An Obscure Case of Hepatic Subcapsular Hematoma

Spontaneous liver bleeding is often reported in preeclampsia. It is otherwise rare and has been linked to gross anatomical lesions and coagulopathy. We report a case of subcapsular hematoma of the liver without any apparent lesion and in the absence of coagulopathy. A 41-year-old male, paraplegic for 16 years, presented to the emergency department 3 days after sudden onset of right upper quadrant and shoulder pain. He had been on vitamins and 5,000 units subcutaneous heparin 12-hourly at the nursing home for the last month. He was in no distress, afebrile, with stable vitals. Physical examination showed a diverting colostomy, tender hepatomegaly and sacral decubiti. A fecal occult blood test was negative. There was spastic paraplegia below the level of T12. Two days after admission, the patient was afebrile and hemodynamically stable. PTT, PT, liver profile, BUN and creatinine were all normal, however his hemoglobin had dropped from 11.3 to 7.6 g/dl. An abdominal CT scan revealed an isolated 9.0 × 1.8 cm subcapsular hematoma. The patient received blood transfusion in the intensive care unit and was discharged 7 days later. In conclusion, spontaneous liver hemorrhage occurs in the nonobstetrical population in the setting of gross anatomical lesions or coagulopathy. This is the first report of an isolated subcapsular liver hematoma

A Dominating Tree Based Leader Election Algorithm for Smart Cities IoT Infrastructure

International audienceIn wireless sensor and IoT networks dedicated to smart-cities, a leader node performs critical tasks such as generating encryption/decryption keys. In this paper, the leader is the node situated at the extreme left of the network. It is the node which starts the algorithm of searching the boundary nodes. These nodes will be used to monitor any sensitive, dangerous or inaccessible site. For this type of application, the used algorithm must be robust and fault-tolerant because it is difficult or even impossible to intervene in the presence of node failures. If this node is the leader, such a situation can be catastrophic. In this article, we present a new algorithm called DoTRo, which is based on a tree routing protocol. It starts with local leaders which will launch the flooding process to determine a spanning tree. During this process, their values will be forwarded. If two spanning trees meet, the tree that routes the best value continues its process while the other tree stops. The remaining tree root will be the leader. This algorithm is low energy consuming with reduction rates that can exceed 85% with respect to the classical minium finding algorithm. It is efficient and fault-tolerant since it works even in the presence of node failures and communication disconnectivity. Additionally, the energy consumption is well balanced between nodes. Finally, the complexity and the proof of convergence of the proposed algorithm is presented