Ceftriaxone-Induced Acute Pancreatitis

1993 ◽  
Vol 27 (1) ◽  
pp. 36-37 ◽  
Author(s):  
Anthony E. Zimmermann ◽  
Brian G. Katona ◽  
Joginder S. Jodhka ◽  
Richard B. Williams
Keyword(s):  
Acute Pancreatitis ◽  
Abdominal Pain ◽  
Acute Abdominal Pain ◽  
Signs And Symptoms ◽  
Etiologic Agent ◽  
Antibiotic Regimen ◽  
Intravenous Injections ◽  
Case Summary ◽  
Catheter Sepsis ◽  
History Of

OBJECTIVE: To report a case of probable ceftriaxone-induced acute pancreatitis. CASE SUMMARY: A patient with a history of short-bowel syndrome on home total parenteral nutrition developed fever, chills, and right flank pain. She was diagnosed with gram-negative catheter sepsis and prescribed antibiotic therapy to be administered for four weeks. After completion of the first week of therapy, the antibiotic regimen was changed to intravenous injections of ceftriaxone to be given daily at home. Prior to discharge the patient developed acute abdominal pain, leukocytosis, jaundice, and markedly elevated lipase and amylase concentrations consistent with acute pancreatitis. The patient's condition improved upon discontinuation of the ceftriaxone and the remainder of her stay was uneventful. DISCUSSION: There is only one other case report in the literature of probable ceftriaxone-induced pancreatitis. Multiple other medications have been implicated in causing acute pancreatitis. The exact mechanism of this uncommon adverse effect of ceftriaxone is unknown. CONCLUSIONS: There was a temporal relationship between the development of this patient's signs and symptoms and the administration of ceftriaxone. We could not identify any other factors that may have been responsible for the development of her acute pancreatitis. Ceftriaxone should be considered as a possible etiologic agent in patients who present with acute abdominal pain and elevated lipase and amylase concentrations.

scholarly journals Acute Pancreatitis Coincided with Multiple Arteriolar Aneurysms in a Patient with Polyarteritis Nodosa

2021 ◽  
Author(s):  
Ko Takamatsu ◽  
Yasuyoshi Kusanagi ◽  
Hideyuki Horikoshi ◽  
Takashi Nakanishi ◽  
Akinori Wada ◽  
...  
Keyword(s):  
Septic Shock ◽  
Weight Loss ◽  
Acute Pancreatitis ◽  
Abdominal Pain ◽  
Severe Acute Pancreatitis ◽  
Disseminated Intravascular Coagulation ◽  
Polyarteritis Nodosa ◽  
Acute Abdominal Pain ◽  
Necrotizing Vasculitis ◽  
History Of

Abstract A 78-year-old man presented to our hospital with a history of 10kg weight loss within 6 months previously, and general fatigue and fever for 2 and 1 months, respectively. On hospitalization, the patient was diagnosed with polyarteritis nodosa after multiple microaneurysms were observed in the liver, kidney, pancreas, and mesenteries. He achieved remission with the administration of 1,000mg methylprednisolone for 3 days, followed by prednisolone (55mg/day). Steroids were successfully tapered with no re-elevation in inflammation. Two months after the administration of steroids, the patient complained of acute abdominal pain, and developed severe acute pancreatitis. During treatment for pancreatitis, the patient died due to septic shock and disseminated intravascular coagulation. An autopsy revealed necrotizing vasculitis in the intrapancreatic arteries and ischemia of the downstream arterioles resulting in acute pancreatitis.

scholarly journals Pacreatititis induced pseudoaneurysm of splenic artery: an unusual cause of gastrointestinal bleeding

2021 ◽  
Vol 8 (3) ◽  
pp. 1020
Author(s):  
Oseen Hajilal Shaikh ◽  
Suresh Chilaka ◽  
Gopal Balasubramanian ◽  
Uday Shamrao Kumbhar ◽  
Muhamed Tajudeen
Keyword(s):  
Computed Tomography ◽  
Acute Pancreatitis ◽  
Abdominal Pain ◽  
Splenic Artery ◽  
Acute Abdominal Pain ◽  
Uneventful Recovery ◽  
Chronic Alcoholic ◽  
Visceral Arteries ◽  
History Of ◽  
Endovascular Coil Embolization

Acute or chronic pancreatitis can cause pseudoaneurysm of visceral arteries. The splenic artery is the most common to get affected. Here, we report a case of acute pancreatitis with pseudoaneurysm of the splenic artery. A 40 year old male, a chronic alcoholic with a known history of acute pancreatitis, presented with acute abdominal pain, haematemesis, and melena. Diagnosis of pseudoaneurysm of splenic artery was confirmed by computed tomography abdomen. The endovascular coil embolization was done successfully, following which the patient made an uneventful recovery

Antibiotic Therapy Did Not Prevent the Rupture of Mycotic Aneurysm of the Superior Mesenteric Artery

2015 ◽  
Vol 18 (3) ◽  
pp. 088
Author(s):  
Ye-tao Li ◽  
Xiao-bin Liu ◽  
Tao Wang
Keyword(s):  
Abdominal Pain ◽  
Infective Endocarditis ◽  
Aortic Valve ◽  
Superior Mesenteric Artery ◽  
Mesenteric Artery ◽  
Mycotic Aneurysm ◽  
Acute Abdominal Pain ◽  
Rare Complication ◽  
Emergency Operation ◽  
History Of

<p class="p1"><span class="s1">Mycotic aneurysm of the superior mesenteric artery (SMA) is a rare complication of infective endocarditis. We report a case with infective endocarditis involving the aortic valve complicated by multiple septic embolisms. The patient was treated with antibiotics for 6 weeks. During preparation for surgical treatment, the patient developed acute abdominal pain and was diagnosed with a ruptured SMA aneurysm, which was successfully treated with an emergency operation of aneurysm ligation. The aortic valve was replaced 17 days later and the patient recovered uneventfully. In conclusion, we present a rare case with infective endocarditis (IE) complicated by SMA aneurysm. Antibiotic treatment did not prevent the rupture of SMA aneurysm. Abdominal pain in a patient with a recent history of IE should be excluded with ruptured aneurysm.</span></p>

scholarly journals Computed Tomography Imaging in Lemmel Syndrome: A Report of Two Cases

2019 ◽  
Vol 9 ◽  
pp. 23
Author(s):  
Giulia Frauenfelder ◽  
Annamaria Maraziti ◽  
Vincenzo Ciccone ◽  
Giuliano Maraziti ◽  
Oliviero Caleo ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Abdominal Pain ◽  
Bile Duct ◽  
Common Bile Duct ◽  
Acute Abdominal Pain ◽  
Imaging Modality ◽  
Biliary Duct ◽  
History Of ◽  
The Common ◽  
Solid Lesions

Lemmel syndrome is a rare and misdiagnosed cause of acute abdominal pain due to a juxtapapillary duodenal diverticulum causing mechanical obstruction of the common bile duct. Frequently, patients suffering from Lemmel syndrome have a history of recurrent access to the emergency room for acute abdominal pain referable to a biliopancreatic obstruction, in the absence of lithiasis nuclei or solid lesions at radiological examinations. Ultrasonography (US) may be helpful in evaluation of upstream dilatation of extra-/intra-hepatic biliary duct, but computed tomography (CT) is the reference imaging modality for the diagnosis of periampullary duodenal diverticula compressing the intrapancreatic portion of the common bile duct. Recognition of this entity is crucial for targeted, timely therapy avoiding mismanagement and therapeutic delay. The aim of this paper is to report CT imaging findings and our experience in two patients affected by Lemmel syndrome.

Unscheduled Revisits after Diagnosis of Abdominal Pain at Emergency Department, Mukdahan Hospital

2021 ◽  
Vol 104 (Suppl. 1) ◽  
pp. S40-S43
Keyword(s):  
Emergency Department ◽  
Abdominal Pain ◽  
Patient Care ◽  
Acute Abdominal Pain ◽  
Signs And Symptoms ◽  
Discharge System ◽  
Effective Discharge ◽  
Time Period ◽  
Pain Patients

Background: Abdominal pain is a common complaint for patients revisiting the Emergency Department (ED). Evaluating the cause of the revisit can improve the quality of ED patient care. Objective: We aimed to analyzed unscheduled revisits after diagnosis of abdominal pain at emergency department. Materials and Methods: In order to determine the characteristics of their abdominal pain and the causes for the revisits, the charts of 90 patients were reviewed. These patients had experienced acute abdominal pain and had returned to the Emergency Department within 48 hours after their initial treatment during the period between January 2019 and December 2019. Results: During that time period, 44,000 patients visited the ED. Of these, 90 patients (0.2%) with acute abdominal pain or related symptoms had revisited the ED within the following 48 hours. Most of these patients had been 20 to 60 years of age and had had no co-morbid diseases. Almost half of patient revisits had occurred during the evening shift (45.6%). There were 74% of these patients, who had been admitted to hospital for observation or for procedures. No in-hospital mortality was reported for this study. The signs and symptoms of abdominal pain in these patients had not been specific. The factors, which most often contributed to the ED revisits, had been inappropriate consultations and inappropriate discharges or advises. Conclusion: The majority of the acute abdominal pain patients, who revisited the ED within 48 hours, had been admitted. The most common cause of revisits had been inappropriate consultations and inappropriate discharges. Improving ED patient care can be managed by contributing to effective consultations and to establishing an effective discharge system for the ED. Keywords: Revisits, Emergency medicine department, Acute abdominal pain

Sumatriptan in the Treatment of Cyclic Vomiting

1995 ◽  
Vol 29 (10) ◽  
pp. 997-999 ◽  
Author(s):  
John M Benson ◽  
Sherri L Zorn ◽  
Linda S Book
Keyword(s):  
Abdominal Pain ◽  
Subcutaneous Injection ◽  
Migraine Headache ◽  
Agonist Activity ◽  
Single Subcutaneous Injection ◽  
Serotonin Agonist ◽  
Case Summary ◽  
History Of ◽  
Time Of Admission ◽  
Cyclic Vomiting

Objective: To describe a patient with cyclic vomiting who was treated successfully with sumatriptan, a serotonin, agonist. Case Summary: A patient with a 4-year history of cyclic vomiting was treated for an episode of nausea, vomiting, and abdominal pain. This patient had been hospitalized numerous times for cyclic vomiting over the previous 4 years, each hospitalization lasting from 3 to 11 days. Following a single subcutaneous injection of sumatriptan 6 mg, the patient ceased vomiting and was discharged 40 hours from the time of admission. Discussion: The efficacy of sumatriptan in migraine headache appears to be mediated through its agonist activity at the serotonin1D receptor, resulting in constriction of dural blood vessels. According to published reports, therapeutic attempts at controlling cyclic vomiting often have included antimigraine therapies. Consistent with these reports, sumatriptan also appears effective in the treatment of cyclic vomiting. Conclusions: The pathogenesis of cyclic vomiting appears to share similarities with classic migraine, both of which may respond to sumatriptan therapy according to this report and previous work. Further study of the use of sumatriptan in the treatment of cyclic vomiting appears warranted.

scholarly journals SAT-579 Experiences with Hypertriglyceridemic Pancreatitis: A Mini Case Series

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Priyanka Majety ◽  
Richard D Siegel
Keyword(s):  
Acute Pancreatitis ◽  
Abdominal Pain ◽  
Early Recognition ◽  
Rare Complication ◽  
Case Series ◽  
Diagnostic Challenge ◽  
Eruptive Xanthomas ◽  
History Of ◽  
Appropriate Therapy ◽  
Pruritic Skin

Abstract Background: Hypertriglyceridemia (HTG) is a well-established cause of acute pancreatitis (AP) in up to 14% of all cases & up to 56% cases during pregnancy. The triad of HTG, Diabetic ketoacidosis (DKA) and AP is rarely seen posing diagnostic challenges. Early recognition of HTG-induced pancreatitis (HTGP) is important to provide appropriate therapy & prevent recurrence. In this case series, we discuss the diagnostic challenges and clinical features of HTGP. Clinical cases: Our first patient was a 65-year-old male with a history of hypertension who presented to the ER with abdominal pain and new-onset pruritic skin rash after a heavy meal. His exam and labs were notable for a diffuse papular rash on his back, triglycerides (TG) of 7073mg/dL (normal: &lt;150mg/dL). The rash improved with the resolution of HTG. Our second patient was a 29-year-old male with a history of alcohol dependence who was found to have AP complicated by ARDS requiring intubation. Further testing revealed that his TG was 12,862mg/dL & his sodium (Na) was 102mEq/L. Although HTG was known to cause pseudohyponatremia, it was a diagnostic challenge to estimate the true Na level. In a third scenario, a 28-year-old female with a history of T2DM on Insulin presented with nausea & abdominal pain. Labs were suggestive of DKA and lipase was normal. CT abdomen showed changes consistent with AP. The TG level that was later added on was elevated to 4413mg/dL. She was treated with insulin that improved her TG level. Discussion: We present three cases of hypertriglyceridemic pancreatitis. While the presentation can be similar to other causes of acute pancreatitis (AP), there are factors in the diagnosis and management of HTGP that are important to understand. Occasionally, physical exam findings can be suggestive of underlying HTG. In the first scenario, our patient presented with eruptive xanthomas - a sudden eruption of crops of papules that can be pruritic. They are highly suggestive of HTG, often associated with serum TG levels &gt; 1500mg/dL. Our second patient presented with pseudohyponatremia. HTG falsely lowers Na level, by affecting the percentage of water in plasma. Identifying this condition is important to prevent possible complications from aggressive treatment. This can be corrected either by using direct ion-specific electrodes or with the formula: Na change = TG * 0.002. DKA is associated with mild-moderate HTG in 30–50% cases. This is due to insulin deficiency causing activation of lipolysis in adipocytes & decreased activity of lipoprotein lipase (LPL). However, severe HTG is a rare complication of DKA, increasing the risk of AP. Diagnosis of AP in DKA poses many challenges: the common presenting complaint of abdominal pain, non-specific hyperlipasemia in DKA. AP with DKA has also been associated with normal lipase levels. A high clinical index of suspicion is required to diagnose HTGP in patients with DKA.

scholarly journals Case Report: Acute Abdominal Pain as Presentation of Pneumonia and Acute Pancreatitis in a Pediatric Patient With COVID-19

JPGN Reports ◽  
2020 ◽  
Vol 2 (1) ◽  
pp. e011
Author(s):  
Raul E. Sanchez ◽  
Colleen B. Flahive ◽  
Ethan A. Mezoff ◽  
Cheryl Gariepy ◽  
W. Garrett Hunt ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Abdominal Pain ◽  
Case Report ◽  
Pediatric Patient ◽  
Acute Abdominal Pain

scholarly journals Paediatric ovarian torsion: a case report and review of literature

2020 ◽  
Vol 9 (6) ◽  
pp. 2638
Author(s):  
Umang . ◽  
Harleen Kaur Cheema ◽  
Sidharth Khullar ◽  
Madhu Nagpal
Keyword(s):  
Abdominal Pain ◽  
Acute Abdominal Pain ◽  
Rare Condition ◽  
Signs And Symptoms ◽  
Conservative Surgery ◽  
Ovarian Torsion ◽  
High Clinical Suspicion ◽  
Abdominal And Pelvic Pain ◽  
Intra Abdominal Infection ◽  
Prompt Diagnosis

Ovarian torsion is a surgical emergency, can result in ovarian loss, intra-abdominal infection and even death. Paediatric ovarian torsion is a rare condition, requires high clinical suspicion and prompt diagnosis. Diagnosis is a challenge since signs and symptoms are similar to those of other causes of acute abdominal pain such as appendicitis, gastroenteritis, urinary tract infection, renal colic or other conditions of acute abdominal and pelvic pain. Here, authors describe a case of a 4-year-old girl with a presentation of acute abdominal pain, treated empirically elsewhere. After investigations, a provisional diagnosis of ovarian torsion was made and patient was taken up for surgery. Intraoperatively, ovary was found to be necrosed. Detorsion was tried but ovary was unsalvageable. Right sided salpingectomy with oophorectomy was performed. Conservative surgery by laparoscopic detorsion can be tried in cases of ischemia but if necrosis has already set in, then salpingo-oophorectomy has to be performed.

A Homeopathic Approach to Inflammatory Bowel Disease (Crohn’s and Colitis)

2017 ◽  
Vol 4 (3) ◽  
Author(s):  
M.P Sharma
Keyword(s):  
Inflammatory Bowel Disease ◽  
Crohn’S Disease ◽  
Abdominal Pain ◽  
Crohn's Disease ◽  
Treatment Plan ◽  
Signs And Symptoms ◽  
Lifestyle Advice ◽  
History Of ◽  
Inflammatory Bowel ◽  
Positive Results

Homeopathy for Chrohn’s disease and colitis. “In clinical practice I have come across countless cases, in various stages of IBD and have had extremely positive results. The most useful tool in treatment is accurate case taking and history. Many patients typically ignore or neglect key symptoms that help accurately determine the most beneficial remedy or remedies for treatment. Proper administration of the treatment plan, nutritional, and lifestyle advice and patient compliance pay dividends in healing.”The first signs and symptoms of both Crohn's disease and UC are very similar. These symptoms include diarrhea, abdominal pain and cramping, rectal bleeding, fever, and fatigue. Both UC and Crohn's disease occur more commonly in people ages 15 to 35 and people with a family history of either type of IBD.

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