MyMedR

Spontaneous hemorrhage into the lateral part of the pons with sequelae compatible with survival has been documented previously. The author describes an unusual case with spontaneous hemorrhage into the lateral pons, with intraneural extension into the right trigeminal nerve root. Radiological features were of an expanding mass of the cerebellopontine angle. The patient was treated surgically with success.

Matched MeSH terms: Cerebral Hemorrhage/surgery*

Uterine bleeding with an IUD requiring emergency hysterectomy

Glew S, Singh A

Adv Contracept, 1989 Mar;5(1):51-3.

PMID: 2782134

A case is described of profuse uterine bleeding with a dislodged Multiload Cu 250 intrauterine device (IUD). Multiple blood transfusions were necessary, and ultimately, an emergency hysterectomy was performed.

Matched MeSH terms: Uterine Hemorrhage/surgery

Fulltext Intracranial arteriovenous malformations in Malaysian population

Chee CP, Loh TG

Med J Malaysia, 1987 Sep;42(3):186-90.

PMID: 3506642

Thirty-four patients with intracranial arteriovenous malformations seen in the University Hospital, Kuala Lumpur, over a is-year period were reviewed. A VM was found to be more common in young, male patients with preponderance Chinese origin. The advent of the Cl-scan has increased the detection of small A VMs and intracerebral haematomas proportionally. The majority of the lesions were situated in the posterior half of the brain unlike the distributions in patients in the West and in Singapore. On the other hand, most of the intracranial bleeding were subarachnoid haemorrhage; a presentation similar to the western community, but unlike that reported from Singapore. The treatment policy is not unlike the western community with good results in 82% of patients selected for surgery.

Matched MeSH terms: Subarachnoid Hemorrhage/surgery

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/surgery*; Uterine Hemorrhage/surgery

Valsalva haemorrhagic retinopathy after push-ups

Hassan M, Tajunisah I

Lancet, 2011 Feb 5;377(9764):504.

PMID: 21255827 DOI: 10.1016/S0140-6736(10)60677-0

Matched MeSH terms: Retinal Hemorrhage/surgery

Dieulafoy's lesion of the rectum

Gul YA, Jabbar MF, Karim FA, Moissinac K

Acta Chir. Belg., 2002 Jun;102(3):199-200.

PMID: 12136541

Dieulafoy's lesion is an uncommon cause of gastrointestinal haemorrhage. It may present with massive and life threatening bleed and although more common in the upper gastrointestinal tract, it is being increasingly reported as affecting the lower gastrointestinal tract. Diagnosis is usually achieved during proctoscopic and endoscopic visualization. In cases where there is profuse and torrential hemorrhage, angiography may help to confirm the diagnosis. There are a few treatment options available, all of which have a varying degree of success. More commonly than not, a combination of treatment is warranted as illustrated by our case. Recurrent bleeding may occur just as in cases of Dieulafoy's lesion affecting the upper gastrointestinal tract. Even though endoscopic visualization of the lower gastrointestinal tract in the presence of profuse lower gastrointestinal haemorrhage may not be possible, this important procedure should not be omitted as the bleeding source may be lying in a low and accessible location for prompt interventional haemorrhage control.

Matched MeSH terms: Gastrointestinal Hemorrhage/surgery

Fulltext Ileal strongyloidiasis in a Malaysian patient

Shekhar KC, Pathmanathan R, Loo VS, Chan KS

Med J Malaysia, 1999 Sep;54(3):361-3.

PMID: 11045064

Matched MeSH terms: Gastrointestinal Hemorrhage/surgery

Fulltext A cervical ectopic masquerading as a molar pregnancy

Masir N, Tamby MR, Jamil MA

Med J Malaysia, 2000 Mar;55(1):138-40.

PMID: 11072500

We report a case of cervical pregnancy complicated by life threatening hemorrhage. An initial diagnosis of molar pregnancy was made preoperatively. During uterine evacuation she developed profuse hemorrhage which required an emergency hysterectomy for uncontrolled bleeding. Histopathological examination confirmed a cervical pregnancy. The clinical and pathological criteria for the diagnosis and the etiology of cervical pregnancy are discussed.

Matched MeSH terms: Postoperative Hemorrhage/surgery

Caesarean hysterectomy--a review of 21 cases in the University Hospital, Kuala Lumpur

Rachagan SP, Sivanesaratnam V

Eur J Obstet Gynecol Reprod Biol, 1984 Jan;16(5):321-6.

PMID: 6608460

Caesarean hysterectomy is a useful surgical procedure. However, the increased blood supply to the pelvis during pregnancy, distortion of the anatomy caused by the enlarged uterus, fragility of oedematous pelvic tissues and adhesions from prior caesarean sections predispose to poor haemostasis and urinary tract injuries. In this series all the cases were done as an emergency procedure and, despite the multiple obstetric complications, there was no maternal mortality and the incidence of post-operative morbidity was low.

Matched MeSH terms: Postpartum Hemorrhage/surgery

Management Options and Outcome of Cerebral Arteriovenous Malformation in Pregnancy: Case Series

Teik CK, Basri NI, Abdul Karim AK, Azrai Abu M, Ahmad MF, Abdul Ghani NA, et al.

Arch Iran Med, 2019 06 01;22(6):340-343.

PMID: 31356101

Cerebral arteriovenous malformation (AVM) is a rare entity with an estimated prevalence of 0.01-0.05% in the general population. We reviewed hospital obstetric records during 2010-2017 and reported a case series of six patients with cerebral AVM in pregnancy, of which five patients had successful pregnancy, and one maternal mortality.

Matched MeSH terms: Cerebral Hemorrhage/surgery

Endoscopic variceal ligation as primary prophylaxis for oesophageal variceal bleeding at a Malaysian tertiary hospital

Wendy Tan AY, Chieng JY

Med J Malaysia, 2018 12;73(6):361-364.

PMID: 30647204

OBJECTIVE: Approximately one-third of patients with esophageal varices will develop bleeding which is a major cause of morbidity and mortality in patients with liver cirrhosis. Currently, the two most widely used modalities to prevent variceal bleeding are pharmacologic and oendoscopic variceal band ligation (EVL). However, EVL has been associated with significant complications. Hence we aim to evaluate and to identify the epidemiology, demography, and complications of EVL at our local Malaysian tertiary hospital.

METHOD: This is a retrospective study of all the patients that had undergone endoscopic variceal surveillance at the Gastroenterology endoscopy unit, Serdang Hospital from 1st January 2015 to 31st March 2017. Patients' demography, aetiologies of liver cirrhosis, platelet level and international normalised ratio (INR) prior banding procedure, and the post EVL complications were recorded and further analysed with SPSS version 16.

RESULTS: In this study, 105 patients were screened for varices. Fifty-five of them had undergone EVL, with a quarter of the patients requiring repeated ligation. There was a male preponderance with 76.4%. 56.4% of patients were in age from 40-59 years. The majority of our patients were of the Malay ethnicity. The major aetiology for liver cirrhosis in our patients was viral hepatitis with Hepatitis C (31.0%), and Hepatitis B (20.0%). Most of our patients had platelet count >50,000 and INR <1.5 prior to EVL. There was no major complication in all of our subjects.

CONCLUSION: EVL is relatively safe and feasible treatment for prevention of oesophageal variceal bleeds with a low complication rate.

Matched MeSH terms: Gastrointestinal Hemorrhage/surgery

Fulltext Coital injury requiring internal iliac artery ligation

Sivalingam N, Rajesvaran D

Singapore Med J, 1996 Oct;37(5):547-8.

PMID: 9046215

Profuse bleeding after voluntary sexual intercourse is an uncommon reason for admission to the gynaecological wards. Out of 12 such patients admitted to the Ipoh Hospital over a three-year period, one patient had life-threatening upper vaginal injury after coitus. Blood replacement and conventional suturing failed to arrest the bleeding. Bilateral internal iliac artery ligation promptly arrested further haemorrhage. Vigorous intercourse increases intra-abdominal pressure in women causing tensing of the cul-de-sac, decreasing the elasticity of the posterior fornix, resulting in vaginal laceration. Bilateral internal iliac artery ligation produces a 'pelvic compartment hypotension' converting a high arterial flow system to that of a low one resembling venous flow. The useful role of this procedure to contain pelvic haemorrhage is discussed.

Matched MeSH terms: Hemorrhage/surgery

Demographics and characteristics of endoscopic findings among COVID-19 patients with upper gastrointestinal bleeding in a single centre

Mohamed AK, Tang YC

Med J Malaysia, 2023 Dec;78(7):893-896.

PMID: 38159924

INTRODUCTION: Novel coronavirus 19 disease (COVID-19) pandemic poses healthcare providers challenges in the endoscopic suite. It is unclear whether it affects the endoscopic manifestations of upper gastrointestinal (GI) bleeding. This retrospective study was done to review demographic data, site of lesions and need of interventions for those lesions.

MATERIALS AND METHODS: Oesophagoduodenoscopy (OGDS) reports of COVID-19 patients with indication of upper GI bleeding from March 2021 to April 2022 were reviewed. Data of 35 patients were then analysed.

RESULTS: Of the 35 patients, 8.6% (n = 3) were female and 91.4% (n = 32) were males. A total of 31.4% (n = 11) were below 50 years and 68.6% (n = 24) were 50 and above. 34.3% (n = 12) with lesions requiring endoscopic intervention, 34.3% (n = 12) with lesions not requiring endoscopic intervention, 31.4% (n = 11) has no significant stigmata of recent haemorrhage. Among subgroup requiring endoscopic intervention, 50% (n = 6) are non-variceal bleeding (NVUIB), and 50% (n = 6) are variceal bleeding (VUGIB). Among NVUGIB, 16.7% (n = 1) is gastric and duodenal angiodysplasia requiring argon plasma coagulation, 50% (n = 3) are duodenal F2A ulcer requiring thermoablation, 16.7% (n = 1) is gastric F2A ulcer requiring hemoclip, and 16.6% (n = 1) is Cameron's ulcer requiring hemoclip. Among VUGIB, 100% (n = 6) are oesophageal varices requiring endoscopic variceal banding (EVL).

CONCLUSIONS: Lower proportion of NVUGIB among COVID-19 patients raises hypothesis on whether prothrombotic state of COVID-19 is a protective factor of NVUGIB. Studies with larger sample size are needed to establish significance.

Matched MeSH terms: Gastrointestinal Hemorrhage/surgery

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/surgery

Fulltext Massive bleeding from colonic diverticular disease with NSAID use

Muthu A, Qureshi A, Ismail MA

Med J Malaysia, 1999 Sep;54(3):374-6.

PMID: 11045068

Non-steriodal anti-inflammatory drugs (NSAID) are not only associated with bleeding in the stomach and duodenum, but can also complicate pre-existing diverticular disease of the colon. Here, a 58 year-old male with severe per rectal bleeding is presented and the role of NSAID as a causative factor of his problem is discussed.

Matched MeSH terms: Gastrointestinal Hemorrhage/surgery

Spontaneous intracerebral hemorrhage in northeast Malaysian patients: a four-year study

Muiz AJ, Abdullah J, Naing NN, Ghazaime G, Ariff AR

Neuroepidemiology, 2003 May-Jun;22(3):184-95.

PMID: 12711851

The aim of this study was to compare nonsurgical versus stereotactic aspiration of intracerebral hematomas in relation to clinical aspects, computed tomographic imaging features of the brain, laboratory parameters and specific risk factors that may influence the outcome in southeast Asian Malay patients. Fifty-five of the patients with intracerebral hemorrhage (ICH) underwent stereotactic aspiration and 57 did not. Analysis was done on risk factors, locations and treatments of ICH, and the final outcomes measured by the Glasgow Outcome Scale. A total of 112 patients were evaluated. Mean age was 52 years with ages ranging from 12 to 80 years. Hypertension was seen in 60.7% of patients with ICH. The mortality rate was 25% by 3 months. 58.9% had a poor final outcome, while 41.1% had a good outcome. The selected variables were incorporated into models generated by multiple logistic regression method analysis to define the significant predictors of outcome. Significant predictors of outcome were the Glasgow Coma Scale score on admission, the duration of surgery and the total volume of the hematoma. Significant predictors of mortality were high total white blood cell differential count, low plasma protein, and high plasma lactate dehydrogenase and brain edema. The study suggests that stereotactic aspiration of patients with ICH does not offer any definite advantage over conservative treatment.

Matched MeSH terms: Cerebral Hemorrhage/surgery*

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