Hemorrhagic shock with delayed retroperitoneal hemorrhage after deployment of an inferior vena cava filter: report of a case.
ABSTRACT Although inferior vena cava (IVC) filter placement has demonstrated an excellent therapeutic efficacy in preventing pulmonary embolism, several filter-related complications have been reported. Among them, retroperitoneal hemorrhage due to IVC perforation is one of the most serious complications. We report herein a female patient who underwent TrapEase IVC filter placement with anticoagulation and thrombolytic therapy for treatment of pulmonary embolism, and later demonstrated hemorrhagic shock 5 days after filter placement. The patient's blood pressure stabilized after the anticoagulant therapy was stopped and she received a blood transfusion. We should therefore carefully observe patients after IVC filter placement, particularly those receiving simultaneous anticoagulation therapy.
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ABSTRACT: Postoperative hemorrhage (PH) is rare, but it is widely recognized as a postoperative complication of a hemorrhoidectomy. The assessment of this complication may provide information which can be used to improve the clinical outcome of a patient who has undergone a hemorrhoidectomy. Between January 2006 and December 2007, a total of 1294 patients with symptomatic hemorrhoids underwent a hemorrhoidectomy at our hospital. The patient records were retrospectively analyzed. In this study, 23 patients had suffered from PH and had undergone a second operation (1.7%). The bleeding points were located as follows: 14 anterior,7 right laterally, 8 left laterally, and 2 posteriorly. Of these patients with early hemorrhage, 1 case was at the anterior, 1 was left lateral, and 2 were posterior. A significant correlation was observed between the period and the location of postoperative hemorrhage (P = 0.0023). From one to four piles were excised (1 in 264 patients, 2 in 240 patients, 3 in 702 patients, 4 in 88 patients). A significant correlation was also observed between the number of piles and the occurrence of PH (P = 0.032). At the posterior wall, a late period hemorrhage is less likely to be found than an early period hemorrhage. It was found that the more piles that were excised, the greater the occurrence of PH.Surgery Today 10/2009; 39(10):866-9. DOI:10.1007/s00595-009-3971-3 · 1.21 Impact Factor
- Journal of vascular and interventional radiology: JVIR 09/2009; 20(8):1102-4. DOI:10.1016/j.jvir.2009.05.001 · 2.15 Impact Factor
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ABSTRACT: To verify the penetration of struts and hooks of two inferior vena cava (IVC) filters (Günther tulip retrievable filter [GTF] and Celect filter) through the vena cava wall and to assess local or systemic complications resulting from this penetration. Eight IVC filters were placed in the IVC of four ewes for 30 days (1 GTF and 1 Celect filter in each ewe). Angiographic and laparoscopic examinations of the animals were performed to demonstrate the penetration through the vena cava wall, and the filters were removed under laparoscopic control. Specimens were extracted for anatomicopathological and histologic examination. Two-projection cavography showed a filter leg seemingly out of the vena cava in 19 of 32 legs (59.3%). Laparoscopy showed 7 real penetrating legs (5 Celect filters and 2 GTFs) out of the 14 legs that could be identified by laparoscopy owing to technique limitations. Neither laparoscopy nor necropsy showed any sign of wall hemorrhage or other injuries. Histologic examination showed intimal remodeling and slight thickening of adventitial tissue around filter legs. GTFs and Celect filters can produce a real penetration 1 month after implantation. This penetration did not lead to any complications in the IVC or surrounding tissues and did not compromise the subject's health in any of the studied cases.Journal of vascular and interventional radiology: JVIR 06/2011; 22(6):851-6. DOI:10.1016/j.jvir.2010.12.042 · 2.15 Impact Factor