MyMedR

A rare cause of spontaneous bleeding per oral in an elderly

Ibrahim FM, Mohamad I

Ann Acad Med Singap, 2010 Oct;39(10):817-8.

Matched MeSH terms: Oral Hemorrhage/etiology*

Activated recombinant factor VII in the treatment of retroperitoneal haemorrhage in a patient with factor VIII inhibitor

Ng SC

Ann Acad Med Singap, 1994 Nov;23(6):901-2.

PMID: 7741509

The management of haemorrhagic episodes in patients with factor VIII inhibitor is difficult and the outcome rather unpredictable. The use of an investigational drug, that is, activated recombinant factor VII (rFVIIa) in a young non-haemophiliac patient with spontaneous occurrence of factor VIII inhibitor who presented with life-threatening retroperitoneal haemorrhage is reported. There was prompt achievement of haemostasis with rFVIIa after the patient had failed conventional therapy with factor IX and Autoplex. Two further episodes of retroperitoneal bleeding again responded promptly to rFVIIa therapy.

Matched MeSH terms: Hemorrhage/etiology

Pulmonary manifestation as initial presentation for systemic lupus erythematosus

Khor CG, Kan SL, Tan BE

Int J Rheum Dis, 2018 Jun;21(6):1322-1325.

PMID: 24495523 DOI: 10.1111/1756-185X.12302

We report a 29-year-old Malay man who had pulmonary manifestations as an initial presentation for systemic lupus erythematosus. He had prolonged hospitalization and was treated with intensive care therapy with immunosuppressants.

Matched MeSH terms: Hemorrhage/etiology*

Fulltext Hemorrhagic cardiac tamponade: rare complication of radiofrequency ablation of hepatocellular carcinoma

Loh KB, Bux SI, Abdullah BJ, Raja Mokhtar RA, Mohamed R

Korean J Radiol, 2012 Sep-Oct;13(5):643-7.

PMID: 22977334 DOI: 10.3348/kjr.2012.13.5.643

Local treatment for hepatocellular carcinoma (HCC) has been widely used in clinical practice due to its minimal invasiveness and high rate of cure. Percutaneous radiofrequency ablation (RFA) is widely used because its treatment effectiveness. However, some serious complications can arise from percutaneous RFA. We present here a rare case of hemorrhagic cardiac tamponade secondary to an anterior cardiac vein (right marginal vein) injury during RFA for treatment of HCC.

Matched MeSH terms: Hemorrhage/etiology*

Unilateral moyamoya disease with co-existing arteriovenous malformation

Nawawi O, Sinnasamy M, Ramli N

Br J Radiol, 2006 Jul;79(943):e12-5.

PMID: 16823046

A case of an intracerebral bleed in a young man with a rare combination of arteriovenous malformation (AVM) and unilateral moyamoya disease is presented. The location of the bleed in the left basal ganglia corresponded to the area supplied by the basal moyamoya vessels. The AVM which received supply from collateral moyamoya vessels as well as normal cerebral arteries was located in the ipsilateral parieto-occipital region posterior to the basal ganglia bleed. This is the first reported cerebral AVM co-existing with a unilateral moyamoya disease in the English literature. Unusual features of the case such as the unilaterality of the angiographic abnormalities, their coexistence and hypotheses as to their development are discussed.

Matched MeSH terms: Cerebral Hemorrhage/etiology

Arterial embolization of a bleeding gastric Dieulafoy lesion: a case report

Mohd Rizal MY, Kosai NR, Sutton PA, Rozman Z, Razman J, Harunarashid H, et al.

Clin Ter, 2013;164(1):25-7.

PMID: 23455738 DOI: 10.7417/T.2013.1506

Dieulafoy's lesion is one of an unusual cause of upper gastrointestinal bleeding (U GIB). Endoscopic intervention has always been a preferred non-surgical method in treating UGIB including bleeding from Dieulafoy's lesion. Owing to recent advances in angiography, arterial embolization has become a popular alternative in non- variceal UGIB especially in cases with failed endoscopic treatment. However, managing bleeding Dieulafoy's with selective arterial embolization as the first line of treatment has not been exclusively practiced. We hereby, report a case of bleeding Dieulafoy lesion which had been primarily treated with arterial embolization.

Matched MeSH terms: Gastrointestinal Hemorrhage/etiology

Risk factors associated with subaponeurotic haemorrhage in full-term infants exposed to vacuum extraction

Boo NY, Foong KW, Mahdy ZA, Yong SC, Jaafar R

BJOG, 2005 Nov;112(11):1516-21.

PMID: 16225572

To determine obstetric and neonatal risk factors associated with subaponeurotic haemorrhage (SAH) in infants exposed to vacuum extraction.

Matched MeSH terms: Hemorrhage/etiology*

Long-term patterns of safety and efficacy of bleeding prophylaxis with turoctocog alfa (NovoEight(®) ) in previously treated patients with severe haemophilia A: interim results of the guardian(™) 2 extension trial

Ozelo M, Misgav M, Abdul Karim F, Lentz SR, Martin-Salces M, Matytsina I, et al.

Haemophilia, 2015 Sep;21(5):e436-9.

PMID: 26058730 DOI: 10.1111/hae.12737

Matched MeSH terms: Hemorrhage/etiology

Calibre persistent submucosal artery of the jejunum: a rare cause of massive gastrointestinal bleeding

Wan Muhaizan WM, Julia MJ, Al Amin D

Malays J Pathol, 2002 Dec;24(2):113-6.

PMID: 12887171

Historically a calibre persistent submucosal artery was most often described in the stomach. However in later years it was also discovered in the duodenum and jejunum. It is an uncommon and important cause of massive gastrointestinal bleeding in which failure of detection and early intervention would lead to death. In this paper we report a 27-year-old man with no significant medical history who presented at the emergency unit for recurrent melaena, haematochezia and hypotension. Initial investigations failed to localize the source of bleeding. Emergency exploratory laporatomy revealed a small jejunal mucosal nodule that was actively spurting blood. Histopathological evaluation identified a calibre persistent submucosal artery.

Matched MeSH terms: Gastrointestinal Hemorrhage/etiology*

Management of a rare case of arteriovenous malformation of the head of the pancreas

Shahrudin MD, Noori SM

Hepatogastroenterology, 1997 Jan-Feb;44(13):284-7.

PMID: 9058160

Arterio-venous malformation (AVM) of the head of the pancreas is a rare condition that may cause upper gastro-intestinal tract (GIT) bleeding. A 45-year-old man with a large AVM at the pancreato-biliary region is described. The patient had recurrent episodes of hematemesis and melena. Enlargement of the AVM was documented by serial abdominal CT scans performed after each bleed. Whipple procedure was successfully performed in this patient.

Matched MeSH terms: Gastrointestinal Hemorrhage/etiology

Fulltext Experience with sublabial transseptal transsphenoidal hypophysectomy at the Universiti Kebangsaan Malaysia

Said H, Cheah F, Mohamed AS, Hadi AR

Med J Malaysia, 1993 Jun;48(2):222-4.

PMID: 8350800

The transseptal transsphenoidal hypophysectomy has become a relatively frequent procedure in recent years. We performed 20 such procedures between January 1984 and December 1987 for various pituitary disorders. Significant complications such as CSF rhinorrhea, meningitis, diabetes insipidus, haemorrhage and septal perforation are discussed. The mortality rate for the series was 5%. In analysing the data, we feel that this technique of hypophysectomy is a safe procedure.

Matched MeSH terms: Hemorrhage/etiology

Uterine leiomyomata in pregnancy

Hasan F, Arumugam K, Sivanesaratnam V

Int J Gynaecol Obstet, 1991 Jan;34(1):45-8.

PMID: 1671020

Sixty cases with uterine leiomyomata in pregnancy are presented. The incidence was 1 in 1033 deliveries. The median age of the patients was 33.4 years. The majority were primigravidae (60%). A significant number of patients gave a history of infertility (43%) and spontaneous abortions (25%). The commonest antenatal complication was malpresentation and in all these patients the myomata were larger than 6 cm. Typical features of red degeneration occurred in 10% of cases. The cesarean section rate was 73%, the commonest indication being obstructed labor. Severe hemorrhage was encountered at cesarean section in 10 patients, 3 of whom needed hysterectomy. There were no perinatal deaths.

Matched MeSH terms: Uterine Hemorrhage/etiology

Internal iliac and ovarian artery ligation in the control of pelvic haemorrhage

Thavarasah AS, Sivalingam N, Almohdzar SA

Aust N Z J Obstet Gynaecol, 1989 Feb;29(1):22-5.

PMID: 2562595

Bilateral ligation of the internal iliac artery with or without ligation of the ovarian arteries was carried out in 17 patients who had life-threatening pelvic haemorrhage; 14 were due to obstetric haemorrhage, 2 followed abdominal hysterectomy and 1 intractable haemorrhage associated with carcinoma of the cervix. The procedure was successful in arresting the haemorrhage in 13 patients but 4 needed hysterectomy in spite of the ligation; 1 patient died from disseminated intravascular coagulation following surgery and 1 had cardiac arrest due to extensive blood loss during surgery and died 12 hours later. A review of the literature, a brief description of the procedure and its indications are discussed.

Matched MeSH terms: Hemorrhage/etiology

Fulltext Blood pressure in acute intracerebral haemorrhage

Rasool AH, Rahman AR, Choudhury SR, Singh RB

J Hum Hypertens, 2004 Mar;18(3):187-92.

PMID: 14973513 DOI: 10.1038/sj.jhh.1001647

Stroke is one of the leading causes of death worldwide, and spontaneous bleeding into the brain parenchyma, intracerebral haemorrhage (ICH), is a stroke subtype associated with high morbidity and mortality. Overall, it comprises about 15% of all stroke in Caucasians, this figure being much higher in Asians and black people. Blood pressure (BP) appears to play an important role in this disease. We have reviewed available literature on the relationship of BP to the occurrence of primary and secondary ICH, the association of BP levels measured early after stroke with prognosis and complications, and evidence about the effects of early BP lowering treatments on post-stroke outcomes. BP appears to be an important risk factor for primary and secondary ICH. In addition, high BP early after ICH may be detrimental to outcome, possibly contributing to complications such as rebleeding and haematoma enlargement. Few data are available about the effects of early lowering of BP on outcome after ICH with no reliable trial yet conducted. Proper randomised trials are required to establish the effect of early lowering of BP on outcome after ICH.

Matched MeSH terms: Cerebral Hemorrhage/etiology*

Fulltext Rurioctocog alfa pegol PK-guided prophylaxis in hemophilia A: results from the phase 3 PROPEL study

Klamroth R, Windyga J, Radulescu V, Collins PW, Stasyshyn O, Ibrahim HM, et al.

Blood, 2021 04 01;137(13):1818-1827.

PMID: 33150384 DOI: 10.1182/blood.2020005673

Rurioctocog alfa pegol prophylaxis targeting factor VIII (FVIII) troughs ≥1% has shown to be efficacious with an acceptable safety profile in people with hemophilia A (PwHA). The PROPEL trial compared safety and efficacy of 2 target FVIII troughs in PwHA aged 12 to 65 years, with severe disease, annualized bleeding rate ≥2, and previous FVIII treatment. PwHA were randomized to 12 months' pharmacokinetic (PK)-guided rurioctocog alfa pegol prophylaxis targeting FVIII troughs of 1% to 3% (reference arm) or 8% to 12% (elevated arm); first 6 months was treatment-adjustment period. The primary endpoint was absence of bleeds during the second 6 months, analyzed using multiple imputations (full analysis set [FAS]). In the 1% to 3% and 8% to 12% arms, respectively, point estimates (95% confidence interval) of proportions of PwHA with zero total bleeds were 42% (29% to 55%) and 62% (49% to 75%) in FAS (N = 115; P = .055) and 40% (27% to 55%) and 67% (52% to 81%) in per-protocol analysis set (N = 95; P = .015). Dosing frequency and consumption varied in each arm. Adverse events (AEs) occurred in 70/115 (60.9%) PwHA; serious AEs in 7/115 (6%) PwHA, including 1 treatment-related in 8% to 12% arm (transient anti-FVIII inhibitor). There were no deaths, serious thrombotic events, or AE-related discontinuations. PK-guided prophylaxis was achievable and efficacious in both arms. No new safety signals were observed in the 8% to 12% arm. These results demonstrate elevated FVIII troughs can increase the proportion of PwHA with zero bleeds and emphasize the importance of personalized treatment. This trial was registered at www.clinicaltrials.gov as #NCT02585960.

Matched MeSH terms: Hemorrhage/etiology

Review of the complications in peritoneal dialysis

Mukherjee AP

Med J Malaya, 1969 Sep;24(1):21-3.

PMID: 4243838

Matched MeSH terms: Hemorrhage/etiology

Retained Endoscope: An Unexpected but Serious Complication of Hemospray®

Yii RSL, Chuah KH, Poh KS, Lau PC, Ng KL, Ho SH, et al.

Dig Dis Sci, 2022 01;67(1):344-347.

PMID: 33491164 DOI: 10.1007/s10620-021-06835-4

Matched MeSH terms: Gastrointestinal Hemorrhage/etiology

Bariatric Surgery in Patients on Chronic Anticoagulation Therapy

Sharma G, Hanipah ZN, Aminian A, Punchai S, Bucak E, Schauer PR, et al.

Obes Surg, 2018 08;28(8):2225-2232.

PMID: 29455405 DOI: 10.1007/s11695-018-3120-4

BACKGROUND: Perioperative management of chronically anti-coagulated patients undergoing bariatric surgery requires a balance of managing hemorrhagic and thromboembolic risks. The aim of this study is to evaluate the incidence of hemorrhagic complications and their management in chronically anticoagulated (CAT) patients undergoing bariatric surgery.

METHODS: A retrospective review of CAT patients undergoing bariatric surgery at an academic center from 2008 to 2015 was studied.

RESULTS: A total of 153 patients on CAT underwent surgery [Roux-en-Y gastric bypass (n = 79), sleeve gastrectomy (n = 63), and adjustable gastric banding (n = 11)] during the study period: 85 patients (55%) were females; median age was 56 years (interquartile range [IQR] 49-64), and median BMI was 49 kg/m2 (IQR 43-56). The most common indications for CAT were venous thromboembolism (n = 87) and atrial fibrillation (n = 83). Median duration of procedure and estimated intraoperative blood loss was 150 min (IQR 118-177) and 50 ml (IQR 25-75), respectively. Thirty-day postoperative complications were reported in 33 patients (21.6%) including postoperative bleeding (n = 19), anastomotic leak (n = 3), and pulmonary embolism (n = 1). Nineteen patients (12%) with early postoperative bleeding were further categorized to intra-abdominal (n = 10), intraluminal (n = 6), and at the port site or abdominal wall (n = 3). All-cause readmissions within 30 days of surgery occurred in 19 patients (12%). There was no 30-day mortality.

CONCLUSION: In our experience, patients who require chronic anticoagulation medication are higher than average risk for postoperative complications and all-cause readmission rates. Careful surgical technique and close attention to postoperative anticoagulation protocols are essential to decrease perioperative risk in this high-risk cohort.

Matched MeSH terms: Postoperative Hemorrhage/etiology

Fecal occult blood testing on Trichuris-infected primary school children in northeastern peninsular Malaysia

Raj SM

Am J Trop Med Hyg, 1999 Jan;60(1):165-6.

PMID: 9988342

Stool specimens of 104 primary schoolchildren (mean+/-SD age = 8.2+/-0.3 years) were examined for helminth eggs and for occult blood to investigate the possibility that trichuriasis causes occult intestinal bleeding in the absence of the overt Trichuris dysentery syndrome. A commercially available guaiac test was used to detect fecal occult blood. Sixty-one children had Trichuris infection, 11 of whom had heavy infections (> 10,000 eggs per gram of feces [epg]), and 53 had Ascaris infections. No hookworm infection was detected. Baseline screening yielded only one weakly positive occult blood test result in a child with a light (800 epg) Trichuris infection. Serial stool occult blood testing on the 11 subjects with heavy trichuriasis and 8 uninfected controls yielded a single weakly positive result in the control group. The results provide no evidence that trichuriasis predisposes to significant occult gastrointestinal bleeding in children in the absence of the dysenteric syndrome.

Matched MeSH terms: Gastrointestinal Hemorrhage/etiology*

Diagnostic Challenges in an Atypical Case of IRVAN Syndrome: Literature Review

Sinnayya D, Lott PW, Tajunisah I

Ocul Immunol Inflamm, 2024 Aug;32(6):1048-1060.

PMID: 37134302 DOI: 10.1080/09273948.2023.2202758

A 60-year-old female with known seropositive rheumatoid arthritis and other co-morbids, presented with right eye hypertensive retinopathy and exudative macroaneurysms. Over the years, she developed vitreous haemorrhage, macula oedema and full thickness macula hole. Fluorescein angiography showed macroaneurysms and ischaemic retinal vasculitis. Initial diagnosis was thought to be hypertensive retinopathy with macroaneurysms and retinal vasculitis secondary to rheumatoid arthritis. Laboratory investigations did not support other causes for macroaneurysms and vasculitis. Hence, delayed diagnosis of IRVAN syndrome was made after detailed review of clinical findings, investigations, and angiographic evidence. Our understanding of IRVAN continues to evolve in the face of challenging presentations. To our knowledge, this is the first reported case of IRVAN associated with rheumatoid arthritis.

Matched MeSH terms: Vitreous Hemorrhage/etiology

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