Hemoperitoneum in cirrhotic patients in the absence of abdominal trauma.

Hemoperitoneum in cirrhotic patients in the absence of abdominal trauma. Expert Rev Gastroenterol Hepatol. 2019 Jun 17;:1-10 Authors: Aseni P, Di Domenico SL, Barbosa F, Rampoldi A, Berry C Abstract 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 ob...
Source: Expert Review of Gastroenterology and Hepatology - Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

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Source: Journal of the Association of Physicians of India - Category: General Medicine Tags: J Assoc Physicians India Source Type: research
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Source: The British Journal of Radiology - Category: Radiology Authors: Tags: Br J Radiol Source Type: research
Conclusion Revascularization of a diffusely diseased LAD using the off-pump LIMA onlay-patch technique results in encouraging clinical outcomes with favorable angiographic results. Concomitant LAD endarterectomy and intraoperative LIMA graft flow are associated with the risk of postoperative LIMA graft failure.
Source: Coronary Artery Disease - Category: Cardiology Tags: CABG Source Type: research
ConclusionCangrelor is a  new antiplatelet therapy with a P2Y12 inhibiting effect, with a rapid onset and offset of action, owing to its short half-life. This cases series presents a pilot experience with promising results in terms of antiplatelet management for challenging intracranial aneurysms treated by stent assist ed coiling or flow-diverter stents.
Source: Klinische Neuroradiologie - Category: Radiology Source Type: research
ConclusionAcute complications of uterine leiomyomas requiring surgical intervention are exceptionally rare. Candidates for the massive transfusion protocol must be appropriately and timely identified. Additionally, because surgery is a potential treatment for hemorrhage control in leiomyoma-related hemoperitoneum, surgeons should be aware of such complications.
Source: International Journal of Surgery Case Reports - Category: Surgery Source Type: research
This study aimed to evaluate current rates of ad hoc PCI use and associated risks of adverse outcomes in patients with stable coronary artery disease (CAD).MethodsWe identified 550,742 patients with stable CAD who underwent PCI in the National Cardiovascular Data Registry (NCDR) CathPCI Registry from 2009–2017. We compared in-hospital bleeding, acute kidney injury (AKI), and mortality between patients receiving ad hoc vs. non-ad hoc PCI using logistic regression with inverse probability weighted propensity adjustment.ResultsBetween 2009 and 2017, 82.9% of patients underwent ad hoc PCI. Patients who did not undergo ad...
Source: American Heart Journal - Category: Cardiology Source Type: research
Background: To determine the clinical outcomes of perimesencephalic subarachnoid hemorrhages based on the computed tomography (CT) bleeding patterns. Methods: This retrospective cohort study included: (1) patients ( ≥18 years) admitted to a comprehensive stroke center (January 2015-May 2018), (2) with angiography-negative, nontraumatic subarachnoid hemorrhage in a perimesencephalic or diffuse bleeding pattern, and (3) had CT imaging performed in less than rqual to 72 hours of symptom onset. Patients were stra tified by location of bleeding on CT: Peri-1: focal prepontine hemorrhage; Peri-2: prepontine with suprasellar c...
Source: Journal of Stroke and Cerebrovascular Diseases - Category: Neurology Authors: Source Type: research
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Source: PubMed: Eur J Vasc Endovasc ... - Category: Surgery Authors: Tags: Eur J Vasc Endovasc Surg Source Type: research
We describe the case of a 55-year-old patient with a history of pulmonary embolism who presented in shock with ST-elevation on his electrocardiogram. He was triaged to the catheterization laboratory where he suffered a cardiac arrest. A pulmonary embolism was diagnosed angiographically, the thrombus was aspirated, and he received systemic thrombolysis. The combination of clot debulking and systemic thrombolysis acted synergistically to improve his right ventricular function by resolving his pulmonary hypertension. Although it is associated with a higher bleeding risk, the combination of clot aspiration with a thrombolytic ...
Source: Canadian Journal of Cardiology - Category: Cardiology Source Type: research
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Source: Canadian Journal of Cardiology - Category: Cardiology Source Type: research
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