Index Note: Page numbers of article numbers are in boldface type. A Abdomen, acute, as cancer emergency, 381 399 in cancer patients, etiologies unique to, 390 392 in perforation, 388 surgery of, portal vein thrombosis following, 454 tumors of, in children, 489 490 Adrenal infection, thrombosis in, 453 Allopurinol, in hyperuricemia, 501 Amegakaryocytic thrombocytopenia, congenital idiopathic, 510 Amegakaryocytopoiesis, hereditary, 510 Amyloidosis, systemic, bleeding in, 436 Anemia(s), 511 519 clinical signs and symptoms of, 512 Diamond-Blackfan, 513 514 due to decreased red blood cell production, 512 516 due to increased red blood cell production, 516 519 extrinsic hemolytic, 519 intrinsic hemolytic, 517 519 iron deficiency, 514 516 of chronic disease, 516 physical examination in, 512 physiologic causes of, 511 thrombocytopenia and, as presentation of childhood cancer, 505 506 in infants and children, 505 523 Angiography, in lower gastrointestinal bleeding, 371 Angiotherapy, in lower gastrointestinal bleeding, 371 Antibiotics, broad spectrum, in neutropenia and fever, 534 535 in neutropenic enterocolitis, 419 421 Anticoagulation, and thrombocytopenia, 452 Antifungals, in neutropenia and fever, 536 Antiplatelet agents, and aspirin and bleeding complications, 436 Antithrombotic therapy, complications of, 436 438 Antivirals, in neutropenia and fever, 535 536 Ascites, malignant, in cancer, 390 391 B Benzodiazepines, in hepatic encephalopathy, 406 Bernard-Soulier syndrome, 510 Emerg Med Clin N Am 27 (2009) 547 554 doi:10.1016/s0733-8627(09)00085-6 0733-8627/09/$ see front matter ª 2009 Elsevier Inc. All rights reserved. emed.theclinics.com
548 Index Bleeding, coagulation factor-related, 427 428 gastrointestinal. See Gastrointestinal bleeding. hematologic cancers associated with, 434 436 in platelet refractory patient, 429 430, 431 in uremia, 434 Bleeding problems, acquired, in cancer patients, management of, 423 444 Bone and soft-tissue tumors, in children, 490 493 Bowel obstruction, malignant, 382 388 in gastric outlet obstruction, 387 388 in malignant intussusception, 388 in small bowel obstruction, 383 385 Brain tumors, primary, thrombosis in, 451 452 Budd-Chiari syndrome, hypercoagulable states associated with, 451, 453 therapy of, 453 thromboses in, in malignancies, 391 392 C Cancer, childhood, emergency department presentation of, 477 495 general signs and symptoms of, 478 thrombocytopenia and anemia as presentation of, 505 506 Cancer emergencies: acute abdomen, 381 399 Cancer patients, acquired bleeding problems in, laboratories in, 423 425 management of, 423 444 patient review in, 423 transfusion therapy in, 425 427 gastrointestinal bleeding in, 363 378 thrombosis in, 451 454 Capsule endoscopy, in lower gastrointestinal bleeding, 370 Catheters, central venous, and upper-extremity thrombosis, 452 Central nervous system, tumors of, in children, 478 482 headache in, 479 history and physical examination in, 478 increased intracranial pressure in, 479 480 MRI in, 481, 482 seizures in, 480 signs and symptoms of, 479 Childhood, cancer in, emergency department presentation of, 477 495 general signs and symptoms of, 478 thrombocytopenia and anemia as presentation of, 505 506 Children, abdominal tumors in, 489 490 acute leukemia in, 482 487 hematologic malignancies in, 482 489 infants and, thrombocytopenia and anemia in, 505 523 lymphoma in, 487 489 tumor lysis syndrome in, management in emergency department, 497 504 Coagulation tests, in cancer patients, interpretation of, 423 424 Colonoscopy, in lower gastrointestinal bleeding, 370, 371 Colony-stimulating factor, in neutropenia and fever, 536 537 Computed tomography, in neutropenic enterocolitis, 418 419 Computed tomography angiography, in lower gastrointestinal bleeding, 371
Index 549 D Deep venous thrombosis, diagnostic pathways for, 448, 449 immediate therapy of, 448 451 prediction model for, 446 Dexamethasone, in spinal cord compression, 482 Diamond-Blackfan anemia, 513 514 Diarrhea, infectious, lower gastrointestinal bleeding in, 372 Disseminated intravascular coagulation, bleeding in, 427 428 causes of, 428 Disseminated intravascular coagulation syndromes, drug-induced, 433 434 Dysproteinemias, bleeding in, 435 436 E Embolectomy, in deep venous thrombosis, 449 450 Emergent surgery, in lower gastrointestinal bleeding, 371 Encephalopathy, hepatic. See Hepatic encephalopathy. Enteritis, radiation, following cancer irradiation, 391 Enterocolitis, neutropenic, 415 422 background and state of evidence of, 415 416 chemotherapeutic agents implicated in, 416, 417 clinical presentation and risk factors for, 416 418 diagnostic imaging in, 418 419 in immunocompromised patient, 389 390 lower gastrointestinal bleeding in, 371 372 nononcologic causes of, 417 signs and symptoms of, 417, 418 treatment of, 419 Erythroblasstopenia, transient, of childhood, 512 513 Erythrocytosis, polycythemia vera and, 463 Erythropoietin, red blood cell production and, 516 F Factor VIII inhibitors, acquired, bleeding in, 427 Fever, and neutropenia. See Neutropenia, and fever. Fibrinolytic agents, bleeding associated with, 438 Fluid resuscitation, in upper gastrointestinal bleeding, 366 Fondaparinox, bleeding and, 438 G Gastrointestinal bleeding, in cancer patient, 363 378 lower, 363 angiography in, 371 capsule endoscopy in, 370 colonoscopy in, 370 computed tomography angiography in, 371 etiologies of, 368 369 evaluation in, 369 371
550 Index Gastrointestinal (continued) management of, 371 pediatric causes of, 373 radionuclide imaging in, 370 signs and symptoms of, 369 special considerations in, 367 368 upper, 363 diagnostic evaluation of, 365 367 etiology of, 363 364 presenting signs and symptoms of, 364 365 therapeutic interventions in, 366 367 Graft-versus-host disease, lower gastrointestinal bleeding in, 372 H Headache, in central nervous system tumors, in children, 479 Hematologic malignancies, in children, 482 489 Hematological cancers, associated with bleeding, 434 436 Hemolytic uremic syndrome, 510 Heparin, reversal, in bleeding, 437 438 Heparin-induced thrombocytopenia, 431, 432 Hepatic encephalopathy, 401 414 chronic, diagnosis of, 402 403 management of, 403 406 prognosis in, 406 407 classification of, 402 grading of, criteria for, 405 in acute liver failure, 407 management of, 407 408, 409 in liver injury, in cancer patients, 408 409 medications used for, dosages of, 405 overt, clinical features of, 402, 403 pathogenesis of, 401 402 precipitating factors for, 404 Hydrocephalus, in posterior fossa tumor, 481, 482 Hyperkalemia, in tumor lysis syndrome, 498, 500 Hyperleukocytosis, clinical presentation of, 466, 467 diagnosis of, 466 laboratory evaluation of, 467 468 morbidity of, 466 pathophysiology of, 465 466 risk factors for, 465 treatment of, 468 Hyperphosphatemia, in tumor lysis syndrome, 498 499, 500 Hyperproteinemia, hyperviscosity syndrome related to, 460 463 Hyperuricemia, in tumor lysis syndrome, 499, 501 Hyperviscosity syndrome, 459, 460 clinical presentation of, 461 462 diagnosis of, 462 management of, 462 463 myelomas as cause of, 460
Index 551 myeloproliferative disorders and, 459 476 pathophysiology of, 461 plasma exchange in, 462 463 plasmapheresis in, 463 related to hyperproteinemia, 460 463 Walderstrom macroglobulinemia as cause of, 460 Hypocalcemia, in tumor lysis syndrome, 499, 501 I Immune thrombocytopenic purpura, 508 509 Immunosuppression, presentations unique to, 389 profound, pathology unique to, 389 390 Immunosupression, impact of, 381 Infection, physiologic compensation to, 527 528 Inferior vena cava filters, in deep venous thrombosis, 450 Iron deficiency anemia, 514 516 K Kasabach-Merritt phenomena, 509 L Lactulose, in hepatic encephalopathy, 404 Leukemia, acute, in children, 482 487 laboratory tests in, 484 486 lymphoblast in, 483 484 presenting features of, 482 483 transfusions of blood products in, 486 acute promyelocytic, bleeding in, 434 435 in childhood, 477 Leukocytosis, 465 Leukostasis, 465 Liver failure, acute, hepatic encephalopathy in, 407 408, 409 Liver injury, in cancer patients, hepatic encephalopathy in, 408 409 Lymphoma, in children, 487 489 history in, 487 laboratory evaluation in, 488 489 physical examination in, 487 488 presenting features of, 483, 487 M Medication toxicity, thrombocytopenia caused by, 510 MRI, in central nervous system tumors in children, 481, 482 Mucositis, in upper gastrointestinal bleeding, 365 Musculoskeletal tumors, in children, 490 493 Myelodysplastic syndromes, bleeding in, 435 Myelomas, as cause of hyperviscosity syndrome, 460
552 Index Myeloproliferative disorders, and hyperviscosity syndrome, 459 476 Myeloproliferative syndromes, bleeding in, 435 N Nasogastric aspiration with lavage, in upper gastrointestinal bleeding, 366 Neomycin, in hepatic encephalopathy, 404 405 Nephronic syndrome, renal vein thrombosis in, 454 Neuroblastoma, in children, 489 490 Neutropenia, and fever, adaptive immunity and, 527 antifungals in, 536 antivirals in, 535 536 assessment and evaluation in, 530 533 broad-spectrum antibiotics in, 534 535 colony-stimulating factor in, 536 537 definitions of, 526 general management of, 533 534 in pediatric patients with cancer, 525 544 infections in, 529 530 innate immunity and, 526 527 laboratory tests in, 532 533 pathophysiology of, 526 physical examination in, 531 532 pituitary dysfunction in, 538 transfusions in, 537 Neutropenic enterocolitis. See Enterocolitis, neutropenic. Nonrhabdomyosarcomatous soft-tissue sarcoma, 493 O Osteosarcoma, in children, 491 492 P Peptic ulcer disease, as cause of upper gastrointestinal bleeding, 364 Perforation, acute abdomen in, 388 Pituitary dysfunction, in neutropenia and fever, 538 Plasma exchange, in hyperviscosity syndrome, 462 463 Plasmapheresis, in hyperviscosity syndrome, 463 Platelet destruction, thrombocytopenia secondary to, 508 510 Platelet production, decreased, thrombocytopenia secondary to, 510 511 Platelet refractory patient, bleeding in, 429 430, 431 Polycythemia vera, diagnosis of, 464 erythrocytosis and, 463 pathophysiology of, 463 464 treatment of, 464 465 Prednisone, in thrombotic thrombocytopenic purpura, 432 Proctitis, radiation, lower gastrointestinal bleeding in, 372 373 Protein, dietary, in hepatic encephalopathy, 406 Proton pump therapy, in upper gastrointestinal bleeding, 366 Pulmonary embolism, probability score for, 447
Index 553 Pulmonary embolism/deep venous thrombosis, diagnostic tests in, 446 448 natural history of, 445 pathophysiology of, 445 446 Purpura, post-transfusion, platelet counts in, 429 R Radionuclide imaging, in lower gastrointestinal bleeding, 370 Recombinant factor Vlla, in bleeding disorders, 426 427 Renal replacement, in tumor lysis syndrome, 501 Rhabdomyosarcoma, in children, 492, 493 Rifaximin, in hepatic encephalopathy, 405 406 S Sodium benzoate, in hepatic encephalopathy, 406 T Thrombocytopenia, and anemia, as presentation of childhood cancer, 505 506 in infants and children, 505 523 anticoagulation and, 452 drug-induced, platelet counts in, 429 drugs implicated in, 429, 430 heparin-induced, 431, 432 immune, platelet counts in, 429 Thrombocytopenic purpura, immune, 508 509 Thrombocytosis, causes of, 468, 469 diagnosis of, 469 470 pathophysiology of, 468 469 prognosis in, 470 treatment of, 470 Thrombosis, cerebral vein, in malignancies, 452 453 in adrenal infection, 453 in cancer patients, 451 454 in primary brain tumors, 451 452 portal vein, following abdominal surgery, 454 renal vein, in nephronic syndrome, 454 upper-extremity, central venous catheters and, 452 visceral vein, 454 Thrombotic thrombocytopenic purpura, 431 432 Thrombycytopenia, childhood, 507 508 neonatal, 506 507 secondary to decreased platelet production, 510 511 secondary to platelet destruction, 508 510 Transfusion therapy, massive, complications of, 426 in bleeding in cancer patients, 425 427 Transfusions, in neutropenia and fever, 537 TTP/hemolytic uremic syndrome, therapy-related, 432 433
554 Index Tumor lysis syndrome, definition of, 497 498 disposition in, 501 502 epidemiology of, 498 evaluation in, 499 500 management of, 500 502 metabolic sequelae of, 498 499 pediatric, management in emergency department, 497 504 risk factors for, 499 Typhlitis, in immunocompromised patient, 389 390 U Ultrasound, in neutropenic enterocolitis, 418 419 Uremia, bleeding in, 434 Urine alkalinization, in tumor lysis syndrome, 500 V Venous thrombotic emergencies, 445 458 von Willebrand disease, acquired, bleeding in, 427 W Waldenstrom macroglobulinemia, as cause of hyperviscosity syndrome, 460 Warfarin, and international normalized ratio, in bleeding, 436 437 in deep venous thrombosis, 451 Wilms tumor, 491 Wiskott-Aldrich syndrome, 510 511