Case Reports

Four patients (♂/♀: 1/3), aged 51, 52, 50 and 58 years old, who underwent general surgery procedures, suffered acute major blood loss intraoperatively. For the management of acute hemorrhage, 4ml/kg NaCl 7.5% were administered in each patient at the fastest possible rate through the existing intravenous line. Both standard monitoring and Oesophageal Doppler Monitoring (ODM) were applied and heart rate (HR), mean arterial pressure (BPmean), stroke volume (SV), peak velocity (PV), mean acceleration (MA) and corrected flow time (FTc) were recorded at six different phases, before blood loss (Phase 1), before and after completion of NaCl 7.5% administration (Phases 2 & 3), 10min and 20min after NaCl 7.5% administration (Phases 4 and 5) and at the end of the surgical procedure (Phase 6). Continue reading
Thoracic epidural anaesthesia (TEA) is frequently used for anaesthesia and analgesia in today's practice. Although cholecystectomy is a surgical procedure performed under general anaesthesia (GA), many studies in recent years have shown that neuraxial techniques can be used safely. We aimed to present the anaesthesia management under dexmedetomidine sedation with TEA in high-risk patients who underwent laparoscopic cholecystectomy surgeries. Both patients were of geriatric age and had several comorbidities. In patients, we preferred TEA to avoid the cardiorespiratory effects of GA. Preoperative preparation of patients with a multidisciplinary approach, cooperation, and close follow-up is essential in preventing complications. Continue reading
Choice of peritoneal dialysis over other renal replacement therapy modalities for adult critically ill patients is still limited; despite the data against it. The present article presents a case of peritoneal dialysis in a patient with intracerebral hemmorhage and reviews the relevant literature. Continue reading
Death is the reason for the existence of resuscitation. The Western definition of death has evolved continuously over the last three centuries. Today, the world recognizes two types of biological death: cardiac or “real” death (I,e. definitive cease of cardiac , respiratory and cerebral function) and encephalic death. The latter (brain death) has been accepted worldwide medically and legally as the biological state of death of the organism. Continue reading
Behçet’s Disease is a chronic autoimmune disorder manifesting mainly with mucocutaneous ulcers (mostly in the oral cavity and the genitalia), ophthalmic lesions and systemic vasculitis. Neuro-Behçet is a severe though rare form of the disease. Behçet’s Disease effect on pregnancy is controversial with higher rates of miscarriage, but with symptoms remission during peripartum period. Mouth scarring from ulcers can complicate general anesthesia rendering intubation impossible and neuro-Behçet’s CNS complications can avert general techniques. Here, we present the case of a C-section in a parturient with this uncommon disease and the anesthetic considerations. Literature review is also discussed. Continue reading
Raoultella planticola is a Gram-negative, oxidase-negative, aerobic that belongs to Enterobacteriaceae family and has a lot of similarities with Klebsiella spp. Though initially rare mentioned as an opportunistic infection, more and more reports are published. In the present article we present a case of an R. planticolla upper respiratory infection and we review the relevant literature. Continue reading
Adrenal masses in pregnancy are extremely rare. Vascular rupture or venous thrombosis are the main complications and they are also related to increased morbidity and mortality.We present a case of a parturient in the 3rd trimester of pregnancy with a sizeable adrenal mass, which was successfully and uneventfully resected. Continue reading
We present the case of a 64-year old super-obese female who underwent Open Reduction Internal Fixation (ORIF) for proximal humeral fracture, and our anaesthetic management. We performed interscalene brachial plexus block prior to induction, and general anaesthesia, following the guidelines for difficult airway. What is interesting about this case, are the technical difficulties that often arise in such obese individuals, concerning both the peripheral nerve block and the airway management. Moreover, due to those difficulties we created a systematic management plan consistent with guidelines so as to minimize the failure risk. Continue reading
Turner syndrome is a genetic disorder that was first described by Ullrich in 19301, followed by a report of a 7-women series with the phenotype of turner syndrome, “short-stature and gonadal dysgenesis”, by the American physician Henry Turner in 19382. The main phaenotypical characteristics of Turner syndrome are the short stature which is prevalent in approximately 9 out of 10 cases, the zygomandibular abnormalities, cardiovascular abnormalities, endocrine, and reproductive dysfunctions3. Continue reading
The novel coronavirus disease 2019 (COVID-19) caused by severe respiratory syndrome coronavirus 2 (SARS-CoV-2) has become a global health emergency since its declaration as a pandemic by the World Health Organization. Advanced maternal age is considered a high-risk pregnancy and therefore may affect the severity of Covid-191. Data regarding the management and outcome of a cesarean section in an extremely increased aged woman with Covid-19 disease are limited to a few case reports. In this case report, we discuss the perioperative management of an in vitro fertilization (IVF) cesarean section in a 48-year-old woman with Covid-19 infection. Continue reading
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