Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0162871 (abdominal aortic aneurysm)
 8,664 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

From 1976 to 1984, 23 operations were performed on 22 patients with hemophilia (18 patients with factor VIII and four with factor IX deficiency). Elective procedures included resection of abdominal aortic aneurysm, liver transplantation, vagotomy/pyloroplasty, insertion of Mousseau-Barbin tube, colectomy, cholecystectomy, inguinal herniorrhaphy (four patients), colonoscopy/polypectomy, mediastinoscopy, arteriovenous fistula for dialysis, anal fistulectomy, and miscellaneous skin and soft-tissue procedures (five patients). Emergency operations were appendectomy (two patients), repair of bleeding liver biopsy site, and repair of an incarcerated inguinal hernia. There were two deaths (9%) within 30 days of operation, neither directly caused by the coagulopathy. Four patients had bleeding after surgery, which was treated with additional cryoprecipitate or factor concentrate. There were no nonhemorrhagic complications. Before operation, appropriate replacement therapy with factor VIII concentrate, cryoprecipitate, or fresh-frozen plasma was provided. Coagulation factor levels were measured before operation and monitored daily after operation. Generally, factor levels were raised to at least 1.0 U/ml and maintained at greater than 0.5 U/ml for 7 to 14 days after operation. However, when patients were treated with fresh-frozen plasma, plasma exchange was performed and factor levels of approximately 0.35 U/ml were achieved before surgery. We conclude that operations in patients with hemophilia can be accomplished safely with careful monitoring of coagulation factor levels and appropriate replacement therapy.
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PMID:General surgery in adult hemophiliacs. 308 Aug 17

A 77-year-old man with abdominal aortic aneurysm (AAA) was referred to our department. His AAA, which was 6 cm in diameter, was found incidentally with ultrasonography. On admission the diagnosis of hemophilia A was made for the first time in his life because activated partial thromboplastin time was decreased to 32.3% and factor VIII coagulant activity was 2.1% (normal range 40% to 140%). Recombinant factor VIII supplemental therapy was continued during surgery to maintain his factor VIII level within the normal range. His AAA was operated successfully with bifurcated graft replacement. No unusual bleeding complications occurred during his hospitalization. With proper preparation the patient with AAA and hemophilia A can safely undergo surgical treatment. Three other cases of AAA with hemophilia in the English literature were reviewed, and this is the oldest patient with hemophilia who underwent AAA surgery.
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PMID:Treatment for abdominal aortic aneurysm in a patient with hemophilia A: a case report and review of the literature. 915 26

Acute low back pain is a common complaint heard in the emergency room and in a physiatrist's practice. It is important to rule out occult pathology in patients with an atypical presentation. In the case presented here, the patient was elderly, developed back pain without preceding trauma or lifting, had a history of easy bruisability, had a large ecchymosis, and had worsening back pain with bedrest. An abdominal aortic aneurysm was ruled out and the patient was discovered to have a large retroperitoneal hemorrhage. He was diagnosed with acquired hemophilia secondary to factor VIII inhibitors. This has implications for physicians who treat patients with acute low back pain. They must be alert to potentially life-threatening causes of low back pain.
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PMID:Acute low back pain secondary to retroperitoneal hemorrhage in an elderly man. 919 76