RESUMO
We report a rare case of diabetes insipidus following fire burn injury. Meticulous fluid balance and the use of carbamazepine resulted in her survival.
Assuntos
Feminino , Humanos , Adulto Jovem , Queimaduras/complicações , Carbamazepina/uso terapêutico , Diabetes Insípido Neurogênico/tratamento farmacológico , Incêndios , Hidratação/métodos , Comportamento AutodestrutivoRESUMO
Two unusual cases of small intestinal intussusception presenting as bowel obstruction are presented. They both had freckle-like pigmentation of the perioral area, palms and soles of the feet with intestinal polyps which acted as lead points in the intussusception. Peutz-Jeghers syndrome was diagnosed. This report highlights the high risk of cancer of the intestines and extra-intestinal sites associated with this interesting but rare condition.
Assuntos
Adolescente , Adulto , Feminino , Humanos , Masculino , Doenças do Íleo/complicações , Valva Ileocecal , Intussuscepção/etiologia , Síndrome de Peutz-Jeghers/complicaçõesRESUMO
Trauma is a leading cause of admissions to the surgical ward in Papua New Guinea (PNG), accounting for about 35% of cases. Of these, 15% of cases are abdominal injuries, of which 19% are penetrating injuries. Selective surgical management of patients with a low-velocity anterior abdominal wound (AAW) is beneficial in some patients. AIM: To determine if selective surgical management is a viable therapeutic option in PNG. METHODS: A non-random prospective study of consecutive cases was done on 60 patients with an AAW based entirely on clinical symptoms and signs. The outcome measures were length of hospital stay, morbidity and mortality. Data were analysed using SPSS 10.0 for Windows and Microsoft Excel. RESULTS: Immediate laparotomy was done on 24 (40%) of cases and 36 (60%) had nonoperative conservative management, of which 6 (17%) failed and went on to have laparotomy on demand. The average hospital stay was 4 days shorter (p = 0.0001) for the nonoperative group, which had significantly fewer complications (p = 0.01). No deaths were recorded in either of the two groups of patients. CONCLUSION: Selective nonoperative management of stable patients with an AAW with or without omental signs is a safe therapeutic option in PNG.