Concomitant Intraspinal and Retroperitoneal Hemorrhage Caused by an Aneurysm on the Celiac Artery: A Case Report (original) (raw)

Massive gastroduodenal hemorrhage and perforation in acute spinal cord injury

Surgical neurology, 1982

Fatal gastrointestinal hemorrhage or perforation are important problems in the management of patients in the acute phase of spinal cord injury. This paper describes 3 patients with these conditions, and shows some of the associated hazards, especially the danger of painless penetration, perforation, and peritonitis, plus the increased morbidity of these serious problems in the presence of the neurological sequelae of spinal cord injury. Our experience shows that life-threatening hemorrhage from the gastrointestinal tract occurs in about 2.5% of patients with cord injury, and often occurs during the first few days after the accident. We believe that a high index of suspicion and an aggressive therapeutic approach are necessary to save these patients from the traditionally high mortality associated with massive upper gastrointestinal hemorrhage, especially during this critical period of acute spinal cord injury.

Treatment of an aneurysm of the celiac artery arising from a celiomesenteric trunk. Report of a case

International journal of surgery case reports, 2015

Visceral artery aneurysms (VAA) are rare, frequently present as a life-threatening emergency and are often fatal. The celiacomesenteric trunk (CMT), a common origin of the celiac trunk (CT) and the superior mesenteric artery (SMA) from abdominal aorta, is quite rare. Aneurysms that involve this celiomesenteric anomaly are even rarer and in the last 32 years have been reported in only 20 cases in the literature. We describe a case with 30mm aneurysm arising from a CMT. In general, an aneurysm that is 20mm or greater in size is considered to be significant enough to warrant treatment. Abdominal VAA sometimes can be treated with low-invasive procedures: our patient required open surgical repair with the celiac artery replanted on to the aorta. The clinical course was complicated only by an increase of hepatic cytolysis enzymes, and by a low output pancreatic fistula, treated conservatively. The patient was discharged on the fifteenth postoperative day. One month after discharge, imagin...

Hemorrhagic Events in Adult Celiac Disease Patients. Case Report and Review of the Literature

Journal of gastrointestinal and liver diseases : JGLD, 2018

Celiac disease (CD) presents with a wide spectrum of extra-digestive symptoms, including hemorrhagic manifestations. The aim of this review was to conduct an extensive analysis of the hemorrhagic events reported in adult CD patients. Case report and review of the literature. Pubmed (MEDLINE) database search from January 1970 onwards was performed using the medical subject headings [MeSH] terms "celiac disease" AND "blood coagulation disorders", "hemorrhage", "hematoma", "hematuria", "hemoptysis", "epistaxis", "hemosiderosis". Only case reports were identified on the search theme. Information on patients' characteristics, diagnostic features, coagulation parameters, symptomatology duration, and evolution under treatment were systematically collected and summarized. We present the case of a 40-year-old man hospitalized for spontaneous muscular hematomas, in whom CD was diagnosed. We performed a review ...

Ruptured mycotic abdominal aortic aneurysm presenting with spinal cord ischaemia: A very rare presentation

2020

Mycotic abdominal aortic aneurysms (AAA) are rare. This case report describes a 59 year old female who presented with a history of sudden onset abdominal pain and bilateral lower limb paralysis. She presented after 24 hours of the onset of symptoms. Bilateral distal lower limb pulses were absent. Computerized tomographic (CT) scan of abdomen showed a leaking, saccular, juxtarenal AAA. There was a thin layer of thrombus on the posterior wall of the aneurysm. The lumbar arteries were not visualised, indicating that they were thrombosed. On bilateral fasciotomy of the legs all muscles were viable. Therefore acute lower limb paralysis due to leaking AAA and thrombosis of the spinal arteries leading to spinal cord ischaemia was clinically diagnosed. Patient underwent repair of the AAA with antibiotic coated tube polyester graft. Salmonella was isolated from the aortic wall tissue. Patient was treated with prolonged course of antibiotics. Hemo-dynamically she improved but her lower limb m...

Spontaneous Spinal Haemorrhage as a Complication of Oral Anticoagulant Therapy: A Case Report and Literature Review

European Journal of Case Reports in Internal Medicine

Spinal cord haematoma, or haematomyelia, is a rare condition caused by several unusual disease processes. Traumatic events, such as spinal cord injury and surgery or procedures involving the spinal cord, are the most important causes of spinal cord haematoma. Rarely, it is associated with anticoagulation therapy. Irrespective of cause, spinal cord haematoma is considered a neurosurgical emergency and must be treated promptly in order to prevent neurological sequelae. The authors describe the case of a 69-year-old patient taking warfarin in the therapeutic range for a mechanic mitral valve, who developed chest pain with cervical and dorsal radiation, and experienced sudden paraparesis of the limbs. A CT of the spine confirmed haematomyelia. A high index of suspicion, prompt recognition and immediate intervention are essential to prevent major morbidity and mortality from intraspinal haemorrhage.

Spinal Cord Infarction following Abdominal Surgery and Postoperative Epidural Analgaesia

Sultan Qaboos University medical journal, 2010

Ischemic infarction is a rare cause of acute myelopathy. We report the case of a young woman admitted to Sultan Qaboos University Hospital, Oman, who developed extensive spinal cord infarction in the setting of surgical evacuation and packing of liver haematoma and post-operative epidural analgesia. She had no vascular risk factors for stroke. The vascular mechanism underlying ischemic myelopathy and the relationship to abdominal surgery and epidural analgesia are discussed.

Ruptured Visceral Artery Aneurysms: A Deadly Cause of Epigastric Pain

Clinical practice and cases in emergency medicine, 2019

Visceral artery aneurysms (VAA) are rare, life-threatening disease processes that often affect the celiac, superior mesenteric, or inferior mesenteric arteries and their respective branches. The splenic, hepatic, superior mesenteric, and tripod celiac arteries are most commonly affected and have high rupture and mortality rates. This case describes splenic and celiac artery aneurysms in a patient that led to hemorrhagic shock and multisystem organ failure despite timely diagnosis and ligation. A brief review of the literature further elucidates the key risk factors in identifying patients with VAAs and their treatment course. [Clin Pract Cases Emerg Med. 2019;3(2):132-136.]