Rare Case Of Spontaneous Rupture Research Articles

A rare case of spontaneous rupture of the uterine artery.

SynopsisSpontaneous rupture of the uterine artery is extremely rare in nonpregnant women, and bleeding can be rapidly controlled by laparoscopy.

Spontaneous rupture of an undifferentiated carcinoma with osteoclast-like giant cells of the pancreas presenting as intra-abdominal bleeding: a case report

BackgroundUndifferentiated carcinoma is a very rare histologic subtype, representing only 0.8% to 5.7% of all pancreatic exocrine neoplasms. Additionally, spontaneous abdominal hemorrhage is a particularly rare, life-threatening cause.Case presentationA 68-year-old man was taken by ambulance to our hospital because of sudden-onset abdominal pain. Contrast-enhanced abdominal computed tomography revealed a huge mass measuring 99 × 70 mm in the pancreatic tail with enhanced rim staining in the peripheral area. Imaging also showed extravasation and fluid collection beside the tumor. Hence, spontaneous rupture of the pancreatic tumor and intra-abdominal bleeding were diagnosed. Emergency laparotomy was performed because of acute abdominal pain with peritoneal signs. With an intraoperative diagnosis of rupture of the pancreatic tumor, distal pancreatectomy was successfully performed. Histologically, hematoxylin and eosin staining showed round to spindle-shaped, highly pleomorphic mononuclear cells and multinucleated giant cells as well as a component of ductal adenocarcinoma. Immunohistochemical staining showed that the tumor cells were negative for AE1/AE3, whereas the non-neoplastic osteoclast-like giant cells were positive for CD68. Taken together, these results led to a diagnosis of undifferentiated carcinoma with osteoclast-like giant cells. The patient’s postoperative course was uneventful.ConclusionWe experienced an extremely rare case of spontaneous rupture of an undifferentiated carcinoma with osteoclast-like giant cells presenting as intra-abdominal bleeding. Obtaining a correct preoperative diagnosis is quite difficult at the first evaluation. Undifferentiated carcinoma should be considered as a differential diagnosis in the case with spontaneous rupture of a pancreatic tumor.

A rare case of spontaneous rupture of renal artery pseudoaneurysm in a previously hypertensive patient

Introduction. The renal artery and segmental renal artery pseudoaneurysm is a rare and usually asymptomatic vascular lesion which in most of the cases thrombose spontaneously, but at same time it can be a source of life-threatening hemorrhage and shock. Today, these pseudoaneurysms are discovered with increasing frequency due to unrelated abdominal imaging or on screening work-ups for hypertension, as well as widespread use of angiography. Typically, they are seen in patients after trauma, inflammation, or renal surgery or biopsy. Case outline. In our case, a 52-year-old male patient with no prior history of surgery, significant abdominal trauma and systemic disease, presented with left flank pain and signs of hypovolemic shock that manifested before the admission to the surgical emergency room. The CT scan promptly demonstrated rupture of a large retroperitoneal hematoma with massive intraperitoneal hemorrhage. The angiography confirmed the rupture of the renal artery pseudoaneurysm. The patient underwent urgent operation. A life-saving nephrectomy was performed while intraperitoneal hemorrhage and retroperitoneal hematoma was evacuated. Fourteen days after surgery the patient was discharged fully recovered, with normal diuresis and serum levels of creatinine and urea within referential values. During the period of hospitalization, he was diagnosed with and treated for hypertension. Conclusion. Rupture of pseudoaneurysms followed by hemorrhage into the intraperitoneal cavity and retroperitoneum is a life-threatening condition, as proven with this case, in which hypovolemic shock manifested itself before the admission. We would like to highlight the importance of high blood pressure control and the importance of regular check-ups.

Anaesthetic Management of a Spontaneously Ruptured Vertebral Artery Pseudoaneurysm with Dynamic Airway Obstruction

Expanding neck hematoma with progressive airway obstruction is a life-threatening airway emergency. Patients are at risk of cranio-cerebral circulation compromise leading to perioperative cerebrovascular accidents. Furthermore, precipitous fall of blood pressure following neck hematoma exploration mandate the activation of protocols for massive transfusion. We describe the successful anaesthetic management of an extremely rare case of spontaneous rupture of a vertebral artery pseudoaneurysm.

A RARE CASE OF SPONTANEOUS RUPTURE OF THE LEFT COMMON ILIAC VEIN WHICH WAS THE LATE COMPLICATION OF CAVA FILTER INSTALLATION

The article is dedicated to a rare case of spontaneous rupture of the pathologically altered left common iliac vein which was a late complication of the cava filter placement. To date this complication has not been described in the national medical literature. In foreign literature only 21 cases of spontaneous rupture of the iliac vein with unclear cause were registered. The article presents a case observed in the practice of the Bureau of forensic medical examination of the Moscow region. It was found that on he background of a number of conditions (occlusion of the inferior vena cava; pathological changes in the venous wall, taking into account its anatomical location; immobilized state of the patient; lack of adequate anticoagulant therapy; predisposing factors in the form of muscle tension) spontaneous rupture of the left common iliac vein should be considered as one of the late cava filter placement complications.Conclusion. Thus, the authors of the article have established the causes of spontaneous rupture of the iliac vein, as well as proposed the inclusion of this pathology in the official list of the late cava filter placement complications.

A Rare Case of Spontaneous Rupture of Hepatocellular Carcinoma in Renal Transplant Patient Under Chronic Immunosuppressive Therapy

Spontaneous rupture of hepatocellular carcinoma (HCC) is a potentially life-threatening condition. Diagnosis may be difficult, particularly in the absence of known liver cirrhosis or tumor. 53 old African male came to emergency unit presented with severe abdominal pain and shock. Past medical history of immunosuppressive medication after renal transplantation, 20 years ago. CT scan of the abdomen reveled large hepatic mass with cortical discontinuity and hemoperitoneum, also sentinel clot Sign is demonstrated due to active bleeding, the findings suggestive of spontaneous HCC rupture. In this case transarterial embolization was preferable as a bridging therapy prior to further diagnostics and therapy, to lower the morbidity and mortality. In this case report, we present the computed tomography finding of a rare case of spontaneous rupture of HCC in a non-cirrhotic liver in a patient with chronic immunosuppressive treatment after renal transplantation .The immunosuppressive drugs are associated with an increased risk for cancer following transplantation .The diagnosis is proven by surgical specimen

Spontaneous rupture of hemorrhagic thyroid nodules causing extensive laryngopharyngeal, neck, and chest hematoma

We report a rare case of spontaneous rupture of a thyroid nodule causing extensive soft tissue hematoma involving the laryngopharyngeal, neck, and chest regions in a 41-year-old healthy woman. Spontaneous hematoma secondary to a thyroid nodule is a rare occurrence. Hematoma usually tends to be secondary to blunt cervical trauma, fine needle aspiration for cytology, and usage of anticoagulants such as heparin or warfarin. It is crucial to assess the patient’s condition and airway in managing a case of spontaneous hematoma secondary to a ruptured thyroid nodule as this would determine the subsequent management. In this case, the patient presented with no obstructive signs or symptoms, and thus was managed conservatively. The hematoma subsequently resolved spontaneously.

A Rare Case of Spontaneous Rupture of Postmenopausal Pyometra presented as Pyoperitoneum

A Rare Case of Spontaneous Rupture of Postmenopausal Pyometra presented as Pyoperitoneum

Spontaneous rupture of non-parasitic or non-neoplastic multiple and giant liver cysts: report of a case.

Simple liver cysts occasionally cause pressure symptoms of the abdomen. We herein report an extremely rare case of spontaneous rupture of simple liver cysts. A 65-year-old woman suffered abdominal fullness and dyspnea. Laboratory examinations revealed general inflammation and mild hepatorenal dysfunction. Computed tomography revealed giant polycystic liver and ascites. Echinococcus antibody was not detected. Abdominal paracentesis provided dark brown transparent ascites in which any parasites or tumor cells were not observed. We diagnosed spontaneous rupture of isolated polycystic liver disease (PCLD) and continuously drained the ascites. After the symptoms and laboratory data were improved, resection of liver cysts and left lateral segmentectomy were performed. Histopathologically, simple columnar epithelia inside of cyst walls were observed. The patient remains well without recurrence of the symptoms 10 months after the surgery. We reviewed characteristics of PCLD and considered appropriate treatment for spontaneous rupture of simple liver cysts based on the previous case reports including the present case.

Spontaneous rupture of the spleen: A case report and review of the literature

Spontaneous rupture of the normal spleen is a rare clinical entity in the absence of trauma; the diagnosis and treatment of this fatal complication are often delayed. Regardless of the mechanism, patients typically present with upper abdominal pain, classically referred to the left shoulder, with evidence of hemoperitoneum and moderate to severe shock. Here we are presenting a rare case of spontaneous rupture of normal spleen in a young female.

Spontaneous rupture of splenic abscess in post renal transplant

We report a rare case of spontaneous rupture of splenic abscess in a patient who was on immuno-suppressants following renal transplant. She was incidentally found to have this rupture when an ultrasound abdomen was done to rule out hypersplenism. Diagnosis requires a high index of suspicion and early intervention produces good outcomes.

A Case of Spontaneous Ruptured Solid Pseudopapillary Tumor of Pancreas Resected by Laparoscopic Surgery

Solid pseudopapillary tumor (SPT) is an uncommon neoplasm of the pancreas. A rare case of spontaneous rupture of SPT is reported. A 13-year-old female felt acute abdominal pain without blunt abdominal trauma. Enhanced computed tomography (CT) revealed a tumor in the pancreas tail with fluid collection around it. The tumor was diagnosed as SPT with hemoperitoneum associated with spontaneous rupture. The bleeding was stopped conservatively and she was referred for surgery at three months after the rupture. At that time, CT revealed a tumor 4 cm in diameter, which protruded from pancreas tail without distant metastases. Since peritoneal dissemination was not seen on intraoperative exploration, laparoscopic enucleation was performed. Pathologically, the tumor was diagnosed as SPT with rupture of the capsule of tumor, and complete resection was confirmed. The patient has been followed up for two years, and she is alive without recurrence.

E-014 Endovascular occlusion of trigeminal artery-cavernous fistula following spontaneous rupture of a persistent trigeminal artery (PTA): technical considerations and case report

PurposeTo report a rare case of spontaneous rupture of dysplastic trigeminal artery in the cavernous sinus, imaging findings and technical considerations for treatment with vessel preservation.Case reportA 47-years-old female presented...

Abdominal apoplexy: A rare case of spontaneous rupture of the superior mesenteric artery in a hypertensive patient

INTRODUCTIONSpontaneous rupture of an intra-abdominal visceral artery is an exceptionally rare and potentially fatal cause of abdominal apoplexy. PRESENTATION OF CASEWe present a case of a 54-year-old hypertensive male who developed hypovolemic shock in our Emergency Department after presenting with abrupt onset of abdominal pain and diarrhea. Intra-operative findings revealed rupture of the superior mesenteric artery with massive hemoperitoneum. The bleeding vessel was ligated and the patient made a full recovery after 3 weeks in the Intensive Care Unit. DISCUSSIONHigh index of suspicion is necessary for early preoperative diagnosis and must be considered in any patient with a history of hypertension presenting with abrupt abdominal pain, signs of peritoneal irritation and unexplained hypovolemic shock. Immediate resuscitation and prompt surgical control of bleeding is paramount in patient prognosis. CONCLUSIONThe seemingly unpredictable nature of abdominal apoplexy must be noted, a precipitating cause in most cases is untraceable and early diagnosis relies solely on awareness of the condition.

Transcatheter Arterial Embolization for Spontaneous Rupture of the Omental Artery

We encountered a rare case of spontaneous rupture of the omental artery. A 25-year-old man without any episode of abdominal trauma or bleeding disorders came to the emergency unit with left upper abdominal pain. Hematoma with extravasation of the greater omentum and a hemoperitoneum was confirmed on abdominal contrast-enhanced computed tomography. Bleeding from the omental artery was suspected based on these findings. Transcatheter arterial embolization was successfully performed after extravasation of the omental artery, which arises from the left gastroepiploic artery, was confirmed on arteriography. Partial ometectomy was performed 10 days after transcatheter arterial embolization, revealing that the hematoma measured 10 cm in diameter in the greater omentum. Pathological examination showed rupture of the branch of an omental artery without abnormal findings, such as an aneurysm or neoplasm. Thus, we diagnosed him with spontaneous rupture of the omental artery. The patient recovered and was discharged from the hospital 10 days after the surgery, with a favorable postoperative course.

Spontaneous rupture of urinary bladder in second trimester Of pregnancy

A rare case of spontaneous rupture of urinary bladder in the second trimester of pregnancy is described. This report highlights the rarity of this complication and its diagnostic challenge. The patient presented with acute abdominal pain, voiding difficulty and biochemical features of renal failure. Four days prior to her presentation, she was treated empirically as urinary infection when she complained of retention like symptoms. At laparotomy, around 3 liters of urine found in abdominal cavity with a 2 cm hole in the vault of bladder.TB culture was negative and bladder biopsy showed non specific inflammation. Laparotomy, bladder repair with antibiotics cover and indwelling catheter constitutes the basis of a successful outcome.

Spontaneous rupture of incisional hernia associated with pregnancy

Incisional hernia following Caesarean section is a common clinical entity with numerous complications. We report a rare case of spontaneous rupture of incisional hernia associated with pregnancy.

Spontaneous Rupture of Idiopathic Thymic Abscess with a Markedly Increased CA-125 Level

We report a rare case of spontaneous rupture of idiopathic thymic abscess into the pleural cavity. A 64-year-old woman was admitted to hospital with pleuritic retrosternal chest pain. Chest roentgenograms disclosed a small amount of bilateral pleural effusion, the examination of which exposed a sterile serous exudate with a markedly increased CA-125 level. Chest computed tomography revealed a large anterior mediastinal cystic mass with bilateral pleural effusions. Following complete resection of the mass, the histological examination revealed cavitary lesion with necrotic thymic tissue and inflammatory infiltrate surrounded by fibrous wall. The immunohistochemical staining for CA-125 displayed strong positivity at the Hassall's corpuscles. Cyst fluid also revealed a highly elevated CA-125 level. Her serum CA-125 concentration two months after surgery had fallen to 28 IU/L. She is now doing well without recurrence of the cyst five months after surgery.

Rare case of spontaneous rupture of a urinary bladder carcinoma causing intestinal obstruction and peritonitis

Spontaneous rupture of the urinary bladder is a rare condition, especially due to squamous cell carcinoma. Less than 10 cases have been reported so far. The patient was a 30‐year‐old male presenting with difficulty passing urine, dribbling, dysuria and right loin pain of 4 days duration and constipation for 2 days. He then developed features of intestinal obstruction with peritonitis. Laparotomy revealed advanced urinary bladder carcinoma adherent to the ileum and urine in the peritoneal cavity. There was a perforation of the urinary bladder separate from the area of adherence. Palliative surgery was performed. Histopathology report was squamous cell carcinoma. The present case is being reported, as it is a diagnostic dilemma and is a rare condition, this being only the seventh case reported in the literature. The mortality rate is high and even though the patient had postoperative problems, he survived.

Bowel Evisceration After Use of Rectus Abdominis Transposition Flap for Sternal Wound Reconstruction: A Case Report

Rectus abdominis muscle transposition (RAMT) flaps can be successfully used for coverage of sternal defects caused by mediastinitis in poststernotomy patients. Information regarding abdominal wall morbidities associated with the use of this particular flap is scarce. We hereby present a rare case of spontaneous rupture of the posterior rectus fascia leading to bowel evisceration in a patient who had previously undergone sternal reconstruction with a RAMT flap. We hypothesize that certain high-risk factors present in this patient, such as morbid obesity, inadequate nutrition, and chronic cough may have had a direct impact on the integrity and strength of the abdominal wall after surgery, eventually leading to evisceration. Based on recent studies, we also suggest the consideration of allograft reinforcement to the abdominal wall fascia after RAMT flap elevation in high-risk patients, even in the presence of a concomitant infection.