Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “ECCHYMOSIS”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 577 records · Page 32Linked to original sources
PubMed1989

[Refractory idiopathic thrombocytopenic purpura which responded to protein A column].

Currently, there is no satisfactory therapy available for patients with chronic idiopathic thrombocytopenic purpura (ITP) who are unresponsive to conventional therapeutic modalities. In this report, we describe a patient with chronic refractory ITP treated with immobilized protein A in an extracorporeal system. The patient was a 74 years old male diagnosed as ITP in 1980. Despite steroid therapy, the disease progressed and the patient exhibited ecchymosis and gum bleeding which was unresponsive to intravenous gammaglobulin therapy. Severe gastrointestinal bleeding was evident and administration of danazol was discontinued due to liver dysfunction. The patient was treated with extracorporeal protein A immunoabsorption. The patient's whole blood (200-300 ml per treatment) was separated into plasma and cellular components and the plasma was passed through an immunoabsorption column containing 200 mg of covalently bound protein A. The treated plasma and cellular components were returned to the patient. After 4 immunoabsorption treatments, the platelet counts elevated and there was evidence of improvement in gastrointestinal bleeding. This report indicates that protein A immunoabsorption therapy should be considered in patients with chronic refractory ITP.

Aged↗
PubMed1989

[Purpura fulminans. Presentation of a clinical case].

Purpura fulminans is a catastrophic febrile illness, characterized by confluent ecchymosis skin lesions, low blood pressure an disseminated intravascular coagulation. The case of 32 year old female ratify that it is not only a pediatric condition. We emphasize the importance of an early diagnosis and the adequacy of the treatment. The possible etiology is discussed.

Adult↗
PubMedDate not supplied

[The compartment syndrome].

The compartment syndrome is in fact secondary to intracompartmental hypertension which creates ischemia of the muscles, nerves, vessels, and anterior tibial and peroneal arteries in the leg. Described in the 19th century, the clinical picture is better known when progressing either in the acute form or in the chronic form. Diagnosis depends basically on the measurement of intramuscular pressure; treatment, at least initially, apart from subcutaneous aponeurotic decompression, also calls for hyperbaric oxygen therapy. The latter is particularly indicated in those cases bordering on surgical and medical treatment, for preventing deterioration and improving muscular possibilities in the post-surgical period. At the present time, the physiopathology of the condition is still poorly understood. The whiplash syndrome was well described by Martorelli and is due to rupture of the muscular veins of the calf. The clinical picture is often ambiguous and can suggest underlying phlebitis. The triad of symptoms --pain, disability and ecchymosis-- generally enables a diagnosis to be made, with treatment consisting primarily of immobilization. As for Bywaters' syndrome (crush syndrome), it is still very topical. The original description of the clinical picture by Bywaters during the bombardment of London in 1942 has been replaced by the picture resulting from large scale accidents that are part of modern society. The picture is still highly dramatic and if untreated progresses to acute renal insufficiency. Treatment has certainly changed and hyperbaric therapy (administered at two or three atmospheres) is a valid adjuvant to basic treatment and modifies the progress of the phenomenon with entirely satisfactory results.

Compartment Syndromes↗
PubMed1978

Oral manifestations of acute promyelocytic leukemia.

A study was conducted of 16 patients with acute promyelocytic leukemia. The most common oral manifestations were hemorrhagic diathesis and leukemic involvement. There was gingival bleeding, petechiae, and ecchymosis of the oral mucosa, massive infiltration-induced gingival swelling, ulcerative glossitis, swelling of the tonsils, and facial palsy. Inflammatory stomatitis also occurred. Patients with acute promyelocytic leukemia had a higher incidence and severity of oral bleeding than those with other types of acute leukemia. However, the oral findings in our series were not necessarily specific for acute promyelocytic leukemia because the same oral symptoms occur in other forms of acute leukemia.

Humans↗
PubMed1989

Medial gastrocnemius hematoma mimicking deep vein thrombosis: report of a case.

Tennis leg, strain of the medial head of the gastrocnemius muscle, may follow a trivial trauma in athletic and nonathletic activities. Complete or partial tears of the musculotendinous unit may result in a hematoma. Clinical manifestations of gastrocnemius hematoma in a 64-year-old man with local swelling, pain and tenderness that was aggravated by passive dorsiflexion of the ankle joint, mimicked deep vein thrombosis. Failure to appreciate the precedent trivial trauma and the localized swelling and ecchymosis led to delayed diagnosis and inappropriate heparinization. The definite diagnosis was established by CT scan which revealed a local soft tissue mass within the gastrocnemius consistent with a hematoma. A compartment syndrome developed the day after heparinization and was adequately treated by discontinuation of heparin, aspiration and rest. Differentiation between tennis leg and deep vein thrombosis is of paramount importance, since the etiology, treatment and prognosis of these two clinical entities are quite different. Venography is recommended as specifically diagnostic for deep vein thrombosis while CT scan for gastrocnemius hematoma.

Diagnosis, Differential↗
PubMed1988

[Hematomas of the rectus abdominis muscle. 27 cases].

A series of 27 haematomas of the rectus abdominis muscle is reported; 10 occurred under anticoagulants, 6 were spontaneous, 5 followed a trauma, and 6 were consecutive to a surgical procedure. The clinical picture was subacute in 20 cases, with abdominal pain and extensive ecchymosis, acute in 4 cases, and reduced to an abdominal mass in 3 cases. Since 1977, ultrasonography has been of considerable help in the diagnosis, which was found to be accurate in 5 out of the 10 cases seen before its introduction, and in 13 out of the 14 cases where it was used among the 17 cases recorded later. Nineteen patients were operated upon for the following reasons: 4 for cardiovascular collapse, 3 because no diagnosis had been made, 8 in order to confirm the diagnosis, 1 because of an increase in size of the haematoma and 3 owing to infection. In the 8 patients who did not undergo surgery, the haematoma followed a favourable course. The therapeutic approach must be chosen according to the patient's condition and to the size, side effects and course of the haematoma.

Abdominal Muscles↗
PubMed1988

Injection therapy for impotence.

Injection of vasoactive drugs is an effective form of treatment for selected patients with impotence from virtually all causes. The two most commonly employed drugs in the United States are either papaverine alone or various combinations of papaverine and phentolamine. Patients with organic and mixed impotence are best suited for injection treatment, but selected patients with psychogenic impotence also benefit from therapy. After the patient is selected for injection therapy, he undergoes a series of trial injections in the physician's office. The incidence of priapism will be minimized if the initially administered doses are low and the patient is titrated to an appropriate dose level. Uncontrolled trials have revealed that injection treatment produces a satisfactory erection in 65 to 100 per cent of patients for a follow-up period of as long as 2 years with minimal side effects, but the dropout rate is high. If priapism does occur, it almost always responds readily to treatment with aspiration, low doses of an alpha-adrenergic agent, or both. The other common side effects are bruising or ecchymosis and nodule formation at the injection site. This latter complication has not been noted to cause significant abnormal penile curavature necessitating cessation of the program.

Clinical Trials as Topic↗
PubMed1988

[The diagnosis of morbus maculosus in horses].

This is a review on Morbus maculosus equorum (purpura haemorrhagica) on the base of literature data and of a case report on 13 own patients. It is shown, that the clinical picture of this disease has not changed within the last 150 years. Clinical main symptoms are haemorrhagic diathesis (petechiae, ecchymosis, suggillations) as well as peripheral edema and fever. The main haematological findings are neutrophilia, mostly going along with shift to the left and lymphopenia. In the last few years thrombocytopenia was also described in some cases. Basic therapeutics are glucocorticoids and penicillins. Problems of differential diagnosis and of nomenclature are discussed.

Animals↗
PubMed1987

Postoperative sequelae and complications of rhinoplasty.

This article has overviewed complications of rhinoplasty. Generally, these complications fall into two categories: aesthetic (that is, cosmetic sequelae that may require a revision rhinoplasty) and nonaesthetic. Of the nonaesthetic complications, infection has the widest span of severity. A localized Staphylococcus aureus abscess or Pseudomonas infection of the nose may occur postoperatively. Owing to the proximity of the nose to the cranium, a cavernous sinus thrombosis or basilar meningitis may result. Postoperative toxic-shock syndrome is a rare occurrence that surgeons should be aware of; most cases have occurred with the presence of nasal packing, but a case using only plastic nasal splints has been reported also. Bacteremia seems to be uncommon during rhinoplasty. Infection after rhinoplasty is generally much less frequent than one would expect from an operation in an unsterile field. Antibiotics are frequently utilized electively. Postoperative nasal-periorbital edema and ecchymosis are regarded as unavoidable but may be lessened significantly by postoperative head elevation and cold packs. The possibility of postoperative bleeding must be evaluated by the surgeon preoperatively. This sequela usually occurs either within 72 hours postoperatively or at around 10 days postoperatively. Many different causes exist for chronic postoperative nasal obstruction, from poorly supported nasal valves closing upon inspiration to an enhanced allergic rhinitis leading to chronic nasal mucosal edema. The latter may be treated by injection of steroid into the turbinates. Among aesthetic complications, supratip prominence, saddle deformity, and persistent hump are among the more commonly reported. Supratip prominence--"polly-beak"--can be caused by inadequate reduction of tip cartilaginous or soft-tissue elements, especially in relation to the reduction of the dorsum. An over-reduced dorsum will leave an otherwise normal nasal tip with a relative prominence. An accumulation of blood or a mucous cyst occurring under the skin of the tip will produce a prominence. Poor tip projection, tip ptosis, and alar collapse are the result of overreduction of tip elements. A dislocated alar cartilage can appear as an asymmetric nasal bossa. Saddle-nose deformity occurs after overaggressive bony and/or cartilaginous hump removal. Infractured nasal bones that subsequently drop into the piriform aperture can create a bony saddle. Persistent hump is due to inadequate reduction of a bony or cartilaginous hump. If the septal cartilage reduction is disproportionate to the bony septum reduction, the appearance of either a hump or a saddle is possible.(ABSTRACT TRUNCATED AT 400 WORDS)

Consumer Behavior↗
PubMed1987

[Acute epididymitis in Schoenlein-Henoch purpura: a case report of emergency exploration].

A case of acute scrotal swelling with pain in a 4-year-old boy suffering from Schoenlein-Henoch purpura is reported. Immediate scrotal exploration revealed epididymal ecchymosis and slightly edematous spermatic cord on the right side. Spermatic cord torsion was not recognized. The testis had a normal appearance. Convalescence was uneventful. Scrotal lesion disappeared within a week. Schoenlein-Henoch purpura is systemic vasculitis, which is noticed on any site of the body including male external genitalia. Several reports mainly on the testicular lesion have been made, but the epididymal findings were obscure. This case showed the prominent lesion on the epididymis. The anatomical architecture of the epididymis suggested that the principal inflammatory change of scrotal signs of Schoenlein-Henoch purpura is epididymitis.

Acute Disease↗
PubMed1986

Chocolate cysts of the orbit.

Acute spontaneous development of proptosis and periorbital ecchymosis may be the presenting sign of an orbital lymphangioma. This benign hamartoma should not be confused with other orbital malignancies.

Child, Preschool↗
PubMed1986

Retrobulbar anesthesia and orbicularis akinesia.

After noting that simple retrobulbar injection often caused orbicularis akinesia, we evaluated this phenomenon prospectively. A total of 50 patients were given a standard injection using 3 cc of a 50-50 mixture of 0.75% bupivacaine and 2% lidocaine with epinephrine and hyaluronidase. The entire 3 cc was injected into the muscle cone through an inferolateral lid entry using a 35-mm retrobulbar needle of either 23- or 27-gauge. Injection was considered successful if orbicularis function was sufficiently reduced to proceed with an intraocular case after a single retrobulbar injection. If facial nerve block was necessary or if the patient's lid moved during surgery, then the procedure was considered a failure. Of the 50 patients, 44 achieved adequate akinesia of the orbicularis after retrobulbar injection alone, giving a success rate of 88%. Benefits of this method include lower drug volume. decreased chance for direct nerve damage during a facial nerve block, less pain, less ecchymosis, and less edema following surgery.

Anesthesia, Local↗
PubMed1986

Arthroscopy--"no-problem surgery". An analysis of complications in two thousand six hundred and forty cases.

In a retrospective review of 3,261 arthroscopic procedures on the knee, 2,640 met the criteria for inclusion in this analysis. The patients' ages ranged from eight to eighty-three years. There were 1,541 male and 1,099 female patients. Eight hundred and ninety-five of the injuries were work-related. A tourniquet was used in 1,175 procedures and the average tourniquet time was thirty minutes. There were 216 complications over-all (8.2 per cent), 126 being designated as major and ninety-seven, as minor. The major complications that were evaluated were infections, hemarthrosis, adhesions, effusions, cardiovascular, neurological, reflex sympathetic dystrophy, and instrument breakage, and the minor complications were difficulties with wound-healing and ecchymosis. Chi-square analysis showed the following factors to be significant (p less than 0.05). Patients with an industrial injury had a higher rate of neurological complications and reflex sympathetic dystrophy. Diagnostic arthroscopy had the lowest over-all complication rate. Partial medical meniscectomy was associated with a higher over-all complication rate and the highest hemarthrosis rate, and partial lateral meniscectomy was associated with the highest rate of instrument breakage. Abrasion arthroplasty had the highest rate of complications of wound-healing, and subcutaneous lateral release was associated with the most adhesions. The sex of the patient and whether or not a tourniquet had been used had no effect on complications. The experience of the surgeon with arthroscopic procedures also had no correlation with the complication rate. Multiple regression analysis showed that two factors (age and, if a tourniquet was used, the tourniquet time) were dominant predictors of complications. From these data, a model was devised for predicting which patients were at risk for complications and their relative levels of risk. Certain complications may be preventable, and for others the risk factors can be reduced. The high-risk patients in our series were fifty years old or older and had a tourniquet time of sixty minutes or longer.

Adolescent↗
PubMed1985

Purpura fulminans. Medical, surgical, and rehabilitative considerations.

Purpura fulminans is a rare catastrophic disease of childhood that begins as a seemingly benign infectious process and subsequently progresses to high fever, purpuric ecchymosis of the skin, hypotension, disseminated intravascular coagulation, and gangrene. Initial treatment consists of resuscitation with Ringer's lactate, correction of clotting parameters with heparin, avoidance of adrenergic agents, and monitoring of limbs for compartment syndromes. Of 12 patients reported here, three had fasciotomies to limit the ischemic changes, but eventually 24 amputations were performed on the group as a whole. Delayed debridement of up to three weeks was the rule in order to allow ischemic tissue to fully demarcate. Split-thickness skin grafts were used to preserve as much length as possible, particularly where open growth plates were involved. Regardless of how hopeless the situation may initially appear, with prompt recognition and institution of appropriate care the prognosis for a productive life is good.

Adolescent↗
PubMedDate not supplied

Grand rounds. Immune globulin in the treatment of autoimmune thrombocytopenic purpura.

Two patients with autoimmune thrombocytopenic purpura (ATP) who received high-dose intravenous immune globulin before undergoing splenectomy are described, and the pathogenesis, clinical presentation, diagnosis, and treatment of chronic ATP are reviewed. One patient was a 62-year-old white man who was admitted to the hospital with a history of thrombocytopenia and probable steroid-induced diabetes mellitus. The second patient was a 24-year-old black woman who was admitted for recurrent bleeding episodes and splenectomy. In both patients, immune globulin 1.5 g/kg administered over four to six days resulted in marked elevations of platelet counts. ATP is a platelet disorder of unknown etiology. Platelets with surface-bound antiplatelet antibody are destroyed by the reticuloendothelial system. As the platelet count falls below 30,000-50,000/cu mm, the patient may manifest signs of bleeding such as petechiae, purpura, ecchymosis, menorrhagia, epistaxis, and bleeding from other mucosal surfaces. Corticosteroids are the initial treatment of choice. Splenectomy is considered for children with the life-threatening hemorrhage and for patients who do not respond to corticosteroids. Patients who are refractory to steroid therapy and splenectomy may respond to immunosuppressant agents. Approximately, 80% of patients treated with immune globulin have responded with an increase in platelet count, although this increase is sometimes transient. Immune globulin therapy is recommended for emergency treatment of ATP, as preoperative medication before splenectomy, and for young children in order to postpone splenectomy. Despite a good response to treatment, immune globulin therapy should not be considered a cure for ATP.

Adrenal Cortex Hormones↗
PubMedDate not supplied

[Neuroblastoma metastatic to the skull. Radiologic aspects and therapeutic problems].

Clinical-radiological findings, treatment and prognosis of cranial involvement in 19 cases of neuroblastoma stage IV have been considered. The most frequent clinical features were periorbital ecchymosis and intracranial hypertension. The radiographic aspects, graduated according to the type of the lesion, showed a close correlation with clinical findings and sometimes preceded them. Computerized tomography, carried out in 12 cases, was more reliable than plain films in identifying the site and extent of cranial lesions and the presence of cerebral extensions, as occurred in 2 patients. The presence of cranial involvement at diagnosis was an unfavorable prognostic sign. The 19 children were treated in various ways so that firm conclusions cannot be drawn, but cranial radiotherapy in combination with chemotherapy appeared to be more efficacious than chemotherapy alone.

Combined Modality Therapy↗
PubMed1979

Drifting hematomas.

When blood is released into the tissues of the lower extremities, it may drift downward under the influence of the force of gravity to produce the influence of the force of gravity to produce pain, edema, redness and heat. A crescent shaped ecchymosis may appear around the malleoli. The relationship between cause and effect may be obscured by a time interval of up to four weeks before conclusive signs are seen. Early differentiation of this condition from that of phlebitis and deep venous thrombosis is necessary. Such differentiation prevents inappropriate and potentially dangerous anticoagulation as well as the disastrous consequences of untreated edema of the legs. With prompt, appropriate treatment, complete recovery can be expected. If treatment is delayed, permanent damage to the leg can result.

Adult↗
PubMed1981

Ultrasonography in the diagnosis of rectus abdominis hematoma.

Because bleeding into the rectus sheath may give a clinical picture simulating an acute abdomen, it is essential that an accurate diagnosis be made so that an unnecessary laparotomy is not performed. Plain films do not give adequate information and computerized axial tomography is not always available, but ultrasonography, which is noninvasive and is readily available, provides an accurate diagnosis as in the case reported in this paper. A 57-year-old woman had bilateral hematomas of the rectus sheath that did not occur simultaneously. She had a chronic debilitating disease as do the majority of such patients. Long-term cortisone therapy with secondary breakdown of connective tissue was probably the predisposing factor. During a blood transfusion that was needed following operation for osteomyelitis the patient had a severe reaction accompanied by sudden onset of severe abdominal pain on the left side. Ultrasonography confirmed the tentative diagnosis of rectus sheath hematoma. The patient was treated conservatively. The pain subsided within a few days leaving an ecchymosis. Two weeks later she experienced a similar pain on the right side which was also diagnosed by ultrasonography as a rectus sheath hematoma. Again, with conservative treatment the pain subsided leaving discolouration of the skin. The authors stress the value of ultrasonography in diagnosing rectus sheath hematoma and the importance of conservative management.

Abdominal Muscles↗