scholarly journals Non-occlusive mesenteric ischaemia associated with anorexia nervosa

2019 ◽  
Vol 12 (5) ◽  
pp. e229703
Author(s):  
Takashi Sakamoto ◽  
Alan Kawarai Lefor ◽  
Tadao Kubota
Keyword(s):  
Anorexia Nervosa ◽  
Distal Ileum ◽  
Interdisciplinary Management ◽  
Emergency Laparotomy ◽  
Diffuse Peritonitis ◽  
Chronic Haemodialysis ◽  
Mesenteric Ischaemia ◽  
Threatening Condition ◽  
Life Threatening ◽  
History Of

Non-occlusive mesenteric ischaemia (NOMI) is a life-threatening condition that requires emergent intervention and anorexia nervosa is a chronic eating disorder that requires careful medical and nutritional management. A 54-year-old woman with a history of anorexia nervosa and undergoing chronic haemodialysis developed abdominal pain and called an ambulance. On arrival, she was in shock and abdominal examination was consistent with diffuse peritonitis. Computed tomography scan suggested ischaemia from the distal ileum to the ascending colon. Emergency laparotomy revealed NOMI from the distal ileum to the transverse colon. The treatment strategy included staged operations and careful medical management to optimise nutritional support and electrolyte management with survival of the patient. NOMI and anorexia nervosa are both difficult to manage. Meticulous interdisciplinary management can result in a good outcome.

Haemophagocytic lymphohistiocytosis secondary to brucellosis in a young child

2021 ◽  
Vol 14 (3) ◽  
pp. e240759
Author(s):  
Jashan Mittal ◽  
Prawin Kumar ◽  
Jagdish Prasad Goyal ◽  
Abhishek Purohit
Keyword(s):  
Haemophagocytic Lymphohistiocytosis ◽  
Appetite Loss ◽  
Specific Therapy ◽  
Adequate Treatment ◽  
Underlying Condition ◽  
Persistent Fever ◽  
Threatening Condition ◽  
Life Threatening ◽  
History Of ◽  
Life Threatening Complication

Brucellosis is a common zoonotic disease worldwide. It has protean clinical manifestation and sometimes may has a life-threatening complication. A 4-year-old boy presented with a history of fever, myalgia and appetite loss for 3 weeks. On examination, he had hepatosplenomegaly. The initial working diagnosis was an infection, autoimmune disease and malignancy. Investigations showed positive Brucella serology, and he was started on rifampicin and cotrimoxazole. He was further investigated because of persistent fever, which revealed evidence of haemophagocytic lymphohistiocytosis (HLH). He continued treatment for brucellosis, except rifampicin which was replaced with doxycyclin due to a worsening liver function. The child showed complete clinical and biochemical improvement after 6 weeks of therapy. HLH is a life-threatening condition and should be suspected in children with brucellosis, who did not respond to appropriate antibiotics treatment. Secondary HLH does not always require specific therapy; it may improve with adequate treatment of the underlying condition.

Midgut volvulus secondary to congenital malrotation in pregnancy

2020 ◽  
Vol 13 (5) ◽  
pp. e234664 ◽  
Author(s):  
Eelyn Chong ◽  
David S Liu ◽  
Vishnupriya Rajagopal ◽  
Neil Strugnell
Keyword(s):  
Perinatal Outcomes ◽  
First Trimester ◽  
Small Bowel Resection ◽  
Emergency Laparotomy ◽  
Midgut Volvulus ◽  
Threatening Condition ◽  
Life Threatening ◽  
Uncommon Condition ◽  
Adverse Perinatal Outcomes ◽  
In Pregnancy

Midgut volvulus complicating congenital malrotation is a rare but life-threatening condition that can occur in pregnancy. We present a case of intestinal infarction resulting from midgut volvulus in a healthy 32-week pregnant woman who underwent emergency laparotomy and small bowel resection in the setting of fetal death in utero. This case highlights several challenging issues in diagnosing and managing this uncommon condition which leads to increased adverse perinatal outcomes. Prompt investigation and definitive surgical treatment are required when pregnant women present with bilious vomiting and new-onset abdominal or back pain especially beyond the first trimester.

Salicylate Intoxication

1997 ◽  
Vol 12 (2) ◽  
pp. 66-78 ◽  
Author(s):  
Luke Yip ◽  
Michael S. Jastremski ◽  
Richard C. Dart
Keyword(s):  
Life Support ◽  
Care Facility ◽  
Health Care Facility ◽  
Poison Control ◽  
Electrolyte Balance ◽  
Threatening Condition ◽  
Life Threatening ◽  
History Of ◽  
Salicylate Intoxication ◽  
Base Management

Aspirin (acetylsalicylic acid) is one of the most widely used over-the-counter medications. Because of its availability and widespread use, aspirin has a long history of human toxicity from accidental or intentional overdosing. According to the American Association of Poison Control Centers aspirin was implicated in 19083 exposures in 1995, with 11800 cases treated in a health care facility, and 52 associated deaths. Aspirin toxicity may be a life-threatening condition that produces multiple system organ failure requiring treatment in an intensive care unit. Managing a patient with salicylism will challenge the skills of the critical care team, especially in the areas of life support, fluid and electrolyte balance, and acid-base management. This article reviews the physiology, pathophysiology, acute and chronic salicylism in children and adults, and management of salicylate intoxication.

scholarly journals Case Report: severe hemoperitoneum due to spontaneous rupture of uterine vessels during the second trimester of pregnancy

F1000Research ◽  
2021 ◽  
Vol 10 ◽  
pp. 568
Author(s):  
G.V. Ishara Geelaka Bandara Jayarathna ◽  
G.K. Chaminda Jayalath ◽  
Ramya Pathiraja
Keyword(s):  
Case Report ◽  
Spontaneous Rupture ◽  
Emergency Laparotomy ◽  
Second Trimester ◽  
Rare Occurrence ◽  
Healthy Baby ◽  
Induced Hypertension ◽  
Threatening Condition ◽  
Life Threatening ◽  
Uterine Vessels

Spontaneous rupture of uterine vessels during pregnancy is a life-threatening condition though, it has a rare occurrence. This case report discusses about a 32-year-old lady at 16 weeks of gestation presented with spontaneous rupture of uterine artery and she was managed with emergency laparotomy with suturing of ruptured artery. She had delivered a healthy baby after 37 weeks of gestation by a caesarean section due to pregnancy induced hypertension at 36 weeks of gestation.

scholarly journals Spontaneous Ruptured Pyometra: A Gynaecological Emergency

2019 ◽  
Vol 34 (1) ◽  
pp. 48-51
Author(s):  
Liza Chowdhury ◽  
Mahbubur Rahman ◽  
Shahnur Chisty ◽  
Jesmin Jahan
Keyword(s):  
Spontaneous Rupture ◽  
Elderly Women ◽  
Uterine Cavity ◽  
Diffuse Peritonitis ◽  
Surgical Emergency ◽  
Threatening Condition ◽  
Life Threatening

Pyometra is a condition characterized by the accumulation of pus within the uterine cavity that usually develops in elderly women . Spontaneous rupture of pyometra causing diffuse peritonitis is very rare.Unless recognized in time it can be a life threatening condition. The aim of this article is to report a case of spontaneous rupture of pyometra who was admitted in our hospital as surgical emergency and was successfully treated by surgery. Bangladesh J Obstet Gynaecol, 2019; Vol. 34(1): 48-51

scholarly journals Localized Aortic Dissection in a Patient with Polycystic Kidney Disease: A Case Report

2021 ◽  
Vol 6 (04) ◽  
pp. 285-287
Author(s):  
Sarah A. Alkuraydis ◽  
Abdulaziz S. Allihimy ◽  
Osama Smettei ◽  
Rami M Abazid
Keyword(s):  
Chest Pain ◽  
Aortic Dissection ◽  
Acute Chest Pain ◽  
Uncontrolled Hypertension ◽  
Polycystic Kidney ◽  
Threatening Condition ◽  
Life Threatening ◽  
History Of ◽  
The Right ◽  
Multiple Cysts

Aortic dissection (AD) is the most frequent life-threatening aortic disorder. It is commonly associated with hypertension; however, aortic dissection occasionally represents a complication of more complex syndromes. In this article we aim to report. A 40-year-old male patient, with a known case of ADPKD and a strong family history of ADPKD. He presented to the emergency department with prolonged sharp retrosternal chest pain radiating to the back and uncontrolled hypertension. Computed tomography angiography showed a localized dissection flap at the aortic root and multiple cysts in the right kidney. AD is a life-threatening condition and should be suspected in patients presenting with acute chest pain with history of ADPKD.

scholarly journals The Challenge of the Non-Compliant Patient: A Case of Caesarean Section Scar Ectopic Pregnancy

2021 ◽  
pp. 1-3
Author(s):  
Jessica Audet ◽  
Brittany Noel Robles ◽  
Nicolle M Arroyo Lluberas ◽  
Jessica Audet ◽  
Daniel Faustin ◽  
...  
Keyword(s):  
Ectopic Pregnancy ◽  
Emergency Laparotomy ◽  
Pharmacological Management ◽  
Compliant Patient ◽  
Life Saving ◽  
Close Observation ◽  
Life Threatening ◽  
History Of ◽  
Ruptured Uterus

Ectopic pregnancy is a quite common and life-threatening pregnancy. The most common site of ectopic implantation of a fertilized embryo is the fallopian tube. In extremely rare situations, the embryo can implant in other locations, which makes the diagnosis and management even more complex. Although close observation of a new pregnancy is key in the diagnosis and treatment of an ectopic pregnancy, there is still a major risk of life-threatening outcomes. This is a case report of a 31-year-old patient with a history of multiple pregnancies who presented to a community hospital in the spring of 2021 with an ectopic caesarean scar pregnancy. A diagnosis of ectopic pregnancy was on a timely basis, and surgical management was advised. Upon refusal of treatment and admission, pharmacological management was initiated, but patient compliance challenged the success of the therapy. Patient non-compliance to close follow-up resulted in a ruptured uterus. Emergency laparotomy with supracervical hysterectomy was performed as a life-saving procedure.

scholarly journals A Case of Unilateral Coccidioidal Chorioretinitis in a Patient with HIV-Associated Meningoencephalitis

2019 ◽  
Vol 2019 ◽  
pp. 1-3 ◽  
Author(s):  
Christopher B. Toomey ◽  
Andrew Gross ◽  
Jeffrey Lee ◽  
Doran B. Spencer
Keyword(s):  
Risk Factors ◽  
Vision Loss ◽  
Complement Fixation ◽  
Rare Condition ◽  
Threatening Condition ◽  
Life Threatening ◽  
History Of ◽  
Blurry Vision ◽  
Systemic Symptoms ◽  
The Right

Intraocular coccidioidomycosis is a rare condition, with the most commonly reported presentation being an idiopathic iritis in patients who live in or have traveled thorough endemic areas. A paucity of reports exists describing the chorioretinal manifestations of coccidioidomycosis. Here we report a case of unilateral coccidioidal chorioretinitis and meningoencephalitis in an AIDS patient that led to near complete unilateral loss of vision. A 48-year-old Hispanic female with poorly controlled HIV/AIDS in southern California presented with a three-week history of headache, nausea, vomiting, right eye blurry vision, and a one-day history of subjective fever. Examination of the right eye revealed vitritis and several large chorioretinal lesions scattered throughout the periphery and macula with optic disc pallor. Serum coccidioidomycoses complement fixation (CF) was positive (titers of 1 : 256). Neuroimaging revealed a new area of enhancement in the left anterior frontal lobe consistent with meningoencephalitis. The patient was treated with intravenous fluconazole and intravitreal voriconazole with resolution of systemic symptoms and vitritis but persistence of unilateral, severe chorioretinal scarring and vision loss. In conclusion, in spite of the rarity of intraocular coccidioidomycosis, one must carry a degree of suspicion for this vision- and life-threatening condition as a potential etiology of chorioretinitis in individuals with pertinent risk factors.

Paralysis from an ear infection: a severe case of otitis externa leading to acute complete cervical cord syndrome

2021 ◽  
Vol 14 (12) ◽  
pp. e245594
Author(s):  
Rachael Collins ◽  
George Lafford ◽  
Laura Parry
Keyword(s):  
Otitis Externa ◽  
Severe Case ◽  
Complete Recovery ◽  
Cervical Cord ◽  
Team Approach ◽  
Neck Stiffness ◽  
Threatening Condition ◽  
Life Threatening ◽  
History Of ◽  
Red Flag

We report a case of a generally fit and well 54-year-old man who presented with a 2-day history of worsening left-sided otorrhea, headache, neck stiffness, vomiting and fever on the background of a 7-week history of otitis externa (OE). His condition progressed dramatically as he developed symptoms consistent with acute complete cervical cord syndrome with radiological evidence of skull base osteomyelitis, parapharyngeal, retropharyngeal and paravertebral abscesses and sigmoid sinus thrombus. Ultimately, he made a significant, although not complete, recovery. This case is unique in demonstrating how OE can develop into a potentially life threatening condition. It emphasises the importance of early diagnosis and treatment of OE, the recognition of ‘red flag’ symptoms and highlights the importance of a multidisciplinary team approach when managing complex complications of OE.

Vascular calcifications and calciphylaxis in a patient on concurrent haemodialysis and Coumadin therapy

2021 ◽  
Vol 14 (3) ◽  
pp. e240310
Author(s):  
Jack Schnur ◽  
Hadeer Sinawe ◽  
Athina Lidia Yoham ◽  
Damian Casadesus
Keyword(s):  
Pulmonary Oedema ◽  
Wound Care ◽  
Sodium Thiosulfate ◽  
High Morbidity ◽  
Threatening Condition ◽  
Life Threatening ◽  
History Of ◽  
Stage Renal Disease ◽  
End Stage ◽  
Haemodialysis Treatment

Calciphylaxis is a rare life-threatening condition, with calcification of small and medium-sized vessels leading to skin necrosis. It has a high morbidity and mortality, and most of the patients die from wound superinfection and sepsis. A 48-year-old man with a history of end-stage renal disease on haemodialysis and Coumadin therapy for venous thromboembolism presented with pulmonary oedema after missing two haemodialysis treatment. At examination, he had bilateral lower extremity dark brown, possibly necrotic, painful ulcers. He was diagnosed with calciphylaxis and treated with sevelamer hydrochloride, low calcium dialysate and sodium thiosulfate with haemodialysis. He received daily wound care with topical collagenase. After daily wound care treatment for 4 months, the patient’s ulcers completely healed. The patient had been followed for 8 months, which included 29 additional readmissions, 3 admissions related to bacteraemia and 26 admissions with the diagnosis of pulmonary oedema and hyperkalaemia requiring haemodialysis.

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