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Complications in Laparoscopic Colorectal Surgery
Published in Haribhakti Sanjiv, Laparoscopic Colorectal Surgery, 2020
Sanjiv Haribhakti, Shobhit Sengar
Minor bleeding is defined as bleeding that does not require blood transfusion and/or intervention (endoscopic, angiographic, or surgical). It usually ceases within 24 hours. Minor anastomotic bleeding after hand-sewn or stapled anastomoses is common but rarely reported. It is usually manifested by the self-limited passage of dark blood with the patient's first few bowel movements. The risk of bleeding is increased in patients with a bleeding diathesis. Proposed techniques to reduce minor bleeding include [21] careful inspection of the staple line, especially for side-to-side and functional end-to-end anastomosis, inversion and inspection of the linear staple line prior to closure of the enterotomy through which a stapling instrument was passed has been advocated by the author; suture ligation, as opposed to electro-cauterization, of significantly bleeding points; utilization of the antimesenteric borders of each limb to construct the anastomosis, thereby avoiding inclusion of the mesentery into the staple line, and reinforcement of the anastomosis with an absorbable suture.
Congenital Platelet Dysfunction and von Willebrand Disease
Published in Harold R. Schumacher, William A. Rock, Sanford A. Stass, Handbook of Hematologic Pathology, 2019
This gentleman presents with an impressive history of excessive bleeding that emphasizes, although is not necessarily restricted to, bleeding from mucosal surfaces. The past transfusion requirement is noteworthy, although without more detail as to the extent of bleeding that may have occurred in relationship to the degree of tissue injury, this information remains difficult to interpret. The apparently life-long history of bleeding certainly suggests a congenital disorder. The available family history, however, appears to exclude any autosomal-dominant bleeding diathesis.
A Systematic Approach To The Diagnosis Of Bleeding Disorders
Published in Genesio Murano, Rodger L. Bick, Basic Concepts of Hemostasis and Thrombosis, 2019
A bleeding diathesis can rarely be completely defined without the aid of laboratory tests, but the selection and interpretation of these tests should be predicted on the basis of major clinical data. A careful history is therefore paramount, with particular emphasis on the family history. Drug administration, obvious or surreptitious, must be carefully considered. Detailed discussions of drugs affecting hemostasis are found in Chapters 5, 6, and 7. A history of obstetrical and surgical events associated with unusual bleeding require a search for defects in hemostasis. Vascular or platelet abnormalities usually manifest as easy and spontaneous bruisability, petechiae or purpura, commonly dependent, and bleeding from the mucous membranes, although the hereditary disorders may present primarily as gastrointestional bleeding. Conversely, the hemophilias rarely, if ever, cause petechiae or purpura, but joint bleeding is a hallmark. In an age of social awareness, a note of caution seems warranted concerning the “battered child syndrome”. Idiopathic thrombocytopenic purpura, a disease most commonly seen in children, may simulate this condition because of the painful associated hematomas. The presence of blue sclerae, hyperelasticity of the skin, and hyper-extensible joints suggest a hereditary connective tissue disorder. Telangiectasia of buccal mucosal membranes or subungual areas is a classic finding in Osler-Weber-Rendu disease. Splenic enlargement most often suggest thrombocytopenia, usually secondary.
Clinical manifestations and treatments of Protobothrops mucrosquamatus bite and associated factors for wound necrosis and subsequent debridement and finger or toe amputation surgery
Published in Clinical Toxicology, 2021
Yan-Chiao Mao, Po-Yu Liu, Liao-Chun Chiang, Chi-Hsin Lee, Chih-Sheng Lai, Kuo-Lung Lai, Wen-Loung Lin, Hung-Yuan Su, Cheng-Hsuan Ho, Uyen Vy Doan, Tri Maharani, Yi-Yuan Yang, Chen-Chang Yang
Although ecchymosis is frequently described in P. mucrosquamatus bites [6,9], it is usually limited around the wound, probably because the anticoagulant effect is weak [55], despite high proportion of hemorrhagic SVMPs in the venom [47]. In this study, bleeding diathesis was not observed; however, we could not exclude the possibility that bleeding diathesis might develop if antivenom was not promptly administered. Even though early antivenom administration (<6 h) was not associated with a lower incidence of coagulopathy in our study, all of our patients received antivenom within 25.5 h after the bite, which might have halted the late-onset coagulopathy that would occur several days later. If specific antivenom is unavailable, we suggest close monitoring of the patients for bleeding up to 1 week. Thrombocytopenia is uncommon after P. mucrosquamatus bite and typically not severe. The mechanism may involve platelet aggregation/agglutination and the effect of SVMPs on the microvessel wall to induce platelet sequestration [59,60,63,64].
Can bipolar energy serve as an alternative to monopolar energy in the management of large bladder tumours >3 cm? A prospective randomised study
Published in Arab Journal of Urology, 2019
Mahmoud A. Mahmoud, Ahmed Tawfick, Diaa Eldin Mostafa, Hossam Elawady, Mohamed Abuelnaga, Karim Omar, Hisham Elshawaf, Mohamed Hasan
Exclusion criteria: Unfitness for spinal anaesthesia.Patients with recurrent bladder tumour.Patients with other urological malignancies.Patients requiring anticoagulation.Patients with pacemakers.Patients with back pressure change.Patients with urethral stricture.Active UTIs.Patients with uncontrolled bleeding diathesis.
Thrombocytopenia in congenital heart disease patients
Published in Platelets, 2015
Efrén Martínez-Quintana, Fayna Rodríguez-González
Bleeding and thrombotic complications are two known complications seen in patients with congenital heart disease (CHD), especially if there is associated hypoxemia. The bleeding diathesis manifests in various ways, such as epistaxis, menorrhagia, gingival bleeding, perioperative bleeding, bruising, and hemoptysis. Meanwhile, thrombotic complications present as venous (deep vein, renal vein, jugular vein or cerebral venous sinus thrombosis among others) or arterial thrombosis (stroke, myocardial infarction, or arterial embolisms) being an important source of morbidity and mortality in CHD patients. However, the varied pathophysiology of thrombosis and bleeding in the setting of CHD reflects diverse predisposing substrates and the heterogeneous patient population [1,2].