Acute Colonic Pseudo-Obstruction in an Elderly Female Patient With Chronic Constipation.

Acute colonic pseudo-obstruction (ACPO), or Ogilvie's syndrome, is an acute colonic dilatation without mechanical obstruction; it is most commonly seen in severely ill or postoperative patients. While this syndrome has no clear pathophysiology, it is diagnosed when the cecum and right colon expand without physical obstruction. This condition can lead to perforation and intestinal ischemia. Ogilvie's syndrome is associated with a relatively high morbidity and mortality rate. The diagnosis of ACPO can be often missed due to its vague symptoms such as bloating, abdominal distention, abdominal pain, nausea and vomiting, and severe constipation. We report the case of an 82-year-old female patient who had a unique diagnosis of ACPO, or Ogilvie's syndrome, overshadowed by the diagnosis of severe constipation. This case highlights the importance of maintaining a high index of suspicion and early diagnosis of symptoms that can rapidly become dangerous.

A Curious Case of Chryseobacterium indologenes Culture in a Young Adult Kidney Transplant Patient.

Chryseobacterium indologenes (C. indologenes) is an increasingly common multidrug-resistant organism (MDRO) and is not part of the normal human flora. It is most commonly found in patients who are immunocompromised and/or in poor health, with multiple comorbidities. As an increasingly identified MDRO, C. indologenes needs to be identified early, especially in patients with multiple comorbidities, organ transplants, or on mechanical ventilation. We present a case of a young immunocompromised male with an extensive kidney disease history who acquired this new MDRO bacteria, C. indologenes.

A Rare Case of Acute Compartment Syndrome (ACS) Involving the Upper Limb in a Patient on Warfarin.

Acute compartment syndrome (ACS) is an acute event characterized by increased pressure in the extremities where fascia encloses muscles, vessels, and nerves, leading to complications in tissue perfusion and, eventually, tissue necrosis and death. This is usually seen after trauma, crush injuries, and fractures. Similar events can also happen in the abdomen and lead to impaired perfusion in the abdominal organs. Hypovolemia, medications, and repeated or suboptimal diagnostic tests tend to worsen a pre-existing ACS, and the mainstay of its management is fasciotomy to prevent ischemic necrosis and rhabdomyolysis. Here we discuss a 64-year-old female with ACS involving the left upper limb, secondary to anticoagulation on warfarin and aspirin for atrial fibrillation. Her history was significant for peripheral vascular disease, above-knee amputation, and congestive heart failure. This article emphasizes the importance of early recognition and management of ACS to salvage limbs.

A Case Report of Sepsis Post Cardiac Catheterization.

Percutaneous coronary intervention (PCI) and cardiac catheterization are clean procedures done under aseptic precautions, but studies have shown transient bacteremia following the process, mostly involving Staphylococcus. This has many complications, from localized wounds at arterial access sites to endocarditis, mycotic aneurysm, and sepsis, and are associated with high mortality. These may require surgical intervention and prolonged antibiotic use. The risk of acquiring these infections is higher in femoral catheterization than in radial access. This risk also increases in patients with congestive cardiac failure, age 60 and above, and those with diabetes and obesity. Procedural hazards include multiple punctures and leaving the sheath for future access due to the needle tract's colonization. We present a case of sepsis presenting two days after PCI using single puncture radial access and a rapid downhill course.