Accidentally ingested textile foreign bodies, a cause of gastrointestinal
obstruction in dogs and cats – a retrospective study

Gastrointestinal obstruction is a life-threatening condition that is usually caused by accidental ingestion of inedible objects, through play or food indiscretions. Ingested foreign objects generate the mechanical obstruction of the gastrointestinal segment, characterized by a relatively typical set of symptoms, depending on the location. The aim of this study was the clinical and imaging description of some cases of gastrointestinal obstruction in dogs and cats, caused by swallowing textile foreign bodies. The study included 12 dogs and 8 cats of different breeds and ages, belonging to both sexes, which showed clinical signs suggestive from a clinical-anamnestic point of view for gastrointestinal obstruction. These patients had symptoms with acute or chronic progressive evolution of the gastrointestinal tract, including restlessness, deviation, vomiting (single or repeated episodes), abdominal tenderness, constipation and tenesmus. The diagnosis was confirmed by radiographic examination, simple and with contrast medium, and ultrasound, completed in some situations with laparotomy. Ingested textile foreign bodies were represented by socks/stockings (5 dogs and 3 cats), underwear (3 dogs), rope (1 dog and 3 cats), carpet fragments (2 dog and 1 cat), toy fragments (1 dog and 1 cat), and they were located in the stomach (7/12; 58.33%, respectively 4/8; 50%), in the gastro-duodenal segment (2/12; 16.67%, respectively 3/8; 37.5%), in the jejunum (3/12; 25%, respectively 1/8; 12.5%) and in the colon (1/12; 8.33%, respectively 1/8; 12.5%). Gastrointestinal obstruction in pets, caused by accidental ingestion of textile foreign bodies, is a medical emergency and imaging examinations are the main diagnostic tool in the establishment of a subsequent therapy with maximum efficiency.

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Myelodysplastic Syndrome Clinically Presenting with the “Classic TTP Pentad”

Case Reports in Hematology ◽

10.1155/2017/4619406 ◽

2017 ◽

Vol 2017 ◽

pp. 1-6 ◽

Cited By ~ 1

Author(s):

Santiago Fabián Moscoso Martínez ◽

Evelyn Carolina Polanco Jácome ◽

Elizabeth Guevara ◽

Vijay Mattoo

Keyword(s):

Myelodysplastic Syndrome ◽

Clinical Presentation ◽

Renal Involvement ◽

Medical Emergency ◽

Complete Blood Cell Count ◽

Blood Cell Count ◽

Thrombocytopenic Purpura ◽

Life Saving ◽

Threatening Condition ◽

Life Threatening

The clinical presentation of myelodysplastic syndrome (MDS) is not specific. Many patients can be asymptomatic and can be detected only due to an abnormal complete blood cell count (CBC) on routine exam or for other reasons while others can be symptomatic as a consequence of underlying cytopenias. Thrombotic thrombocytopenic purpura (TTP) usually is suspected under the evidence of microangiopathic hemolytic anemia (MAHA) and thrombocytopenia and because it is a life-threatening condition (medical emergency) immediate initiation of plasmapheresis could be life-saving. The following case illustrates an unusual presentation of MDS in a patient who came in to the emergency room with the classic TTP “pentad” of fever, renal involvement, MAHA, mental status changes, and thrombocytopenia. We will focus our discussion in the clinical presentation of this case.

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Intensive Care Management of Multiorgan Dysfunction and Hypoxic Brain Injury Secondary to Refractory Status Epilepticus

Life and Science ◽

10.37185/lns.1.1.122 ◽

2021 ◽

Vol 2 (4) ◽

pp. 3

Author(s):

Sanum Kashif

Keyword(s):

Status Epilepticus ◽

Refractory Status Epilepticus ◽

Medical Emergency ◽

High Grade Fever ◽

Refractory Status ◽

Hypoxic Brain Injury ◽

Hypoxic Brain ◽

Threatening Condition ◽

Life Threatening ◽

Permanent Brain Damage

Refractory Status Epilepticus (RSE) is a medical emergency that may lead to permanent brain damage or death.Mortality rate is 16-39%. It is the life threatening condition in which continuous fits occur, despite treatmentwith benzodiazepines and one antiepileptic drug.A 25-year-old female, brought in emergency department with high-grade fever and frequent fits. GlasgowComa Scale (GCS) was 3/15 with unstable hemodynamics. Resuscitation started immediately and managed asstatus epilepticus. Patient was in multi organ failure on arrival. On the basis of history and examination, hypoxicbrain injury was diagnosed initially. Later on, refractory status epilepticus (RSE) with multi organ dysfunctionsyndrome (MODS) was diagnosed, after necessary investigations and treatment. Patient was managed as ateam with multidisciplinary approach and after continuous effort of 2 weeks, patient was successfullydischarged to home.

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Sudden death due to ruptured oesophageal varices – autopsy-based case report

Medico-Legal Journal ◽

10.1177/0025817220926929 ◽

2020 ◽

Vol 88 (4) ◽

pp. 189-191

Author(s):

Nagendra Singh Sonwani ◽

Navneet Ateriya ◽

Arvind Kumar ◽

Anil Kohli ◽

Kalyan Kumar Banerjee

Keyword(s):

Chronic Alcoholism ◽

Medical Emergency ◽

Oesophageal Varices ◽

High Morbidity ◽

Forensic Pathologist ◽

Threatening Condition ◽

Life Threatening ◽

Cirrhotic Patients ◽

Acute Haemorrhage

Acute haemorrhage from ruptured oesophageal varices is a serious consequence of portal hypertension in cirrhotic patients. It represents a medical emergency with a high morbidity and mortality rate. Studies over the years have shown a direct link with chronic alcoholism in the development of such complications. Although the gastrointestinal system accounts for a few numbers of sudden deaths, bleeding through ruptured varices represent a life-threatening condition. The role of forensic pathologist is vital in dealing with sudden deaths. Here, we report a case of a 46-year-old man who died suddenly following the rupture of oesophageal varices.

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Aortic Dissection Presenting as Acute Pancreatitis: Suspecting the Unexpected

Case Reports in Cardiology ◽

10.1155/2018/4791610 ◽

2018 ◽

Vol 2018 ◽

pp. 1-4 ◽

Cited By ~ 1

Author(s):

Adam Hafeez ◽

Dillon Karmo ◽

Adrian Mercado-Alamo ◽

Alexandra Halalau

Keyword(s):

Blood Pressure ◽

Acute Pancreatitis ◽

Aortic Dissection ◽

Epigastric Pain ◽

Pressure Control ◽

Sudden Onset ◽

Medical Emergency ◽

Threatening Condition ◽

Life Threatening ◽

Normal Triglyceride

Aortic dissection is a life-threatening condition in which the inner layer of the aorta tears. Blood surges through the tear, causing the inner and middle layers of the aorta to separate (dissect). It is considered a medical emergency. We report a case of a healthy 56-year-old male who presented to the emergency room with sudden onset of epigastric pain radiating to his back. His blood pressure was 167/91 mmHg, equal in both arms. His lipase was elevated at 1258 U/L, and he was clinically diagnosed with acute pancreatitis (AP). He denied any alcohol consumption, had no evidence for gallstones, and had normal triglyceride level. Two days later, he endorsed new suprapubic tenderness radiating to his scrotum, along with worsening epigastric pain. A MRCP demonstrated evidence of an aortic dissection (AD). CT angiography demonstrated a Stanford type B AD extending into the proximal common iliac arteries. His aortic dissection was managed medically with rapid blood pressure control. The patient had excellent recovery and was discharged home without any surgical intervention.

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Treatment of refractory status epilepticus with electroconvulsive therapy: Need for future clinical studies

International Journal of Epilepsy ◽

10.1016/j.ijep.2017.01.002 ◽

2017 ◽

Vol 04 (01) ◽

pp. 098-103 ◽

Cited By ~ 1

Author(s):

Anindya Ray

Keyword(s):

Status Epilepticus ◽

Electroconvulsive Therapy ◽

Low Cost ◽

Refractory Status Epilepticus ◽

Medical Emergency ◽

Therapeutic Modality ◽

Future Research ◽

Systematic Research ◽

Threatening Condition ◽

Life Threatening

AbstractStatus epilepticus (SE) is a serious medical emergency. Refractory-SE non-responsive to anesthetic medication is a life threatening condition with very high mortality rate. Proper management of those cases is a big medical challenge. Over the last two decades there are anecdotal reports of successful management of such cases with electroconvulsive therapy (ECT) in 12 patients of different age group with variable pattern of seizures and different etiology. However, there is no systematic research about it. ECT is a well-known safe, easy- to-administer, low-cost therapeutic modality in the field of neuro-psychiatry. Thus its potential to treat refractory-SE which essentially lacks effective management should be evaluated in future research. The objectives of this article are to do a thorough literature review on use of ECT in refractory-SE; mechanism of action of ECT in refractory-SE; and finally formulate a working protocol for future study of using ECT in patients of refractory-SE.

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Emphysematous cholecystitis

ABCD Arquivos Brasileiros de Cirurgia Digestiva (São Paulo) ◽

10.1590/s0102-67202009000400011 ◽

2009 ◽

Vol 22 (4) ◽

pp. 235-236

Author(s):

Renato Micelli Lupinacci ◽

Najim Chafai ◽

Emmanuel Tiret

Keyword(s):

Open Cholecystectomy ◽

Clinical Signs ◽

Vascular Diseases ◽

Gallbladder Wall ◽

White Blood Count ◽

Emphysematous Cholecystitis ◽

Reactive Protein ◽

Threatening Condition ◽

Life Threatening ◽

Male Patients

BACKGROUND: Emphysematous cholecystitis is life-threatening condition characterized by gas-forming infection of the gallbladder. It is mostly seems in old male patients with systemic, specially diabetes and vascular diseases. CASE REPORT: - A 30-year-old man without previous diseases was admitted because of right upper quadrant pain and nausea. On admission the patient was febrile (38.7o) with normal bilirubin levels. The white blood count was 26700/µl and reactive protein C was 470. Axial sections of single slice computed tomography imaging (section thickness 5 mm), revealed gallbladder wall enhancement after i.v. contrast, as well as dilatation of the gallbladder with intraluminal air. The patient underwent open cholecystectomy. The culture of the bile showed clostridium perfringes. The postoperative course of the patient was uneventful. CONCLUSION: This is a rare form of cholecystitis that carries a high mortality and usually present insidious clinical signs. CT is the most accurate imaging technique. Antibiotic therapy should begin quickly and include coverage of common pathogens, particularly Clostridia. Surgical intervention should take place as early as possible.

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Analysis of the Interventions of Medical Emergency Teams in Older Patients in Selected Polish Cities with County Status: A Retrospective Cohort Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18147664 ◽

2021 ◽

Vol 18 (14) ◽

pp. 7664

Author(s):

Mariusz Celiński ◽

Mateusz Cybulski ◽

Joanna Fiłon ◽

Marta Muszalik ◽

Mariusz Goniewicz ◽

...

Keyword(s):

Older Patients ◽

Emergency Service ◽

Geriatric Patients ◽

Health Care Facilities ◽

Medical Emergency ◽

Ambulance Dispatch ◽

Medical Emergency Teams ◽

Threatening Condition ◽

Emergency Interventions ◽

Life Threatening

Introduction: Geriatric patients account for a large proportion of interventions of medical emergency teams (METs). The aim of this study was to analyse medical emergency interventions in the Biała Podlaska and Chełm (Poland) between 2016 and 2018 in a group of patients ≥ 65 years of age. Materials and Methods: We analysed medical records of 1200 older patients treated by METs in Biała Podlaska and Chełm (Lublin Province, Poland). The research was conducted from June 2019 to March 2020 at the Emergency Medical Service Station in Biała Podlaska and the Medical Rescue Station in Chełm (Independent Public Complex of Health Care Facilities). Results: A total of 92.5% of medical emergency service interventions took place at the patient’s home. The mean time of stay at the scene was 20 min. The highest number of interventions occurred between 8:00 p.m. and 8:59 p.m. There were no statistically significant differences in the type of ambulance used depending on the patient’s sex, while there was a statistically significant relationship between priority code and sex. Cardiovascular diseases were diagnosed in 40% of patients, and the symptoms were not precisely classified in almost the same percentage of patients. Mortality cases accounted for 3.1% of the 1200 interventions analysed. Ambulance dispatch resulted in the patient being transported to the hospital emergency department in 69.1% of cases. Conclusions: METs were called for a variety of diseases due to the fact that geriatric patients are not able to distinguish a life-threatening condition. Medical procedures performed by METs from Biała Podlaska and Chełm were closely related to the initial diagnoses made by these teams. It was irrelevant whether a specialist or non-specialist medical emergency service was used. Paramedics are very well trained to practice their profession and are able to provide treatment to older patients in a state of sudden life threat.

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Sudden cardiac death in excited delirium, and how to prevent it

10.22514/sv.2021.222 ◽

2021 ◽

Keyword(s):

Medical Emergency Team ◽

Panic Attacks ◽

Medical Emergency ◽

Physical Restraints ◽

Police Intervention ◽

Emergency Team ◽

Excited Delirium ◽

Threatening Condition ◽

Life Threatening ◽

The Individual

The purpose of this study was to review data on restraint related deaths in persons in a state of excited delirium (ExDS) and to propose guidelines for treatment. We analysed three unexpected deaths in persons in a state of ExDS shortly after police restraint. Death which occurs during a police intervention, using physical restraints, may be related to placing the individual in a prone position, the use of neck holds, expert grips, and handcuffs or pepper spray. ExDS results in an altered mental state with agitation, aggression, paranoia, and panic attacks, and is a life-threatening condition. Therefore, before police intervention is initiated, a medical emergency team should be present. In patients with ExDS, physical restraints used by the police should be brief, effective, and include rapid tranquilization (sedation) using benzodiazepines, and antipsychotics.

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THYROID STORM AS A LIFE-THREATENING CONDITION IN THE PRACTICE OF EMERGENCY MEDICAL SERVICE TEAMS

Emergency Medical Service ◽

10.36740/emems202104109 ◽

2021 ◽

Vol 8 (4) ◽

pp. 260-264

Author(s):

Agnieszka Ciastkowska-Berlikowska

Keyword(s):

Thyroid Hormones ◽

Clinical Symptoms ◽

Auxiliary Function ◽

Medical Emergency ◽

Thyroid Storm ◽

The Status ◽

Threatening Condition ◽

Life Threatening ◽

Initiation Of Therapy ◽

The Right

Thyroid storm is a medical emergency. It comprises disorders of several organs and body systems, including disturbances of consciousness (also coma), heart failure, symptoms of shock, and high body temperature. The diagnosis of thyroid storm is challenging because it is based primarily on medical history and physical examination. Additional laboratory tests only perform an auxiliary function, and the initiation of therapy should not be delayed until the determination of thyroid hormones in the blood. Moreover, clinical symptoms often do not correlate with thyroid hormones concentration in the blood. Diarrhea, vomiting, and fever may lead to the diagnosis of thyroid storm. These are not typical symptoms of uncomplicated hyperthyroidism. The remaining symptoms of thyroid storm are symptoms of decompensation of individual organs and systems. When diagnosing thyroid storm, one uses the Burch and Wartofsky criteria. Accurate and quick diagnosis and implementation of initial treatment is the aim of pre-hospital management. These are fluid therapy, oxygen therapy, and antipyretic drugs. For this reason, it is essential not to delay the patient’s transport to the nearest hospital emergency department. One may also consider calling a specialist ambulance with a doctor who can give the right medication on the spot. Rapid treatment initiation can improve the status of most patients within 12-24 hours. Treatment delay worsens, and intensive treatment improves the prognosis in patients with thyroid storm. The mortality rate of thyroid storm has decreased and is now 20-30%.

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Treatment of Electrical Storm – the Electrophysiologist’s Point of View

In a good rythm ◽

10.5604/01.3001.0010.3965 ◽

2017 ◽

Vol 2 (43) ◽

pp. 4-8

Author(s):

Aleksander Bardyszewski ◽

Jacek Kuśnierz ◽

Paweł Derejko

Keyword(s):

Catheter Ablation ◽

Ventricular Arrhythmia ◽

Initial Treatment ◽

Technological Progress ◽

Point Of View ◽

Electrical Storm ◽

Electroanatomical Mapping ◽

Threatening Condition ◽

Life Threatening

Electrical storm is a life-threatening condition and requires immediate treatment. In most cases ventricular arrhythmia originates from previously formed lesions in the cardiac muscle. Such patients, following the necessary initial treatment, should be forwarded to catheter ablation, which is proven to reduce arrhythmia recurrence and to improve overall morbidity. Along with the technological progress related to electroanatomical mapping the growing role of meticulous substrate mapping and modification for successful ablation is being recognized.

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