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1.
Korean Journal of Pancreas and Biliary Tract ; : 162-167, 2015.
Artigo em Coreano | WPRIM | ID: wpr-28883

RESUMO

Acute cholecystitis as a complication of malarial disease is a rare condition, especially with Plasmodium vivax infection. A 62 year-old-female was admitted via emergency room (ER) due to high fever (40.3degrees C) and epigastric pain. Initial abdominal ultrasound and computed tomography (CT) scan showed edematous gallbladder with stone, which suggested acute calculous cholecystitis. Emergency percutaneous transhepatic gallbladder drainage (PTGBD) was done with systemic antibiotic therapy. The clinical course, however, unusually worsened with hypotension and intensive care unit (ICU) management was done. Four days after admission multi-focal splenic infarction was developed and Plasmodium vivax infection was diagnosed afterward. The clinical symptoms and laboratory results, including fever and epigastric pain, improved dramatically after anti-malarial treatment and cholecystectomy was done. The resected gallbladder (GB) specimen shows vasculitis pattern with capillary red blood cell (RBC) engorgement, which suggests the cause of cholecystitis was due to Plasmodium vivax rather than GB stone.


Assuntos
Capilares , Colecistectomia , Colecistite , Colecistite Aguda , Drenagem , Emergências , Serviço Hospitalar de Emergência , Eritrócitos , Febre , Vesícula Biliar , Hipotensão , Unidades de Terapia Intensiva , Plasmodium vivax , Plasmodium , Infarto do Baço , Ultrassonografia , Vasculite
2.
Soonchunhyang Medical Science ; : 112-115, 2014.
Artigo em Inglês | WPRIM | ID: wpr-165839

RESUMO

Acute mesenteric venous thrombosis (MVT) is an uncommon form of intestinal ischemia with high mortality and usually occurs in the setting of preexisting comorbidities including thrombophilia and abdominal inflammatory conditions. Hyperhomocysteinemia has been known to be a risk factor for thromboembolism, often located on an unusual site. Considering that homocysteine metabolism is determined genetically to a high degree, a mutant of methylenetetrahydrofolate reductase (MTHFR) C677T causes hyperhomocysteinemia, leading to thrombophilia. Until now, there have been few reports of MVT associated with MTHFR gene mutation. We, herein, report a case of small bowel infarction associated with MVT by MTHFR gene mutation in an adult without any other risk factors of thrombophilia.


Assuntos
Adulto , Humanos , Comorbidade , Homocisteína , Hiper-Homocisteinemia , Infarto , Isquemia , Veias Mesentéricas , Metabolismo , Metilenotetra-Hidrofolato Redutase (NADPH2) , Mortalidade , Fatores de Risco , Tromboembolia , Trombofilia , Trombose , Trombose Venosa
3.
Gut and Liver ; : 41-48, 2014.
Artigo em Inglês | WPRIM | ID: wpr-36654

RESUMO

BACKGROUND/AIMS: As the incidence rate of and mortality from pseudomembranous colitis (PMC) are increasing worldwide, it is important to study the simple predictive risk factors for PMC among patients with hospital-acquired diarrhea (HAD). This study focused on identifying the clinical risk factors that can easily predict PMC. METHODS: The presumed HAD patients were prospectively recruited at the Hallym University Kangdong Sacred Heart Hospital. RESULTS: Age of 70 and older (adjusted odds ratio [OR], 1.76; 95% confidence interval [CI], 1.12 to 0.75), use of proton pump inhibitors (adjusted OR, 4.07; 95% CI, 2.512 to 6.57), use of cephalosporins (adjusted OR, 2.99; 95% CI, 1.82 to 4.94), and underlying cancer (adjusted OR, 1.72; 95% CI, 1.04 to 2.82) were independent risk factors for PMC in the multivariate logistic regression analysis. The prevalence of PMC was very low in the patients with HAD who exhibited no risk factors. CONCLUSIONS: The risk factors for PMC in patients with HAD included cephalosporin use, proton pump inhibitor use, old age, and cancer. Considering the strongly negative predictive values of these risk factors, endoscopic evaluation can be delayed in patients with HAD without risk of developing PMC.


Assuntos
Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Clostridioides difficile , Infecção Hospitalar/complicações , Diarreia/complicações , Enterocolite Pseudomembranosa/complicações , Prevalência , Estudos Prospectivos , República da Coreia/epidemiologia , Fatores de Risco
4.
Journal of the Korean Society of Emergency Medicine ; : 730-733, 2012.
Artigo em Coreano | WPRIM | ID: wpr-54420

RESUMO

Anterior mediastinal hematoma is often reported as a complication of cardiopulmonary resuscitation (CPR). CPR can be performed as a result of myocardial infarction, and early percutaneous coronary intervention (PCI) and anticoagulant, antiplatelet agent can improve outcome. As use of antiplatelet agents, like glycoprotein IIb/IIIa inhibitors, becomes more widespread, occurrence of complications such as bleeding may be increased. The mediastinal hematoma usually resolves itself without complications; however, a large amount of hematoma can cause cardiac tamponade. Therefore, rapid diagnosis is very important. We describe a case of anterior mediastinal hematoma detected by echocardiography after CPR and PCI.


Assuntos
Angioplastia , Anticorpos Monoclonais , Tamponamento Cardíaco , Reanimação Cardiopulmonar , Ecocardiografia , Glicoproteínas , Hematoma , Hemorragia , Fragmentos Fab das Imunoglobulinas , Mediastino , Infarto do Miocárdio , Intervenção Coronária Percutânea , Inibidores da Agregação Plaquetária
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