Acute Fatty Liver of Pregnancy: A Life-Threatening Condition Requiring a Life-Saving Approach

Acute Fatty Liver of Pregnancy (AFLP) is a rare but catastrophic disease affecting women in pregnancy. It usually occurs in the third trimester or post-partum period. Delay in diagnosis is associated with morbid complications with high morbidity and mortality. We report a case of 24 years old female at 38 weeks period of gestation who presented with jaundice, vomiting for 3 days and deranged liver function test. She was diagnosed as acute fatty liver of pregnancy and was delivered by instrumental delivery but required cesarean hysterectomy due to postpartum hemorrhage. She started improving with supportive care and discharged after 4 weeks of hospital stay. Key words: AFLP, Hysterectomy, Postpartum hemorrhage

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Acute Fatty Liver of Pregnancy

Journal of Interdisciplinary Medicine ◽

10.2478/jim-2020-0001 ◽

2020 ◽

Vol 5 (1) ◽

pp. 23-26

Author(s):

Lucian Gheorghe Pop ◽

Ioan Dumitru Suciu ◽

Nicolae Suciu ◽

Oana Daniela Toader

Keyword(s):

Fatty Liver ◽

Correct Diagnosis ◽

Acid Oxidation ◽

Mitochondrial Fatty Acid Oxidation ◽

Fetal Survival ◽

Mitochondrial Fatty Acid ◽

Threatening Condition ◽

Life Threatening ◽

Acute Fatty Liver ◽

Lchad Deficiency

AbstractAcute fatty liver of pregnancy (AFLP) is a rare but life-threatening condition that develops in the third trimester of pregnancy. AFLP shares similar clinical features with other more common pregnancy-associated conditions. However, early correct diagnosis is important for maternal and fetal survival. Once the diagnosis has been established, immediate delivery and maternal intensive support should be undertaken. Both parents and the infant should be tested for deficiencies of the mitochondrial fatty acid oxidation, especially for long-chain 3-hydroxyacyl-CoA dehydrogenase (LCHAD) deficiency, as many cases of AFLP are related to disruption of this physiological enzymatic pathway.

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Myelodysplastic Syndrome Clinically Presenting with the “Classic TTP Pentad”

Case Reports in Hematology ◽

10.1155/2017/4619406 ◽

2017 ◽

Vol 2017 ◽

pp. 1-6 ◽

Cited By ~ 1

Author(s):

Santiago Fabián Moscoso Martínez ◽

Evelyn Carolina Polanco Jácome ◽

Elizabeth Guevara ◽

Vijay Mattoo

Keyword(s):

Myelodysplastic Syndrome ◽

Clinical Presentation ◽

Renal Involvement ◽

Medical Emergency ◽

Complete Blood Cell Count ◽

Blood Cell Count ◽

Thrombocytopenic Purpura ◽

Life Saving ◽

Threatening Condition ◽

Life Threatening

The clinical presentation of myelodysplastic syndrome (MDS) is not specific. Many patients can be asymptomatic and can be detected only due to an abnormal complete blood cell count (CBC) on routine exam or for other reasons while others can be symptomatic as a consequence of underlying cytopenias. Thrombotic thrombocytopenic purpura (TTP) usually is suspected under the evidence of microangiopathic hemolytic anemia (MAHA) and thrombocytopenia and because it is a life-threatening condition (medical emergency) immediate initiation of plasmapheresis could be life-saving. The following case illustrates an unusual presentation of MDS in a patient who came in to the emergency room with the classic TTP “pentad” of fever, renal involvement, MAHA, mental status changes, and thrombocytopenia. We will focus our discussion in the clinical presentation of this case.

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Ruptured aneurysm of the hepatic artery: a mismatching diagnosis

Italian Journal of Medicine ◽

10.4081/itjm.2009.175 ◽

2013 ◽

pp. 175-178

Author(s):

Vincenzo Bua ◽

Lorenzo Marsigli ◽

Roberto Nardi ◽

Anna Maria Trivella ◽

Salvatore Isceri ◽

...

Keyword(s):

Hepatic Artery ◽

Ct Scanning ◽

Gelatin Sponge ◽

Contrast Enhanced Ct ◽

Life Saving ◽

Contrast Enhanced ◽

Enhanced Ct ◽

Threatening Condition ◽

Life Threatening ◽

Intraabdominal Hemorrhage

Background: Hepatic aneurysms are extremely rare with very few cases reported, and most have been source of misdiagnosis and clinical pitfalls in emergency medicine. Presentation with intraabdominal hemorrhage is associated with a high mortality rate. Case report: We report the case of an adult male, referred for a severe acute pain in the left lower chest-upper quadrant abdomen pain. We present multislice contrast-enhanced CT-scanning and angiographic findings, and a life-saving emergency trancatheter embolization, using fragments of absorbable gelatin sponge. Emergency doctors should consider ruptured hepatic artery aneurysms in the differential diagnosis of acute abdominal pain and promptly cooperate with endovascular specialists to treat this life-threatening condition.

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Laparoscopic Splenectomy for Atraumatic Splenic Rupture

International Surgery ◽

10.9738/1382.1 ◽

2011 ◽

Vol 96 (1) ◽

pp. 87-89 ◽

Cited By ~ 2

Author(s):

Ugo Grossi ◽

Antonio Crucitti ◽

Gerardo D'Amato ◽

Andrea Mazzari ◽

Pasquina M. C. Tomaiuolo ◽

...

Keyword(s):

Laparoscopic Splenectomy ◽

Splenic Rupture ◽

Clinical Entity ◽

Rare Clinical Entity ◽

Life Saving ◽

Threatening Condition ◽

Life Threatening ◽

Atraumatic Splenic Rupture ◽

Prompt Diagnosis

Abstract Atraumatic splenic rupture (ASR) is a rare clinical entity. Several underlying benign and malignant conditions have been described as a leading cause. We report on a case of ASR in a 41-year-old man treated with laparoscopic splenectomy. Considering ASR as a life-threatening condition, a prompt diagnosis can be life saving.

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X-RAY ENDOVASCULAR OCCLUSION IN ACUTE ARTERIAL BLEEDINGS FROM UPPER PARTS OF THE GASTROINTESTINAL TRACT IN CHILDREN

Russian Journal of Pediatric Surgery ◽

10.18821/1560-9510-2018-22-1-17-20 ◽

2018 ◽

Vol 22 (1) ◽

pp. 17-20

Author(s):

I. A. Komissarov ◽

N. A. Borisova ◽

M. I. Komissarov ◽

Ivan Yu. Aleshin

Keyword(s):

Gastrointestinal Tract ◽

X Ray ◽

Endovascular Occlusion ◽

Arterial Bleeding ◽

Life Saving ◽

Surgical Methods ◽

Threatening Condition ◽

Child Patient ◽

Life Threatening ◽

Endoscopic Methods

Acute arterial bleeding from the upper gastrointestinal tract (GIT) is a rare and life-threatening condition in children. The main method of instrumental examination in gastrointestinal hemorrhage (GIH) is fibro-esophagogastroduodenoscopy. If endoscopic diagnostics and hemostasis are ineffective, there are used other diagnostic and surgical methods of the treatment, which are associated with a high incidence of complications and high lethality. Methods of X-ray endovascular surgery, such as embolization of the arteries of the gastrointestinal tract, are life-saving and allow avoid severe traumatic surgical intervention. However, reports about the implementation of these methods in children are rare. We examined and treated 12 children with massive upper arterial GIHs. In 6 children it was managed to stop bleeding with the help of conservative and endoscopic methods of hemostasis. In 6 patients, these methods were ineffective, and they were underwent X-ray endovascular occlusion (XREO) of the blood vessels of the digestive tract. In 5 cases, embolization helped stop the bleeding after the first procedure, one child needed a repeat procedure for another source of the localization. In 6 cases, spirals were used as an embolization material, an autohemulation and microemboli were used in a one child patient. There were no complications associated with X-ray endovascular intervention. XREO is a minimally invasive and highly effective method of stopping the massive upper arterial GIH and can be performed even in children in extremely serious condition.

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Acute fatty liver of pregnancy associated with pancreatitis: A life-threatening complication

American Journal of Obstetrics and Gynecology ◽

10.1016/j.ajog.2003.09.022 ◽

2004 ◽

Vol 190 (2) ◽

pp. 502-505 ◽

Cited By ~ 47

Author(s):

Julie S. Moldenhauer ◽

John M. O'Brien ◽

John R. Barton ◽

Baha Sibai

Keyword(s):

Fatty Liver ◽

Life Threatening ◽

Acute Fatty Liver ◽

Life Threatening Complication

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Considerations on Liver Injuries Caused by CPR Case Presentation

The Bulletin of Legal Medicine ◽

10.17986/blm.2015210947 ◽

2015 ◽

Vol 20 (2) ◽

pp. 104-108

Author(s):

Beatrice Ioan ◽

Bianca Hanganu ◽

Marius Neagu

Keyword(s):

Cardiac Arrest ◽

Cardiac Activity ◽

Cardiac Massage ◽

Injury Death ◽

Emergency Team ◽

Cardio Pulmonary Resuscitation ◽

Life Saving ◽

Threatening Condition ◽

Life Threatening ◽

Intraperitoneal Bleeding

Cardiac arrest is a life-threatening condition which requires fast maneuvers for saving the victim’s life. Cardio-pulmonary resuscitation (CPR) is one of the easiest and handiest maneuver which proved many times to be savior even though sometimes it could worsen the victim’s prognosis. In this paper the authors present the case of a 75-year old male, with a significant medical history and long term thrombolytic treatment who suffered a witnessed cardiac arrest. The emergency team who arrived at the victim’s home initiated the CPR and transported him to the hospital. The electrocardiogram showed inferior-lateral acute myocardial infarction and the cardiologist in the emergency room decided to transfer him to another hospital for specialized treatment. Despite the fact that the CPR was continued in the ambulance in order to maintain the cardiac activity, the blood pressure decreased gradually and he died couple of hours later. Internal examination at the autospy revealed multiple injuries caused by the cardiac massage: rib and sternum fractures, massive intraperitoneal bleeding, liver laceration and contusion. This paper brings to the attention of the physicians the issue of the iatrogenic injuries following the CPR and the possibility for these injuries to contribute to thanatogenesis. The authors also analyze the factors influencing the quality of the life-saving procedures and the role of the pathologist in establishing the correct cause of death taking into the gravity of the CPR related injuries.Keywords: CPR, liver injury, death

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Percutaneous Mechanical Support in Cardiogenic Shock: A Review

Clinical Medicine Insights Cardiology ◽

10.4137/cmc.s19707 ◽

2015 ◽

Vol 9s2 ◽

pp. CMC.S19707

Author(s):

Fahad Syed Gilani ◽

Sarah Farooqui ◽

Rajiv Doddamani ◽

Luis Gruberg

Keyword(s):

Cardiogenic Shock ◽

Pharmacological Therapy ◽

Mechanical Support ◽

Significant Morbidity ◽

First Line ◽

Life Saving ◽

Threatening Condition ◽

Life Threatening ◽

Hemodynamic Improvement ◽

Support Devices

Cardiogenic shock (CS) is a life-threatening condition associated with significant morbidity and mortality. Pharmacological therapy is often the first line of treatment but mechanical support can provide substantial hemodynamic improvement in refractory CS. Percutaneous mechanical support devices are placed in a minimally invasive manner and provide life-saving assistance to the failing myocardium. We review the percutaneous devices currently available, the evidence behind their use, and the new advances in percutaneous technology being evaluated for the treatment of CS.

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Familial and Acquired Hemophagocytic Lymphohistiocytosis

Hematology ◽

10.1182/asheducation-2005.1.82 ◽

2005 ◽

Vol 2005 (1) ◽

pp. 82-88 ◽

Cited By ~ 110

Author(s):

Gritta Janka ◽

Udo zur Stadt

Keyword(s):

Hemophagocytic Lymphohistiocytosis ◽

Clinical Symptoms ◽

Cytotoxic T Cells ◽

Interleukin 2 ◽

Life Saving ◽

Threatening Condition ◽

Immune Deficiencies ◽

Life Threatening ◽

Infected Cells ◽

Cardinal Symptoms

AbstractHemophagocytic lymphohistiocytosis (HLH) is a life-threatening condition characterized by uncontrolled hyperinflammation on the basis of various inherited or acquired immune deficiencies. Cardinal symptoms are prolonged fever, hepatosplenomegaly and cytopenias. Central nervous system (CNS) symptoms are common. Biochemical markers include elevated triglyceride and ferritin, high levels of the α chain of the soluble interleukin-2 receptor and low fibrinogen. Impaired function of natural killer (NK) cells and cytotoxic T-cells (CTL) is a characteristic of all forms of HLH.Genetic HLH occurs in familial forms (FHLH), in which HLH is the primary and only manifestation, and in association with the immune deficiencies Chédiak-Higashi syndrome (CHS), Griscelli syndrome (GS) and X-linked lymphoproliferative syndrome (XLP), in which secondary HLH occurs sporadically. Most patients with acquired HLH have no known underlying immune deficiency. Both acquired and genetic forms are triggered by infections, mostly viruses, or other stimuli. HLH also occurs as a complication of rheumatic diseases (macrophage activation syndrome) and of malignancies. The recent discovery of several genetic defects causing FHLH as well as the identification of the genes responsible for CHS, GS and XLP have underscored the role of granule (perforin/granzymes)-mediated cytotoxicity in both the killing of infected cells and the termination of the immune response. The immediate aim of therapy is suppression of the increased inflammatory response by immunosuppressive/immunomodulatory agents and cytotoxic drugs. Genetic cases can only be cured with stem cell transplantation. Awareness of the clinical symptoms and of diagnostic criteria for HLH is crucial to starting life-saving therapy in time.

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