Spontaneous Nontraumatic Rupture Research Articles

Spontaneous nontraumatic rupture of the biceps tendon

AbstractThe biceps is one of the most important muscles of the flexor compartment of the arm. Recently there has been an increase in the global reported incidence of biceps tendon rupture worldwide. Generally, tears are seen in the elderly population and are precipitated due to underlying risk factors. Diagnosis is done with a combination of clinical findings and ultrasonography. We report a case of a 60-year-old female without any underlying risk factors who presented with nontraumatic spontaneous rupture of the right biceps tendon.

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.

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

1430 Spontaneous Perforation of an Acalculous Hydropic Gallbladder in a Diabetic Patient With Neuropathy: An Under-Diagnosed Entity

INTRODUCTION: Gallbladder hydrops (HGB), a gradual increase in volume of the gallbladder in the absence of inflammation or abnormalities of the biliary tract, is under-reported due to various diagnostic criteria used worldwide. The primary cause is cholelithiasis, and initial management is often conservative as they are mostly clinically silent. Surgery is considered for complications of HGB. The universal rise in prevalence of diabetes mellitus (DM) has led to a concomitant increase in the incidence of gallbladder diseases. We report a case of a diabetic patient who presented with viral gastroenteritis and was found to have non-traumatic spontaneous rupture of a HGB. CASE DESCRIPTION/METHODS: 78-year-old male with a complicated cardiac history including heart failure with placement of an automated implanted cardioverter, and non-insulin dependent DM with neuropathy exhibited one-day history of crampy, epigastric abdominal pain with non-bilious, non-bloody vomiting and watery diarrhea. Recently, his grandson was diagnosed with viral gastroenteritis. Patient was afebrile with unremarkable laboratory findings. CT of the abdomen with contrast highlighted a 6.7 cm × 11 cm HGB without cholecystitis or biliary ductal dilatation. Gallbladder ultrasound demonstrated sludge without evidence of wall thickening, gallstones, or pericholecystic fluid. Surgery recommended medical optimization and outpatient cholecystectomy due to his high risk (ASA III). He was admitted for viral gastroenteritis and began IV hydration. Hours later, patient endorsed worsening epigastric pain radiating to the right flank. HIDA scan revealed patency of the cystic duct with evidence of free biliary leak within the right peritoneal cavity. IV antibiotics were initiated followed by emergent cholecystectomy which uncovered a spontaneously perforated gallbladder with ruptured biliary contents into the peritoneum. Later, he developed septic shock, multi-organ failure, and expired on day 6. DISCUSSION: HGB, although rare, is frequent in the DM population and can present with serious complications. Our literature review uncovered that diabetics can develop HGB even in the absence of gallstones. Autonomic dysfunction affecting gallbladder contractility and reduced sensitivity of the gallbladder wall to cholecystokinin are key mechanisms. A sonogram may be used to screen for gallbladder dysfunction in diabetics, and if HGB is identified, we propose prophylactic cholecystectomy at an appropriate moment to significantly reduce morbidity and mortality.

Boerhaave’s syndrome: case report and review

Well-timed diagnostics of a spontaneous nontraumatic rupture of esophagus or Boerhaave’s syndrome, presents great difficulties because of his rarity and a variety of clinical implications. Esophagus ruptures may feign various organs pathology [2] that most often demands differential diagnostics with a stomach ulcer perforation, acute myocardial infarction, pulmonary artery embolism, aortic dissection and pancreatitis [16, 17]. The treatment can include conservative and surgical tools, but still accompanied by high mortality (up to 35%) [7]; results largely defined by the time between the moment of a rupture and start of the treatment. In addition to the review, described the experience of successful treatment of a patient with Boerhaave’s syndrome in the light of the generalized today data of world medical literature on this problem.

Surgical Management of a Spontaneous Black Tendon Rupture

Spontaneous non-traumatic rupture of Tendo-Achilles (TA) as a presenting feature of alkaptonuria is unusual. In this disorder, there is deposition of homogentisic acid in the cartilage of major joints and intervertebral disc is responsible for the degenerative changes. Infrequently, it also gets deposited in major tendons that renders them structurally weak ensuing in pathological ruptures. A case is presented with non- traumatic TA rupture and its surgical management in alkaptonuria.

Spontaneous Rupture of a Mediastinal Bronchial Artery Aneurysm Induced by Anticoagulant Agent.

Nontraumatic spontaneous rupture of a bronchial artery aneurysm is rarely seen. In this report, we described such a phenomenon in a patient induced by usage of anticoagulant agent. The patient had no antecedent history of trauma, hypertension, or apparent aortic pathology. The patient who had been taking low-molecular-weight heparin and warfarin to treat deep vein thrombosis complained of a sudden upper abdomen pain with shortness of breath and hypoxemia. The patient was diagnosed and treated for an acute hemomediastinum caused by a ruptured bronchial artery aneurysm. If the patient had continued to take the anticoagulant antithrombotic drugs, it may cause a more virulent bleeding. Taken together, CT angiography is a useful diagnosis tool for patients with sudden chest pain and abdominal pain, and rare cause should be considered.

Spontaneous rupture of EPL and ECRB tendons in a washerwoman: an unusual phenomenon.

Spontaneous rupture of the extensor pollicis longus (EPL) tendon is rare, and spontaneous non-traumatic rupture of both extensor pollicis longus (EPL) and extensor carpi radialis brevis (ECRB) tendons is not reported in literature. Rupture of EPL is usually associated with rheumatoid arthritis, systemic or local steroid injections, fractures of the wrist and repetitive and excessive abnormal motion of the wrist joint. We describe a case of spontaneous rupture of the EPL and ECRB tendons in a female patient, washerwoman by occupation, with no predisposing factor. Exploration of the tendons along with end to end tendon repair was done with excellent results. We describe the possible mechanism of the injury and result after one year follow up.

Spontaneous Non-traumatic Upper Urinary Tract Rupture in Pregnancy: Case Report and Literature Review

Background: Hydroureteronephrosis is one of the most common causes of flank pain in pregnancy, which on rare occasions can progress to rupture of the urinary tract. Case presentation: A 31 year old previously healthy primigravida presented to the Emergency Department complaining of severe left flank pain. A provisional diagnosis of renal colic secondary to a possible migrant renal calculus was established based on an initial bedside Ultrasound (US), with no abnormalities, and moderate microscopic haematuria on urinalysis. A Magnetic Resonance urogram was performed and demonstrated perinephric fluid considered related to a pelvicaliceal rupture on the left side, with no evidence of calculi. A left percutaneous nephrostomy was performed, however 48 hours later she developed similar symptoms on the right side. A serial US exam revealed resolution of the hydronephrosis on the left side with persistent and progressing hydronephrosis on the right but no obvious rupture. A right percutaneous nephrostomy, then provided relief of symptoms. She made an uneventful recovery, was discharged home five days later and gave birth at 36 weeks to a healthy baby. Conclusion: Spontaneous rupture of the upper urinary tract is a rare but significant complication of pregnancy that should be considered in the pregnant patients thought to be experiencing renal colic.

Spontaneous kidney rupture in a patient on chronic hemodialysis

■■ Non-traumatic spontaneous rupture of the kidney in subjects on chronic hemodialysis is a rare event. In most cases it is associated with acquired cystic kidney disease (ACKD) [1] or the presence of kidney cancer. [2] There are few reports on this topic. Until 2009 Goto identified in the Japanese literature only five reports of renal cell carcinoma in patients with end-stage renal disease (ESRD) manifesting with spontaneous rupture. [3] In the general population primary neoplasms of the renal pelvis are uncommon and most are malignant. The majority of these cases consist of transitional cell carcinoma. Squamous cell carcinoma (SCC) and adenocarcinoma (AC) of the renal pelvis are highly uncommon tumors and constitute less than 1% of upper urinary tract neoplasms. [4] SCC and AC are known to be associated with chronic renal calculi and infection. The incidence of coexisting urinary stone disease varies from 18% in the United States to 100% in Hong Kong. [5,6] The

Bilateral spontaneous non-traumatic rupture of the Achilles tendon: a case report

IntroductionWe present an interesting case of spontaneous non-traumatic bilateral rupture of the Achilles tendons, which is a rare condition. Delayed or missed diagnosis of Achilles tendon ruptures by primary treating physicians is relatively common.Case reportA 78-year-old Caucasian woman presented with spontaneous non-traumatic bilateral rupture of the Achilles tendons. Her symptoms started two days after she took ciprofloxacin 500 mg twice daily for a urinary tract infection and prednisolone 30 mg once daily for chronic obstructive airway disease.ConclusionThis case report aims to increase the awareness of this rare condition, which should be borne in mind with regard to patients who are on steroid therapy and are concurrently started on fluoroquinolones.

Spontaneous Non-traumatic Rupture of a Non-aneurysmatic Infrarenal Abdominal Aorta in a 10-year old girl without Histological Evidence of Connective Tissue or Autoimmune Disease: A Case Report

Spontaneous Non-traumatic Rupture of a Non-aneurysmatic Infrarenal Abdominal Aorta in a 10-year old girl without Histological Evidence of Connective Tissue or Autoimmune Disease: A Case Report

Spontaneous Non-traumatic Rupture of a Non-aneurysmatic Infrarenal Abdominal Aorta in a 10-Year Old Girl without Histological Evidence of Connective Tissue or Autoimmune Disease: A Case Report

Spontaneous non-traumatic rupture of a non-aneurysmatic infrarenal abdominal aorta is an extremely rare condition, which to our knowledge, has only been described in adults. Rupture is usually associated with some form of connective tissue or autoimmune disease, which causes weakness of the aortic tunica media. This report is the first to present a case of a non-traumatic rupture of a non-aneurysmatic abdominal aorta in a 10-year old girl. Histological investigation of microscopic sections of the ruptured aorta, molecular biological, and DNA mutation analyses, did not demonstrate any abnormalities.

Spontaneous nontraumatic rupture of a contracted kidney with subcapsular and perirenal hematoma in a patient receiving chronic hemodialysis

Spontaneous renal bleeding with diversion of blood into the subcapsular and/or perinephric spaces in a patient on chronic hemodialysis is a very rare clinical entity. We describe a patient on chronic hemodialysis in whom a spontaneous renal subcapsular hematoma and perirenal hemorrhage developed in a contracted kidney.

Nontraumatic Spontaneous Rupture of the Kidney: Etiology and CT Findings

Nontraumatic Spontaneous Rupture of the Kidney: Etiology and CT Findings

Spontaneous rupture of the ascending aorta

A case of spontaneous non-traumatic rupture of the thoracic aorta in a hypertensive patient is presented. The clinical findings suggested acute aortic dissection, and a large pericardial effusion was detected by echocardiography. The typical angiographic features of aortic dissection were not found. Autopsy revealed a longitudinal intimal tear and a rupture in the postero-lateral aspect of the ascending aorta. No false lumen was seen in the ascending aorta. When acute intrapericardial or intrapleural bleeding develops with no evidence of aortic aneurysm or dissection, spontaneous aortic rupture should be suspected.

Spontaneous nontraumatic rupture of the thoracic aorta

Spontaneous nontraumatic rupture of the thoracic aorta is a rare, life-threatening condition for which emergency diagnostic and therapeutic measures are indicated. The entity should be considered in the differential diagnosis of patients presenting with chest pain and signs of pericardial tamponade.

Idiopathic Rupture of the Bladder

Non-traumatic spontaneous rupture of the otherwise normal bladder is a rare occurrence. The literature is reviewed and 4 new cases are reported. Experimental data are presented and a theory is reviewed regarding the frequent intraperitoneal location of the rupture. The frequent paucity of symptoms compared to the high mortality rate is stressed.

Perforated viscus in infants: a new roentgen sign.

Spontaneous nontraumatic rupture of the intestinal tract during the first few hours or days of life is an unusual, rather perplexing condition with a grave prognosis. The perforation most frequently involves the stomach wall, but occasionally occurs in the duodenum or colon. The usual entity, perforation of the stomach, is more common in boys and is often associated with prematurity or other congenital anomalies. The perforation is generally due to a congenital defect in the musculature of the stomach. Peptic ulcer, distal obstruction, trauma (especially that from the passage of tubes or the administration of oxygen), and other known causes of gastric perforation also occur in the newborn. Of 38 cases in which the site of perforation was reported, 25 were on the greater curvature, 5 on the lesser curvature, 4 on the anterior wall, 2 in the cardia, and 1 each in the fundus and posterior gastric wall. Clinically, the general picture in practically every instance is one of a baby perfectly well until four or five days after birth, when emesis occurs, followed by distention, then usually dyspnea, and sometimes cyanosis. Upon x-ray examination there is positive evidence of free air in the peritoneal cavity. In most instances the distention is thought to be due to bowel obstruction and, while supine films are usually made, frequently no upright films are taken and the diagnosis is missed. In 1950, both Leger and his group (5) and Ross, Hill and Haas (9) reported successful repair of gastric perforations in the newborn, their patients being the first to survive. In 1959, Linkner and Benson (6) reported 17 survivals after perforation of the stomach, a survival rate slightly over 46 per cent. Perforation of the duodenum occurs in children of all ages but predominantly in infants. It has been attributed almost uniformly to peptic ulcer. It is believed that circulatory difficulty, especially in prolonged labor, tends to devitalize the duodenal mucosa and any damaged area is more liable to digestion by the acid gastric juices. Miller (7) has shown that a remarkably high acidity is present in the first forty-eight hours of life. More rarely, perforation of the duodenum occurs from an unrecognized surgical nick at a Ramstedt operation and from swallowed objects, such as safety pins. The usual onset of duodenal perforation in infants is quite sudden, with acute fulminating symptoms and marked abdominal distention. A large pneumoperitoneum is present, and often only supine films are made due to the mistaken diagnosis of bowel obstruction. Again, the correct diagnosis is often missed. Over 350 cases of peptic ulcer in infants have been recorded. In most reported cases, the discovery has been made only at autopsy, which, to quote Gross (3), “would suggest that there is room for improvement in recognizing the condition during life.” Bird, Limper, and Mayer's patient is the youngest on record successfully operated upon (1).