Non-traumatic Rupture Research Articles

Perioperative Nursing Influence on Cerebrospinal Fluid Biochemical Markers in Cerebral Hemorrhage Patients Undergoing Minimally Invasive Intracranial Hematoma Removal Surgery

Background: Cerebral hemorrhage refers to a hemorrhagic disease caused by primary non-traumatic rupture of blood vessels in the brain parenchyma. It is a common acute cerebrovascular disease in the elderly. Objectives: To observe the effect of perioperative nursing on minimally invasive intracranial hematoma removal surgery in patients with cerebral hemorrhage. Methods: This randomized controlled trial study was conducted on 106 patients undergoing treatment for minimally invasive internal hematoma (MIRIH) at the First Hospital of Jilin University, Jilin, China, between January and December 2022. These patients were randomly divided into two groups, namely the control and observation groups (n=53 each). The observation group received perioperative care in addition to routine care. Differences between groups were compared using t-tests and Chi-square tests. Results: On the first day, there were no significant differences in the baseline characteristics between the groups. However, on the 7th and 14th days of admission, the observation group showed an increase in potassium ions and a decrease in chloride ions, lactate dehydrogenase, trace microalbumin, and the National Institutes of Health Stroke Scale (NIHSS) scores, compared to the control group (P<0.05). The observation group also had a lower incidence of postoperative complications, including pneumonia, lower limb vein thrombosis, and cerebral hernia, compared to the control group (P<0.05). NIHSS scores on days 7 and 14 were significantly lower in the observation group than in the control group (day 7: 9.60±4.11 vs 12.02±2.83, P<0.05; day 14: 6.77±3.47 vs 9.19±2.86, P<0.05). Conclusion: Perioperative nursing leads to improvement in electrolyte/metabolic levels, neurological recovery, and reduction in post-MIRIH surgical complications.

Non-traumatic rupture of the spleen and marked post-splenectomy thrombocytosis associated with polycythemia vera

Non-traumatic rupture of the spleen and marked post-splenectomy thrombocytosis associated with polycythemia vera

Spontaneous Left External Iliac Vein Rupture.

Spontaneous rupture of the Iliac Vein is very rare in practice. In over 90% of cases, the venous lesion is located on the left side. The exact etiology of this condition is unknown. Spontaneous injury of the iliac vein is thought to be favored by intense exercise, constipation, cough, labor, May-Thurner syndrome or pre-existing inflammatory changes in the venous wall are also implicated. We present the case of an 83-year-old woman who is brought to the Emergency Department for abdominal pain located in the left flank and in the left iliac fossa, which appeared after a medium physical exertion. After an emergency contrast-enhanced abdominal CT scan, the diagnosis of spontaneous rupture of the left external iliac vein is established. Surgery is performed with extreme urgency by retroperitoneal approach and due to the very precarious condition of the patient, venous ligation is done, wishing to perform a Palma-Dale venous bypass at a later time. Although a rare cause of spontaneous retroperitoneal hematoma, a non-traumatic rupture of the common or external iliac vein should be considered in patients in shock with massive retroperitoneal bleeding, accompanied by a high mortality rate.

Secondary Brain Injury by Oxidative Stress After Cerebral Hemorrhage: Recent Advances.

Intracerebral hemorrhage (ICH) is a clinical syndrome in which blood accumulates in the brain parenchyma because of a nontraumatic rupture of a blood vessel. Because of its high morbidity and mortality rate and the lack of effective therapy, the treatment of ICH has become a hot research topic. Meanwhile, Oxidative stress is one of the main causes of secondary brain injury(SBI) after ICH. Therefore, there is a need for an in-depth study of oxidative stress after ICH. This review will discuss the pathway and effects of oxidative stress after ICH and its relationship with inflammation and autophagy, as well as the current antioxidant therapy for ICH with a view to deriving better therapeutic tools or targets for ICH.

НЕТРАВМАТИЧЕСКИЙ РАЗРЫВ ФОРНИКСА С ЭКСТРАВАЗАЦИЕЙ КОНТРАСТА

Purpose: Description of a clinical case of surgical treatment of nontraumatic rupture of the renal calyx fornix, with extravasation of contrast agent into the perirenal tissue. Material and methods: Provided surgical treatment to a patient with spontaneous rupture of the calyx fornix on the background of ureteral obstruction caused by a stone. Results: Considering the concomitant pathology in the form of obstructive pyelonephritis, it was decided to drain the upper urinary tract with an external stent. After 7 days, the patient underwent replacement of the external stent with the internal one. The patient underwent antibacterial, anti-inflammatory therapy, with a positive clinical, laboratory effect. Retrograde pyelography was performed 7 days later. Violations of the integrity of the cavity system of the left kidney were not revealed. The external stent was replaced with an internal one. After 2 months, ureterolitho-extraction was performed on the left. Conclusion: From the data of the world literature and our own experience, we can conclude that spontaneous, non-traumatic rupture of the fornix is an extremely rare, urgent urological disease. We assume that the development of this process is similar to the Burhave syndrome, since smooth muscle fibers are present in the esophagus as well as in the esophagus. In order to provide immediate assistance to such patients, it is necessary to urgently drain the upper urinary tract. Timely diagnosis of this condition requires rapid tactics in the form of immediate ultrasound, radiological diagnostic methods, as well as computed tomography. The operational manual on the removal of stones in this case should be postponed for 2–3 weeks.

Investigating the Link between Alpha-1 Antitrypsin Deficiency and Abdominal Aortic Aneurysms

Alpha-1-Antitrypsin (AAT) is one of the major plasmatic protease inhibitors. In the last decade, an association between Alpha-1-Antitrypsin Deficiency (AATD) and Abdominal Aortic Aneurysms (AAA) has been hypothesized. Multiple factors may be involved in AAA's etiopathogenesis, and an underlying structural defect of the extracellular matrix (ECM) is always present. AATD could be a reasonable risk factor for AAA because it is related to protease/antiprotease imbalance and enhanced ECM degradation of the vessel wall. We performed genotyping of 138 patients hospitalized in the Vascular Surgery Division of the ASST-Spedali Civili di Brescia, Italy, for nontraumatic rupture of AAA. The second purpose was to observe the distribution of main nongenetic risk factors for AAA between patients with and without AATD. Out of 138 patients, 22 were found with AATD: 16 MS, 1 SS, 3 MZ, and 2 with a new rare AAT variant. When compared to the general Italian population, our cohort's frequency of deficient S allele was significantly higher (7.8 vs. 2.2% respectively, P < 0.01), whereas the deficient Z allele was similar (1.1 vs. 1.3% respectively, P > 0.05). Although we found no differences in age, gender, hypertension, diabetes, and smoke habits between AAA patients with and without AATD, hyperlipidemia was significantly less frequent in patients with AATD (46.4 vs. 12.5% respectively, P < 0.05). In our AAA patients' cohort, the S allele frequency was higher than in the general Italian population. Our results support the hypothesis that AATD might be a risk factor for AAA.

Splenic Rupture in a COVID-19 Patient – Case Report

Background: It is well known that Coronavirus disease 2019 (COVID-19) causes coagulation changes, requiring frequent monitoring for potential sequelae such as myocardial infarction and stroke. Non-traumatic splenic rupture is a rare and poorly understood occurrence in the clinical setting. Possible causes of nontraumatic splenic rupture include neoplasm, infection, inflammatory disease, iatrogenic and mechanical causes. Furthermore, increased intrasplenic tension, increased abdominal pressure, and thrombotic vascular occlusion are three possible mechanisms.&#x0D; The Case: We report a case of splenic rupture in a COVID-19 patient. Our patient was a 52 year old black man, presenting with diarrhea and moderate dyspnea, who was found to be COVID-19 positive. He had a past medical history significant for end-stage renal disease, chronic anemia, and aortic valve replacement. In an otherwise uneventful, 7-day hospital course, the patient’s stay abruptly resulted in a nontraumatic splenic rupture and demise. In this report, we have evaluated the likelihood of COVID-19 causing splenic rupture in a patient with no prior splenic disease.&#x0D; Conclusion: This case highlights the possibility of splenic rupture in otherwise normally recovering COVID-19 patients, particularly in the presence of comorbid conditions of renal failure and anticoagulation, with increased abdominal pressure during routine defecation. This information may assist in furthering the pathophysiology of COVID-19 and its life-threatening complications. In patients with COVID-19, non-traumatic splenic rupture should be considered as one of the differential diagnosis in patients who present with abdominal pain and early recognition of the same, owing to a high index of suspicion, can be lifesaving.

Nontraumatic rupture of splenic hamartoma in a healthy patient

Splenic hamartoma is a rare benign neoplasm and most of them have been incidentally detected. We repot that the nontraumatic spontaneous rupture of splenic hamartoma. A previously healthy 58-year-old man was referred to our hospital because of abrupt left upper abdominal pain and massive hemorrhage of abdomen on outside CT scan. He had no history of any trauma. The initial blood pressure (BP) was 106/61 mmHg, heart rate (HR) was 95 per minute. Initial laboratory tests were hemoglobin: 9.9 g/dl, WBC: 15,800 g/L, platelet counts: 138,000 g/L and prothrombin time: 1.08 INR. The CT scan revealed that splenic rupture with active extravasation on splenic mass and massive hemoperitoneum. We initially started to drip 2,000 mL of crystalloid solution and prepared for surgery. However, subsequent BP was 82/47 mmHg and HR was 107 per minute just before going to the operating room. In operative finding, there were a lot of hematoma in abdominal cavity and active bleeding on the ruptured splenic mass. We performed splenectomy and after surgery, his vital sign was stable and abdominal pain disappeared. In pathologic report, there was yellowish white solid mass, measuring 3.7 × 3.4 cm and CD8(+), CD34(+) in the immunohistochemical stain, it was confirmed that ruptured splenic hamartoma. He was well recovered after splenectomy and then discharged on nine hospital days. It is first report of ruptured splenic hamartoma in republic of Korea. We thought, even if the size is small, incidentally discovered splenic hamartoma should be removal because of rupture.

Nontraumatic bladder rupture: The images before and after.

We should consider the complication of bladder rupture for patients with worsened abdominal pain and inability to pass urine following acute cystitis. A CT scan is a useful first‐line modality when evaluating for a suspected bladder rupture.

It’s never too late- spontaneous rupture of spleen and life-threatening hypovolemic shock in a patient recuperating from legionnaire’s disease

Spontaneous non-traumatic rupture of the spleen in the setting of Legionnaires’ disease is very uncommon but a life-threatening condition. The splenic rupture can present within a few days after symptom onset with significant hypotension with drop in haemoglobin along with left side upper quadrant pain. Most of the cases described in the previous literature have presented within 0-11 (mean 4) days of the pneumonia but this case we are reporting presented after 3 weeks after being treated with Legionella pneumonia. The case also highlights an atypical presentation and emphasises the need to maintain a low threshold for diagnosis especially in resource constrained setting so that patient can be transferred at the earliest to a centre where appropriate corrective measures including surgery can be safely undertaken. Keywords: splenic rupture, pneumonia, hypovolemic shock

Spontaneous non-traumatic splenic artery aneurysm rupture : endovascular treatment with a Covera covered stent

Spontaneous non-traumatic splenic artery aneurysm rupture : endovascular treatment with a Covera covered stent

Evaluation of deaths due to non-traumatic aortic rupture

Evaluation of deaths due to non-traumatic aortic rupture

Haemorrhagic shock secondary to non-traumatic spleen rupture as a manifestation of splenic flexure cancer: A case report

Haemorrhagic shock secondary to non-traumatic spleen rupture as a manifestation of splenic flexure cancer: A case report

Surgical treatment of tibialis anterior tendon rupture

BackgroundRuptures of the anterior tibial tendon can be both acute and chronic. The acute lesion can be caused by a sharp cutting trauma or by blunt or hyperplantarflexion trauma.Spontaneous ruptures are rare, and most ruptures are due to degenerative changes mainly affecting the distal avascular 5−30 mm of the tendon. Surgical repair is the preferred treatment for physically active patients.Overall, the literature shows that operative repair results in a very good outcome in most patients.This study compares the clinical outcome in patients with anterior tibial tendon rupture, treated with different surgical techniques. MethodsThis multicenter cohort study was conducted at four different Foot and Ankle specialized clinics. The study was approved by the local ethical committee. A total of 48 patients with surgically treated tibialis anterior rupture was included. The study protocol included the demographic and clinical data of each patient and the surgical treatment. The VAS-FA PROM was recorded pre- and postoperative in all patients. The mean follow-up were 30 (20.8–48.5) months. ResultsA significant difference was found in age between patients who stated “good” versus “fair” (p = 0.002) and “very good” versus “fair”, i.e. younger age for “fair” p = 0.036, thus showing that younger patients do worse than older patient after surgery when rating the results. However there was no significant difference for older versus younger age looking at the results “poor”, “fair, good and very good”.The group with chronic tendon ruptures had a significantly higher preoperative VAS-FA than the group sustaining non-traumatic rupture (p = 0.048). There was no significant linear relation between age, postoperative VAS-FA and VAS-FA improvement. Also, we did not find a significant linear relation between age and outcome. Please see Tables 2–4 for results. ConclusionThe tibialis anterior tendon rupture can be both acute and chronic. We could not identify any significant differences in clinical outcome or PROM between acute and delayed suture of the tibialis anterior tendon rupture. Level of Evidence: Level II. Prospective controlled cohort study.

Rotura no traumática de bazo como presentación de un linfoma difuso de células grandes B.

Few cases of nontraumatic rupture of the spleen in diffuse B-cell lymphoma have been reported. &nbsp; We present a case of a 73-year-old man, multiple comorbidities that hours before biopsy puncture of the liver nodule installed abdominal pain and hypovolemic shock. An emergency operation was performed. A pathological spleen was found with a ruptured nodule, bleeding and moderate hemoperitoneum. Splenectomy was performed. At 96 hours, he installed abdominal pain and shock. The liver node and hemoperitoneum rupture and bleeding, hemodynamic instability and intraoperative death were reoperated and confirmed. The pathological anatomic study diagnosed diffuse large B-cell lymphoma.

Rotura no traumática de bazo como presentación de un linfoma difuso de células grandes B.

Pocos casos se han comunicado de rotura no traumática de bazo en linfoma difuso de células B.&#x0D; Se presenta un caso de un hombre de 73 años, múltiples comorbilidades que horas previas a punción biópsica de nódulo hepático instaló dolor abdominal y shock hipovolémico.&#x0D; Se operó de emergencia. Se constató bazo patológico con nódulo roto, sangrando y hemoperitoneo moderado.&#x0D; Se realizó la esplenectomía. A las 96 horas instaló dolor abdominal y shock. Se reoperó y constató rotura y sangrado de nódulo hepático y hemoperitoneo, inestabilidad hemodinámica y muerte intraoperatoria.&#x0D; El estudio anátomo patológico diagnosticó linfoma difuso de células B grandes.

MORE THAN A TICKLE IN THE THROAT: A CASE OF COUGH-INDUCED LARYNGEAL FRACTURE

SESSION TITLE: Tuesday Medical Student/Resident Case Report Posters SESSION TYPE: Med Student/Res Case Rep Postr PRESENTED ON: 10/22/2019 01:00 PM - 02:00 PM INTRODUCTION: Non-traumatic rupture of the larynx is a very rare entity occurring when strong coughing or sneezing causes rupture of the laryngeal cartilage. This same pathology is more commonly seen in traumatic injuries, particularly with hanging or strangulation victims, but non-traumatic presentations are exceedingly rare. We present the fifth case reported in the literature. CASE PRESENTATION: A 48-year-old male travelling from Brazil presented to our emergency department (ED) with complaints of neck swelling. His past medical history is significant for gastroesophageal reflux disease (GERD) and asthma. He had a recent worsening in his GERD symptoms when he was changed from daily Esomeprazole to Ranitidine, precipitating complaints of increased heartburn and a dry cough. On the day of the presentation, the patient began to experience further worsening cough as well as neck swelling. In the ED, vital signs were normal, mild swelling was noticed over the thyroid cartilage with subtle crepitus. There was no tenderness or hoarseness. Neck X-ray showed thickening of the anterior neck space. Neck computed tomography (CT) without contrast demonstrated a minimally displaced fractures of the thyroid cartilage (Image A) with overlying soft tissue edema and subcutaneous emphysema extending distally (Image B). Swallowing evaluation and esophagram were normal. The patient was observed on the medical ward for two days where he clinically improved and was discharged home on Esomeprazole. The patient was lost to follow up when he returned to Brazil. DISCUSSION: Review of the four published cases of non-traumatic rupture of the larynx in the literature reveal that all of the cases have been in middle aged men. Two cases were associated with sneezing and two were associated with coughing. Clinical presentations were with complaints of odynophagia, dysphagia and/or dysphonia. In all cases, imaging revealed anterior fractures associated with subcutaneous emphysema. Our patient shared all of these demographic and imaging characteristics, however our patient presented with a chief complaint of neck swelling without these other complaints. Management of these cases is conservative, typically with spontaneous resolution not requiring surgical intervention. CONCLUSIONS: Non-traumatic laryngeal fracture is a very rare entity, typically occurring in middle age men, induced by severe coughing or sneezing. Reference #1: Fenig, M, et al. Laryngeal fracture after coughing. The American Journal of Emergency Medicine. 31 (2013) 1421.e1–1421.e3 DISCLOSURES: No relevant relationships by Keith Rose, source=Web Response No relevant relationships by Bertin Salguero, source=Web Response No relevant relationships by Jonathan Stoever, source=Web Response

Nontraumatic rupture of the costal margin: a single-center experience.

Rupture of the costal margin is uncommon. Whilst most often seen after major trauma, we describe its occurrence in patients with no direct chest trauma. A search was performed in our thoracic surgery database for all patients with rupture of the costal margin. Patients were excluded if the injury was a result of trauma. Data were collected on sex, age, body mass index, profession, past medical history, smoking status, presenting complaint, mechanism of injury, and management. There were 9 patients with rupture of the costal margin that was caused in all cases by a severe coughing fit. All patients were male and the mean age was 62.5 years (range 47-76 years). Chronic obstructive pulmonary disease was present in 6 cases. Presentations included a palpable defect (5 cases), cough (9 cases), and chest pain (6 cases). On radiological examination, all patients had widening of the rib space, 4 had associated rib fractures, and 5 had lung herniation. Time from injury to presentation was 12 months (range 1-24 months). All patients underwent surgery and were followed-up for 59 months (range 8-129 months). Two patients suffered major complications in the immediate postoperative period. Rupture of the costal margin, in the absence of direct trauma, is characterized by pain, a palpable defect, and lung herniation. It is associated with widening of the rib space and rib fractures, and can be treated surgically with success but not without significant risks.

Cardiac tamponade and complete aortic rupture following blunt trauma chest: A case report and review of literature

Cardiac tamponade may be due to a traumatic or non-traumatic rupture of heart or root of great vessels. Traumatic rupture of the heart and aorta, due to its high fatality and narrow window period are rarely diagnosed. These are usually detected only during autopsy. An unusual case of cardiac tamponade and aortic rupture following blunt trauma chest sustained due to a collision between a motorcycle and a tractor. Autopsy showed cardiac rupture involving left auricle, left atrium, both ventricles along with interventricular septum. It also showed complete rupture of aorta. Shovelling effect, combination of water-hammer effect and shearing stress could be the possible mechanisms for the unique pattern of a cardiac and aortic rupture.

Conservative Management and Organ Preservation in a Unique Case of Group A Streptococcus Infection Causing Splenomegaly, Splenic Infarction, and Non-Traumatic Rupture Leading to Intra-Abdominal Abscess and Pleural Empyema

Conservative Management and Organ Preservation in a Unique Case of Group A Streptococcus Infection Causing Splenomegaly, Splenic Infarction, and Non-Traumatic Rupture Leading to Intra-Abdominal Abscess and Pleural Empyema