Case Of Hematoma Research Articles

A Preliminary 1-year Follow-up Study to Assess Safety Outcomes of the Mentor ® MemoryGel™ Xtra in Korean Women [RETRACTED

To date, several attempts have been made to assess the safety of a silicone gel-filled breast implant in Korea. Still, however, there is a paucity of data suggesting the safety of the Mentor® MemoryGel™ Xtra (Mentor Worldwide LLC, Santa Barbara, CA) in a cohort of Korean patients. We therefore conducted this multi-center, retrospective study to assess 2-year safety outcomes of the Mentor® MemoryGel™ Xtra in Korean women. We evaluated a total of 4,052 patients (n=4,052) who received an implant-based augmentation mammaplasty using the Mento® MemoryGel™ Xtra at our hospitals between September 26, 2018 and October 26, 2020. We finally included a total of 1,740 Korean women (n=1,740; 3,480 breasts) in the current study. Through a retrospective review of the medical records, we analyzed incidences of postoperative complications and estimated time-to-events (TTEs). Then, we plotted the Kaplan-Meier survival and hazards as a curve. A total of 220 cases (12.6%) of postoperative complications occurred; these include 120 cases (6.9%) of early seroma, 60 cases (3.4%) of rippling, 20 cases (1.1%) of early hematoma and 20 cases (1.1%) of capsular contracture. In addition, TTEs were estimated at 387.72±26.86 days (95% CI 335.08-440.36). In conclusion, we describe preliminary 1-year safety outcomes of an implant-based augmentation mammaplasty using the Mentor® MemoryGel™ Xtra in a cohort of Korean patients. But further studies are warranted to corroborate our results.

Spontaneous pulmonary hematoma in patients with COVID-19

The disease caused by Sars-Cov-2 (Covid-19) has become a worldwide pandemic and consequently a public health problem. Multiple complications associated with Covid-19 have been described, including coagulation abnormalities. Although the infection is known to induce a prothrombotic state, hemorrhagic complications have also been reported in patients with Covid-19, especially in anticoagulated patients. We present two cases of spontaneous pulmonary hematoma in patients with Covid-19 undergoing anticoagulant treatment. We aim to describe this complication, which although uncommon, should be taken into account in anticoagulated patients with Covid-19.

Vein Stripping Versus No Stripping in Varicose Vein Disease

Aim: To comparative analysis of vein stripping versus no stripping in varicose vein disease. Study design: Comparative study Place and duration of study: Department of Surgery, CMH Kharian Medical College, Kharian from 01-01-2019 to 31-12-2021. Methodology: Eighty cases of varicose vein which were having sapheno-femoral valve incompetence as well as perforators-incompetence were enrolled. The age of the cases was between 16 and 70 year. Electrocardiography (ECG), as well as venous Doppler of the affected limb was accomplished. Each group comprised 40 cases. Group A and Group B were constituted in accordance to difference in the operating procedure where vein stripping was done in Group A and without vein stripping was conducted in Group B. Results: The mean age of the patients was 42.3±4.5 years. There was higher number of females than males in this study. In the present study there were higher cases of hematoma observed in group A than in Group B with a percentage difference of 27.7% to 4.4% which was statistically significant. Ambulation comfort was observed higher in cases with ligation then having venous stripping. Pain relief of the patients post 2 months of the surgery was analyzed as higher in the Group A such as venous stripping group in comparison with the without venous stripping group (Group B). Conclusion: The technology of ligation where no vein stripping is conducted is more efficient and reliable then vein stripping methods in terms of pain, hematoma reduction, and trauma reduction with augmenting ambulation comfort. Keywords: Varicose, Mortality, Peroneal vein, Tibia, Femor

Comparison of the safety and efficiency of temporary cardiac pacing methods during left bundle branch pacemaker implantation: Femoral vein pacing versus atrial spiral pacing with electrodes placed at the ventricle.

Left bundle branch pacemakers (LBBPs) can better maintain ventricular electrical synchronization than traditional right ventricular pacing (RVP). Temporary cardiac pacing (TCP) is needed to ensure the safety of the operation in patients undergoing LBBP. Currently, there are two methods of installing TCP in conventional permanent pacemaker implantation. To evaluate the safety and efficiency of replacing femoral vein pacing with atrial spiral pacing in the right ventricle for temporary cardiac pacing (TCP) during left bundle branch pacemaker (LBBP) implantation. A total of 179 patients who underwent TCP during LBBP were selected for retrospective analysis from April 2019 to 2021 and divided into two groups: the atrial spiral electrode group (n = 76) and the femoral vein electrode group (n = 103). The following were observed: operation time; radiation dose; radiation time; operation expenses; hospitalization time; pacemaker parameters immediately after the operation and at 1 week, 1 month, 3 months, and 6 months after the operation; operation complications and femoral vein puncture point complications were observed in the two groups. Compared to the femoral vein electrode group, the atrial electrode group had significantly lower operation times ([116.86 ± 24.63] versus [128.94 ± 25.27] min, p < 0.05), radiation doses ([805.07 ± 132.94] versus [846.42 ± 87.37] mgy, p < 0.05), and decreased risk of a displaced or dislodged temporary pacing electrode during the operation ([0.00%] versus [4.85%], p < 0.05). The atrial electrode group did not have significant operation costs or material costs associated with femoral vein temporary pacing electrode implantation. In addition, the atrial electrode group did not have an increased risk of pacemaker-related infections, and the parameters of the pacemaker were unaffected. However, some puncture point complications appeared in the femoral vein electrode group (8 cases of local subcutaneous hematoma, 3 cases of pseudoaneurysms, 3 cases of arteriovenous fistula). The replacement of the femoral vein pacing electrode with an atrial spiral pacing electrode in the right ventricle for TCP during LBBP implantation was safe and effective.

Acute Intracranial Subdural Hematoma Masquerading as a Postpartum Headache: A Case Report.

An acute subdural hematoma is a collection of blood in the space between the dural and arachnoid membranes overlying the brain. Head trauma is the most common cause. Less frequently, low cerebrospinal fluid pressure, due to a spontaneous or iatrogenic cerebrospinal fluid leak can result in a subdural hematoma. We discuss the case of a 26-year-old woman who presented with a frontal headache following epidural anesthesia for vaginal delivery. The differential diagnosis included spinal headache, postpartum hypercoagulability, dural sinus thrombosis, and intracranial hemorrhage or mass. Her vital signs and physical examination were normal. A computed tomography of the brain revealed an acute subdural hematoma along the left frontal cerebral hemisphere, without midline shift or mass effect. A blood patch was placed with complete resolution of her symptoms. This case illustrates an unusual case of an acute subdural hematoma in the postpartum period following epidural anesthesia for labor pain management. It was thought to be caused by intracranial hypotension following epidural anesthesia and a cerebrospinal fluid leak.

A non-manufacturer-sponsored, retrospective study to assess 2-year safety outcomes of the BellaGel® SmoothFine as compared with its competitors in the context of the first Korean case of a medical device fraud.

We conducted this study to assess preliminary 2-year safety outcomes of an implant-based augmentation mammaplasty using the BellaGel® SmoothFine in the context of the first Korean case of a medical device fraud. Our clinical series of the patients (n = 579; 1,158 breasts) received augmentation using the BellaGel® SmoothFine, Naturgel™, Motiva Ergonomix™, Eurosilicone Round Collection™, Natrelle® INSPIRA™, Natrelle® 410, Mentor® MemoryGel Xtra or Microthane®. The patients were evaluated for incidences of postoperative complications and Kaplan-Meier survival and hazards. Overall, there were a total of 101 cases (17.4%) of postoperative complications; these include 31 cases (5.4%) of shape deformity, 21 cases (3.6%) of CC, 18 cases (3.1%) of early seroma, 8 cases (1.4%) of infection, 5 cases (0.9%) of early hematoma, 1 case (0.2%) of delayed hematoma, 1 case (0.2%) of rupture and 1 case (0.2%) of ripping. Moreover, there were also 15 cases (2.6%) of other complications. There were significant differences in incidences of postoperative complications between the breast implants from different manufacturers (P = 0.034). The Natrelle® 410 showed the longest survival (333.3±268.2 [141.5-525.1] days). A subgroup analysis showed that there were no significant differences in incidences of postoperative complications between the breast implants (P = 0.831). Moreover, the Natrelle® INSPIRA™ showed the longest survival (223.7±107.1 [-42.3-489.6] days). Here, we describe preliminary 2-year safety outcomes of an implant-based augmentation mammaplasty using the BellaGel® SmoothFine in the context of the first Korean case of a medical device fraud.

Nursing Assessment of Vascular Complications after Cardiac Catheterization through the Distal Radial Artery.

Distal Radial Artery (DRA) is a new arterial access for coronary catheterization. Assessment of the vascular complications of this new procedure is important in the provision of nursing care to cardiac patients. The aim of this study was the nursing assessment of vascular complications of DRA in angiography and angioplasty. This qualitative longitudinal study was conducted on 315 consecutive patients who were candidates for coronary catheterization via DRA from 2017 to 2020 in three hospitals in Tehran, Iran. Patients who had palpable DRA and were capable and willing to consent to inclusion in the study were evaluated. Moreover, patients whose DRA access failed, and those who had previously undergone coronary artery bypass graft were excluded from the study. Vascular complications were assessed on the day of the procedure and about 1 month later. After the procedure, 29 cases of ecchymosis, 8 cases of hematoma, and 1 case of arteriovenous fistula in the DRA were observed. We did not observe any major vascular complications. Nursing assessment of the snuffbox area indicated that this approach is a safe and convenient technique for cardiac catheterization with few minor complications.

Inside to outside puncture following endoscopic localization-A novel technique to insert ports and create retromuscular space in eTEP for ventral hernias.

Enhanced-view totally extraperitoneal plasty (eTEP) has been used worldwide to repair ventral hernias. This study aimed to describe a novel technique to insert ports and create retromuscular space in more detail. From 2020 to 2022, 23 consecutive ventral hernia repairs were performed using the eTEP technique. In all cases, inside-to-outside puncture following endoscopic localization was utilized to insert ports and create retromuscular space. All cases were completed with the eTEP technique, and no cases with conversion to open repair or IPOM technique. There were no epigastric vessel injuries and posterior sheath tears due to puncture. In addition, no postoperative hematoma cases were reported. Inside-to-outside puncture following endoscopic localization to insert ports and create retromuscular space is a safe, feasible, reproducible technique in eTEP for ventral hernia repair.

A Case of Atraumatic Rectus Sheath Hematoma Caused by Severe Japanese Spotted Fever

A Case of Atraumatic Rectus Sheath Hematoma Caused by Severe Japanese Spotted Fever

Lights and Shadows of Paracentesis: Is an Ultrasound Guided Approach Enough to Prevent Bleeding Complications?

Paracentesis is a validated procedure for diagnosing and managing ascites. Although paracentesis is a safe procedure with a 1–2% risk of complications such as bleeding, it is necessary to inform the patient about the possible adverse events. We would like to share our experience with two cases of bleeding after paracentesis. In our unit, two major hemorrhagic complications occurred in 162 procedures performed over the year 2020 (frequency of bleeding complications: 1.2%). We report two clinical cases of post-paracentesis abdominal wall hematomas. Despite a similar clinical presentation, the management approach was different: in the first case, embolization of the epigastric artery supplying the hematoma was performed. In the second case, conservative treatment was adopted. Our report aims to provide food for thought about a potentially challenging hemorrhagic complication, even with the risk of adverse outcomes.

Factors Affecting the Complication Rate of Septoplasty: Analysis of 1,506 Consecutive Cases of Single Surgeon.

Based on the analysis of a single surgeon's consecutive cases, we present the incidence of septoplasty complications and factors that contribute to the increased risk of complications. We retrospectively reviewed the medical records from 1,506 patients diagnosed with deviated nasal septum who underwent septoplasty by a single surgeon from January 2003 until May 2020. The incidence of different complications was investigated. Predisposing factors for specific complications were examined with univariate analysis. The average age of patients was 35 (11-76) years. Out of 1,506 patients, 1,252 were male, and 254 were female. The most frequent complication was insufficient correction (78 cases, 5.2%), and revision septoplasty was performed in 21 cases. We also reported 59 (3.9%), 55 (3.7%), 33 (2.2%), 20 (1.3%), and 18 (1.2%) cases of olfactory dysfunction, hematoma, synechia, abscess, and septal mucosal defect, respectively. Additionally, there were nine (0.6%), six (0.4%), five (0.3%), four (0.3%), and four (0.3%) cases of septal perforation, postoperative bleeding, saddle nose, chondritis, empty nose syndrome, respectively. The proportion of insufficient correction was higher in revision cases than in primary cases. Hematoma formation, abscess formation, and septal mucosal defect occurred more frequently in the bilateral flap elevation group. Olfactory dysfunction was significantly more frequent when the bony batten was inserted, while hematoma, abscess formation, and septal mucosal defect were more frequent when the cartilage batten was used. Septoplasty was associated with the risk of several complications, while complication rates were influenced by choice of surgical techniques and approaches.

Anterior and Posterior Approaches for 4-Level Degenerative Cervical Myelopathy: Low-Profile Cage Versus Cervical Pedicle Screws Fixation.

(1) Background: The choice of surgical access for 4-level degenerative cervical myelopathy (DCM) remains controversial, and the clinical and radiological outcomes of anterior surgery using a low-profile cage (Low-P) versus posterior surgery using cervical pedicle screw fixation (CPS) have not been compared. (2) Methods: This is a retrospective controlled study conducted between January 2019 and June 2021 of 72 patients with 4-level DCM who underwent ACDF using a low-profile cage (n = 39) or laminectomy and instrument fusion using CPS (n = 33). The minimum follow-up time was 12 months. The outcomes were C2-7Cobb angle, C2-7sagittal vertical axis (SVA) fusion rate, the Japanese Orthopedic Association (JOA) score, pain visual analog scale (VAS), neck disability index (NDI), and complications. (3) Results: Both anterior and posterior procedures significantly improved the patients' quality-of-life parameters. Anterior cervical convexity and SVA significantly increased in both groups, but the SVA was greater in the posterior group than in the anterior group (p &lt; 0.001). The C2-7 Cobb angle significantly improved in both groups postoperatively, and at the final follow-up, there was a slight but nonsignificant reduction in cervical lordosis in both groups (p = 0.567). There was a longer operative time, less intraoperative blood loss, and reduced mean hospital stay in the anterior group compared to the posterior group, with two cases of postoperative hematoma requiring a second operation, two cases of axial pain (AP), five cases of dysphagia, two cases of c5 palsy in the anterior group, and four cases of axial pain, and three cases of c5 palsy in the posterior group. According to Bridwell fusion grade, anterior fusion reached grade I in 28 cases (71.8%) and grade II in 10 cases (25.6%) in the anterior group, and posterior fusion reached grade I in 25 cases (75.8%) and grade II in 8 cases (24.2%) in the posterior group. (4) Conclusions: There was no difference between the anterior and posterior surgical approaches for MDCM in terms of improvement in neurological function. Posterior surgery using CPS achieved similar recovery of cervical anterior convexity as anterior surgery with a shorter operative time but was more invasive and had a greater increase in SVA. The use of Low-P in anterior surgery reduced the incidence of dysphagia and cage subsidence and was less invasive, but with a longer operative time.

Superomedial pedicle skin-reducing mastectomy in ptotic and large-sized breasts with two-stage reconstruction through transaxillary video-assisted technique: An effective surgical and anesthetic approach.

Skin-reducing mastectomy has been applied to several surgical techniques in which subcutaneous mastectomy is associated with various types of skin reduction, with preservation of a lower dermal flap to reinforce the inferior lateral seat of an implant. The aim of the study is to present a case series of patients with pendulous/ptotic and/or large-sized breasts treated for breast cancer at the Breast Surgery Unit of Istituto Nazionale Tumori IRCCS Fondazione "G. Pascale", Naples, Italy, with the superomedial pedicle skin-reducing mastectomy technique, two-stage reconstruction, and transaxillary video-assisted technique, when a postoperative radiotherapy was indicated. We verified its effectiveness by discussing its results, especially in patients who are candidates for postmastectomy radiotherapy. A single-center retrospective study was performed between January 2020 and March 2021 on a prospectively filled database of conservative mastectomies. Of the 64 patients who underwent nipple/skin-sparing mastectomies in the mentioned period, 17 (mean age 46 years, range 30-62 years) were treated with superomedial pedicle skin-reducing mastectomy, with two-stage breast reconstruction through transaxillary video-assisted replacement expander with definitive prosthesis and contralateral symmetrization, selected for postmastectomy radiotherapy. We had only three minor complications. No flap necrosis, no infections, no breast seromas, and no reconstructive failures were observed. During follow-up of the patients treated with video-assisted reconstruction, there were no cases of infection, hematoma, implant rupture, or suture dehiscence in the reconstructed breast. Skin-reducing mastectomy with superomedial pedicle is a safe and reliable procedure to treat breast cancer in selected patients, i.e., those with pendulous/ptotic and or large-sized breasts. Particularly, in patients who undergo postmastectomy radiotherapy, the two-stage reconstruction with video-assisted transaxillary endoscopic approach can find its main indication, using incisions positioned far from the mammary region, offering numerous advantages.

Two recovered cases of large pontine hematoma

AbstractThe comatose patients with pontine hemorrhage of diameter greater than 2 cm have poor prognosis. A 59‐year‐old male was brought with Glasgow coma scale (GCS) score of E2M5V2. He was mechanically ventilated. Magnetic resonance imaging (MRI) showed a pontine hematoma, of size 3 cm. He improved. Glasgow outcome scale (GOS) score was five. A 57‐year‐old male was brought with GCS score E1M3V1. He was ventilated. MRI scan showed a pontine hematoma of size 2.8 cm. His GOS score was three at 6 months. This is a report of two survived cases of large pontine hematoma with poor prognostic factors. This is the first report of good recovery with large pontine hematoma to GOS 5.

EFFECTS OF COMBINATION THERAPY WITH VIBEGRON FOR ANTICHOLINERGIC-RESISTANT PEDIATRIC NEUROGENIC BLADDER

(Objective) We report the effectiveness of combination therapy with vibegron in pediatric patients with neurogenic bladder inadequately responding to anticholinergic agents. (Subjects and methods) This retrospective study involved 13 pediatric patients with neurogenic bladder treated with anticholinergics at our department from November 2019 to January 2021 who had an inadequate response and received combination therapy with vibegron. Changes in the volume of urinary incontinence before and after the use of vibegron reported during interviews from the 13 patients were compared. In addition, bladder capacity at the end of examination, bladder capacity at the end of examination/expected bladder capacity (EBC), and bladder compliance were compared using the Wilcoxon signed rank test in 9 patients for whom urodynamics (UDS) or video urodynamics (VUDS) was performed before and after introduction of vibegron. (Results) The 13 patients comprised 8 boys and 5 girls. The median age was 13 years (range, 5-18 years). Underlying diseases included 9 cases of spina bifida, 1 case of Hinman syndrome, 1 case of cervical vertebra injury, 1 case of idiopathic cervical epidural hematoma combined with spina bifida, and 1 case of spinal cord infarction. Eight of the 13 patients experienced decrease in urinary incontinence after the introduction of vibegron. All 9 patients who underwent UDS or VUDS before and after introduction of vibegron displayed significant differences in bladder capacity at the end of the examination, bladder capacity at the end of the examination/EBC, and bladder compliance, indicating improvement. (Conclusion) Combination therapy with vibegron is effective for pediatric patients with neurogenic bladder who have inadequately responded to anticholinergic agents.

A Case of Chronic Expanding Hematoma of the Digit Cured by En Bloc Resection

A Case of Chronic Expanding Hematoma of the Digit Cured by En Bloc Resection

A RARE CASE OF PERIRENAL HEMATOMA AFTER URETERORENOSCOPY

Introduction: Ureteroscopy is a standard procedure for the treatment of ureteral stones but it carries the risk of many complications – urinary tract infections being the most common. We present a rare case of a perirenal hematoma after this procedure. Case Presentation: A male patient with bilateral ureteral stones was initially treated with stents. Later a laser disintegration of the stone in the right ureter was tried – unsuccessfully. After the procedure, a perirenal hematoma was found. Discussion: Based on our previous experience, the hematoma was completely unexpected. The ultrasound provided the initial diagnosis but it underestimated its real size -the accurate diagnosis was made with contrast-CT. The initial conservative treatment failed because of the occurrence of fever. Conclusion: Ureterorenoscopy-related hematoma is a rare, but serious complication. Its occurrence can be prevented by reducing the intrarenal pressure during the procedure and also by shortening the duration of the manipulation.

Спонтанные гематомы у госпитальных пациентов с новой коронавирусной инфекцией

Treatment of the new coronavirus infection (NCVI) is associated with high risks of hemorrhagic complications. This is due to the use of anticoagulants to prevent coagulopathy and thrombotic complications, which are the most frequent and severe complications of NCVI. The article presents the results of a retrospective analysis of 80 cases of spontaneous hematomas in patients with NCVI who were treated in a temporary infectious diseases hospital of the Republic of Clinical Hospital. Verification of the diagnosis was carried out using clinical data, ultrasound diagnostics, and computed tomography. The mean age of the patients was 62.4 ± 14.47 years. The most common localizations of spontaneous hematoma were: abdominal wall — 31.3%, retroperitoneal hematoma — 26.3%, chest hematoma — 16.3%, lower or upper limb — 8.8%, neck — 3.8%, combined hematomas — 5%. The number of small hematomas was 87.5%, large – 12.5%. The highest incidence of spontaneous hematomas (74%) and mortality (22%) was recorded in the group of patients receiving therapeutic doses of anticoagulants. X-ray endovascular diagnosis of the source of bleeding and its embolization was performed in 15 patients. The use of therapeutic doses in patients with NCVI is accompanied by a high risk of developing spontaneous hematomas and, as a result, increases the risk of death. X-ray endovascular embolization of spontaneous hematomas is an effective and safe method of treatment in patients with NCVI.

Warfarin-Induced Limb Contusion Section and Haematoma

Warfarin is a narrow therapeutic index drug with high potential to cause adverse effects. It is generally a preferred drug for the management of venous thrombosis. This case is an unusual presentation of left arm contusion and limb haematoma secondary to long-term warfarin use. A 32-year-old male patient was admitted with the complaints of left lower limb oedema and left upper arm oedema. He was on warfarin for dural sinus thrombosis for two years. The integrative analysis of patient clinical presentation, medication history, International Normalized Ratio (INR) level, Ultrasonography (USG) scan and Naranjo assessment showed the probable case of warfarin-induced left arm contusion and limb haematoma. The patient was successively managed with the administration of vitamin K, injection heparin, packed red blood cell and other supportive therapy after the withdrawal of the culprit drug. Thus, patients prescribed with warfarin should be looked at for this typical adverse event. Monitoring of anticoagulant therapy is vital for the positive clinical outcome and minimisation of adverse events. Clinical pharmacists have a key role to play in the patient safety and their inputs can fertilise the concept of pharmacist led anticoagulation clinic in India.

外傷性咽頭後間隙血腫例

Retropharyngeal hematoma is an uncommonly encountered condition. However, early diagnosis and appropriate treatment are important owing to the risk of upper airway obstruction. We report a case of retropharyngeal hematoma that needed surgical drainage. A 73-year-old man receiving anticoagulant therapy sustained injury when he fell to the ground on his face. Cervical CT and MRI showed a retropharyngeal hematoma extending from the retropharyngeal to the superior mediastinal space. Flexible fiberoptic laryngoscopy revealed no airway obstruction. However, on day 10 after the injury, the hematoma was found to have increased in size; although there was no dyspnea at the time, owing to the imminent risk of airway obstruction, we performed surgical drainage of the hematoma with no tracheostomy. We reviewed 43 articles on retropharyngeal hematoma reported in the literature to elucidate the clinical characteristics, treatment, and outcomes of this condition. More than a half of the cases published in these reports received conservative treatment; however, about 30% of the cases eventually required tracheostomy because of airway obstruction.