MyMedR

Fulltext Arteriovenous malformation of the stomach: a rare cause of upper gastrointestinal bleeding

Latar NH, Phang KS, Yaakub JA, Muhammad R

Med J Malaysia, 2011 Jun;66(2):142-3.

Haemorrhage arising from gastric arteriovenous malformation (AVM) is rare and normally occurs in the elderly. Bleeding gastric AVM presenting in the younger age group is even rarer. We report a case of a 14 year old boy who presented with recurrent episodes of haematemesis. He subsequently underwent a proximal gastrectomy and the histological examination confirmed a gastric AVM. After reviewing the literature we believe this is the youngest ever reported case of bleeding gastric AVM reported in English literature.

Matched MeSH terms: Gastrointestinal Hemorrhage/etiology*; Gastrointestinal Hemorrhage/pathology; Gastrointestinal Hemorrhage/therapy

Valsalva haemorrhagic retinopathy after push-ups

Hassan M, Tajunisah I

Lancet, 2011 Feb 5;377(9764):504.

PMID: 21255827 DOI: 10.1016/S0140-6736(10)60677-0

Matched MeSH terms: Retinal Hemorrhage/diagnosis; Retinal Hemorrhage/etiology*; Retinal Hemorrhage/surgery

A rare cause of spontaneous bleeding per oral in an elderly

Ibrahim FM, Mohamad I

Ann Acad Med Singap, 2010 Oct;39(10):817-8.

PMID: 21063648

Matched MeSH terms: Oral Hemorrhage/diagnosis; Oral Hemorrhage/etiology*; Oral Hemorrhage/physiopathology

Fulltext Clinical and endoscopic features of peptic ulcer bleeding in Malaysia

Kandasami P, Harjit K, Hanafiah H

Med J Malaysia, 2004 Dec;59(5):617-22.

PMID: 15889564 MyJurnal

The characteristics of patients and the endoscopic features of 196 patients with bleeding peptic ulcer in a multi-ethnic population were investigated. There was a male preponderance (M: F= 6.3: 1) and their mean age was 63.5 years. The prevalence of peptic ulcer bleeding in the Malays and Indians was similar to the ethnic distribution of population. However, the Chinese were over represented. Nearly 40% of patients studied had at least one co-existing medical illness. Hypertension and ischaemic heart disease were the most common diseases. History of non-steroidal anti-inflammatory drug usage was identified in 48% of the patients and it was the commonest risk factor associated with bleeding ulcers. More than 80% of bleeding ulcers were located in the duodenum and the pylorus. Endoscopic features of active bleeding or recent bleed were identified in more than 60% of the patients. The study notes that bleeding peptic ulcer is a serious and a potentially life threatening condition. It is a disease of the elderly and, with the steadily increasing elderly population in the country, the admissions rates of peptic ulcer bleeding is expected to rise. There is a need to plan for appropriate technical support, critical care facilities and expertise to avoid unacceptable outcomes.

Matched MeSH terms: Peptic Ulcer Hemorrhage/etiology*; Peptic Ulcer Hemorrhage/epidemiology; Peptic Ulcer Hemorrhage/pathology*

Fulltext Uterine artery bleeding and haemoperitoneum during the second trimester in pregnancy

Achanna KS, Goh CS

Med J Malaysia, 2003 Mar;58(1):128-30.

PMID: 14556339

A case of spontaneous rupture of uterine artery in the second trimester of pregnancy is described. Haemorrhage from rupture of uterine artery during pregnancy was discovered at laparotomy. This was an unusual but serious complication of pregnancy. This condition is extremely rare and one must consider it in cases of incomprehensible abdominal pain with or without haemodynamic collapse. A review of the literature revealed only four similar cases so far. This pregnancy continued till 37 weeks pregnancy and had a spontaneous vaginal delivery. Immediate institution of effective resuscitative measures and early surgical intervention were essential to both foetal and maternal survival.

Matched MeSH terms: Uterine Hemorrhage/complications*; Uterine Hemorrhage/diagnosis*; Uterine Hemorrhage/therapy

Outcome prediction in early management of severe head injury: an experience in Malaysia

Selladurai BM, Jayakumar R, Tan YY, Low HC

Br J Neurosurg, 1992;6(6):549-57.

PMID: 1472321

The outcome of 109 patients with severe head injury was studied in relation to clinical and computed tomographic (CT) criteria on admission, after resuscitation. Age, Glasgow Coma Score (GCS) and state of pupils strongly correlated with outcome. The presence of hypothalamic disturbances, hypoxia and hypotension were associated with an adverse outcome. The CT indicators associated with poor outcome were perimesencephalic cistern (PMC) obliteration, subarachnoid haemorrhage, diffuse axonal injury and acute subdural haematoma. The prognostic value of midline shift and mass effect were influenced by concomitant presence of diffuse brain injury. For the subset of patients aged < 20 years, with GCS 6-8 and patent PMC (n = 21), 71.4% correct predictions were made for a good outcome. For the subset of patients aged > 20 years, with GCS 3-5 and partial or complete obliteration of PMC (n = 28), 89.3% correct predictions were made for a poor outcome.

Matched MeSH terms: Cerebral Hemorrhage/etiology; Subarachnoid Hemorrhage/etiology

Activated recombinant factor VII in the treatment of retroperitoneal haemorrhage in a patient with factor VIII inhibitor

Ng SC

Ann Acad Med Singap, 1994 Nov;23(6):901-2.

PMID: 7741509

The management of haemorrhagic episodes in patients with factor VIII inhibitor is difficult and the outcome rather unpredictable. The use of an investigational drug, that is, activated recombinant factor VII (rFVIIa) in a young non-haemophiliac patient with spontaneous occurrence of factor VIII inhibitor who presented with life-threatening retroperitoneal haemorrhage is reported. There was prompt achievement of haemostasis with rFVIIa after the patient had failed conventional therapy with factor IX and Autoplex. Two further episodes of retroperitoneal bleeding again responded promptly to rFVIIa therapy.

Matched MeSH terms: Hemorrhage/blood; Hemorrhage/etiology; Hemorrhage/therapy*

Dengue fever complicated by pulmonary haemorrhage manifesting as haemoptysis

Liam CK, Yap BH, Lam SK

J Trop Med Hyg, 1993 Jun;96(3):197-200.

PMID: 8505777

A 17-year-old girl was admitted to hospital with dengue fever. On the ninth day of fever she developed haemoptysis and chest X-ray changes consistent with haemorrhage in her lungs. Thrombocytopaenia and mild coagulopathy were the most likely cause of this unusual haemoptysis in this patient. Investigations excluded other causes for the haemoptysis.

Matched MeSH terms: Hemorrhage/complications; Hemorrhage/etiology*; Hemorrhage/radiography

Intracranial haemorrhage and child abuse

Cheah IG, Kasim MS, Shafie HM, Khoo TH

Ann Trop Paediatr, 1994;14(4):325-8.

PMID: 7880096

Intracranial haemorrhage is a major cause of severe morbidity and mortality in child abuse cases in developed countries. However, similar data are not available in most developing countries. This study therefore aimed to determine the incidence of intracranial haemorrhage amongst all cases of child physical abuse, the nature of the injuries incurred, and the morbidity and mortality resulting therefrom. Among 369 cases of physical abuse seen over a 4-year period, 41 (11.4%) had intracranial haemorrhage, of whom 37 (90%) were 2 years old or less. A history of trauma was present in only eight (20%), of which only two were compatible with the injuries incurred. Subdural haemorrhages accounted for 80% of the cases, with skull fractures present in only nine cases. Fifty-four per cent of the 37 children aged 2 years of age or less had no external signs of trauma, but 11 of them had retinal haemorrhages. This is in contrast to the children older than 2 years of age who all had external signs of trauma. The overall prognosis was dismal with an early mortality of almost 30% (13 cases) and at least seven cases with severe neurological sequelae. These findings are comparable with studies from developed countries which have established that non-accidental injury must be considered as a cause of intracranial haemorrhage in any young child, despite the absence of external signs of trauma.

Matched MeSH terms: Cerebral Hemorrhage/complications; Cerebral Hemorrhage/etiology; Cerebral Hemorrhage/epidemiology*

Fulltext Delayed haemorrhage in conservative surgery for ectopic pregnancy

Rachagan SP, Neoh HS

Med J Malaysia, 1990 Mar;45(1):84-6.

PMID: 2152077

A case of delayed haemorrhage after conservative surgery for ectopic pregnancy is presented. Brief pathophysiology of the condition is presented. The importance of beta-subunit human chorionic gonadotrophin monitoring of the serum in this patient is highlighted. Surgical procedures to prevent this complication are also discussed.

Matched MeSH terms: Hemorrhage/blood; Hemorrhage/etiology*; Hemorrhage/prevention & control

Fulltext Intracranial haemorrhage due to late haemorrhagic disease of infancy

Yeo TC

Med J Malaysia, 1987 Dec;42(4):276-83.

PMID: 3454400

Thirteen cases of late haemorrhagic disease of infancy due to vitamin K deficiency presenting with intracranial haemorrhage were seen over a three - year period from 1984 to 1986. The clinical picture was fairly typical; a short history of being unwell (poor feeding, vomiting, irritability, high pitched cry, fits) and physical findings of pallor, a normal body temperature, impairment of consciousness, abnormal respiration and a very tense anterior fontanelle. Vitamin K deficiency was implicated by the prolonged prothrombin time which rapidly returned to normal with vitamin K injection. The outcome was poor. Possible factors giving rise to vitamin K deficiency are discussed. The author suggests the introduction of the giving of vitamin K to all new-borns.

Matched MeSH terms: Cerebral Hemorrhage/etiology*; Subarachnoid Hemorrhage/etiology*

Fulltext An audit of upper gastrointestinal bleeding at Seremban Hospital

Lim TM, Lu PY, Meheshinder S, Selvindoss P, Balasingh D, Ramesh J, et al.

Med J Malaysia, 2003 Oct;58(4):522-5.

PMID: 15190627

We retrospectively analyzed all patients presenting with upper gastrointestinal bleeding to Seremban Hospital over a one-year period. A quarter of the oesophagogastro-duodenoscopies (OGD) performed were performed as emergency for upper gastrointestinal tract bleeding. Gastric ulcers and duodenal ulcers were the two most common findings. Our results suggest that there is a male preponderance of 2:1, the Chinese were more likely to be affected and the elderly (> 60 years) were at highest risk.

Matched MeSH terms: Gastrointestinal Hemorrhage/ethnology; Gastrointestinal Hemorrhage/etiology*; Gastrointestinal Hemorrhage/therapy

Uterine torsion in patient with major placenta previa

Wan Adnan WF, Shamsudin F, Mohamad Zon E

Eur J Obstet Gynecol Reprod Biol, 2021 Mar;258:467-469.

PMID: 33483151 DOI: 10.1016/j.ejogrb.2020.12.007

Matched MeSH terms: Uterine Hemorrhage

Fulltext Meningioma with intracranial haemorrhage: A rare occurrence.

Ho, C.C.K., Benedict, M.S.

International Medical Journal Malaysia, 2008;7(1):0-0.

MyJurnal

Meningiomas with intracranial haemorrhage is a rare occurrence and carries a high mortality rate. We present here a case we encountered, where intratumoural, subdural and intraventricular haemorrhage occurred. The pathophysiology and mechanism of intracranial tumoural haemorrhage, is discussed.

Matched MeSH terms: Cerebral Hemorrhage

Fulltext Surgery for massive paediatric head and neck neurofibroma: two case reports

Asha’ari, Z.A., Kahairi, A., Shahid, H.

International Medical Journal Malaysia, 2012;11(2):54-57.

MyJurnal

We report two paediatric patients with massive head and neck plexiform neurofibromas who underwent surgical excision. We wish to highlight issues and implications pertaining to the surgery, in particular, the management of intraoperative bleeding often encountered in these cases.

Matched MeSH terms: Hemorrhage

Fulltext Central Diabetes Insipidus in neonatal brain abscess

Asmaa, H.A., Rohani, A.J., Farah Inaz, S.A., Rosli, F.J.

Malaysian Journal of Paediatrics and Child Health, 2016;22(101):0-0.

MyJurnal

Neonatal Central Diabetes Insipidus (CDI) is extremely rare and its causes include infection, trauma, hemorrhage or tumor. A high index of suspicion is necessary as early treatment is required to prevent further complications. We report a case of Neonatal CDI as a complication of a Serratia brain abscess.(Copied from article)

Matched MeSH terms: Hemorrhage

Case-control comparison brain lesion segmentation for early infarct detection

Ting FF, Sim KS, Lim CP

Comput Med Imaging Graph, 2018 11;69:82-95.

PMID: 30219737 DOI: 10.1016/j.compmedimag.2018.08.011

Computed Tomography (CT) images are widely used for the identification of abnormal brain tissues following infarct and hemorrhage of a stroke. The treatment of this medical condition mainly depends on doctors' experience. While manual lesion delineation by medical doctors is currently considered as the standard approach, it is time-consuming and dependent on each doctor's expertise and experience. In this study, a case-control comparison brain lesion segmentation (CCBLS) method is proposed to segment the region pertaining to brain injury by comparing the voxel intensity of CT images between control subjects and stroke patients. The method is able to segment the brain lesion from the stacked CT images automatically without prior knowledge of the location or the presence of the lesion. The aim is to reduce medical doctors' burden and assist them in making an accurate diagnosis. A case study with 300 sets of CT images from control subjects and stroke patients is conducted. Comparing with other existing methods, the outcome ascertains the effectiveness of the proposed method in detecting brain infarct of stroke patients.

Matched MeSH terms: Hemorrhage

Fulltext QTc Interval Prolongation and Hemorrhagic Stroke: Any Difference Between Acute Spontaneous Intracerebral Hemorrhage and Acute Non-traumatic Subarachnoid Hemorrhage?

Amin OSM, Al-Bajalan SJ, Mubarak A

Med Arch, 2017 Jun;71(3):193-197.

PMID: 28974832 DOI: 10.5455/medarh.2017.71.193-197

BACKGROUND: A variety of ECG changes occur as an aftermath of stroke. Prolongation of the QTc interval is a well-documented change. We analyzed QTc interval prolongation among patients with acute hemorrhagic strokes.

METHODS: This observational study was conducted at the Emergency Department of Sulaymaniyah General Teaching Hospital and Shar Hospital from September 1st, 2014 to August 31st, 2015. Fifty patients who developed acute spontaneous hypertensive intracerebral hemorrhage (ICH) and 50 patients who developed acute non-traumatic subarachnoid hemorrhage (SAH) were included in the study. All patients underwent resting 12-lead ECG within half an hour of admission. The QTc interval was calculated and analyzed in those 100 patients.

RESULTS: Females (62%) outnumbered males (38%) with a female to male ratio of 1.6:1. Forty percent of the patients were between 60-69 years of age. Hypertension was seen in 82% of patients while left ventricular hypertrophy was documented in 40% of patients. The QTc was prolonged in 38 patients (17 patients in the ICH group and 21 patients in the SAH group). In both groups, males demonstrated QTc prolongation more than females. However, there were no statistically significant gender difference between both groups and within the same group. There was a statistically significant association between SAH and QTc prolongation (p-value<0.001); the ICH group did not demonstrate any significant relationship with QTc prolongation.

CONCLUSION: Prolongation in the QTc interval was "statistically" associated with acute SAH only. No gender difference was noted; whether this observation is clinically significant or not, it needs further analytic studies.

Matched MeSH terms: Cerebral Hemorrhage/complications*; Subarachnoid Hemorrhage/complications*

Fulltext Goals, challenges and strategies for wound and bleeding management in total knee arthroplasty: A modified Delphi method

Lyons M, Nunley RM, Ahmed Shokri A, Doneley T, Han HS, Harato K, et al.

J Orthop Surg (Hong Kong), 2022;30(3):10225536221138985.

PMID: 36374258 DOI: 10.1177/10225536221138985

BACKGROUND: Surgical techniques related to soft tissue management play critical roles in optimizing surgical outcomes and patient satisfaction in total knee arthroplasty (TKA). Despite the importance of wound closure and bleeding management approaches, no published guidelines/consensus are available.

METHODS: Twelve orthopedic surgeons participated in a modified Delphi panel consisting of 2 parts (each part comprising two rounds) from September-October 2018. Questionnaires were developed based on published evidence and guidelines on surgical techniques/materials. Questionnaires were administered via email (Round 1) or at a face-to-face meeting (subsequent rounds). Panelists ranked their agreement with each statement on a five-point Likert scale. Consensus was achieved if ≥70% of panelists selected 4/5, or 1/2. Statements not reaching consensus in Round 1 were discussed and repeated or modified in Round 2. Statements not reaching consensus in Round 2 were excluded from the final consensus framework.

RESULTS: Consensus was reached on 13 goals of wound management. Panelists agreed on 38 challenges and 71 strategies addressing surgical techniques or wound closure materials for each tissue layer, and management strategies for blood loss reduction or deep vein thrombosis prophylaxis in TKA. Statements on closure of capsular and skin layers, wound irrigation, dressings and drains required repeat voting or modification to reach consensus.

CONCLUSION: Consensus from Asia-Pacific TKA experts highlights the importance of wound management in optimizing TKA outcomes. The consensus framework provides a basis for future research, guidance to reduce variability in patient outcomes, and can help inform recommendations for wound management in TKA.

Matched MeSH terms: Hemorrhage

Lung, Liver and Skin Changes in an Infant with Positive Methamphetamine

Subramaniam K, Hazmi HB, Guan YS, Zainun KAB

Fetal Pediatr Pathol, 2023 Apr;42(2):263-269.

PMID: 35620894 DOI: 10.1080/15513815.2022.2080309

BACKGROUND: The increased use of illicit drugs continues to lead to the discovery of various unexpected pathologies.

CASE PRESENTATION: This 7-month-old infant died suddenly at home. Pulmonary artery fibrinoid necrosis, diffuse fatty liver changes, and skin rash were the main histologic postmortem findings. Postmortem urine contained traces of methamphetamine. Methamphetamine was smoked by the parents.

CONCLUSIONS: Fibrinoid necrosis has been described with inhaling methamphetamine and can result in fibrinoid angiitis such as in this case. Although this did not result in pulmonary hemorrhage or could be directly related to death, it does suggest that pulmonary artery fibrinoid necrosis may develop with passive inhalation of methamphetamines.

Matched MeSH terms: Hemorrhage

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