Case Reports

The aim of this case report is to demonstrate the efficacy and safety of Continuous Spinal Anesthesia (CSA) in an elderly patient with severe Chronic Obstructive Pulmonary Disease (COPD), who was scheduled for elective laparoscopic cholecystectomy.CSA can be used to provide a sufficient block in order to allow laparoscopic cholecystectomy to be performed even in patients with severely abnormal respiratory function. Safety, efficacy and a decreased need for postoperative analgesia render this approach a valid option for patients with symptomatic gallstone disease, who are poor candidates for general anesthesia due to cardiorespiratory or airway problems as well as for patients with other contraindications for general anesthesia.

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Syncope is a common complaint in clinical medical care. Except of neurological disorder, most of the patients havea brief benign clinical course with spontaneous recovery. Etiology may range from benign disorders to severe life-threatening diseases.Syncope as the leading symptom in patients suffering from intrathoracic neoplasm is uncommon. A rare case of a giant pleural solitary fibrous tumor causing recurrent episodes of syncope is presented. Diagnostic considerations and therapeutic strategy are discussed.

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Posterior Reversible Encephalopathy Syndrome (PRES) is a newly recognised clinical entity, accompanied by characteristic depicted findings. Disturbance of consciousness levels, spasms, vomiting and cortical blindness are the clinical manifestations of the syndrome, while the main causes are hypertensive encephalopathy, renal failure, immunosuppressive and cytotoxic drugs. PRES may be displayed with reversible damage (white matter edema), while if infarcts happen, damage is considered irreversible or neuronal. Early MRI and Diffusion-Weighted MRI (DW-MRI) provide instant information, directly related to a prognosis, as DW-MRI can separate the vasogenic edema from the cytotoxic one, which is accompanied by early infarcts.

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We present two cases of pregnant women with placenta percreta invading the bladder, along with a short review of the literature. The two women sustained early and late major haemorrhagic complications requiring massive transfusion (up to 142 PRBC and 353 blood product units) and urgent reoperation. They were both treated in the ICU and discharged in good state.

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