Résumé
We present a case report of brain death caused by Salmonella enterica serovar Enteritidis bacteremia. A 53-year-old diabetic male was admitted to our hospital with stupor mentality and fever. No evidence of meningitis was found upon cerebrospinal fluid analysis, but diffuse brain edema was shown by magnetic resonance imaging. S. Enteritidis phage type 7 was isolated from blood cultures. We diagnosed the patient with encephalopathy associated with S. Enteritidis bacteremia and treated him by intravenous administration of ceftriaxone and dexamethasone. Fifteen days after admission, the patient was diagnosed with brain death and became a cadaveric donor. Although encephalopathy associated with S. Enteritidis bacteremia is rare, it should be considered as a serious and potentially lethal complication.
Sujets)
Humains , Mâle , Adulte d'âge moyen , Administration par voie intraveineuse , Bactériémie , Bactériophages , Encéphale , Mort cérébrale , Oedème cérébral , Cadavre , Ceftriaxone , Dexaméthasone , Fièvre , Imagerie par résonance magnétique , Méningite , Salmonella , Salmonella enterica , Salmonella enteritidis , État de stupeur , Donneurs de tissusRésumé
We present a case report of brain death caused by Salmonella enterica serovar Enteritidis bacteremia. A 53-year-old diabetic male was admitted to our hospital with stupor mentality and fever. No evidence of meningitis was found upon cerebrospinal fluid analysis, but diffuse brain edema was shown by magnetic resonance imaging. S. Enteritidis phage type 7 was isolated from blood cultures. We diagnosed the patient with encephalopathy associated with S. Enteritidis bacteremia and treated him by intravenous administration of ceftriaxone and dexamethasone. Fifteen days after admission, the patient was diagnosed with brain death and became a cadaveric donor. Although encephalopathy associated with S. Enteritidis bacteremia is rare, it should be considered as a serious and potentially lethal complication.
Sujets)
Humains , Mâle , Adulte d'âge moyen , Administration par voie intraveineuse , Bactériémie , Bactériophages , Encéphale , Mort cérébrale , Oedème cérébral , Cadavre , Ceftriaxone , Dexaméthasone , Fièvre , Imagerie par résonance magnétique , Méningite , Salmonella , Salmonella enterica , Salmonella enteritidis , État de stupeur , Donneurs de tissusRésumé
Pancreatic cancer is usually unresectable upon diagnosis, and treatment aims to optimize the quality of the patient's life by managing symptoms, and, particularly, by providing adequate pain control. When the pain is refractory to opioids, interventions such as celiac plexus neurolysis (CPN) can be considered. Endoscopic ultrasound (EUS)-guided CPN has been introduced for pancreatic cancer. Reported herein is a case of a 75 year-old man with pancreatic cancer who was treated with opioids due to severe abdominal pain. EUS-guided CPN was performed for pain control, and the opioid administration was discontinued as the pain improved dramatically. However, the patient experienced opioid withdrawal symptoms, including anxiety, insomnia, nausea, and vomiting. Thus, although EUS-guided CPN successfully reduced pain in a patient undergoing such treatment and to whom opioid was administered, opioid administration should not be abruptly discontinued. Rather, the opioid dose should be reduced gradually to avoid drug withdrawal.
Sujets)
Humains , Douleur abdominale , Analgésiques morphiniques , Anxiété , Plexus coeliaque , Nausée , Tumeurs du pancréas , Troubles de l'endormissement et du maintien du sommeil , Syndrome de sevrage , VomissementRésumé
Hemobilia is a rare upper gastrointestinal (GI) bleeding phenomenon usually caused by trauma but may occur due to various liver and pancreatobiliary diseases. Causes related to gallbladder disease include vascular disorders, malignancy, polyps, heterotopic GI mucosa, acalculous inflammation, and most commonly gallstones. Most cases are treated with a cholecystectomy. If hemobilia is detected, efforts must be made to exclude malignancy because hemobilia develops from both benign and malignant disease. Particularly in gallbladder disease with hemobilia, the possibility of gallbladder carcinoma should be considered. We report two cases of hemoblia by endoscopic retrograde cholangiopancreatography and duodenoscopy, with a review of the literature. The first case was xanthoglanulomatous cholesystitis and the second case was gallbladder cancer disclosed by cholecystectomy.
Sujets)
Cholangiopancréatographie rétrograde endoscopique , Cholécystectomie , Cholécystite , Duodénoscopie , Vésicule biliaire , Maladies de la vésicule biliaire , Tumeurs de la vésicule biliaire , Calculs biliaires , Granulome , Hémobilie , Hémorragie , Inflammation , Foie , Muqueuse , Polypes , XanthomatoseRésumé
Mesothelioma is a rare aggressive tumor arising from the mesothelial cell and regarded as universally fatal disease with average survival around 1 year. The incidence rate is varied from one to forty per million in different countries and increasing by the year. The most common site of tumor origin is the pleura and only 20% to 33% of mesothelioma arise from the peritoneum. There are increasing reports of malignant mesothelioma with forty to fifty fatal cases per year in Korea. Histological studies with immunohistochemical stain is helpful for the diagnosis of peritoneal mesothelioma and imaging modality alone is not sufficient for diagnosis, so it is difficult to confirm diagnosis. A 64-year-old male patient was admitted to the hospital with a palpable mass on abdomen. The 6x6 cm sized huge mass was seen on the body of stomach adjacent to the peritoneum. We report a case of malignant peritoneal mesothelioma without evident exposure to asbestos, of which direct invasion to the gastric mucosa was confirmed by endoscopic biopsy and immunohistochemical stain.