tailieunhanh - Báo cáo y học: "Bleeding from ruptured hepatic metastases as a cause of syncope in an octogenarian: a case report"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Bleeding from ruptured hepatic metastases as a cause of syncope in an octogenarian: a case report. | Seetho et al. Journal of Medical Case Reports 2010 4 194 http content 4 1 194 jA CASE REPORTS CASE REPORT Open Access Bleeding from ruptured hepatic metastases as a cause of syncope in an octogenarian a case report Ian W Seetho1 Simon Stinchcombe2 and Mazen M Rizeq 3 Abstract Introduction Acute hemoperitoneum as a result of hemorrhage from liver metastases is an uncommon but serious condition. The use of appropriate imaging is important in the diagnosis and can have a profound impact on subsequent management. This case is important because the presentation was of recurrent syncopal episodes with an unusual underlying cause. This case highlights the need to consider this diagnosis in the differential in patients presenting with collapse in the acute setting. Case presentation We present the case of an 85-year-old Caucasian man who was admitted following a collapse episode and was found to be persistently hypotensive despite aggressive resuscitation. An acute intra-peritoneal bleed originating from hepatic metastases from an unknown primary was identified promptly with computed tomography imaging and was subsequently managed conservatively. Conclusions This case aims to convey key teaching points A the need to consider intra-abdominal hemorrhage in the differential diagnosis when assessing patients with collapse and B the use of appropriate imaging such as computed tomography can facilitate a prompt diagnosis and appropriate management steps can then be taken accordingly. Introduction Spontaneous rupture of hepatic metastases leading to hemoperitoneum may initially present as collapse in the elderly and is a serious diagnosis. In this case report we present a patient who was admitted following recurrent syncopal episodes with clinical features of persistent hypotension. A sudden fall in his hemoglobin level suggested that an acute bleed had led to his collapse. This was an important investigation finding in determining .

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