جستجوی مقالات مرتبط با کلیدواژه « hematoma » در نشریات گروه « پزشکی »

Rectus sheath hematoma (RSH) is an accumulation of blood within the rectus sheath, secondary to rupture of the epigastric arteries. It is a rare condition, accounting for 1.6-1.8% of abdominal pain cases. It is more frequently observed in women, over the age of 50. Predisposing factors include the long-term use of anticoagulants, antiplatelets, steroids or immunosuppressants, prolonged INR, pregnancy, cardiovascular disease, hematological disease, hypertension, and diabetes. The symptoms are typically described as persistent and non-radiating acute abdominal pain that classically worsens with movements involving the abdominal wall (Carnett’s sign). Cullen’s signs (periumbilical ecchymosis) and Gray Turner’s signs (flank ecchymosis) may also be present. In stable patients, the management is conservative

The occurrence of ovarian hematoma during controlled ovarian stimulation (COS) is very rare. Until now, there is no such case reported in the literature. In this study, an attempt was made to discuss the possible mechanisms for the development of hematoma in such patients, the clinical presentation, monitoring, and management of these cases.

A rare case of periovarian hematoma was reported in a patient with a history of endometriosis undergoing ovarian stimulation for in vitro fertilization. On the seventh day of stimulation, the patient complained of severe pain in the abdomen. Her vitals and blood investigations were within normal limits. On abdominal examination, mild tenderness was noted in the left iliac fossa. On vaginal examination, fullness and tenderness were noted in the left fornix. On ultrasound, probe tenderness was present and a left ovarian hematoma measuring 2.0x1.81x1.55 cm was observed. She was managed conservatively. The hematoma exhibited a gradual reduction following the pick-up procedure and eventually resolved completely within a month.

Underlying endometriosis could be one of the possible causes of this periovarian hematoma. A conservative approach with close monitoring forms the first-line management in hemodynamically stable patients.

Surgical site hematoma is one of the factors that influence the results of the carpal tunnel release (CTR) and patients’satisfaction; therefore, this study was designed to evaluate the effects of using Penrose drain to reduce the operation site hematoma and improve the results of surgery.

Patients with a diagnosis of carpal tunnel syndrome (CTS) were randomly divided into intervention and control groups and then were evaluated by pain with the visual analog scale (VAS) and pinch power. The Penrose drain was placed for the intervention group and removed after two days. Three months after surgery, all patients were re-evaluated by VAS and pinch power.

Out of 46 patients, Penrose drains were placed for 21 patients. According to the results, the VAS and pinch power evaluations were better in patients with Penrose drain (P = 0.001) but in patients without Penrose drain, only the VAS evaluation resultswere improved, but a decrease in pinch power was detected.

CTR surgery with or without the Penrose drain decreases pain in patients after three months of operation. CTR with Penrose drain improves pinch power and also decreases the pain, but in patients without Penrose drain, pinch power was reducedafter this period.

Propofol is a commonly used medication for sedation during surgery; however, it must be used with precaution in neurologic patients because of the subsequent adverse effects of cardiovascular and neurologic. An 83-year-old male patient with acute subdural hemorrhage was referred with a two-year history of falling and a recent occurrence of imbalance; the patient underwent urgent surgery under general anesthesia, using 100 μg fentanyl for premedication, 50 mg Propofol for induction, and Isoflurane gas and fentanyl drip for maintenance. During transmission of the patient for postsurgical computed tomography, two ccs Propofol 1% were mistakenly injected into the patient's radial artery and managed appropriately by the master. Following this management, the patient represented no alteration in his vital signs and was discharged in a favorable condition. Here, we report how this case could be managed successfully. Robust data regarding the complications of accidental administration of Propofol through an artery are lacking, and the presented results remain controversial. The authors have herby drawn attention to the unique management of an accidental intra-arterial injection of Propofol. Further studies are warranted to establish definite conclusions.

In extra-articular distal femoral fractures (EDFFs), nonunion is a serious complication that occurs rarely. In this study, we examined how longer preservation of initial fracture hematoma by delaying the osteosynthesis (OS) affects the fracture union.  

In a retrospective cohort study, 98 EDFF patients were included. The OS was done within 2 days of injury in 50 patients (early OS group) and after 2 days of injury in 48 patients (late OS group). Time to callus formation and fracture union, bleeding amount, surgical duration, pain, knee range of motion, knee function, and postoperative complications, including the nonunion, knee deformity, infection, and revision, were compared between the 2 groups. Statistical analyses were done with SPSS. A comparison of the mean between the 2 groups was made with an independent t test or its nonparametric counterpart. A comparison of categorical variables between the 2 groups was made using a chi-square or the Fisher's exact test. P ˂ 0.05 was considered statistically significant.   

The mean time to callus formation was 47.1 ± 17.3 days in the early OS group and 46.9 ‎‎± 19.7 in the late OS group (P = 0.950). The mean time to fracture union was ‎‎114.9 ± 21 in the early OS group and 117.4 ± 28.8 days ‎in the late OS group (P = 0.630). The mean operation time and bleeding amount between the 2 groups did not differ significantly (P = 0.230 and P = 0.340, respectively). The knee range of motion, pain, and function were not notably different (P = 0.620, P = 0.790, and P = 0.770, respectively). Nonunion occurred in 3 patients of early OS and 2 patients of the late OS group. Other complications were also comparable in the 2 study groups.  

Delayed OA in EDFF patients has no significant effect on bone healing and fracture union. Future standard studies are required to confirm these results.

In the last decade, the number of patients undergoing thyroidectomy has increased. Compared to other methods, thyroidectomy is a relatively safe method for treating various types of thyroid diseases. However, the blood flow rate in the thyroid gland is high, and hematoma after thyroidectomy is one of its complications. We aimed to evaluate hematoma after thyroidectomy and its related factors.

  In this retrospective study, 2320 patients over 20 years of age who underwent thyroidectomy in Imam Khomeini, Arvand, and Mehr Ahvaz hospitals, Khuzestan Province, southern Iran between 2011 and 2022 were enrolled. Data were analyzed using SPSS software, version 22. 

70.7% of the patients were in the age range of 20-50 years. Twenty-five (1.1%) of patients developed a hematoma after thyroidectomy. Males are more likely to hematoma after surgery (P=0.01). Hematoma was significantly higher in patients with a history of hypertension (P=0.001). Moreover, a significant association was found between male gender, and age over 50 years with the risk of hematoma (P<0.05). The incidence of hematoma had a statistically remarkable correlation with follicular thyroid cancer pathology (P=0.001). Other pathology diagnoses were not significantly related to hematoma formation after thyroidectomy.

Hematoma after thyroidectomy surgery is a rare, but dangerous and life-threatening complication. It is important to identify risk factors for hematoma formation.

Cardiac catheterization is one of the major diagnostic procedures in CADs involving examination of the right or left part of the heart and the coronary arteries. The present study aimed to systematically review the best time to leave the bed with superior care efficacy and minimum complications. Google Scholar, Pub Med, ISI Web of Science, and Scopus databases were searched to obtain the relevant articles. All the clinical trial studies that mentioned all three clinical trial indices, including randomization, control, and intervention groups, were included. Nine RCT papers accounting for 2242 subjects were systematically reviewed. The rest time in bed varied from 2 to 24h. The sandbag's weight in the angiography catheter insertion site ranged from 2.3 to 4.5 kg. All studies revealed that despite decreasing the post-angiography bed hospitalization duration, early ambulation caused no significant difference in the emergence and severity of the angiography-induced complication (hematoma and hemorrhage) in the intervention group compared to the control group. The pain severity difference between the intervention and control groups was statistically addressed in some studies, and the results indicated that the reduction of hospitalization duration managed to decline the pain severity in the intervention group significantly. This review study suggests that the patients can leave the bed 2-4 h after the procedure, which can reduce low back pain and urinary complications.

Rectus sheath hematoma (RSH) mainly occurs due to anticoagulant therapy, and blunt traumas may also rarely cause RSH. However, there is no case report published on the follow‑up and treatment process of RSH after stabbing. A 60‑year‑old man was admitted after stabbing himself for suicide. The patient had a history of using clopidogrel and oral antidiabetic drugs. On physical examination, there were many entrance holes (more than 10) in the anterior abdominal wall, the largest of which was in the periumbilical region, approximately 30 mm in size and reaching toward the intra‑abdominal cavity. On computed tomography, there was a RSH of roughly 95 mm × 55 mm and a wound about 25 mm in diameter on the lateral side of the umbilicus, including hyperdense areas thought to belong to active extravasation. Due to a hemoglobin level decrease, hypotension, and tachycardia, he underwent an emergency laparotomy. On exploration, there was no need to intervene in the RSH. The patient was discharged without complications on the 7th postoperative day.

A paucity of data regarding the implications of postoperative hematoma formation on outcomes after shoulder arthroplasty exists. Previous studies on major joint arthroplasty have associated postoperative hematoma formation with high rates of prosthetic joint infection (PJI) and reoperation.  A total of 6,421 shoulder arthroplasty cases were retrospectively reviewed from an institutional database (5,941 primary cases, 480 revision) between December 2008 and July 2017. Patients who developed a postoperative hematoma were identified through direct chart review. Cases with a history of shoulder infection treated with explant and antibiotic spacer placement were excluded. Demographics, surgical characteristics, treatment course, and outcomes were collected.  Hematoma occurred in 105 (1.6%; 105/6421) cases within the first three postoperative weeks and was more common following revision (3.3%; 16/480) compared to primary cases (1.5 %; 89/5941; P=0.002). Overall, postoperative shoulder hematoma was successfully managed with nonoperative treatment in 87% of cases via observation (62%, 62/105) and aspiration (25%, 26/105). A total of 14 patients (0.22%, 14/6421) underwent reoperation for hematoma. Eight patients (7.6%, 8/105) that required reoperation for hematoma were diagnosed with PJI. Postoperative hematoma is a complication of shoulder arthroplasty. While many postoperative hematomas can be managed without operative intervention, this analysis reiterates the association between hematoma formation and the development of PJI. Level of evidence: IV

Spontaneous subcapsular renal hematoma is a rare complication with potentially fatal effects in clinical practice. We discuss a case of a patient who arrived at the emergency room with abrupt onset flank discomfort and hematuria. The damaged kidney was effectively embolized by interventional radiology, and the patient quickly recovered. Follow-up tests revealed that the hematoma had shrunk in size. We believe that early arterial embolization should be explored in the care of patients with renal bleeding because it may enhance outcomes.

One of the most important pre-angioplasty cares is patient education. The aim of this study was to compare the effect of educational intervention in angiography with CCU on duration of immobility and incidence of hematoma and ecchymosis in the patients undergoing coronary angioplasty admitted to CCU.

In this experimental study, 105 patients who were candidates for coronary angioplasty were randomly divided into two intervention groups (intervention 1, CCU training and intervention 2, angiography training) and one control group (routine training). Intervention groups 1 and 2 also received routine training. Patients in all three groups were evaluated for hematoma, ecchymosis, and duration of immobility at specific hours using a demographic questionnaire, checklist for bleeding and hematoma, as well as duration of immobility. Data were analyzed using one-way ANOVA, Chi-squared test and Fisher's exact test examinations using SPSS 18 software. Significance level was considered p <0.05.

Findings of the study did not show any significant difference between the three groups in terms of hematoma, ecchymosis, and duration of immobility after angioplasty in the mentioned hours (p> 0.05).

Despite the reduction of complications such as ecchymosis and hematoma in the intervention groups compared to the control group, no significant difference was observed between the three groups. The very low number of complications of angioplasty can be considered as an important limitation that influenced the findings of the study.

Tranexamic acid (TXA) belongs to the family of lysine-derived antifibrinolytics. TXA requires a simple molecular breakdown in the liver to be metabolized and has a high renal excretion.

This study aimed to determine the effect of TXA on subdural hematoma (SDH) treatment using the SR method.

Following a systematic review design, this study aimed to evaluate the effect of TXA on SDH treatment using studies published from 2000 to 2020. The search was performed by two researchers who were dominant in various types of SR studies and specialized discussion of neurosurgery. A checklist that contained the following items was used to collect the data: surname, year of study, year of publication, population, sample size, age, intervention, and outcomes. Data were also classified and reported using Word software.

Initially, 178 articles were identified, out of which 118 were removed due to the relevance of the title and method, 44 due to duplication, six due to following the SR method, and three due to having a case report design. Seven studies were found as eligible, as follows: the study by Wakabayashi et al. with a sample of 199 patients, Kageyama et al.’s study with 21 patients, Wan et al.’s study with 90 patients, Kutty et al.’ study with 27 patients, Tanweer et al.’s study with 14 patients, Yamada et al.’s study with 193 patients, and Lodewijkx et al.’s study with 7 patients. All articles showed that TXA could reduce SH.

Regarding the positive effect of TXA on reducing SDH, administration of this medicine is recommended in the treatment of patients with CSDH.

Bleeding events are the most common complications after kidney biopsy. This study aims to evaluate the effect of desmopressin administration on bleeding complication, in native kidney biopsy candidates with reduced kidney function.

This double-blind randomized clinical trial enrolled 18 to 80 years old patients with 15 < eGFR < 90 mL/min/ 1.73m² from July 2017 to August 2020. Patients were randomly assigned to receive either 3 μg/kg of intranasal desmopressin acetate or 1 mL/kg of intranasal sodium chloride 0.65%, one hour before ultrasound-guided, percutaneous native kidney biopsy. The primary outcome was the post-biopsy bleeding complications, and secondary outcomes were the volume of perirenal hematoma, and changes of post-biopsy hemoglobin and hematocrit level, plasma sodium and blood pressure (Clinical Trial Registration ID:IRCT20090701002112N3).

A total of 120 patients (58 men and 62 women), 60 patients in each group, were analyzed. The mean age and eGFR of the patients were 45.29 ± 15.95 years and 51.77 ± 18.02 ml/min/ 1.73m², respectively. Desmopressin administration significantly decreased post-biopsy perirenal hematoma compared to placebo (7/60 [11.6%]) vs. 33/60 [40%]; P < .05), and the hematoma volume was significantly smaller in the desmopressin group, in case of hematoma formation (2.31 ± 1.17 vs. 7.72 ± 5.45 mm³, P < .05).

Desmopressin administration before kidney biopsy is a safe and effective strategy to prevent bleeding complications. Considering absolute risk reduction of about 28%, the number needed to treat is about 4 procedures. We recommend considering desmopressin administration before percutaneous native kidney biopsy.

A review of the literature shows that bruises impair the aesthetic appearance of the skin. At the same time, official medicine has no cure for urgent skin discoloration in the area of bruises. Attention is drawn to the fact that alkaline hydrogen peroxide solutions effectively decolorize blemishes and the traces of blood by local interaction under in vitro and in vivo conditions. It has been shown that the main ingredients of these solutions are water, hydrogen peroxide, and sodium hydrogen carbonate. Some products have been developed for bleaching blood stains and marks on textiles, bandages, skin, nails, and inside the skin in the area of bruises. Here, the leading medical technologies for whitening cosmetic products are reviewed.

Intrapericardial hematomas are mostly found in association with traumas, cardiac surgical operations, and coronary interventions. In the case of open-heart surgeries, intrapericardial hematomas usually resolve without complications. However, in rare cases, they could be chronic or mimic the features of other lesions. We herein introduce a case of pericardial hematoma late after coronary artery bypass surgery with a cystic-like appearance. (Iranian Heart Journal 2022; 23(1): 237-239)

Throughout the coronavirus disease 2019 pandemic, patients using oral anticoagulants for mechanical valve replacement and/or another clinical-pathological condition might have faced various clinical scenarios. Rectus sheath hematoma is one of the acute abdominal pain syndromes. This study presented a patient with developed anticoagulation-induced rectus sheath hematoma after mitral valve replacement.

Coronary angiography is often associated with complications such as hemorrhage and hematoma that should be considered and be minimized.

This study aimed to determine the effect of Zinc oxide scallop-shell powder as a topical hemostatic agent (composed mainly of calcium) on complications after coronary angiography. These complications include hemostasis time, low back pain, hemorrhage, hematoma, the necessity of sandbags, and patient ambulation.

The current research was a blind, parallel, randomized clinical trial done on 150 patients under coronary angiography. They were randomly divided into three equal groups of A (control), B (case 1), and C (case 2). In group A, hemostasis was done with manual compression, use of ChitoHem powder, putting sandbag for 4-6 h in a supine position, and getting out of bed after 24 h. In group B, instead of ChitoHem powder, we used Zinc oxide scallop-shell powder. In group C, hemostasis was done with manual compression, Zinc oxide scallop-shell powder, putting sandbag for 1 h in a supine position, and getting out of bed after 2 h. The duration of hemostasis, bleeding, and hematoma after hemostasis and the severity of low back pain were investigated at 8 point intervals during 24 h. Data analysis was done using descriptive statistics indicators and Kolmogorov-Smirnov, ANOVA, Chi Square, Fisher exact test and Kruskal-Wallis tests.

The mean ±SD ages of groups of A, B, and C were 60.08 ±11.32, 60.22 ±10.30, and 61.69 (10.61), respectively, which was not statistically different. Furthermore, there was no significant difference between these three groups regarding their demographic information. There were statistically significant differences between groups about the amount of low back pain at the second, third, and fourth hours after angiography (P= 0.001). There was a significant difference in the amount of bleeding between the three groups (P=0.017). The difference in time of hemostasis in the three groups was not statistically significant.

The Zinc oxide scallop-shell powder reduces catheter site bleeding after coronary angiography and bed rest time and ultimately the severity of low back pain. Performing a similar study is recommended.