ABSTRACT
A 75-year-old woman is hospitalised for sepsis. The diagnosis of cholecystitis is made and an antibiotic therapy is debuted. The clinical worsening leads to realise an urgent cholecystectomy. A sepsis like shock persisted. The antibiotherapy was changed and a second abdominal look made. A severe lactic acidosis persisted since the cholecystectomy despite a continuous hemofiltration. The diagnosis of type B lactic acidosis secondary to malignancy was suspected. An osteomedullar biopsy revelled B-cell lymphoma EBV induced.
Subject(s)
Acidosis, Lactic/etiology , Hematologic Neoplasms/complications , Lymphoma, B-Cell/complications , Acidosis, Lactic/diagnosis , Aged , Anti-Bacterial Agents/therapeutic use , Cholecystitis/complications , Epstein-Barr Virus Infections/complications , Female , Hematologic Neoplasms/diagnosis , Hemofiltration , Humans , Lymphoma, B-Cell/diagnosis , Sepsis/complicationsABSTRACT
A 58-year-old man was admitted to our hospital for septic shock and meningitis. He had undergone, three weeks earlier, a radiofrequency ablation for drug-refractory atrial fibrillation. A polymicrobian septicemy suggested a digestive etiology. A CT scan suggested an atrio-oesophageal fistula with cerebral and renal emboli. The patient deceased from brain death. The diagnosis of atrio-oesophageal fistula was confirmed by autopsy.
Subject(s)
Atrial Fibrillation/therapy , Catheter Ablation/adverse effects , Esophageal Fistula/etiology , Autopsy , Esophageal Fistula/diagnostic imaging , Esophageal Fistula/pathology , Fatal Outcome , Humans , Male , Middle Aged , Radio Waves , Radiography, ThoracicABSTRACT
Four cases of acute abdomen in para- and tetraplegic patients are reported. One patient had a perforated duodenal ulcer without clinical symptoms, while another had abdominal contracture of neurological origin. Two cases of occlusive syndrome associated with faecaloma and with volvulus of the small bowel are also described. The absence or alteration of classical symptoms makes the diagnosis of abdominal emergencies particularly difficult in paraplegic patients. A better knowledge of the clinical pictures encountered in such cases, close supervision of the patients and carefully selected complementary examinations should help to avoid these problems and result in an early surgical decision.
Subject(s)
Abdomen, Acute/diagnosis , Paraplegia/complications , Quadriplegia/complications , Abdomen, Acute/etiology , Adult , Aged , Colonic Diseases/diagnosis , Diagnostic Errors , Humans , Intestinal Obstruction/diagnosis , Intestinal Perforation/diagnosis , Male , Middle Aged , Nervous System Diseases/diagnosis , Peptic Ulcer Perforation/diagnosisABSTRACT
A case of unilateral lung disease, treated by independent unsynchronized ventilation of each lung, with a selective end expiratory pressure is reported. The better effects of this method seem to be the improvement of respiratory mechanics and gas exchange and the decrease of the intrapulmonary shunt.
