K. Tamehiro, T. Tsuru, H. Koga, Hiroji Shima, Hisashi Kuroda, Masaya Tanaka, K. Taki
A of We herein report on a case in which cardiopulmonary arrest (CPA) was caused due to tension pneumoperitoneum during upper gastrointestinal endoscopy, and the patient was successfully treated by carrying out prompt decompression. The patient was a 63-year-old male. He suffered from epigastralgia and had previously consulted another doc-tor. CPA took place during upper gastrointestinal endoscopy, and he was transported to our institute under cardiopulmonary resuscitation. Over-swelling of the jugular vein and abdominal distension were observed. He was diagnosed to have tension pneumoperitoneum, which occurred during upper gastrointestinal endoscopy. Tube drainage was carried out promptly. Soon after the treatment, his abdomen became flat and a return of spontaneous circulation was observed. He underwent an omental implantation repair and received intensive care after the surgery. The patient was discharged without any aftereffects. Tension pneumoperitoneum is a very rare disease and there are only a few reports on this occurrence. We should keep in mind that its occurrence requires a high degree of urgency. Moreover, a good prognosis may be possible by carrying out accurate BLS, making a timely diagnosis, and performing decompression promptly, even in cases of CPA.
{"title":"A case of tension pneumoperitoneum in which Basic Life Support and prompt decompression was successful","authors":"K. Tamehiro, T. Tsuru, H. Koga, Hiroji Shima, Hisashi Kuroda, Masaya Tanaka, K. Taki","doi":"10.3893/JJAAM.25.734","DOIUrl":"https://doi.org/10.3893/JJAAM.25.734","url":null,"abstract":"A of We herein report on a case in which cardiopulmonary arrest (CPA) was caused due to tension pneumoperitoneum during upper gastrointestinal endoscopy, and the patient was successfully treated by carrying out prompt decompression. The patient was a 63-year-old male. He suffered from epigastralgia and had previously consulted another doc-tor. CPA took place during upper gastrointestinal endoscopy, and he was transported to our institute under cardiopulmonary resuscitation. Over-swelling of the jugular vein and abdominal distension were observed. He was diagnosed to have tension pneumoperitoneum, which occurred during upper gastrointestinal endoscopy. Tube drainage was carried out promptly. Soon after the treatment, his abdomen became flat and a return of spontaneous circulation was observed. He underwent an omental implantation repair and received intensive care after the surgery. The patient was discharged without any aftereffects. Tension pneumoperitoneum is a very rare disease and there are only a few reports on this occurrence. We should keep in mind that its occurrence requires a high degree of urgency. Moreover, a good prognosis may be possible by carrying out accurate BLS, making a timely diagnosis, and performing decompression promptly, even in cases of CPA.","PeriodicalId":19447,"journal":{"name":"Nihon Kyukyu Igakukai Zasshi","volume":"6 1","pages":"734-738"},"PeriodicalIF":0.0,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84327311","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
In addition to pathogen-associated molecular patterns (PAMPs) from invasive microorganisms, alarmins, which are major components of host defense mechanisms, are involved in the pathophysiology of sepsis. In fact, the magnitude of the insult is defined according to the damage-associated molecular pattern (DAMP), which is composed of alarmins as well as PAMPs, such as those involving the nucleosome, histones and DNA. Regarding the antimicrobial mechanism of neutrophils, an alternative non-phagocytic mechanism was first recognized as NETosis in 2004. In this mechanism, microorganisms are trapped and eliminated by neutrophil extracellular traps (NETs). NETs are composed of histones and DNA that have been expelled from the nucleus as well as antimicrobial proteases, includ-ing elastase and myeloperoxidase. NETosis, a cell-death pathway reported to be distinct from apoptosis, is an active area of recent research. Since NETs are composed of deleterious substances, they are extremely harmful to the host cells once they released into the circulating blood. Therefore, the meanings and putative roles of these components in sepsis has attracted much attention. (JJAAM. 2013; 24:
{"title":"敗血症におけるneutrophil extracellular traps（NETs），damage-associated molecular patterns（DAMPs），そして細胞死","authors":"M. Murai, Isao Nagaoka, Yoko Tabe","doi":"10.3893/JJAAM.24.827","DOIUrl":"https://doi.org/10.3893/JJAAM.24.827","url":null,"abstract":"In addition to pathogen-associated molecular patterns (PAMPs) from invasive microorganisms, alarmins, which are major components of host defense mechanisms, are involved in the pathophysiology of sepsis. In fact, the magnitude of the insult is defined according to the damage-associated molecular pattern (DAMP), which is composed of alarmins as well as PAMPs, such as those involving the nucleosome, histones and DNA. Regarding the antimicrobial mechanism of neutrophils, an alternative non-phagocytic mechanism was first recognized as NETosis in 2004. In this mechanism, microorganisms are trapped and eliminated by neutrophil extracellular traps (NETs). NETs are composed of histones and DNA that have been expelled from the nucleus as well as antimicrobial proteases, includ-ing elastase and myeloperoxidase. NETosis, a cell-death pathway reported to be distinct from apoptosis, is an active area of recent research. Since NETs are composed of deleterious substances, they are extremely harmful to the host cells once they released into the circulating blood. Therefore, the meanings and putative roles of these components in sepsis has attracted much attention. (JJAAM. 2013; 24:","PeriodicalId":19447,"journal":{"name":"Nihon Kyukyu Igakukai Zasshi","volume":"273 1","pages":"827-836"},"PeriodicalIF":0.0,"publicationDate":"2013-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75918931","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A case of blunt hepatic injury with spontaneous resolution of two delayed hepatic pseudoaneurysms depicted on multidetector-row CT Atsuhiko Onaka, Keisuke Takano, Hiroyasu Oka, Toru Ueyama Masanori Matsusaka, Tatsuya Nakamura Emergency and Critical Care Center, Nara Prefectural Nara Hospital There have been few reports on spontaneous resolution of pseudoaneurysms after blunt hepatic injury. We report a case of blunt hepatic injury with spontaneous resolution of two delayed pseudoaneurysms depicted on multidetectorrow CT (MDCT). The patient was a 17-year-old male with hepatic injury after a motorcycle accident. Initial MDCT showed a complex deep hepatic injury, and there was no extravasation and no pseudoaneurysm on angiography. On a following MDCT, delayed formation of a 6-mm pseudoaneurysm on the 12th day after injury and a spontaneous resolution on the 19th day after injury were seen. Moreover, another 4-mm pseudoaneurysm was depicted on the 19th day after injury and disappeared on the 26th day after injury on MDCT. In this patient, pseudoaneurysms observed on arterial phase MDCT images were not be visualized in the portal venous phase, and arterial phase MDCT images were useful to demonstrate spontaneous resolution of delayed pseudoaneurysms. Arterial phase MDCT images could improve the detection of pseudoaneurysms. To evaluate pseudoaneurysms after blunt hepatic injury properly, arterial phase MDCT images are essential. (JJAAM. 2013; 24: 231-6)
{"title":"Multidetector-row CTにより2個の遅発性仮性動脈瘤の自然消失を描出し得た鈍的肝損傷の1例","authors":"敦彦 尾中, 啓佑 高野, 宏保 岡, 徹 植山, 正訓 松阪, 達也 中村","doi":"10.3893/JJAAM.24.231","DOIUrl":"https://doi.org/10.3893/JJAAM.24.231","url":null,"abstract":"A case of blunt hepatic injury with spontaneous resolution of two delayed hepatic pseudoaneurysms depicted on multidetector-row CT Atsuhiko Onaka, Keisuke Takano, Hiroyasu Oka, Toru Ueyama Masanori Matsusaka, Tatsuya Nakamura Emergency and Critical Care Center, Nara Prefectural Nara Hospital There have been few reports on spontaneous resolution of pseudoaneurysms after blunt hepatic injury. We report a case of blunt hepatic injury with spontaneous resolution of two delayed pseudoaneurysms depicted on multidetectorrow CT (MDCT). The patient was a 17-year-old male with hepatic injury after a motorcycle accident. Initial MDCT showed a complex deep hepatic injury, and there was no extravasation and no pseudoaneurysm on angiography. On a following MDCT, delayed formation of a 6-mm pseudoaneurysm on the 12th day after injury and a spontaneous resolution on the 19th day after injury were seen. Moreover, another 4-mm pseudoaneurysm was depicted on the 19th day after injury and disappeared on the 26th day after injury on MDCT. In this patient, pseudoaneurysms observed on arterial phase MDCT images were not be visualized in the portal venous phase, and arterial phase MDCT images were useful to demonstrate spontaneous resolution of delayed pseudoaneurysms. Arterial phase MDCT images could improve the detection of pseudoaneurysms. To evaluate pseudoaneurysms after blunt hepatic injury properly, arterial phase MDCT images are essential. (JJAAM. 2013; 24: 231-6)","PeriodicalId":19447,"journal":{"name":"Nihon Kyukyu Igakukai Zasshi","volume":"37 1","pages":"231-236"},"PeriodicalIF":0.0,"publicationDate":"2013-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86143824","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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