Massive Incidental Pneumoperitoneum in an Amyotrophic Lateral Sclerosis Patient.

In this report, we present the case of a 61-year-old male patient diagnosed with amyotrophic lateral sclerosis (ALS), who presented to the ER with worsening shortness of breath, several hours following elective percutaneous endoscopic gastrostomy (PEG) tube placement. During his hospitalization, he was diagnosed with massive pneumoperitoneum, a potential complication of such procedures. We aim to provide a general overview of this condition and to discuss the special considerations in the treatment of ALS.

Nonpsychotic Hallucinations and Impaired Vision: The Charles Bonnet Syndrome.

Charles Bonnet syndrome is a clinical entity that presents with visual hallucinations in patients with worsening visual acuity and no underlying neuropsychiatric disorder. A 93-year-old male presented to the emergency department complaining of complex visual hallucinations. He had been without his prescription glasses as they were being repaired. After work-up and medication review, no underlying drug or neuropsychiatric disease was found. Moreover, the hallucinations resolved after his vision improved. This case illustrates a frequently missed clinical entity in our practice. Clinical suspicion and reassurance are paramount for adequate patient care.