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Splenic artery aneurysm (SAA) occurs predominantly in women and the majority of them are asymptomatic until rupture. In cases of spontaneous rupture of an SAA, maternal and fetal mortality rates remain extremely high. Furthermore, the spontaneous ruptures of SAAs predominantly appear during the third trimester of pregnancy. We present the third known case of spontaneous SAA rupture during the first trimester of pregnancy, which manifested as sudden hypovolemic collapse and was successfully confronted with combined aggressive resuscitation and emergency surgical operation.

Pregnant and postpartum women are considered a population at increased risk of hospitalization of H1N1 infection. We report the case of a young postpartum woman, who developed evidence of respiratory failure reaching the point of requiring intubation due to an H1N1 influenza virus infection two days after a caesarean delivery. We emphasize the diagnosis, management, and the outcome focusing on the question “what the care providers, including obstetric health care workers, ought to know?” Diagnostic and management strategy for pregnant or postpartum women with novel influenza A (H1N1) viral infection and increased awareness amongst patients and health care professionals may result in improved survival.

Takotsubo cardiomyopathy (TCM) is an underrecognized transient left ventricular dysfunction that mimics clinically an acute coronary syndrome. It has been linked to emotional stress and several clinical entities that provoke a catecholamine surge in the blood stream. We investigated the case of a young female patient who was admitted to the intensive care unit after a significant blood loss due to miscarriage. The patient was fully monitored and was treated for the hypovolemia. A dramatic aggravation of her clinical status was directly linked to the appearance of TCM 1 hour after her admission. This study sought to assess the appearance of TCM in a hypovolemic patient. We found no reports in the literature linking these 2 clinical entities. The blood loss and the pathophysiology of hypovolemia, especially through the excess of catecholamines that are released in the blood stream, seem to provoke the appearance of a subclinical form of TCM. As a result, TCM worsened further the general condition of the patient. There is a high possibility that TCM and hypovolemia can be closely related, and therefore, the treatment of hypovolemia can be adjusted to new standards. Because it has already been proved that TCM can be induced by emotional stress and various pathological entities, further investigations are necessary. [ABSTRACT FROM AUTHOR]

A 24-year-old man developed systolic hypertension as a result of renal contusion, perinephric fluid collection, and renal compression (Page kidney) after blunt renal trauma. The patient was treated with an angiotensin-converting enzyme inhibitor for 30 days, after which his blood pressure normalized and the medications were discontinued. Follow-up clinical and laboratory examinations at 3, 6, and 12 months showed normal results. Transient hypertension may develop in patients after blunt renal injury as a result of Page phenomenon. Appropriate medical therapy is warranted and may be successful because spontaneous resolution may be delayed or not occur at all. [Copyright &y& Elsevier]

Introduction: Despite the warnings of health hazards of cigarette smoking, still one third of the population in industrial countries smoke. This review was conducted with the aim of exploring the effects of preoperative tobacco smoking on the risk of intra- and postoperative complications and to identify the value of preoperative smoking cessation., Methods: The databases that were searched included The Cochrane Library Database, Medline, and EMBASE. Articles were also identified through a general internet search using the Google search engine. The incidence or risk of different types of intra- and postoperative complications were used as outcome measures., Results: Tobacco smoking has a negative effect on surgical outcome, as has been found to be a risk factor for the development of complications during and after many types of surgery, even in the absence of chronic lung disease. Furthermore, the long-term health hazards of smoking reduce health-related quality of life and premature death., Conclusion: It is widely documented that stopping smoking before surgery has substantial health benefits in the longer term and should be recommended to every smoker in order for them to gain maximum benefit from their treatment. However, identification of the optimal period of preoperative smoking cessation on postoperative complications cannot be determined., (Copyright © 2011 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved.)