RESUMO
BACKGROUND: Portomesenteric venous thrombosis (PMVT) is uncommon but associated with ischemic bowel and mortality. OBJECTIVE: The purpose of this study was to determine the occurrence of PMVT in a community setting and evaluate current diagnosis, treatment, and outcomes. METHODS: Medical records of consecutive patients admitted to a community-based hospital diagnosed with PMVT were reviewed. Patients were divided into 2 groups: those diagnosed from 1997 to 2003 and those diagnosed from 2004 to 2009. RESULTS: One hundred three patients were included. The proportion of chronic PMVT diagnoses increased in the recent group (14% in contrast to 44%, P = .001). Treatment was more common in acute in contrast to chronic PMVTs (70% in contrast to 48%, P = .035). The median length of stay decreased over time (6 in contrast to 3 days, P = .004). Three patients underwent surgical intervention. Overall, 30-day mortality was 17% and did not change over time. CONCLUSIONS: Diagnosis and treatment have changed with increased differentiation between acute and chronic PMVT; outcomes were similar. Surgical intervention was rarely necessary. Mortality is attributed to patient comorbidity rather than PMVT.
Assuntos
Fibrinolíticos/uso terapêutico , Hospitais Comunitários , Veias Mesentéricas , Veia Porta , Trombectomia/métodos , Terapia Trombolítica/métodos , Trombose Venosa/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Diagnóstico Diferencial , Feminino , Seguimentos , Mortalidade Hospitalar/tendências , Humanos , Incidência , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Flebografia , Estudos Retrospectivos , Trombose Venosa/diagnóstico , Trombose Venosa/terapia , Wisconsin/epidemiologia , Adulto JovemRESUMO
Aseptic meningitis could be a rare side effect of lamotrigine. Aseptic meningitis is a clinical condition where symptoms, signs and laboratory findings are consistent with meningeal inflammation but routine bacterial cultures are negative. Clinical presentation of aseptic meningitis is similar to bacterial meningitis with prominent symptoms of fever, headache and neck stiffness. Drug-induced aseptic meningitis is an uncommon adverse effect of several drugs. The most common ones are nonsteroidal anti-inflammatory drugs, intravenous immunoglobulins, intrathecal agents and vaccines. Disease manifestations vary with different drugs. A few cases of lamotrigine-induced aseptic meningitis have been published earlier. This is the fifth case reported of lamotrigine-induced aseptic meningitis. However, this is the first case which is associated with a second episode on rechallenge of lamotrigine.
