Deep Venous Thrombosis
Deep Venous Thrombosis is a condition wherein a blood clot develops in a deep vein that accompanies an artery, mostly in the lower limbs. Consequently, the clot affects blood circulation.
Usually thrombosis sets in when the coagulation function is impaired or imbalanced due to abnormalities in the blood, altered blood flow or damage to the blood vessels. Typically the main veins affected by deep venous thrombosis are inner thigh, calf, groin and lower abdomen. A person suffering from deep venous thrombosis is likely to experience pain and swelling in the affected limbs. The pain in the affected leg can become so severe that the person is unable to bear weight on it. This condition is different from arterial thrombosis where the clot forms in the arteries. The main risk factor associated with deep venous thrombosis is that the clot may break off and travel along the blood stream to lodge itself in the lungs, heart or brain. This disease is usually noticed in adults over 60 years.
Deep venous thrombosis is brought about by reduced blood flow or thickening of the blood. Persons who have undergone surgery and been given anti-clotting drugs are likely to develop this condition. Long car or plane journeys, fractures, birth control pills and surgery are potential conditions that may lead to this disease. Those with a history of polycythemia vera or hypercoagulability are more likely to suffer this condition. One of the potential dangers of deep venous thrombosis is pulmonary embolism. Pulmonary embolism is a serious, life-threatening condition where the embolism blocks or closes the artery in the lung. Another complication of deep venous thrombosis is post-thrombotic syndrome characterized by edema, hyperpigmentation and skin ulceration.
Some of the diagnostic tests that help detect deep venous thrombosis are ultrasound Doppler, venograpy of the legs and D-dimer blood test. The Doppler ultrasound aids in studying the reduced blood flow in the affected limbs. The venogram is a special x-ray that reveals any blood clot that is responsible for obstructed blood flow. The blood tests can reveal the clotting tendency. Heparin is an anticoagulant that has been intravenously given to a patient along with oral warfarin. These medications cause an increase in clotting time. But careful monitoring is of the essence so as to avoid risk of haemorrhage.
Appendicitis
An inflamed appendix leads to a condition of appendicitis. In this condition, the opening of the appendix into the cecum is blocked. Mucus or stool can be the causes for the blockage. A blood clot or carcinoid tumor may also be a cause for the blockage of the appendiceal orifice. In some cases, appendicitis follows a gastrointestinal viral infection. The inflammation causes reduced blood supply to the appendix thereby diminishing its ability to fight infection. Inflammation and infection can lead to a rupture of the appendix thereby spreading the infection to the entire abdominal area. Perforation of the appendix usually warrants immediate surgery. If the infection is allowed to enter other parts of the body, it can be life-threatening. Another fallout of appendicitis is that the contents of the intestine are blocked from passing. This leads to abdominal distension with nausea and vomitting. In few cases, the body is able to resolve the inflammation and infection with antibiotics and care. This usually happens when the appendicitis is noticed and diagnosed at a very early stage.
Symptoms of appendicitis are abdominal pain that is diffused and not localized. The patient might have elevated body temperature with tenderness in the lower right abdomen, if palpated. When the appendiceal inflammation increases, the pain is clearly localized to a single area - between the front of the right hip bone and the belly button. Early symptoms of appendicitis are often easily mistaken for gastroenteritis. Children may have fewer symptoms thereby making diagnosis more difficult. Appendicitis is first diagnosed with a thorough physical examination. Abdominal scans are useful in detecting the cause of blockage. A blood test of a person suffering from appendicitis will reveal abnormal white blood count. But it cannot be taken as the only sign of appendicitis. A CT Scan can help reveal the area of the appendix that is affected.
Appendectomy
With traditional appendectomy, the surgeon enters the abdomen through a 3 inch long incision. The appendix is removed by freeing it from the attachment to the abdomen and colon. Pus will need to be drained in case of an abscess. Laparoscopy is now regularly used to remove an inflamed appendix. A small fiber optic tube with camera is inserted through one or two small punctures made on the abdominal wall. Tiny instruments are passed through the other abdominal incisions to remove the appendix. Laparoscopy allows a surgeon to view the appendix and other abdominal organs. A decision can then be made whether the appendix needs to be removed at all. A clear diagnosis is possible with laparoscopy on doubtful cases of appendicitis. Laparoscopic appendix removal allows faster recovery and lesser scarring.
Intracranial Hematoma
Head injuries account for approximately 70% of traumatic accident deaths. Intracranial hematoma plays an important role in the death and disability that are associated with head injury. Intracranial hematoma is a serious and possibly a life threatening condition that often requires immediate medical attention. Many patients with intracranial hematoma harbor mass lesions that require emergency decompression. Other causes include brain tumors, liver disease, autoimmune syndromes and bleeding disorders.
The human brain floats within the skull. It is surrounded by cerebrospinal fluid which cushions the brain from the bounces of everyday movements. Sometimes it becomes impossible for the fluid to absorb the force of a sudden blow or a quick stop. Under such situations, the brain may slide forcefully against the inner wall of the skull and get bruised. An intracranial hematoma occurs when the blood vessel ruptures between the skull and the brain. The blood leaks between the brain and the skull. This collection of blood, hematoma, which is possibly clotted, compresses the brain tissue. Some hematomas require surgery to remove the blood clot whereas some others can be treated without surgery.
Symptoms of intracranial hematoma include headache, nausea, vomiting, lethargy and slurred speech. The pupils may appear of unequal size. Memory loss is often associated with head trauma. One may even forget that they have suffered a blow. These symptoms of intracranial hematoma may occur either immediately or several weeks or months after a blow has been received in the head.
Injury in the head is the most common cause of intracranial hematoma. Among elderly persons, even a mild head trauma is more likely to cause a hematoma in the brain. Hematoma resulting from injury in the head is classified as:
Subdural hematoma: This occurs when the blood vessels, most often the veins rupture between the brain and the dura mater which is the outermost of three membrane layers that covers the brain. The blood that leaks forms a hematoma. This compresses the brain tissue. The danger here is that if the hematoma keeps growing then there is a progressive decline in consciousness and possible death. The risk of subdural hematoma is greater in people who use aspirin or other anticoagulants regularly. Alcoholics and very young and very old people also stand to be affected by subdural hematoma. All types of subdural hematomas require medical attention as soon as the symptoms become apparent. Other wise permanent brain damage may be the result.
Epidural hematoma: This type of hematoma occurs when the blood vessel, usually the artery, ruptures between the surface of the dura mater and the skull. Morbidity and mortality from epidural hematoma is substantial unless immediate medical attention is given. The cause of epidural hematoma is most of the time road automobile accidents or any other traumatic injuries.
Intraparenchymal hematoma: When blood pools in the white matter of the brain, Intraparenchymal hematoma occurs. There may be multiple severe Intraparenchymal hematomas after a head trauma. Serious brain damage can occur, as the neurons can no longer communicate.
A physician may find it difficult to diagnose intracranial hematoma, as it may not be immediately apparent. It is better to seek medical advice after any significant blow has been received to the head and if the patient has lost consciousness or experiences symptoms such as headache, lethargy, nausea and vomiting. A CT scan or MRI scan is suggested to define the position and size of a hematoma.
After a head injury, doctors use medications such as corticosteroids and diuretics to control the edema in the brain after head injury. Often surgery is required. If the blood clot is localized and there is no excessive clotting, then perforation is made through the skull and the liquid is removed by suction. Large hematomas require opening of a section of the skull to remove blood clots.
It is essential to wear appropriate safety equipment and gadgets during sports, including helmet when riding, motorcycling, horseback riding, skating or doing any other activity that may result in injury to head. Chances of motor vehicle accidents can be minimized by wearing a seat belt.
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