A rare presentation of Rapunzel syndrome with multiple small bowel intussusceptions

Rapunzel syndrome is caused by gastric trichobezoar with extended tail and small bowel obstruction. Patients with gastric trichobezoar can be asymptomatic until the bezoar increases in size. We report a case of a girl who visited the emergency department with abdominal pain. She was finally diagnosed with Rapunzel syndrome that causes multiple small bowel intussusceptions associated with trichophagia. Surgery was needed to reduce the multiple intussusceptions, and to remove the large trichobezoar. This case highlights to consider the possibility of Rapunzel syndrome when diagnosing the main cause of intussusceptions.

Clinical characteristics of heat stroke in bath facilities, and analysis of predictive factors of multiple major complications

OBJECTIVE: The aim of this study was to evaluate the clinical characteristics of heat stroke in a bath facility and investigate predictive factors of multiple major complications in heat stroke patients. METHODS: This was a retrospective study on heat stroke patients who visited an urban emergency center from January 2010 to March 2018. We compared clinical characteristics, complication, and outcomes of heat stroke patients in bath and non-bath facilities. Multivariate logistic regression analysis were performed to identify independent predictors of multiple major complications in heat stroke patients. RESULTS: A total of 67 heat stroke patients with heat stroke were enrolled, of which 42 (62.6%) were in a bath facility and 25 (37.3%) were in a non-bath facility. Patients with heat stroke in the bath facility were characterized by old age, past medical history of hypertension and diabetes mellitus, and high incidence of hypotension compared with those in the non-bath facility but also low incidence of acute renal failure, seizure, and multiple major complications. In the multivariate analysis, predictive factors of multiple major complications in heat stroke patients were non-bath facility (odds ratio [OR], 5.4; 95% confidence interval [CI], 1.2–29.9), Glasgow Coma Scale (GCS)≤8 (OR, 8.2; 95% CI, 1.3–49.4), and mean arterial pressure (MAP), body temperature above 40.5℃ (OR, 8.1; 95% CI, 1.1–58.8) < 60 mmHg (OR, 14.8; 95% CI, 1.8–122.9). CONCLUSION: Heat stroke in the bath facility resulted in less major complications, and high body temperature, GCS ≤8, and MAP < 60 mmHg were independent predictive factors of multiple major complications in heat stroke patients.

Erratum: Moderate to Severe Left Ventricular Ejection Fraction Related to Short-term Mortality of Patients with Post-cardiac Arrest Syndrome after Out-of-Hospital Cardiac Arrest / 대한구급학회지

The author's affiliation should be corrected. We apologize for any inconvenience that may have caused.

Erratum: Moderate to Severe Left Ventricular Ejection Fraction Related to Short-term Mortality of Patients with Post-cardiac Arrest Syndrome after Out-of-Hospital Cardiac Arrest / 대한중환자의학회지

The author's affiliation should be corrected. We apologize for any inconvenience that may have caused.

Moderate to Severe Left Ventricular Ejection Fraction Related to Short-term Mortality of Patients with Post-cardiac Arrest Syndrome after Out-of-Hospital Cardiac Arrest / 대한구급학회지

BACKGROUND: The aim of this study was to investigate the relationships between left ventricular ejection fraction (LVEF) and mortality and neurologic outcomes with post-cardiac arrest syndrome (PCAS) after out-of-hospital cardiac arrest (OHCA). METHODS: Patients with PCAS after OHCA admitted to the intensive care unit between January 2014 and December 2015 were analyzed retrospectively. RESULTS: total of 104 patients were enrolled in this study. The mean age was 54.4 ± 15.3 years, and 75 of the patients were male (72.1%). Arrest with a cardiac origin was found in 55 (52.9%). LVEF 55% was measured in 39 (37.5%), 18 (17.3%), and 47 (45.2%) of patients, respectively. In multivariate analysis, severe LV dysfunction (LVEF < 45%) was significantly related to 7-day mortality (odds ratio 3.02, 95% Confidence Interval 1.01-9.0, p-value 0.047). CONCLUSIONS: In this study, moderate to severe LVEF within 48 hours after return of spontaneous circulation was significantly related to 7-day short-term mortality in patients with PCAS after OHCA. Clinicians should actively treat myocardial dysfunction, and further studies are needed.

Moderate to Severe Left Ventricular Ejection Fraction Related to Short-term Mortality of Patients with Post-cardiac Arrest Syndrome after Out-of-Hospital Cardiac Arrest / 대한중환자의학회지

BACKGROUND: The aim of this study was to investigate the relationships between left ventricular ejection fraction (LVEF) and mortality and neurologic outcomes with post-cardiac arrest syndrome (PCAS) after out-of-hospital cardiac arrest (OHCA). METHODS: Patients with PCAS after OHCA admitted to the intensive care unit between January 2014 and December 2015 were analyzed retrospectively. RESULTS: total of 104 patients were enrolled in this study. The mean age was 54.4 ± 15.3 years, and 75 of the patients were male (72.1%). Arrest with a cardiac origin was found in 55 (52.9%). LVEF 55% was measured in 39 (37.5%), 18 (17.3%), and 47 (45.2%) of patients, respectively. In multivariate analysis, severe LV dysfunction (LVEF < 45%) was significantly related to 7-day mortality (odds ratio 3.02, 95% Confidence Interval 1.01-9.0, p-value 0.047). CONCLUSIONS: In this study, moderate to severe LVEF within 48 hours after return of spontaneous circulation was significantly related to 7-day short-term mortality in patients with PCAS after OHCA. Clinicians should actively treat myocardial dysfunction, and further studies are needed.