• Title/Summary/Keyword: Massive bleeding

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MASSIVE POSTOPERATIVE BLEEDING: A CASE REPORT (극심한 술후 출혈 : 증례보고)

  • Kim, Young-Kyun;Kim, Hyoun-Tae
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.25 no.4
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    • pp.367-370
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    • 1999
  • While oral and maxillofacial surgery such as orthognathic surgery, TMJ surgery is in progress, there always exists a risk of bleeding from maxillary artery, and this perplexes the surgeon in operation. In case of massive bleeding, it is mostly very difficult or even impossible to take an immediate action in order to stop bleeding. Even when hemostasis is possible by applying such methods as the use of local hemostatics, pressing, electrocoagulation or direct ligation, there is a high risk of secondary bleeding. Therefore, in case there is bleeding from maxillary artery, it is the best to restrain bleeding completely either by the ligation of the artery in bleeding in operation fields or by the ligation of the external carotid artery.

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A Case of Pulmonary Artery-bronchial Fistula with Massive Hemoptysis due to Pulmonary Tuberculosis (대량객혈로 내원하여 폐결핵에 의한 폐동맥기관지루로 진단된 1예)

  • Jo, Kyung-Wook;Hong, YoonKi;Han, Jung-Hye;Lee, Jae-Keun;Hong, Sang-Bum
    • Tuberculosis and Respiratory Diseases
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    • v.63 no.5
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    • pp.430-434
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    • 2007
  • Massive and untreated hemoptysis is associated with a >50% mortality rate. Since bleeding has a bronchial arterial origin in most patients, bronchial artery embolization (BAE) has become an accepted treatment in massive hemoptysis. The possibility of bleeding from pulmonary artery should be considered in patients in whom the bleeding focus cannot be found by Bronchial angiogram. Indeed, the bleeding occurs from a pulmonary artery in approximately 10% of patients with massive hemoptysis. The most common causes of bleeding from the pulmonary artery are pulmonary artery rupture associated with a Swan-Ganz catheter, infectious diseases and vasculitis. We report a rare case of a fistula between the right upper lobar pulmonary artery and the right upper lobar bronchus in a 71-year-old woman who presented with massive hemoptysis.

Retroperitoneal Gauze Packing with Vacuum-Associated Closure for Pelvic Fracture with Hemodynamic Instability (혈역학적으로 불안정한 골반 골절에서 진공 폐쇄 드레싱을 병용한 후복막 거즈 충전법 치료)

  • Kim, Sung Jeep;Kim, Ji Hoon T.
    • Journal of Trauma and Injury
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    • v.27 no.2
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    • pp.29-32
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    • 2014
  • Pelvic bone fracture with hemodynamic instability is fatal and the mortality rate can range up to 40%. Despite the big advances in the treatment of massive bleeding and hemorrhagic shock, the mortality associated with hemodynamically unstable pelvic bone fractures remains high. The gold standard of treatment for pelvic bone fracture with hemodynamic instability has not yet been determined and is an issue of main discussion among many doctors. Retroperitoneal packing is not yet wide spread in Korea, but is a good modality for managing of massive bleeding from pelvic bone fractures when an angiography suite or an expert surgeon is not available. A vacuum-assisted closure (VAC) system can also be applied with retroperitoneal packing in the manner of damage control surgery and open abdomen surgery. We present the case of a 51-year-old male who had a pelvic bone fracture with massive bleeding. We performed retroperitoneal gauze packing with a VAC system for the first time. The postoperative vital signs of patient were immediately stable, the massive bleeding was easily and quickly controlled, and the amount of transfusion of blood components was reduced.

Delayed rupture of a posttraumatic retromaxillary pseudoaneurysm causing massive bleeding: a case report

  • Hwang, Jae Ha;Kim, Woo Hyeong;Choi, Jun Ho;Kim, Kwang Seog;Lee, Sam Yong
    • Archives of Craniofacial Surgery
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    • v.22 no.3
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    • pp.168-172
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    • 2021
  • Posttraumatic pseudoaneurysm of the face is caused by blunt, penetrating, or surgical trauma. Although its incidence is low, pseudoaneurysm rupture can cause a life-threatening, massive hemorrhage. A 48-year-old man visited our emergency center due to a fall-down accident. Three-dimensional computed tomography (CT) showed a comminuted zygomaticomaxillary complex fracture of the left face. After open reduction and internal fixation, the surgical wound healed without any complications. However, the patient was readmitted 10 days after surgery due to pus-like discharge from the wound. Contrast-enhanced CT to find the abscess unexpectedly revealed a pseudoaneurysm in the left retromaxillary area. Massive oral bleeding occurred on the night of re-hospitalization and emergency surgery was done. The bleeding site was identified as a pseudo-aneurysmal rupture of the posterior superior alveolar artery in the retromaxillary area. Hemostasis was achieved by packing Vaseline gauze in the maxillary sinus using an endoscope. Delayed rupture and massive bleeding of posttraumatic retromaxillary pseudoaneurysm after a zygomaticomaxillary fracture is a low-probability, but high-impact event. Therefore, additional contrast-enhanced CT should be considered to evaluate the possibility of a posttraumatic pseudoaneurysm in cases of severe comminuted zygomaticomaxillary fracture.

Endoscopic Management with Ethanol Injection in a Child with Gastric Dieulafoy Lesion (Dieulafoy 병변 소아의 내시경적 치료 1례)

  • Kim, Hyun-Jin;Shin, Jee-Seon;Seo, Jeong-Wan
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.6 no.2
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    • pp.187-191
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    • 2003
  • The Dieulafoy's lesion is a rare cause of recurrent massive gastrointestinal bleeding in children. The bleeding results from an abnormally large submucosal artery that protrudes through a small mucosal defect. The lesion is commonly found on proximal stomach. Surgical intervention was believed to be the best treatment in the past, but recent advancement in endoscopy has made effective hemostasis possible. We report a case of a 9-year-old boy with underlying mycoplasma pneumonia with effusion who presented with massive upper gastrointestinal bleeding. Bleeding was controlled with endoscopic treatment by epinephrine and ethanol injection and the patient was successfully treated.

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Juvenile Polyp associated with Hypovolemic Shock Due to Massive Lower Gastrointestinal Bleeding

  • Kim, Dong Yeop;Bae, Joon Yeol;Ko, Kyung Ok;Cheon, Eun Jung;Lim, Jae Woo;Song, Young Hwa;Yoon, Jung Min
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.22 no.6
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    • pp.613-618
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    • 2019
  • Juvenile polyps are the most common types of polyps in children, and patients usually present with lower gastrointestinal (GI) bleeding as the predominant symptom. These lesions, which are referred to as hamartomas, usually measure approximately 2 cm in size and are benign tumors located mainly in the rectum and sigmoid colon. The most common symptom of a juvenile polyp is mild intermittent rectal bleeding. It is rare for anemic patients because the amount of blood loss is small and often not diagnosed immediately. We present the case of a 6-year-old girl with a juvenile polyp in the distal transverse colon, who developed hypovolemic shock due to massive lower GI bleeding. Pediatricians must perform colonoscopy for thorough evaluation of polyps, because their location and size can vary and they can cause massive bleeding.

Massive bleeding from a rectal Dieulafoy lesion in a patient with alcoholic cirrhosis

  • Choi, Young Hoon;Eun, Jong Ryeol;Han, Jae Ho;Lim, Hyun;Shin, Jung A;Lee, Gun Hwa;Lee, Seung Hee
    • Journal of Yeungnam Medical Science
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    • v.34 no.1
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    • pp.88-90
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    • 2017
  • Although Dieulafoy lesion can occur in any part of the gastrointestinal tract, its occurrence in the rectum is rare. Rectal Dieulafoy lesions have been associated with advanced age, renal failure, burns, liver transplantation and cirrhosis. Here, we report on a case of massive bleeding from a rectal Dieulafoy lesion after lung decortication surgery in a 57-year-old male patient with alcoholic cirrhosis. Although rare, a rectal Dieulafoy lesion should be included in the differential diagnosis of massive lower gastrointestinal bleeding in a patient with cirrhosis.

Tracheoinnominate Artery Fistula after Tracheal Reconstruction and Tracheostomy (기관재건술 및 기관절개술 후 발생한 기관무명동맥루)

  • 김동원
    • Korean Journal of Bronchoesophagology
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    • v.8 no.1
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    • pp.57-60
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    • 2002
  • Tracheoinnominate artery fistula is a rare but a catastrophic complication after tracheostomy or tracheal reconstruction. We experienced two cases of tracheoinnominate artery fistula after tracheal reconstruction and tracheostomy. The first patient was a 11 year old girl with cerebral arteriovenous malformation who maintained tracheostomy for 6 months before undergoing tracheal reconstruction. Three days after tracheal reconstruction, massive bleeding occurred through the intubation tube. She underwent emergency reoperation of repair the innominate artery with 5-0 Prolene and reconstruction of trachea. She died of bleeding 3 days after the reoperation. The second patient was a 68 year old man who underwent right upper lobectomy due to lung cancer. After operarion MRSA Pneumonia was developed and tracheostomy was performed 10 days after intubation. Twelve days after tracheostomy, massive bleeding occurred and emergency operation of ligation of innominate artery was performed. He died of sepsis 7 days after reoperation.

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Gastric Duplication Cyst Presenting as Massive Gastrointestinal Bleeding

  • Youssef, Alexey;Ibrahim, Alexander;AlShehabi, Zuheir;Omran, Ammar;Sharara, Ala I.
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.22 no.2
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    • pp.189-192
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    • 2019
  • Gastric duplication cysts (GDCs) are rare congenital anomalies. Presentation of GDCs varies from an asymptomatic abdominal mass to fulminant or massive gastrointestinal (GI) bleeding. Herein, we describe a case of a GDC in a 10-month-old infant presenting with unexplained massive GI hemorrhage and hematemesis. An abdominal ultrasound was negative, while computerized tomography was, initially, inaccessible. Through a series of repeated esophagogastroduodenoscopies, we documented penetration of the GDC into the gastric cavity that was later confirmed by computerized tomography. The patient was treated successfully with surgical resection.

A Case of Life-Threatening Arteriovenous Malformation Treated with Transcutaneous Embolization (경피적 색전술로 치료한 치명적 동정맥기형)

  • Choi Eun-Chang;Kim Eun-Seo;Kim Shi-Chan;Kim Young-Ho;Kim Dong-Ik
    • Korean Journal of Head & Neck Oncology
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    • v.12 no.2
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    • pp.224-229
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    • 1996
  • Head and neck arteriovenous malformation usually forms huge mass, cause profuse bleeding or potenially compromise the airway. This bleeding is vulnerable to be uncontrollable and life­threatening. Sometimes it has a high mortality. Although surgical resection is possible in some cases, the morbidity such as a defects of soft tissue is very high and its reconstruction is very difficult. The authors report an 11 year old female patient in whom occlusion of arteriovenous malformation with glue after transcutaneous embolization made a satisfactory results. At the beginning, she was transferred for massive oral bleeding. The bleeding was persistent and it was not possible to remove the packing in spite of many times of embolizations through feeding arteries. The massive bleeding trom the left upper alveolar mucosa compromised the airway and tracheotomy was done. Whenever the hypovolemic shock was occurred in a short time, blood transfusion and cardiopulmonary resucitation were done. To embolize the vascular mass of arteriovenous malformation, as a final trial before operation, the spinal needle was administered through the left upper gingiva under the fluoroscopy. The glue was injected on the target. The bleeding was stopped and we have noticed the absence of nidus on follow-up angiography after 3 weeks. We experienced that some cases of arteriovenous malformation in head & neck revealing the bleeding could be treated with transcutaneous embolization instead of surgical resection.

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