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At least 19 recordsLinked to original sources
PubMedDate not supplied

Fatal spontaneous rupture of a gravid uterus: case report and literature review of uterine rupture.

Spontaneous uterine rupture is a life-threatening obstetrical emergency encountered infrequently in the emergency department. The diagnosis of spontaneous uterine rupture is often missed or delayed, leading to maternal and fetal mortality. Emergency physicians must consider this diagnosis when presented with a pregnant patient in shock with abdominal pain. We present the case of a 38-year-old gravid female who presented to the emergency department in cardiac arrest 24 hours after an initial complaint of abdominal pain. We review the uterine rupture literature with specific focus on risk factors, signs and symptoms, diagnosis, treatment, and outcome.

Adult↗
PubMed1992

Spontaneous rupture of normal spleen: an enigma recalled.

That a normal spleen can rupture spontaneously has long been a point of debate. A definitive case is reported here in an attempt to resolve the issue in its favour. Spleen involved in tropical diseases like malaria, infectious mononucleosis and typhoid fever is prone to rupture spontaneously as well as in cases follow minor trauma. In contrast, normal spleen ruptures almost always following severe trauma, such as road accidents or fall from significant heights. Though cases of spontaneous rupture of normal spleens have appeared off and on in the past, doubt has always surrounded the very existence of such an entity. We are reporting a definitive case of spontaneous rupture of normal spleen. This is only the second case of its kind since 1958 and the first ever from the Indian subcontinent.

Adult↗
PubMed1986

[Spontaneous rupture of renal leiomyosarcoma: report of a case].

A case of renal leiomyosarcoma ruptured spontaneously is reported. A 36-year-old man was admitted to our clinic with the complaint of right flank pain. The urographic examination, including an excretory urography, renal CT-scan, renal angiography, and ultrasonography revealed a renal tumor with spontaneous rupture on the right side. A nephrectomy through the lumbal flank incision on the right side was performed on February 28, 1984, and histopathological diagnosis was renal leiomyosarcoma. Five courses of adjuvant chemotherapy, VCR, ADM and CPM, combined with maintenance immunochemotherapy using Tegafur and Krestin and with radiotherapy (3,000 rad) were performed post-operatively. The patient was followed for 18 months after operation as an outpatient with no evidence of local recurrence and metastasis. The 40 reported cases including our case with leiomyosarcoma in Japan is reviewed and some characteristics of this entry are discussed.

Adult↗
PubMed1985

[Spontaneous rupture of the spleen in chronic pancreatitis].

Excepting splenomegaly related to segmental portal hypertension, splenic complications observed during the course of chronic pancreatitis are uncommon. These may include splenic necrosis, intrasplenic pseudocysts and splenic rupture. Spontaneous rupture of the spleen is one of the least common events, a total of 29 cases being reported thus far. We present herein 4 new cases, and previously documented cases were reviewed. In our cases, the splenic rupture occurred in young male patients. This complication revealed the pancreatic disease in one case while in the others, it occurred on the average 7 months after the symptomatic onset of pancreatic disease. This suggests that this complication occurs early in the natural history of chronic pancreatitis. The mechanism of the splenic lesion remains unclear, the different causes advanced, mechanic, enzymatic or vascular, are discussed. None of our patients had minimal trauma emphasizing the spontaneous character of rupture. Diagnosis was a surgical discovery except in one case in which selective arteriography was of most valuable aid in confirming diagnosis preoperatively. Treatment was simple splenectomy in 2 cases and associated with distal pancreatectomy in the 2 other cases. Recovery was uneventful. A corporal pancreatic pseudocyst was treated at the same time.

Adult↗
PubMed1980

Acquired functional asplenia. Association with spontaneous rupture of the spleen and fatal spontaneous rupture of the liver in amyloidosis.

A 45-year-old woman who had lower extremity ecchymoses and vague abdominal and back complaints was found to have acquired functional asplenia manifested by Howell-Jolly bodies and poikilocytosis on peripheral blood smear. On spleen scan there was inability to take up radioactive colloid. Shortly thereafter, she was found to have a spontaneous rupture of the spleen. At operation, the spleen, liver, and periaortic lymph nodes were found to be diffusely involved with amyloidosis. Five months later, an acute, serious, intra-abdominal condition developed secondary to spontaneous rupture of the liver, and the patient died. To our knowledge, neither acquired functional asplenia nor spontaneous rupture of the liver has been reported previously in association with amyloidosis.

Amyloidosis↗
PubMedDate not supplied

Aneurysm of the membranous septum in critical pulmonary stenosis: spontaneous rupture after balloon dilatation.

We report a case of critical pulmonary valve stenosis in which congenital aneurysm of the membranous septum ruptured spontaneously after balloon dilatation of the pulmonary valve. It is considered that the chronic mechanical trauma with phasic protrusion and collapse of the aneurysm during the cardiac cycles was responsible for an aneurysm rupture.

Aneurysm, Ruptured↗
PubMed1983

Spontaneous rupture of the quadriceps tendon and patellar ligament during treatment for chronic renal failure.

The quadriceps tendon and patellar ligament rupture rarely, even when under great stress or trauma, but can rupture spontaneously in patients with chronic diseases such as gout, rheumatoid arthritis and renal disease. Several factors probably combine to weaken the tendon, including an impoverished local vascular supply, repeated microtrauma and secondary hypoparathyroidism with osteodystrophy. In the three cases reported here, one of which was bilateral, the patients were being treated for chronic renal disease; surgical repair of the tendons led to sound healing and a return to normal function of the joints.

Adult↗
PubMed2006

Peritoneal lavage with distilled water during liver resection in patients with spontaneously ruptured hepatocellular carcinomas.

Spontaneously rupture of hepatocellular carcinoma is a life threatening and worse prognosis. Not only the lower rate of resection and hemodynamic unstable, but also the hepatic failure and recurrence. Distilled water irrigation had been applied in several cancer surgeries including colon, stomach, breast, ovary, and bladder; thus had good results in lowering the tumor spreading. We applied distilled water peritoneal lavage after liver resection in patients with spontaneous rupture of hepatocellular carcinoma to define the influence of prognosis. Thirteen patients with spontaneous ruptured hepatocellular carcinoma underwent distilled water peritoneal lavage after curative liver resection (Group A). Nineteen patients with spontaneous ruptured hepatocellular carcinoma did not undergo distilled water peritoneal lavage after curative liver resection (Group B). There were 11 patients of tumor recurrence in Group B; 2 in Group A. The mean disease-free time of Group B was 2.05 +/- 0.74 years; for Group A it was 3.59 +/- 0.60 (P = 0.045). Peritoneal lavage in this series resulted in significantly better survival time for the patients in Group A (P = 0.0158). That implies distilled water peritoneal lavage during liver resection would retard the tumor recurrence and further improve the survival rate in patients with spontaneously ruptured hepatocellular carcinoma.

Carcinoma, Hepatocellular↗
PubMed1991

Ischemic necrosis: a hypothesis to explain the pathogenesis of spontaneously ruptured enterocystoplasty.

Spontaneous enterocystoplasty rupture represents a devastating and potentially fatal late complication. Previously proposed mechanisms of rupture include catheter trauma, chronic infection, avulsion of adhesions between the bowel patch and peritoneum, and chronic overdistension with elevated intravesical pressures. We have witnessed this complication 4 times in 3 patients 5 weeks to 46 months postoperatively. Tissue specimens from 3 episodes in 2 patients with detubularized sigmoid enterocystoplasties were available for histological examination. All patients had a neurogenic bladder from myelomeningocele, all had an AMS800 artificial urinary sphincter and all had a documented history of chronic distension from inadequate emptying of the augmented bladder. At exploration, all of the ruptures were found within the bowel segment near the bladder apex in an area remote from the anastomotic line. In each case tissue specimens from the rupture site showed marked vascular congestion, intramural hemorrhage, abundant hemosiderin laden macrophages, myofiber atrophy and intravascular thrombi. These features are interpreted to reflect the sequelae of vascular compromise and ischemia. We propose that enterocystoplasty rupture results from ischemia, possibly due to chronic overdistension and subsequent vascular compromise. This mechanism may account for many of the previously reported cases of enterocystoplasty rupture.

Child↗
PubMedDate not supplied

Spontaneous rupture of spleen.

Spontaneous rupture of spleen, is a rare abdominal catastrophe, during pregnancy and labour, associated with 100% maternal and foetal mortality if not diagnosed in time. An awareness about this rare entity on the part of an obstetrician leading to timely diagnosis, prompt splenectomy and proper replacement of blood provides good prognosis for mother and foetus. A rare case of spontaneous rupture of NORMAL spleen during labour with delivery of a live baby by lower segment caesarean section followed by splenectomy is presented and the literature is reviewed.

Adult↗
PubMed2004

[Management of spontaneous ruptured hepatocellular carcinoma].

Spontaneous rupture is a major life-threatening complication of hepatocellular carcinoma(HCC). Ruptured HCC often causes hypovolemic shock and hepatic hypoperfusion. Patients with impaired liver function tend to lapse into liver failure, which is the main cause of death. To prevent liver failure, accurate diagnosis and adequate treatment for the restoration of the efficient liver perfusion are required. Emergent transarterial embolization (TAE) is the most effective and less-invasive treatment for hemostasis. On the other hand, emergent hepatic resection should be avoided because of the increased risk of postoperative liver failure and incomplete resection of the tumor. After achieving hemostasis, a second-stage therapeutic approach for HCC is required. Patients with acceptable liver function should undergo surgery. The prognosis of ruptured HCC treated with second-stage hepatectomy is considered to be comparable with that of nonruptured HCC. In conclusion, spontaneous rupture of HCC is considered to be a combination of acute and severe peritoneal hemorrhage with malignant disease. To improve the prognosis, adequate early treatment for the control of hemorrhage while preserving liver function is an important factor. TAE followed by elective hepatectomy is considered the most effective treatment.

Carcinoma, Hepatocellular↗
PubMed1997

[Uterine rupture. A case of spontaneous rupture in a thirty week primiparous gestation ].

Uterine rupture is one of the major complications of pregnancy. Most spontaneous uterine ruptures occur during labor in parturients with a scarred uterus. Spontaneous rupture where the uterus is unscarred are more rare and occur more frequently in older multiparous patients. Starting from a case of uterine rupture occurring in a 40 year-old primiparous women, we will present a review of the literature concerning cases of rupture in healthy uteri with no obvious cause.

Adult↗
PubMed2004

[The clinical study on spontaneously ruptured hepatocellular carcinoma].

BACKGROUND/AIMS: Spontaneous rupture of hepatocellular carcinoma (HCC) is known as a rare but life- threatening condition because of massive blood loss into the peritoneal cavity. In the countries with high prevalence, the reported incidence of spontaneous rupture and hemorrhage ranged from 10.2% to 14.5% of patients with HCC. This study was aimed to analyze the risk factors for spontaneous rupture and prognosis in the patients with ruptured HCC. METHODS: Among 642 consecutive patients with HCC who had admitted to Gyeongsang National University Hospital from January 1998 to September 2003, spontaneous rupture of HCC occurred in 83 patients (12.9%). The medical records of the 83 patients were reviewed retrospectively, and the clinico-laboratory parameters and radiologic findings were analyzed. RESULTS: Sixty-nine out of the 83 patients were male, the mean age was 57.7 +/- 13.2 years (male, 56.8 +/- 12.9 years; female, 62.3 +/- 13.5 years). Location of tumor, Child-Pugh class and Okuda stage were the risk factors influencing spontaneous rupture of HCC, whereas the TNM stage, presence of portal vein thrombosis, and size of the tumor were not. Among the 83 patients with ruptured HCC, 51 were treated by transarterial embolization (TAE), 31 by supportive measures, and 1 by operation. The median survival time was 3.4 +/- 4.5 months in all patients with ruptured HCC, 4.9 +/- 5.1 in successful TAE, and 2.1 +/- 3.4 in supportive measure groups. CONCLUSIONS: Advanced Child-Pugh class, advanced Okuda stage, and peripheral location were the risk factors for spontaneous rupture of HCC. The prolonged survival could be achieved in patients eligible for successful transarterial embolization rather than supportive measures.

Aged↗