Le Journal médical libanais. The Lebanese medical journal
-
Malignant hyperthermia (MHS) is a rare potentially fatal complication of general anesthesia. Anesthetic agents most frequently incriminated are succinylcholine and halogenated agents. Respiratory acidosis is the most specific and sensitive sign. ⋯ Tachycardia and/or arrhythmias often develop due to hyperkalemia and metabolic acidosis. Muscle rigidity whenever present is pathognomonic The "gold standard" test for the diagnosis of MHS is the halothane-caffeine contracture test. Dantrolene is the treatment of choice and prognosis depends on the early administration of this agent.
-
Review Case Reports
[Spontaneous splenic rupture due to heparin. Report of a case and review of the literature].
We describe in this report a case of spontaneous rupture of the spleen in a 68-year-old man on heparin therapy for cerebrovascular disease. This spontaneous splenic rupture is a rare complication of anticoagulant or thrombolytic therapy. Twenty cases were reported in the world medical literature. ⋯ It is possible that altered hemostatic mechanisms may aggravate unrecognized micro trauma to provoke a rupture of the spleen. Once the rupture is suspected, the diagnosis can be confirmed with CT scan, or ultrasound. The treatment will be mainly reversal of anticoagulation and splenectomy.
-
Management of the obstructed upper airway may be very challenging. It requires careful clinical evaluation as well as supportive laboratory data and physiologic monitoring. A team approach is essential. ⋯ Various options of intervention including endotracheal intubation, tracheotomy and transtracheal jet ventilation are discussed. The indications, advantages, disadvantages and potential complications of each of these methods are detailed. Recent advances in this field are described such as new tube material and technology, non-invasive physiologic monitoring (oxygen saturation measurements) and modifications of the surgical techniques.
-
Technological advances in optics, laser, anesthesia, and radiology have improved our ability to diagnose and treat airway obstruction in the very young. Concomitant advances in neonatology and critical care have led to an increase in laryngeal and tracheal stenosis secondary to prolonged endotracheal intubation. This manuscript presents a summary of the management of many common pediatric airway diseases.
-
A retrospective study of 27 cases of umbilical pilonidal sinus (UPNS) was conducted at the Central Military Hospital of Beirut between 1987 and 1991. In this study a simple conservative surgical technique is described by removing the dead hair and the cotton like dirt as an outpatient procedure without need for anaesthesia or hospitalization. There were 26 male and one female, a mean age of 26 years, patients were followed for a period of 2 years (1987-1991). The cure rate was 98% with only four cases which needed more than one session of treatment.