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This document is an update of the multidisciplinary document HEMOMAS, published in 2016 with the endorsement of the Spanish Scientific Societies of Anaesthesiology (SEDAR), Intensive Care (SEMICYUC) and Thrombosis and Haemostasis (SETH). The aim of this document was to review and update existing recommendations on the management of massive haemorrhage. The methodology of the update was based on several elements of the ADAPTE method by searching and adapting guidelines published in the specific field of massive bleeding since 2014, plus a literature search performed in PubMed and EMBASE from January 2014 to June 2021. Based on the review of 9 guidelines and 207 selected articles, the 47 recommendations in the original article were reviewed, maintaining, deleting, or modifying each of them and the accompanying grades of recommendation and evidence. Following a consensus process, the final wording of the article and the resulting 41 recommendations were approved by all authors.
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http://dx.doi.org/10.1016/j.medine.2023.03.019 | DOI Listing |
Eur J Case Rep Intern Med
August 2025
Internal Medicine, University of California, Riverside School of Medicine, Riverside, USA.
Introduction: Pulmonary embolism (PE) is a life-threatening condition with well-defined management strategies; however, the presence of a clot-in-transit (CIT)-a mobile thrombus within the right heart-introduces a uniquely high-risk scenario associated with a significantly elevated mortality rate. While several therapeutic approaches are available-including anticoagulation, systemic thrombolysis, surgical embolectomy, and catheter-directed therapies-there is no established consensus on a superior treatment modality. Catheter-based mechanical thrombectomy has emerged as a promising, minimally invasive alternative that mitigates the bleeding risks of systemic thrombolysis and the invasiveness of surgery.
View Article and Find Full Text PDFCureus
August 2025
Vascular Surgery, Conde S. Januário Hospital, Macao, CHN.
Spontaneous femoral artery pseudoaneurysms (SFAPs) represent a rare vascular entity. We report the successful hybrid management of a large, wide-necked ruptured SFAP in an 85-year-old male. Computed tomography angiography (CTA) confirmed a massive pseudoaneurysm originating from the distal right superficial femoral artery (SFA) with severe circumferential arterial calcification.
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August 2025
Department of Neurosurgery, The University of Osaka Graduate School of Medicine, Suita, JPN.
Fungal cerebral aneurysms, particularly those resulting from direct invasion by fungal sinusitis, are rare and often fatal when involving the cavernous segment of the internal carotid artery (ICA). We present a case of a ruptured fungal ICA aneurysm caused by sinusitis, successfully treated with parent artery occlusion (PAO). In this case, an 80-year-old woman presented with right ptosis, facial pain, and cranial nerve III, IV, and VI palsies.
View Article and Find Full Text PDFInt J Surg Case Rep
September 2025
Department of Liver Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No.1, Shuaifuyuan, Beijing, 100730, China. Electronic address:
Introduction And Importance: Giant splenic hemangiomas are rare and pose diagnostic and management challenges, particularly during pregnancy. This case highlights the need for multidisciplinary approach to manage such a massive splenic lesion in the second trimester.
Case Presentation: A 34-year-old woman with pre-pregnancy splenic cysts developed left upper quadrant distension at 19 weeks of gestation.
World J Pediatr Congenit Heart Surg
September 2025
Department of Pediatric Cardiac Surgery, National Institute of Cardiovascular Diseases, Karachi, Pakistan.
Severe tricuspid regurgitation (TR) can lead to significant enlargement of the right atrium (RA) and poses unique clinical challenges. We report this case of a 17-year-old boy previously misdiagnosed with Ebstein anomaly who presented with dyspnea and palpitations. Initial examination revealed irregular heart rhythm, distended neck veins, and a significant murmur.
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