform on a daily basis. It is considered a low-risk outpatient procedure and patients can be discharged on the same day after the procedure. Colonoscopy has become more feasible with the increasing application of standard screening for colon cancer and diagnostic procedures for large intestinal disease. There are reported possible risk factors of splenic rupture during the procedure. However, splenic injury after colonoscopy is considered a rare complication and less than 100 cases have been reported in international literature. Interestingly, this is the first case report demonstrating systemic lupus erythematosus (SLE) as a possible risk factor leading to splenic rupture post-colonoscopy. Failure to recognise this possibility even in its rarity can lead to life-threatening complications. We present a case of an acute splenic rupture with massive intraperitoneal bleeding after colonoscopy in a patient with SLE.


Assuntos
Colonoscopia/efeitos adversos , Lúpus Eritematoso Sistêmico/complicações , Ruptura Esplênica/etiologia , Feminino , Hemoperitônio/diagnóstico por imagem , Hemoperitônio/etiologia , Humanos , Pessoa de Meia-Idade , Fatores de Risco , Esplenectomia , Ruptura Esplênica/diagnóstico por imagem , Ruptura Esplênica/cirurgia
11.
Clin Imaging ; 58: 1-4, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31207444

RESUMO

Major bleeding, typically due to laceration of abdominal wall arteries or venous varices, is a rare but serious complication of paracentesis. We report a case of major bleeding post paracentesis to evidence that a sequence of 1) customized post processing of computed tomographic angiography data for periprocedural guidance, followed by 2) transcatheter cyanoacrylate glue embolotherapy, is the optimal treatment of this complication.


Assuntos
Hemoperitônio/diagnóstico por imagem , Paracentese/efeitos adversos , Testes Imediatos , Idoso , Angiografia por Tomografia Computadorizada , Diagnóstico Diferencial , Embolização Terapêutica/métodos , Hemoperitônio/etiologia , Hemoperitônio/terapia , Humanos , Doença Iatrogênica , Masculino
12.
Expert Rev Gastroenterol Hepatol ; 13(9): 867-876, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31204541

RESUMO

Introduction: Hemoperitoneum can be a life-threating condition in cirrhotic patients who have a limited compensatory reserve during hemorrhagic shock. We aim to review the literature on the different etiologies associated with non-traumatic hemoperitoneum (NTH), summarizing the most relevant conditions associated with spontaneous and iatrogenic peritoneal and retroperitoneal bleeding that may occur in cirrhotic patients and to illustrate the most relevant diagnostic strategies and optimal management. Area covered: This review encompasses the current literature in hemoperitoneum in cirrhotic patients in the absence of abdominal trauma. Established diagnostic procedures, therapeutic interventions and potential novel targets are reported and discussed. Expert opinion: To ensure the optimal management regardless of the underlying etiology of NTH, the first goal for the clinician is to obtain immediate hemodynamic stabilization with supportive measures and to control the source of bleeding. The latter can be achieved with angiographic embolization, which is usually the first choice, or with open surgery. Other therapeutic options according to specific etiologies include transjugular intrahepatic portosystemic shunt (TIPS), balloon-occluded retrograde transvenous obliteration (BRTO), balloon-occluded anterograde transvenous obliteration (BATO) or intra operative radio frequency (RF).


Assuntos
Hemoperitônio/etiologia , Cirrose Hepática/complicações , Traumatismos Abdominais/complicações , Humanos
13.
A A Pract ; 12(11): 409-411, 2019 Jun 03.
Artigo em Inglês | MEDLINE | ID: mdl-31162171

RESUMO

A 31-year-old primigravid parturient with no pertinent medical history was admitted at 40 weeks and 4 days of gestation for postdate induction of labor. She was subsequently diagnosed with preeclampsia and developed hemolysis, elevated liver enzymes, and a low platelet count. An emergency cesarean delivery ensued owing to fetal bradycardia. Massive hemorrhage occurred on incision, and a diagnosis of ruptured subcapsular hepatic hematoma was made. The hemorrhage was managed using our institution's massive transfusion protocol. Early transfusions and mobilization of necessary support stipulated in this protocol led to full recovery of the patient, with no significant morbidity.


Assuntos
Cesárea/efeitos adversos , Síndrome HELLP/diagnóstico , Hemoperitônio/etiologia , Fígado/lesões , Pré-Eclâmpsia/diagnóstico , Adulto , Transfusão de Sangue , Feminino , Hemoperitônio/terapia , Humanos , Idade Materna , Gravidez , Resultado do Tratamento
14.
Pan Afr Med J ; 32: 70, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31223361

RESUMO

Ophidian envenomations are a public health problem in Africa, causing 20.000 annual deaths. This mortality reflects the difficulties in the management of these complications, in particular of bleeding complications. We report the case of Mr SL, aged 35 years, farmer, victim of snake bite causing haemorrhagic syndrome followed by a progressive onset of acute abdomen. Ultrasound objectified high abundant effusion. Effusion puncture was performed which showed unclotting blood. Given the re-establishment of the hemoperitoneum after three doses of antivenin serum as well as the coagulation of the samples collected using drying tube, exploratory laparotomy was performed on day 9. It showed retroperitoneal hematoma, with bulging appearance, in the mesocolon which flowed in the peritoneal cavity. Aspiration of 1500ml of blood and rinsing with physiological serum were performed. The postoperative course was uneventful. The patient was transferred to the department of surgery three days after surgery and was discharged on day 19.


Assuntos
Antivenenos/administração & dosagem , Hematoma/etiologia , Mordeduras de Serpentes/complicações , Abdome Agudo/etiologia , Abdome Agudo/terapia , Adulto , Hematoma/cirurgia , Hemoperitônio/etiologia , Hemoperitônio/terapia , Hemorragia/etiologia , Hemorragia/terapia , Humanos , Masculino , Recidiva , Espaço Retroperitoneal
15.
BMC Gastroenterol ; 19(1): 112, 2019 Jun 27.
Artigo em Inglês | MEDLINE | ID: mdl-31248359

RESUMO

BACKGROUND: Acute anaemia in decompensated liver cirrhosis is commonly caused due to gastrointestinal bleeding; however, sometimes, detecting the site of blood loss is challenging. A patient on waitlist for orthotopic liver transplantation because of decompensated liver cirrhosis was admitted with acute anaemia and recurrence of ascites. Their abdomen CT showed migration of gallbladder stones in the pelvis while paracentesis documented hemoperitoneum. A diagnosis of gallbladder perforation was performed. CONCLUSION: Challenging choice of a "wait and see" strategy with conservative therapy, avoiding high-risk cholecystectomy, resulted in a successful liver transplant.


Assuntos
Anemia/etiologia , Cálculos Biliares/complicações , Hemoperitônio/etiologia , Cirrose Hepática/complicações , Anemia/terapia , Ascite/etiologia , Tratamento Conservador , Cálculos Biliares/diagnóstico por imagem , Cálculos Biliares/terapia , Hemoperitônio/terapia , Humanos , Transplante de Fígado , Masculino , Pessoa de Meia-Idade , Listas de Espera
17.
J Med Case Rep ; 13(1): 135, 2019 May 08.
Artigo em Inglês | MEDLINE | ID: mdl-31064402

RESUMO

BACKGROUND: Pregnancy following hysterectomy is very rare and may lead to significant morbidity, especially when diagnosis is delayed. CASE PRESENTATION: A 32-year-old G3P3002 African woman presented with increasing abdominal distension and 1 day of worsening abdominal pain and vomiting. Her previous pregnancy had ended 6 years prior with a stillborn baby delivered by Cesarean hysterectomy after laboring at home for 1 day. At the time of current presentation, this patient was confused and irritable, with an undetectable blood pressure, tachycardia, labored breathing, and a distended and tender abdomen. Urine human chorionic gonadotropin was positive and a transabdominal ultrasound showed significant intraperitoneal fluid collections and a singleton, viable pregnancy consistent with 13 weeks of gestation. A diagnosis of hypovolemic shock secondary to ruptured ectopic pregnancy was made, and she underwent emergency laparotomy. Intraoperative findings included 4.5 liters of hemoperitoneum and a cervical stump pregnancy with active bleeding from a partially detached placental site. CONCLUSION: Any reproductive-aged woman with at least one ovary and a means for sperm to meet egg should be screened for pregnancy if she presents with an acute abdomen or abdominal or pelvic pain.


Assuntos
Histerectomia/efeitos adversos , Gravidez Ectópica/diagnóstico , Abdome Agudo/etiologia , Adulto , Colo do Útero , Feminino , Hemoperitônio/etiologia , Humanos , Gravidez , Gravidez Ectópica/cirurgia
18.
J Vet Emerg Crit Care (San Antonio) ; 29(3): 239-245, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30994972

RESUMO

OBJECTIVE: To calculate a risk prediction model for hemangiosarcoma (HSA) diagnosis in dogs presenting with nontraumatic hemoabdomen. DESIGN: Retrospective multicenter observational cohort study enrolling dogs presented 2003-2016. SETTING: Five academic veterinary medical centers. ANIMALS: A total of 406 dogs with nontraumatic hemoabdomen as the presenting complaint that underwent surgical exploration or necropsy and received a histological diagnosis. Overall, 219 dogs from 3 centers provided the data for model construction, and 187 dogs from 2 centers provided the population for external validation. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: The risk score was modeled on 4 predictors: bodyweight (P = 0.01), total plasma protein (P < 0.01), platelet count (P < 0.01), and thoracic radiograph findings (P = 0.02). The incidence of HSA diagnosis was 36%, 76%, and 96% in the low risk (≤40), medium risk (41-55), and high risk (>55) score groups, respectively. The risk score AUROC was 0.85 (95% CI 0.79-0.90) on the construction population, and 0.77 (95% CI 0.70-0.84) on the validation population. CONCLUSIONS: The risk of HSA diagnosis in dogs presenting with nontraumatic hemoabdomen could be predicted using a simple risk score, which could aid in identification and treatment of dogs at lower risk for this diagnosis.


Assuntos
Neoplasias Abdominais/veterinária , Doenças do Cão/diagnóstico , Hemangiossarcoma/veterinária , Índice de Gravidade de Doença , Neoplasias Abdominais/complicações , Neoplasias Abdominais/diagnóstico , Animais , Estudos de Coortes , Doenças do Cão/sangue , Cães , Feminino , Hemangiossarcoma/complicações , Hemangiossarcoma/diagnóstico , Hemoperitônio/etiologia , Hemoperitônio/veterinária , Masculino , Ontário , Reprodutibilidade dos Testes , Estudos Retrospectivos , Fatores de Risco , Estados Unidos
19.
Saudi J Kidney Dis Transpl ; 30(2): 451-461, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31031381

RESUMO

Published data on the outcome of maintenance peritoneal dialysis (PD) since the initiation of PD in Tunisia is poor. The purpose of this study is to report long-term clinical outcomes of PD patients through a 10-year experience at a single unit. This is a retrospective review of the medical records of 182 PD patients who were followed up from January 2006 to June 2016. All patients were followed till death, renal transplant, switch over to hemodialysis (HD) or the end of the study in June 2016. The mean age of the incident patients was 43.93 ± 16.95 years. Nineteen (10.4%) were aged >65 years and 59.3% were male. The average duration of follow-up was 27.75 ± 26.18 months. The mean duration of PD treatment was 27.75 ± 26.18 months. There were 186 episodes of peritonitis that occurred over the total study period (54 episodes during the 1st year). The overall incidence of peritonitis during the 10-year study period was 1 per 27.25 patient months. Mechanical complications were noted in 31.2% of cases. Thirty- two (17.6%) patients had catheter displacement. Only 26 cases of hemoperitoneum (14.3%) were recorded. Death occurred in 23.1% of cases. Twenty-two patients (27.5%) were transplanted; 56 patients (70%) were transferred to HD, one patient had renal recovery and one case had voluntarily interrupted PD. In Kaplan-Meier curves of residual renal function (RRF) loss, there was a significant difference between peritonitis group and peritonitis-free group (P = 0.01). Technique and patient survival were associated with diabetes with a significant difference. The main cause of technique failure was peritonitis (61.4%). Moreover, the main repertoried causes of death were cardiovascular and septic causes. The mortality of diabetic and elderly PD patients was higher than mortality in nondiabetic and nonelderly groups, respectively, in our study. Peritonitis was associated with loss of RRF and technique failure.


Assuntos
Falência Renal Crônica/mortalidade , Falência Renal Crônica/terapia , Diálise Peritoneal/estatística & dados numéricos , Adolescente , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Doenças Cardiovasculares/mortalidade , Cateteres de Demora/efeitos adversos , Diabetes Mellitus/epidemiologia , Falha de Equipamento , Feminino , Seguimentos , Hemoperitônio/etiologia , Humanos , Estimativa de Kaplan-Meier , Falência Renal Crônica/fisiopatologia , Transplante de Rim/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Diálise Peritoneal/efeitos adversos , Peritonite/etiologia , Estudos Retrospectivos , Sepse/mortalidade , Taxa de Sobrevida , Fatores de Tempo , Resultado do Tratamento , Tunísia/epidemiologia , Adulto Jovem
20.
Z Geburtshilfe Neonatol ; 223(2): 109-112, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30847878

RESUMO

Acute hemoperitoneum (AHP) in early gestation is commonly treated via laparotomy. A ruptured corpus luteum (CL) cyst is a rare cause of AHP in pregnancy. This case report describes a 33-year-old, hemodynamically stable G2/P1 who presented at 5+5 gestational weeks with an acute abdomen due to ruptured CL cyst (7 cm). Emergent laparoscopy was performed. After evacuation of 1 L of hemoperitoneum, an atraumatic hemostasis was obtained without diathermy by use of hemostatic matrix (Floseal®). The ovary was reformed with an absorbable suture under preservation of CL. The postoperative recovery was uncomplicated. The hemoglobin drop was 2.8 g/dl. Further pregnancy course was uneventful. A healthy baby (2860 g) was delivered vaginally at 38+3 weeks of gestation. CONCLUSION: Laparoscopic approach to AHP in early pregnancy is suitable. CL preservation is feasible by use of atraumatic hemostatics.


Assuntos
Hemoperitônio/cirurgia , Laparoscopia , Cistos Ovarianos , Adulto , Feminino , Hemoperitônio/etiologia , Humanos , Luteína , Cistos Ovarianos/complicações , Cistos Ovarianos/cirurgia , Gravidez , Ruptura Espontânea
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