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Pelvic Hematoma

Pelvic Haematoma


Presentation

  • We present a case of an ulcerated perforation of the bladder caused by a large pelvic hematoma without any direct injury to the bladder in a 71-year-old woman.[ncbi.nlm.nih.gov]
  • Spontaneous hematomas are rare and can present with acute or chronic symptoms. Our patient presented with deep vein thrombosis of the lower extremity associated with a spontaneous pelvic hematoma.[ncbi.nlm.nih.gov]
  • Macroscopically, a mass of 6 cm was present impinging on the pelvi-caliceal system. Microscopically, the lesion was composed by hemorragic material with feature of an hematoma.[ncbi.nlm.nih.gov]
  • A case of a man with a massive pelvic hematoma from blunt trauma without bony fracture is presented. The pressure of the hematoma on the iliac vein prevented fluid resuscitation using this route.[ncbi.nlm.nih.gov]
  • We present 20-year-old male presenting with acute pain in lumbar and right fossa with tenderness and guarding, this case was clinically mimicking general surgical emergency.[urologyannals.com]
Pleural Effusion
  • Abdominal-pelvic CT-scan showed a small left pleural effusion, minimal ascites, left lower quadrant abdominal wall masses consistent with omental metastases, and a 9.4 x 10.3 x 9.0-cm complex left adnexal mass.[ncbi.nlm.nih.gov]
  • Initial evaluation with a chest x-ray revealed bilateral pleural effusion and basal consolidation in the right lung. She developed respiratory, renal and heart failure, requiring management in an intensive care unit.[bjuinternational.com]
Foul Smelling Discharge
  • One of the major complications of pelvic surgery is symptomatic pelvic hematoma, which can present with pain, fever, and foul smelling discharge.[clinicaltrials.gov]
  • Pelvic hematoma may be associated with pain, fever, and foul-smelling discharge. Most of what is published so far on symptomatic postoperative pelvic hematoma is limited to vaginal or abdominal hysterectomy.[omicsonline.org]
Abdominal Pain
  • Conclusion Keeping a high suspicion of abdominal haemorrhage is important if a patient on long term warfarin therapy presented with abdominal pain.[omicsonline.org]
  • Abstract In a woman patient aged 80 years under anticoagulation with dicumarol (Marcumar), abdominal pain suddenly occurred which was located on the right side as well as signs of acute bleeding.[ncbi.nlm.nih.gov]
  • He subsequently developed hematuria and complained of lower abdominal pain. On physical exam, he was found to be pale, with diffuse abdominal tenderness, guarding and tachycardia.[wjnu.org]
  • A 79-year-old woman who was taking warfarin and enoxaparin because of deep venous thrombosis reported abdominal pain after coughing. On physical examination, a mass was felt in the left side of the abdomen.[nejm.org]
  • Holmes,SJ, Yale SH, Mazz JJ, Rectus sheath hematoma as a cause of acute abdominal pain, Am Fam Physician, 2001;64(10):1681–2.[radcliffecardiology.com]
Pelvic Mass
  • Two weeks following cardiac catheterization at time of myocardial infarction a patient was noted to have a complex pelvic mass on ultrasound and serum CA-125 of 53 units per milliliter.[ncbi.nlm.nih.gov]
  • From our experience of this case, we suggest that if a pelvic mass remains as a highly suspicious haematoma through the complete diagnostic imaging and procedures, it should be managed with careful follow-up to avoid unnecessary nephrectomy.[academic.oup.com]
  • On her admission, the patient had mild fever (38 C), with slight mucocutaneous pallor, and a painless pelvic mass. This mass was reaching halfway to the umbilicus, but its size was not well defined. Her hemoglobin level was 8 g/dl.[omicsonline.org]
  • While ultrasound (US) might properly demonstrate the presence of an anterior pelvic mass, this modality may not provide a definitive diagnosis.[ispub.com]
Pelvic Pain
  • Pelvic hematoma should be strongly considered in the patient with lower abdominal, hip, or pelvic pain after blunt injury from parachute landing fall even in the absence of associated fracture.[ncbi.nlm.nih.gov]
  • All cases occurred after transvaginal hysterectomy, 25 (90%) presented with fever, 20 (71%) with pelvic pain and 5 (20%) with urinary retention. All hematomas were diagnosed by ultrasound.[ncbi.nlm.nih.gov]
  • The diagnosis of pelvic pain may also be challenging in patients with hemophilia.[spandidos-publications.com]
  • In the patient who presents with pelvic pain and has stable vital signs, the plain film is an appropriate initial imaging study.[ahcmedia.com]

Workup

  • Earlier in the day, the patient underwent ultrasound evaluation of the abdomen, as part of her workup for elevated liver enzymes found at the time of admission.[ispub.com]
  • Further workup with a pelvic computed tomography scan showed a large gluteal hematoma at the surgical site ( Figure 2 ).[healio.com]
  • […] mm Back to top Penetrating Pelvic Trauma Journal of Trauma and Acute Care Surgery:October 2016 – Volume 81 – Issue 4 – p 692–698doi: The diagnostic yield of commonly used investigations in pelvic gunshot wounds Schellenberg, Morgan CONCLUSION: In the workup[crashingpatient.com]
  • Extraperitoneal rupture can usually be managed with an indwelling bladder catheter. 11 Laboratory Workup Blood analysis should be sent for all patients with a suspected pelvic injury.[ahcmedia.com]
Left Pleural Effusion
  • Abdominal-pelvic CT-scan showed a small left pleural effusion, minimal ascites, left lower quadrant abdominal wall masses consistent with omental metastases, and a 9.4 x 10.3 x 9.0-cm complex left adnexal mass.[ncbi.nlm.nih.gov]
Mycoplasma Hominis
  • Mycoplasma hominis was isolated in pure culture from six of seven specimens taken from a retroperitoneal hematoma over a one-week period, and mycoplasmacidal antibodies were present in high titer in the convalescent-phase serum.[ncbi.nlm.nih.gov]
Pleural Effusion
  • Abdominal-pelvic CT-scan showed a small left pleural effusion, minimal ascites, left lower quadrant abdominal wall masses consistent with omental metastases, and a 9.4 x 10.3 x 9.0-cm complex left adnexal mass.[ncbi.nlm.nih.gov]
  • Initial evaluation with a chest x-ray revealed bilateral pleural effusion and basal consolidation in the right lung. She developed respiratory, renal and heart failure, requiring management in an intensive care unit.[bjuinternational.com]

Treatment

  • The transobturator tape (TOS) procedure is rapidly becoming a preferred treatment for female stress urinary incontinence due to excellent outcomes and minimal morbidity. Though rare, significant bleeding complications can occur.[ncbi.nlm.nih.gov]
  • Investigation and treatment of this diagnostic problem are uncertain. We add 6 patients with this entity to the 15 previously published cases. All 6 were clinically suspected of having cancer, and 5 underwent nephrectomy.[ncbi.nlm.nih.gov]
  • The patient was given antibiotic treatment for two weeks with subsequent good clinical improvement. Four months after the treatment, the hematoma size decreased (59.5%) and the patient was set for a continuous follow up (Figures 2 and 3).[omicsonline.org]
  • The clinical findings subsided following initiation of treatment with recombinant activated FVII (rFVIIa). The treatment included 90 mcg kg 1 every 3 h for 3 days.[spandidos-publications.com]
  • Warfarin treatment was reinitiated as small dose with adjustment of the dose during hospital stay.[omicsonline.org]

Prognosis

  • A person would have to come in immediately to be treated,” said Samadi, while noting that he has not treated Chavez and, therefore, could not be sure of the leader's prognosis.[foxnews.com]
  • The management is by laparotomy and control of hemorrhage from the bleeding point, and when the origin of the bleeding is not found, the prognosis is poor. 5 Our case was treated conservatively after excluding obvious cause by CT scan and angiography.[annsaudimed.net]
  • What Is the Prognosis for Hematoma? Blood vessels are routinely injured and may leak blood causing hematomas or blood clots. Depending upon their size and location, hematomas may be insignificant or may cause life-threatening damage.[emedicinehealth.com]
  • The location of a hematoma plays a role in its prognosis . From Reviewed by: Tova Alladice, M.D. American Board of Physical Medicine & Rehabilitation[rxlist.com]

Etiology

  • Iliopsoas haematoma leads to compression of the femoral nerve due to the developing lesion in the muscle; there is generally no traumatic etiology and the first occurrence is sudden, with intense lower abdominal or groin pain ( 9 ).[spandidos-publications.com]
  • Magnetic resonance imaging and computed tomography myelography showed that the patient had minimal lumbar stenosis ( Figure 1 ), thereby excluding lumbar stenosis as the etiology of her neurologic deficit.[healio.com]
  • Non-operative management is recommended A 67-year-old woman hospitalized for acute pulmonary failure of unknown etiology developed a one-day history of increasing lower abdominal pain and distension associated with new-onset tachycardia and hypotension[ispub.com]

Epidemiology

  • Bowen v Contents 1 Epidemiology of Hip and Pelvis Injury . . . . . . . . . . . . . . 1 Brandon Larkin 2 Physical Examination of the Hip and Pelvis . . . . . . . . . . 9 devin P. McFadden and Peter H.[books.google.es]
  • Landefeld CS, Beyth RJ (1993) Anticoagulant-related bleeding: clinical epidemiology, prediction and prevention. Am J Med 95: 315-328. Coon WW, Willis PW 3rd (1974) Hemorrhagic complications of anticoagulant therapy. Arch Intern Med 133: 386-392.[omicsonline.org]
  • Epidemiology The overall mortality rate for patients with pelvic ring fractures is approximately 6%. 2 This rate increases to 18-40% in patients with uncontrolled pelvic-related hemorrhage.[ahcmedia.com]
Sex distribution
Age distribution

Pathophysiology

  • […] discharge, diarrhea, and mild abdominal distension, and if large, even paralytic ileus.Since most studies describe fever as a common finding in women with pelvic hematomas [ 4 ], it seems that infection and/or inflammation play an important role in the pathophysiology[omicsonline.org]

Prevention

  • The pressure of the hematoma on the iliac vein prevented fluid resuscitation using this route. A pelvic hematoma should be suspected in patients with iliac vein obstruction after blunt pelvic trauma even in the absence of fractures.[ncbi.nlm.nih.gov]
  • Early recognition, prompt diverting colostomy, and aggressive wound management are necessary after open pelvic fracture to prevent local and systemic infectious sequelae of PHN.[ncbi.nlm.nih.gov]
  • Awareness of this rare condition may prevent unnecessary surgical explorations in doubtful situations.[ncbi.nlm.nih.gov]
  • It is indicated for the prevention of systemic embolism in patients with prosthetic heart valves or atrial fibrillation and for the primary and secondary prevention of venous thromboembolism [ 2 , 9 ].[omicsonline.org]

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