RESUMO
This case report presents an old hemiparetic male admitted to hospital from nursing home due to dark-coloured emesis. Transdermal buprenorphine 5 mcg/h had been instigated without laxatives in the preceding month. Upon arrival, an enlarged tense abdomen was found. A CT-scan dem-on-strated a 19 cm wide faecal colon impaction. Limited effect of enemas and endoscopic disimpaction resulted in surgery. The patient died shortly after discharge. The case stresses the prevention of constipation when using opioids; in particular in immobilized patients.
Assuntos
Analgésicos Opioides/efeitos adversos , Buprenorfina/efeitos adversos , Impacção Fecal/induzido quimicamente , Idoso de 80 Anos ou mais , Analgésicos Opioides/administração & dosagem , Analgésicos Opioides/uso terapêutico , Buprenorfina/administração & dosagem , Buprenorfina/uso terapêutico , Estado Terminal , Evolução Fatal , Impacção Fecal/diagnóstico por imagem , Impacção Fecal/tratamento farmacológico , Impacção Fecal/cirurgia , Humanos , Laxantes/uso terapêutico , Masculino , Tomografia Computadorizada por Raios XRESUMO
A 17-year-old female presented with an isolated pelvic vein thrombosis (PVT) which was not visualised at the first compression ultrasound scan of the femoral vein. Isolated PVT should be suspected when the patient demonstrates the possible symptoms of a deep vein thrombosis with unilateral leg swelling extending to the groin and a negative compression ultrasound scan of the femoral vein. Supplemental ultrasound scan with Doppler flow, computed tomography or magnetic resonance venography are alternative diagnostic modalities if PVT is suspected.
