RESUMEN
Splenic injury during pregnancy after blunt abdominal trauma is rare. The physiological and anatomical changes during pregnancy modify the clinical, biological and radiological signs. The authors report a case of a 30-year-old-woman in the 32nd week of pregnancy, with an isolate splenic injury after a motor vehicle accident. Splenectomy was realised 4 days after an initial decision of abstaining from surgery. In pregnancy, the frequency of recurrent bleeding, the possibility of concomitant uterine injuries and the risk of foetal loss should modify the surgeon's attitude to splenic rupture after abdominal blunt trauma.
Asunto(s)
Complicaciones del Embarazo/etiología , Bazo/lesiones , Accidentes de Tránsito , Adulto , Femenino , Humanos , Embarazo , Complicaciones del Embarazo/diagnóstico por imagen , Bazo/diagnóstico por imagen , Esplenectomía , Ultrasonografía , Heridas no Penetrantes/diagnóstico por imagenRESUMEN
Diabetic patients with urinary tract infections had a certain risk of developping emphysematous pyelonephritis with gas producting bacteria. This disease was accompagned with high mortalité. We will report one case who was treated successfully by high dose antibiotic regim and emergency nephrectomy.
Asunto(s)
Enfisema/etiología , Pielonefritis/etiología , Antibacterianos/uso terapéutico , Complicaciones de la Diabetes , Enfisema/tratamiento farmacológico , Enfisema/cirugía , Femenino , Humanos , Persona de Mediana Edad , Nefrectomía , Pielonefritis/tratamiento farmacológico , Pielonefritis/cirugíaRESUMEN
In a prospective randomized study in patients undergoing carotid endarterectomy, we compared the hemodynamic effects, the quality of induction, and the quality of recovery from a hypnotic drug for the induction of anesthesia with sevoflurane, a target-controlled infusion (TCI) of propofol, or propofol 1.5 microg/kg followed by isoflurane. All patients were premedicated with midazolam and received sufentanil 0.4 microg/kg at induction. The induction of anesthesia was associated with a decrease in arterial blood pressure in all groups, but this was least pronounced in the Sevoflurane group. There were similar a number of episodes of hypotension, hypertension, and tachycardia among groups, but the incidence of bradycardia was less in the TCI group (P < 0.05) compared with the other groups. The duration of episodes of hypotension was shorter (P < 0.05) in the TCI Propofol group (1.9 +/- 2.3 min) compared with the Sevoflurane group (4.7 +/- 3.6 min). The duration of episodes of bradycardia was significantly lower (P < 0.05) in the TCI Propofol group (0.1 +/- 0.5 min) in comparison with the Propofol Bolus group (2.5 +/- 3.9 min). Similar doses of vasoactive drugs were used in all groups. The induction of anesthesia with sevoflurane was associated with inferior conditions for intubation in comparison with both Propofol groups, although the time to intubation was faster in the Sevoflurane group (P < 0.05). The recovery characteristics were similar in the three groups.
Asunto(s)
Anestesia Intravenosa , Anestésicos por Inhalación , Anestésicos Intravenosos , Endarterectomía Carotidea , Isoflurano , Éteres Metílicos , Propofol , Anciano , Periodo de Recuperación de la Anestesia , Anestésicos Intravenosos/administración & dosificación , Presión Sanguínea/efectos de los fármacos , Femenino , Frecuencia Cardíaca/efectos de los fármacos , Hemodinámica/efectos de los fármacos , Humanos , Masculino , Persona de Mediana Edad , Propofol/administración & dosificación , Estudios Prospectivos , SevofluranoRESUMEN
The cerebral thrombophlebitis is a rare complication of the pregnancy and the postpartum. We report a case of a 21 year-woman presenting a post-partum cerebral thrombophlebitis, secondary to an acquired deficiency of antithrombin III. The clinical symptoms of cerebral thrombophlebitis can be misleading. The angiography and the magnetic resonance imaging permit the diagnosis. The treatment is relied on anticoagulating heparin therapy. This treatment will be adapted in case of coagulation's factors deficiency that must be searched in any thromboembolic accident having an unusual localization.
Asunto(s)
Deficiencia de Antitrombina III , Embolia y Trombosis Intracraneal/etiología , Trastornos Puerperales/etiología , Tromboflebitis/etiología , Adulto , Anticoagulantes/uso terapéutico , Angiografía Cerebral , Femenino , Humanos , Embolia y Trombosis Intracraneal/diagnóstico , Embolia y Trombosis Intracraneal/tratamiento farmacológico , Imagen por Resonancia Magnética , Trastornos Puerperales/diagnóstico , Trastornos Puerperales/tratamiento farmacológico , Tromboflebitis/diagnóstico , Tromboflebitis/tratamiento farmacológico , Tomografía Computarizada por Rayos XRESUMEN
AT III is a physiologic inhibitor of blood clot formation: its deficiency is manifested by venous thrombosis. The authors reported case of mesenteric venous infarction in a 42-years-old woman. AT III deficiency was transient and caused by an oral contraceptive. In patients with AT III acquired deficiency it is necessary to suppress any risk factors of venous thrombosis.