BMJ case reports
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Case Reports
Spontaneous intraperitoneal haemorrhage from short gastric artery avulsion secondary to forceful retching.
Spontaneous intraperitoneal haemorrhage can occur in any age group. It is defined as presence of free blood in the peritoneal cavity which can results from a non-traumatic and non-iatrogenic cause. ⋯ The clinical presentation is usually non-specific; it can vary from mild abdominal pain to a shock status. We report a very rare case of a 17-year-old male patient who presented to our institution with spontaneous intraperitoneal bleeding secondary to avulsion of one of the short gastric artery following forceful retching.
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Case Reports
Subcutaneous emphysema of periorbital region after stainless steel crown preparation in a young child.
Subcutaneous emphysema occurs when air is forced beneath the tissue, leading to swelling, crepitus on palpation and has the potential to spread along the fascial planes. This report describes the youngest case of subcutaneous emphysema related to dental treatment that has been documented to date. In addition to the patient's age, the case is of interest because periorbital subcutaneous emphysema is a rarest complication of stainless steel crown procedure.
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It is unusual for pneumothorax to occur spontaneously during pregnancy. Its occurrence during or following caesarean section is extremely uncommon with only three other cases reported previously. ⋯ We report the successful management of a multigravida female patient, who developed spontaneous pneumothorax following caesarean section, performed under spinal anaesthesia. Tube thoracostomy was required for management and the patient had an uneventful recovery.
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The case report illustrates an acute myocardial infarction (MI) in a 41-year-old hypertensive woman possibly because of an intake of a combination of tranexamic acid and mefenamic acid for dysmenorrhoea and menorrhagia. There are multiple case reports of MI occurring in the setting of the use of antifibrinolytic agents including tranexamic acid. The present case serves as a warning that, even in patients with an apparently low risk for arterial thrombosis, these drugs may be implicated as a precipitant of MI.
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Traumatic injuries of the elbow in children pose a diagnostic challenge. They demand precise knowledge of radiographic anatomy, growth characteristics of healthy and injured bones as well as specific fracture dynamics in this age group. Dislocation of the elbow is rare in children, accounting for 3-6% of all childhood elbow injuries. ⋯ Diagnosis and recognition of the injury pattern was fundamental in the successful management of this case. We recommend the use of CT with three-dimensional reconstructions, to fully understand the fracture pattern and dictate subsequent reduction manoeuvres during closed manipulation. Thus preventing open surgical techniques and their associated morbidities.