著者

松本 昭憲 篠原 一彰 中川 雅之 佐久間 宏規 熊田 芳文 田勢 長一郎 小林 国男

出版者

Japanese Association for Acute Medicine

雑誌

日本救急医学会雑誌 (ISSN:0915924X)

巻号頁・発行日

vol.12, no.9, pp.455-458, 2001-09-15 (Released:2009-03-27)

参考文献数

9

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Iodoformgauze topical applications are often used to wound infections. We report a postoperative epidural abscess with delirium due to iodoformgauze topical application in an open wound. We had inserted an epidural catheter in 79-year-old man with an epidural abscess. After proper drainage, iodoformgauze was used to cover for the abscess. He suffered consciousness disturbance for 12 days postoperatively. Suspecting iodoform toxicity, we checked protein binding iodine (PBI) and total serum iodine. PBI was 14.5μg/dl and total serum iodine 152μg/dl. We stopped iodoformgauze use, and the man's consciousness cleared, indicating the importance of watching for side effects such as consciousness disturbance when using iodoformgauze.

著者

篠原 一彰 佐久間 宏規 岡崎 美智弥 松本 昭憲 熊田 芳文 野崎 洋文

出版者

Japanese Association for Acute Medicine

雑誌

日本救急医学会雑誌 (ISSN:0915924X)

巻号頁・発行日

vol.10, no.11, pp.692-696, 1999-11-15 (Released:2009-03-27)

参考文献数

18

被引用文献数

1

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Severe pulmonary thromboembolism (PE) during pregnancy occurred in 2 young patients. One patient died from PE recurrence without placement of an inferior vena cava (IVC) filter, but the other survived with emergent filter placement before cesarean section. A 31-year-old woman presented with sudden dyspnea at 34 weeks of pregnancy. On examination, she was cyanotic and echocardiography revealed marked right heart dilatation and pulmonary hypertension. An emergent cesarean section was performed, but soon after the delivery, she fell into circulatory arrest. PE recurrence was suggested as cause, and t-PA was administered into the pulmonary artery. She was resuscitated but she died from another PE recurrence 4 days later. A 25-year-old woman, 35 weeks pregnant was admitted because of threatened abortion. She felt sudden dyspnea 3 days after admission and was diagnosed with severe PE by echocardiography and pulmonary catheterization. A Vena-Tech IVC filter™ was inserted at the suprarenal position to prevent PE relapse. Emergent cesarean section was then carried out uneventfully. Heparin and urokinase were administered postoperatively, and her pulmonary arterial pressure decreased. She was extubated 7 days later, and is now doing well 10 months later. Once severe PE has occurred, its relapse may be lethal. The IVC filter is effective in preventing recurrence. Even if the patient is young, emergent IVC filter placement to avoid fatal PE relapse is essential.