Le Journal médical libanais. The Lebanese medical journal
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Review Case Reports
Intrathoracic transverse colon and small bowel infarction in a patient with traumatic diaphragmatic hernia. Case report and review of the literature.
Herniation of abdominal contents through the diaphragm has been described for a variety of diaphragmatic defects and may be secondary to diaphragmatic injury, either traumatic or iatrogenic. The sequelae of diaphragmatic hernia include intestinal obstruction, strangulation, gangrene and, eventually, perforation. The aim of this study was to report a case of intrathoracic infarction of transverse colon and two meters of small bowel in a patient with traumatic diaphragmatic hernia. ⋯ Surgeons, internists and emergency medicine personnel should be aware of the possibility of diaphragmatic hernia in patients with a known history of abdominal trauma. Though uncommon, strangulation of colon and small bowel through a rent in diaphragm should be considered when there is radiologic evidence of herniation.
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Case Reports
Acute limb ischemia secondary to heparin-induced thrombocytopenia after cardiac surgery.
Heparin-induced thrombocytopenia is an important and sometimes life-threatening immunological drug reaction. About 2.5% of patients receiving heparin develop immune-mediated (type II) heparin-induced thrombocytopenia that may be complicated by a paradoxical thrombotic syndrome either arterial or venous. This severe syndrome carries relevant rates of mortality and morbidity secondary to cerebral, myocardial and limb infarction. ⋯ Early recognition of heparin-induced thrombocytopenia syndrome has allowed for significant advances in therapy leading to marked reduction in mortality and morbidity. Recently, available thrombin inhibitor drugs have dramatically changed outcomes for patients having this severe syndrome.