The American journal of emergency medicine
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The major symptoms of median arcuate ligament syndrome, celiac axis stenosis, or occlusion compressed by the median arcuate ligament include eating-associated abdominal pain and weight loss. Because celiac stenosis increases retrograde collateral blood flow from the superior mesenteric artery to the celiac artery via the pancreaticoduodenal arcade, a pancreaticoduodenal artery aneurysm could occur at a low incidence rate. Rupture of the pancreaticoduodenal artery aneurysm and hemorrhagic shock are rare. ⋯ Case 1 demonstrated severe hemorrhagic shock, whereas case 2 demonstrated moderate shock. We treated ruptured pancreaticoduodenal artery aneurysms with coil embolization. Case 3 demonstrated complete celiac occlusion and moderate hemorrhagic shock, and no aneurysm was detected.
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This study aimed to determine the clinical factors in predicting acute renal failure (ARF) in rhabdomyolysis and investigate the potential risk of renal replacement therapy (RRT). ⋯ Age, dark urine, etiologies, serum levels of blood urea nitrogen, creatinine and potassium, and initial and peak serum myoglobin levels may serve as important factors in predicting ARF in patients with rhabdomyolysis. We suggest that the appropriate cutoff value of initial serum myoglobin for predicting ARF is 600 ng/mL.
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The aim of this study is to determine the prevalence of cardiac disease and its relationship to the victim's probable intent among patients with cardiac arrest due to drowning. ⋯ Among 2166 autopsied cases of drowning, more than half were considered to be accidental, and less than one-third, suicidal. Among accidents, 14% were found to have a cardiac disease as a possible contributory factor; among suicides, the proportion was 0%. The low proportion of cases showing ventricular fibrillation was similar, regardless of the presence of a cardiac disease.
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This report presents the case of a 59-year-old man with sudden severe pain in the right lower abdomen after manually reducing the right indirect inguinal hernia who had bilateral indirect inguinal hernia for 5 years. A subsequent contrast computed tomography scan with contrast of the abdomen and pelvis revealed a significant extensive retroperitoneal hematoma at the abdomen and pelvis of the right side. ⋯ The bleeding ruptured inferior epigastric artery at the interior side of the deep inguinal ring was found, the deep inguinal ring was avulsed, ligature of the inferior epigastric artery and removal of the retroperitoneal hematoma were done, and the patient was discharged from hospital on the seventh postoperative day. This is the first report in the literature on retroperitoneal hematoma caused by manual reduction of indirect inguinal hernia.