Primary spindle cell sarcoma is a rare tumour. The presentation of acute intra-abdominal bleeding from a metastatic spindle cell tumour has not been previously reported. We report a case of a 40-year-old woman with a history of curative resection of the medial compartment of the right thigh for spindle cell sarcoma presenting with an acute onset abdominal pain and haemorrhagic shock after 5 uneventful years. Emergency exploratory laparotomy was conducted that revealed a retropancreatic mass which had ruptured along its inferior border. Histological evaluation revealed a metastatic deposit of the spindle cell sarcoma. In cases of spontaneous abdominal haemorrhage, it is important to consider the possibility of a ruptured metastatic deposit among the differentials especially in patients with a history of malignancies. Moreover, this is the first reported case of metastatic malignant spindle cell sarcoma presenting with intra-abdominal haemorrhage.
Polyuria is defined as a urine output (UOP) of more than 3 litres per day in adults or 2 l/m2/day in children. Polyuria is common following live donor kidney transplantation (LDKT). This case report and review describes a 32-year-old male with chronic kidney disease who underwent LDKT. The donor was his brother. He had polyuria in the postoperative period with the maximum urine flow rate of 3700 ml/hr and the first 24-hour urine output of 42 litres. He was managed with intravenous crystalloid solutions guided by the central venous pressure and the mean arterial pressure. Electrolytes were replaced with potassium chloride, calcium gluconate and magnesium sulfate. He made an uneventful recovery. The Polyuria improved without any pharmacological interventions. Therefore, guided fluid and electrolyte administration is the key to the successful management of post-transplant polyuria.
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