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

A resume of the aetiology, precipitating factors, pathology and management of spontaneous rupture of the liver in pregnancy, with a report of 5 cases, is presented. Misdiagnosis and late treatment contribute to the high mortality rate. Pre-operative diagnosis is very rare despite the fact that this is a diagnosable syndrome in pregnant multiparas with evidence of pre-eclampsia or eclampsia, and right-sided hypochondrial or epigastric pain which rapidly progresses to peripheral vascular collapse, often with signs of intraperitoneal haemorrhage. An awareness of this syndrome and early active surgical management constitute the best and only chance of survival for these patients.
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PMID:Spontaneous rupture of the liver associated with pregnancy. A report of 5 cases. 49 35

A 55-yr-old male with carcinoma of bladder received transurethral coagulation (TUC) under epidural anesthesia. A few min after the operation, he went into anaphylactic shock during irrigation of urinary bladder with thrombin solution. The symptoms were epigastralgia, circulatory collapse, skin rashes over the whole body and dyspnea. Oxygen inhalation and iv administration of epinephrine and steroid were performed, and his general condition improved within several hours. On the 2nd day after recovery from the anaphylactic shock, the patient received prick test on several agents which he had been given during operation. Prick test and RAST (radioallergosorbent test) on thrombin were positive. Based on our experience, thrombin may act to produce anaphylactic reaction. Although anaphylactic shock following topical thrombin is rare, we feel that thrombin should not be used without prick test.
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PMID:[Anaphylactic shock following topical use of thrombin for irrigation of urinary bladder]. 223 33

We report on a case of a 34-year old nullipara who suffered from rupture of the liver during eclampsia and survived despite most serious complications. Most cases of rupture of a non-traumatic subcapsular haematoma of the liver during pregnancy are associated with symptoms of pre-eclampsia. The pathogenesis of this severe complication as well as diagnostic imaging and surgical treatment are discussed. The classical trias of pre-eclampsia, epigastric pain and sudden circulary collapse may vary considerably. Since early diagnosis is crucial for maternal and foetal outcome, a subcapsular haematoma of the liver should be considered in women during pregnancy and childbed presenting with pre-eclampsia and upper abdominal pain. Here ultrasonographic imaging is a valuable and readily available diagnostic tool for the obstetrician.
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PMID:[Spontaneous liver rupture in eclampsia]. 330 21

Three cases of spontaneous rupture of the distal esophagus are presented. All three patients presented in acute distress, exhibiting epigastric pain and signs of cardiovascular collapse. They all underwent surgery for repair of the lesion. One died postoperatively, and the other two patients recovered after a complicated postoperative period. Because Boerhaave syndrome has a high mortality rate and its diagnosis can be elusive, a high index of suspicion should be maintained by the attending physician.
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PMID:Atraumatic panmural rupture of the esophagus: Boerhaave syndrome. 685 36

Rupture of a splenic artery aneurysm, commonly associated with pregnancy is a rare and catastrophic event. We report here a case of a patient in her second pregnancy who presented with a short history of left hypochondriac and epigastric pain, followed by collapse at 32 weeks gestation. Sudden fetal distress lead to emergency caesarean delivery when splenic artery aneurysm rupture was diagnosed. With timely involvement of multidisciplinary personnel both mother and baby survived and had an uneventful recovery.
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PMID:Splenic artery aneurysm rupture in pregnancy. 1522 61

A 76-year-old man was referred to the Emergency Department because of collapse, epigastric pain and nausea. The patient had been diagnosed with an infrarenal aneurysm of the abdominal aorta nine years earlier. His symptoms were attributed to an aortic-duodenal fistula originating from the aneurysm. The patient died despite placement of an aortic prosthesis. A hospital screening programme for chronic Q fever in patients with aortic aneurysm revealed chronic Q fever. Until recently, vascular infection with Coxiella burnetii was an unknown disease in the Netherlands. In view of the nonspecific clinical presentation, severity and therapeutic consequences of the disease, we advise screening for chronic Q fever in all symptomatic patients with an aortic aneurysm or prosthesis - whether or not with aspecific symptoms - in regions where the disease is endemic.
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PMID:[Screening for chronic Q fever in symptomatic patients with an aortic aneurysm or prosthesis]. 2069 30

Disulfiram treatment for alcohol dependence is used with acceptable outcomes. By inhibiting the aldehyde dehydrogenase enzyme, this treatment increases acetaldehyde concentration after the ingestion of alcohol causing an unpleasant disulfiram-alcohol reaction. Typical symptoms include flushing, headache, nausea, vomiting, sweating, vertigo, and lightheadedness. However, there have also been descriptions of more serious reactions including severe hypotension, arrhythmias, myocardial infarction, and cardiovascular collapse. We report a patient with a severe disulfiram-alcohol reaction marked by flushing, confusion, generalized malaise, epigastric pain, and hypotension. Cardiac biomarker and electrocardiographic changes were suggestive of non-ST-elevation myocardial infarction (NSTEMI). Left heart catheterization showed no angiographic evidence of coronary artery disease. Because of the frequency of alcohol dependence and its treatment with disulfiram, it is critical for physicians to be aware of these types of life-threatening complications.
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PMID:Disulfiram--alcohol reaction mimicking an acute coronary syndrome. 2474 56

Gastric volvulus is a rare complication of diaphragmatic rupture. We report the case of an 82-year-old man who presented following an out-of-hospital cardiac arrest. Chest radiography and thoracic computed tomography revealed an acute gastric volvulus and a chronic diaphragmatic hernia containing transverse colon and abdominal viscera. He had complained of retching and associated epigastric pain prior to collapse, and had sustained a motorcycle accident approximately 60 years earlier. Insertion of a nasogastric tube was unsuccessful (completing Borchardt's diagnostic triad) and his condition prevented both operative and endoscopic reduction of his volvulus. He died soon afterwards.
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PMID:Delayed diaphragmatic rupture presenting with acute gastric volvulus. 2524 17

Aluminum phosphide (AlP) is an insecticide and rodenticide that produces phosphine gas when exposed to moisture. Exposure to AIP has been described as through inhalation and ingestion routes and is typically either accidental or a suicidal attempt. The result is potential multiorgan toxicity involving the heart, kidneys, lungs, and liver, with an overall mortality related to exposure reported from 30% to 77%. The initial symptoms are nonspecific and can include epigastric pain, vomiting, diarrhea, dizziness, and dyspnea. Patients rapidly experience multisystem organ failure, cardiovascular collapse, and, finally, death. We report the case of a 3 year old girl with AlP poisoning who developed cardiogenic shock, ventricular arrhythmias, respiratory failure, liver injury, and significant acute kidney injury (AKI). She was successfully supported with veno-arterial extracorporeal membrane oxygenation (ECMO) for 16 days, treated with lidocaine and magnesium sulfate for ventricular arrhythmias, and received continuous renal replacement therapy (CRRT) and hemodialysis for 24 days for metabolic acidosis secondary to AKI. Despite her severe clinical presentation, she had complete normalization of her end-organ dysfunction with no neurological sequelae. This case demonstrates the high index of suspicion required for AlP poisoning given the potential for rapid progression and severe multiorgan toxicity. The authors recommend prompt referral to a tertiary care center with ECMO and CRRT capability in cases of suspected or documented AlP poisoning.
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PMID:Aluminum phosphide poisoning: Successful recovery of multiorgan failure in a pediatric patient. 3080 53