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Query: UMLS:C0344329 (collapse)
 28,634 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A patient had delayed spontaneous rupture of the spleen complicating infective endocarditis. In 20 other cases reported through 1973, the most common presentation was found to be left upper quadrant pain followed by signs of peritoneal irritation and cardiovascular collapse. Abdominal paracentesis consistently yields free blood or pus in the peritoneal cavity; blood replacement and emergency splenectomy may be lifesaving. The basic pathological mechanisms may be (1) rupture of a mycotic aneurysm into the splenic substance (2) rupture of a splenic abscess, and (3) rupture of a suppurating intrasplenic vessel with hematoma formation, subcapsular dissection, and delayed capsular tear.
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PMID:Rupture of the spleen in infective endocarditis. 116 28

A 73-year-old man was admitted to the hospital due to severe hematemesis and collapse, severe anemia and inflammation. Two months ago, the patient had been treated with antibiotics due to septicemia with staphylococcus aureus. At that time CT scan had shown only thoracic arteriosclerosis. The subsequent high urgency upper endoscopy identified a circular mucosal defect in distal esophagus as bleeding origin. The patient died 10 hours after admission. Performing autopsy, a fistula between the thoracic aortic aneurysm and the distal esophagus was found in the background of severe arteriosclerosis. The rapid onset of an aneurysm with rupture after a bacterial infection is typical for a mycotic aneurysm.
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PMID:[A rare cause of haematemesis with fatal gastrointestinal bleeding]. 2045 58

Mycotic aneurysms are a well-recognised complication of infective endocarditis. In contrast to many sequelae of endocarditis, they can present late in the course of the disease, despite adequate treatment. We discuss the case of an 82-year-old patient who was successfully treated for Enterococcus faecalis endocarditis, but presented late with a hypotensive collapse. CT imaging demonstrated a ruptured mycotic aneurysm. He underwent laparotomy, but the decision was made to treat conservatively to protect the vascular supply to the bowel. The patient subsequently made a full recovery.
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PMID:Conservative management of a ruptured mycotic aneurysm. 2368 82