Treatment Of Extravasation Research Articles

Treatment of Vincristine Extravasation

To the Editor.— Vincristine sulfate, a commonly used chemotherapeutic drug, is often associated with severe tissue reactions when extravasated subcutaneously. I would like to report my experience with two cases that seemed to be treated effectively with hydrocortisone. Report of Cases.— Case1.—A 63-year-old woman with a history of multiple myeloma was given vincristine sulfate, 2 mg intravenously (IV), as part of her chemotherapy. Approximately 1.5 mL of vincristine sulfate was extravasated subcutaneously in the volar aspect of the left arm. Hydrocortisone, 100 mg, was infiltrated subcutaneously in the region of the extravasation. The patient was seen one week later, and although there was some initial pain and some edema, this had subsided completely, and the area was healing satisfactorily. On further follow-up, there were no sequelae noted. Case2.—A 73-year-old woman with a history of breast carcinoma received vincristine sulfate, 1 mg IV. During administration, approximately 3 mL of

Spontaneous extravasation of contrast medium during intravenous urography: Report of fourteen cases and a review of the literature

To sixty-one reported cases of spontaneous extravasation of contrast medium during intravenous urography, we have added fourteen of our own. In the majority of cases, the extravasation occurs as a result of a sudden increase in intrapelvic pressure secondary to a ureteric calculus. In a few cases, the obstruction may be due to secondary neoplasm and in some cases the cause is never found. The contrast passes through a minute tear in the calyceal fornix into the renal sinus, and from there either passes down the retroperitoneal space around the ureter or is ultimately absorbed by lymphatics. Retrograde pyelography is not necessary, since the diagnosis is usually obvious and this procedure may enlarge the forniceal tear. In most cases no further sequelae result, but occasionally a peripelvic cyst or a peripelvic abscess may result from the extravasation. It has also been postulated that the fibroblastic reaction following obstruction may be sufficient to obstruct renal calyces or pelvis. Despite this, treatment for spontaneous extravasation is essentially supportive, whereas extravasation due to rupture of the renal pelvis or ureter usually requires surgical intervention. The distinction between the two entities can most often be made on clinical and radiological grounds.

The Treatment of Intraperitoneal Extravasations of Blood in Ruptured Tubal Gestation

The Treatment of Intraperitoneal Extravasations of Blood in Ruptured Tubal Gestation