Introduction. We present a case of concurrent spontaneous sublingual and intramural small bowel hematoma due to warfarin anticoagulation. Case. A 71-year-old man presented to the emergency department complaining of a swollen, painful tongue. He was on warfarin therapy. Physical examination revealed sublingual hematoma. His international normalized ratio was 11.9. The computed tomography scan of the neck demonstrated sublingual hematoma. He was admitted to emergency department observation unit, monitored closely; anticoagulation was reversed with fresh frozen plasma and vitamin K. 26 hours after his arrival to the emergency department, his abdominal pain and melena started. His abdomen tomography demonstrated intestinal submucosal hemorrhage in the ileum. He was admitted to surgical floor, monitored closely, and discharged on day 4. Conclusion. Since the patient did not have airway compromise holding anticoagulant, reversing anticoagulation, close monitoring and observation were enough for management of both sublingual and spontaneous intramural small bowel hematoma.
Objectıves: Pulmonary embolism (PE), which has an inflammatory component, has high mortality and morbidity rates. The platelet/lymphocyte ratio is a novel marker of inflammation that is an independent predictor of mortality in cardiac and various oncological diseases. The aim of the present study was to determine the prognostic value of the platelet/lymphocyte ratio for short-term mortality for patients with acute pulmonary embolism. Materials and Methods:A total of 290 patients who were admitted to the emergency department and diagnosed with acute PE were enrolled retrospectively. Acute pulmonary embolism was confirmed via multislice computerized tomography. Results ÖzetAmaç Pulmoner emboli yüksek mortalite ve morbidite oranları ile inflamatuvar bileşeni iyi bilinen bir hastalıktır. Platelet / lenfosit oranı, kalp ve çeşitli onkolojik hastalıklarda mortalitenin bağımsız belirleyicisi olan inflamasyonun yeni bir belirtecidir. Bu çalışmanın amacı, akut pulmoner emboli hastalarında kısa süreli mortalite için platelet / lenfosit oranının prognostik değerini belirlemektir.Materyal ve Metot: Acil servise başvuran ve akut PE tanısı toplam 290 hasta çalışmaya retrospektif olarak alındı . Akut pulmoner emboli çok kesitli bilgisayarlı tomografi ile teyit edildi.Bulgular: Pulmoner emboli tanısı alan 290 hastanın, tanı aldıktan sonra 53'ü (%18,2) 1 ay içinde öldü. Yaş, malignite, koroner arter hastalığı, sağ ventrikül dilatasyonu, hemoglobin beyaz kan hücresi nötrofil ve trombosit sayımları sistolik pulmoner arter basıncı nötrofil / lenfosit oranı platelet / lenfosit oranı ve pulmoner emboli ciddiyet indeksi grup 1'de grup 2'ye göre anlamlı derecede yüksek bulundu. Platelet / lenfosit oranının 176.31 ve üzerinde olması akut pulmoner emboli sonrası 30 günlük mortaliteyi predikte ettirmedeki duyarlılığı %79 ve özgüllüğü %70'ti. Platelet / lenfosit oranı, hemoglobin ve basitleştirilmiş pulmoner emboli ciddiyet indeksi, akut pulmoner emboli tanısı almış hastalarda mortalitenin bağımsız bir belirleyicisiydi.Sonuç: Platelet / lenfosit oranı, pulmoner emboli sonrası erken dönemde mortalite gelişen hastalarda, mortalite gelişmeyenlere göre daha yüksekti. Bu sebeple, platelet / lenfosit oranı gibi ucuz ve pratik bir parametre akut pulmoner embolide mortalite risk tahmininde kullanılabilir.
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