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==================== THE KASABACH–MERRITT PHENOMENON  ==================== Large congenital hemangiomas may result in shunting of blood and high-output cardiac failure or entrapment of platelets and a thrombocytopenic coagulopathy and a potentially life-threatening hemorrhage (the Kasabach–Merritt syndrome or phenomenon) (Fig). The pathogenesis of congenital hemangiomas is poorly understood. There is an association with prematurity. Kasabach-Merritt phenomenon is a rare, life-threatening condition in which either of two specific vascular tumors (tufted angioma or kaposiform hemangioendothelioma) traps and destroys platelets, which are a component of blood that helps clotting. This condition is also associated with other abnormal clotting conditions in which there is excessive consumption of clotting factors. Kasabach-Merritt phenomenon does not occur in children with infantile hemangiomas. Tumors usually occur shortly after birth and are equally common in males and females. These ...
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Transorbital endotracheal intubation: a nonstandard approach to a difficult airway.
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A 49-year-old gentleman with a history of adenoid cystic carcinoma of the left nare status post curative bifrontal craniotomy, left lateral rhinotomy and medial maxillectomy, adjuvant radiotherapy, and orbital exenteration for optic neuropathy, complicated by medial wall dehiscence. His course was also complicated by severe radiation trismus, for which he was scheduled to undergo bilateral mandibular coronoidectomies. Given his limited mouth opening, the surgeon requested a nasal endotracheal tube. Because of concerns of traumatizing his nare, we utilized a flexible fiberoptic bronchoscope to perform asleep transorbital intubation. Airway management in patients with severe trismus may require ingenuity.
(Credit : Waldron NH, Stolp BW, Ogilvie MP, Powers DB, Shaughnessy MR.)


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=============== The bronze baby syndrome: A complication of  # phototherapy =============== **The Bronze baby syndrome is the dark grey-brown pigmentation of skin, mucous membrane and urine following phototherapy. **Hepatic dysfunction has to be there for this condition to be present. We report a neonate with dark brown pigmentation of skin. Lesions were spread over the abdomen (Fig. 1), chest, back and both upper and lower limb after receiving phototherapy for neonatal jaundice. **It is assumed that abnormal accumulation of photoisomer of bilirubin is the cause of this condition. **The second cause postulated is abnormal hepatic function leading to copper-porpyhrin complex which is photodestroyed leading to brown pigmentation. **The third explanation is accumulation of biliverdin leading to pigmentation. **It should be differentiated from grey baby syndrome exclusively seen in neonates and very young infants receiving high doses of chloramphenicol. The infant is cyanosed, acidot...
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==================== THE KASABACH–MERRITT PHENOMENON  ==================== Large congenital hemangiomas may result in shunting of blood and high-output cardiac failure or entrapment of platelets and a thrombocytopenic coagulopathy and a potentially life-threatening hemorrhage (the Kasabach–Merritt syndrome or phenomenon) (Fig). The pathogenesis of congenital hemangiomas is poorly understood. There is an association with prematurity. Kasabach-Merritt phenomenon is a rare, life-threatening condition in which either of two specific vascular tumors (tufted angioma or kaposiform hemangioendothelioma) traps and destroys platelets, which are a component of blood that helps clotting. This condition is also associated with other abnormal clotting conditions in which there is excessive consumption of clotting factors. Kasabach-Merritt phenomenon does not occur in children with infantile hemangiomas. Tumors usually occur shortly after birth and are equally common in males and females. These ...
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