scholarly journals Peritonitis secondary to a blocked perforated ulcer: management

2022 ◽  
Author(s):  
Amine Chaabouni ◽  
Haroun Guermazi ◽  
Mohamed Ali Mseddi ◽  
kais fourati
Keyword(s):  
Emergency Department ◽  
Young Patient ◽  
Epigastric Pain ◽  
Perforated Ulcer ◽  
Peritoneal Effusion ◽  
Exploratory Laparoscopy

We report the case of a 42 years old young patient who was examined in the emergency department for epigastric pain lasting for 3 days. The abdominal tomodensitometry allowed to highlight the presence of an intra peritoneal effusion without pneumopertoneum. The patient underwent an exploratory laparoscopy. There was peritoneal toilet

scholarly journals Comparison of Intra-Venus Ranitidine with Pantoprazole in Patients with Epigastric Pain Referring to Emergency Department

2020 ◽  
Vol 8 (1) ◽  
pp. 1-5
Author(s):  
Iraj Goli Khatir ◽  
Fatemeh Jahanian ◽  
Nooshin Varedi ◽  
Hamed Amini Ahidashti ◽  
Seyyed Hosein Montazar ◽  
...  
Keyword(s):  
Emergency Department ◽  
Epigastric Pain

scholarly journals Eroded GDA coil surgically managed with Roux-en-Y reconstruction

2019 ◽  
Vol 2019 (8) ◽  
Author(s):  
Michael Iannamorelli ◽  
Adam Bowling ◽  
Elie Semaan
Keyword(s):  
Emergency Department ◽  
Interventional Radiology ◽  
High Risk ◽  
African American Male ◽  
Distal Gastrectomy ◽  
Epigastric Pain ◽  
Duodenal Bulb ◽  
Gastroduodenal Artery ◽  
Loss Of Consciousness ◽  
Upper Endoscopy

Abstract Here, we describe the case of a 56-year-old African American male who initially presented to the emergency department with 2 days of abdominal cramping, epigastric pain, loss of consciousness, melena and hematochezia. He underwent coil embolization of his gastroduodenal artery by the interventional radiology team after it was felt he was a high risk for rebleed. The patient then returned to the hospital with 3 weeks of epigastric pain, lightheadedness and melanotic stool. An upper endoscopy revealed a metallic coil embedded into the duodenal bulb. This coil was believed to be from prior embolization to the gastroduodenal artery. The patient then underwent a laparoscopic distal gastrectomy and partial duodenectomy with antecolic antegastric Roux-en-Y reconstruction bypassing the area where erosion occurred.

scholarly journals The Curious Case of Opioid-Induced Pancreatitis

2021 ◽  
Vol 9 (VII) ◽  
pp. 3378-3379
Author(s):  
Glenn Goodwin
Keyword(s):  
Emergency Department ◽  
Acute Pancreatitis ◽  
Effective Treatment ◽  
Epigastric Pain ◽  
Clinical Importance ◽  
Sphincter Of Oddi ◽  
Acute Onset ◽  
Increased Risk ◽  
Opioid Medications ◽  
Patient Presentation

While most cases are known to be caused by gallstones or alcohol, a myriad of other causes have also been identified; medications being one of them. A wide array of medications have robustly been proven to cause pancreatitis 1 Opioid-induced pancreatitis, specifically, is less well documented. Only a handful of cases have been published, with Codeine being implicated as the trigger.2–7 Interestingly, these Codeine pancreatitis cases are almost exclusively seen in post-cholecystectomy patients.2–7 This is the case of a 54-year-old female presenting to the emergency department with acute-onset severe, crampy, epigastric pain, radiating to her back. The patient had accidentally ingested Acetaminophen with Codeine, thinking it was a sleeping aid. Approximately one hour after the ingestion, her symptoms began. The pathophysiology of opioid-induced pancreatitis is reviewed, with the proposed mechanism of codeine-induced Sphincter of Oddi spasm. In conclusion, opioid-induced acute pancreatitis in post-cholecystectomy patients has been well-established but surprisingly under-documented. There is tangible and pragmatic clinical importance, as clinicians should consider the increased risk of acute pancreatitis in patients with prior cholecystectomy, when prescribing opioid medications. Should a clinician find themselves with this patient presentation, naloxone seems to be an effective treatment, along with standard pancreatitis treatment, and discontinuation of the offending agent.

scholarly journals Development of pulmonary embolism in a nonhospitalized patient with COVID-19 who did not receive venous thromboembolism prophylaxis

2020 ◽  
Vol 77 (23) ◽  
pp. 1957-1960
Author(s):  
Ellen M Uppuluri ◽  
Nancy L Shapiro
Keyword(s):  
Risk Factors ◽  
Emergency Department ◽  
Pulmonary Embolism ◽  
Venous Thromboembolism ◽  
Chest Pain ◽  
Young Patient ◽  
Lower Lobe ◽  
Thromboembolism Prophylaxis ◽  
Vte Prophylaxis ◽  
Thrombotic Complications

Abstract Purpose Coronavirus disease 2019 (COVID-19) has been associated with thrombotic complications such as stroke and venous thromboembolism (VTE), and VTE prophylaxis for hospitalized patients with COVID-19 is recommended. However, extended postdischarge VTE prophylaxis and VTE prophylaxis for nonhospitalized patients with COVID-19 are not routinely recommended due to uncertain benefit in these populations. Summary Here we report development of a pulmonary embolism (PE) in a young patient without other VTE risk factors who was treated for COVID-19 in an emergency department (ED) and discharged home without VTE prophylaxis, which was consistent with current recommendations. The patient presented to the ED 12 days later with complaints of chest pain for 1 day and was found to have a PE within the segmental and subsegmental branches of the left lower lobe. Conclusion This case suggests that nonhospitalized patients with COVID-19 may be at higher risk for VTE than patients with other medical illnesses and warrants further research into the risk of VTE in outpatients with COVID-19.

scholarly journals Gastric Outlet Obstruction Due to Malposition of Replacement Gastrostomy Tube

2019 ◽  
Vol 3 (4) ◽  
pp. 442-443
Author(s):  
Brent Becker ◽  
Travis Walker
Keyword(s):  
Computed Tomography ◽  
Emergency Department ◽  
Small Bowel ◽  
Gastric Outlet Obstruction ◽  
Epigastric Pain ◽  
Outlet Obstruction ◽  
Gastrostomy Tube ◽  
Abdominal Radiography ◽  
Radiographic Findings ◽  
Proximal Small Bowel

A 78-year old male presented to the emergency department after accidental dislodgement of his chronic gastrostomy tube. A replacement gastrostomy tube was passed easily through the existing stoma and flushed without difficulty. Confirmatory abdominal radiography demonstrated contrast in the proximal small bowel, but the patient subsequently developed epigastric pain and refractory vomiting. Computed tomography revealed the tip of the gastrostomy tube terminating in the pylorus or proximal duodenum. This case highlights gastric outlet obstruction complicating the replacement of a gastrostomy tube and the associated radiographic findings.

scholarly journals Acute Pancreatitis and Posterior Reversible Encephalopathy Syndrome: A Case Report

2016 ◽  
Vol 29 (9) ◽  
pp. 567 ◽  
Author(s):  
Vítor Magno Pereira ◽  
Luís Marote Correia ◽  
Tiago Rodrigues ◽  
Gorete Serrão Faria
Keyword(s):  
Magnetic Resonance Imaging ◽  
Computed Tomography ◽  
Emergency Department ◽  
Magnetic Resonance ◽  
Posterior Reversible Encephalopathy Syndrome ◽  
Epigastric Pain ◽  
Brain Magnetic Resonance Imaging ◽  
Resonance Imaging ◽  
Posterior Reversible Encephalopathy ◽  
Reversible Encephalopathy

The posterior reversible encephalopathy syndrome is a neurological syndrome characterized by headache, confusion, visual disturbances and seizures associated with identifiable areas of cerebral edema on imaging studies. The authors report the case of a man, 33 years-old, leukodermic with a history of chronic alcohol and tobacco consumption, who is admitted to the emergency department for epigastric pain radiating to the back and vomiting with about six hours of evolution and an intense holocranial headache for two hours. His physical examination was remarkable for a blood pressure of 190/100 mmHg and tenderness in epigastrium. His analytical results revealed emphasis on amylase 193 U/L and lipase 934 U/L. During the observation in the emergency department,he presented a generalized tonic-clonic seizure. Abdominal ultrasonography was performed and suggestive of pancreatitis withoutgallstones signals. Head computed tomography showed subarachnoid haemorrhage and a small right frontal cortical haemorrhage. The brain magnetic resonance imaging done one week after admission showed areas of a bilateral and symmetrical T2 / FLAIR hyperintensities in the subcortical white matter of the parietal and superior frontal regions, suggesting a diagnosis of posterior reversible encephalopathy syndrome. Abdominal computed tomography (10 days after admission) demonstrated a thickened pancreas in connection with inflammation and two small hypodense foci in the anterior part of the pancreas body, translating small foci of necrosis. The investigation of a thrombophilic defect revealed a heterozygous G20210A prothrombin gene mutation. The patient was discharged without neurological sequelae and asymptomatic. The follow-up brain magnetic resonance imaging confirmed the reversal of the lesions, confirming the diagnosis.

Cardiac computed tomography in the emergency department: A patient with acute epigastric pain

2010 ◽  
Vol 4 (2) ◽  
pp. 142-143
Author(s):  
Vahid Etezadi ◽  
Constantino Pena ◽  
Angelo La-Pietra ◽  
Jack A. Ziffer ◽  
Barry T. Katzen ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Emergency Department ◽  
Epigastric Pain ◽  
Cardiac Computed Tomography

scholarly journals Abruptio Placentae Caused by Hypertriglyceridemia-Induced Acute Pancreatitis during Pregnancy: Case Report and Literature Review

2018 ◽  
Vol 2018 ◽  
pp. 1-8
Author(s):  
Pınar Yalcin Bahat ◽  
Gokce Turan ◽  
Berna Aslan Cetin
Keyword(s):  
Emergency Department ◽  
Acute Pancreatitis ◽  
Risk Factor ◽  
Abdominal Pain ◽  
Literature Review ◽  
Epigastric Pain ◽  
Serum Insulin ◽  
High Rate ◽  
Abruptio Placentae ◽  
Uterine Contractions

Background. Hormonal effects during pregnancy can compromise otherwise controlled lipid levels in women with hypertriglyceridemia and predispose to pancreatitis leading to increased morbidity for mother and fetus. Elevation of triglyceride levels is a risk factor for development of pancreatitis if it exceeds 1000 mg/dL. Pancreatitis should be considered in emergency cases of abdominal pain and uterine contractions in Emergency Department at any stage of pregnancy. We report a case of abruptio placentae caused by hypertriglyceridemia-induced acute pancreatitis. Also, literature review of cases of acute pancreatitis induced by hypertriglycaemia in pregnancy has been made. Case. A 22-year-old woman presented to our Emergency Department, at 35 weeks of gestation, for acute onset of abdominal pain and uterine contractions. Blood tests showed a high rate of triglyceride. The patient was diagnosed with abruptio placentae caused by hypertriglyceridemia-induced acute pancreatitis. Immediate cesarean section was performed and it was observed that blood sample revealed a milky turbid serum. Insulin, heparin, and supportive treatment were started. She was discharged on the 10th day. Conclusion. Consequently, patients with known hypertriglyceridemia or family history should be followed up more closely because any delay can cause disastrous conclusions for mother and fetus. Acute pancreatitis should be considered in pregnant women who have sudden onset, severe, persistent epigastric pain and who have a risk factor for acute pancreatitis.

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