摘要:

Objective: To increase awareness of the unusual complication of pneumoperitoneum after cardiopulmonary resuscitation.Clinical features: A 57‐year‐old male farmer with a history of chronic renal failure and heart disease, as well as severe oesophageal reflux for which fundoplication had been performed, developed a tension pneumoperitoneum after cardiopulmonary resuscitation. This resulted in lower limb cyanosis and an erection, a previously unreported complication.Intervention and outcome: The tension was relieved by uncapping a peritoneal dialysis catheter that wasin situ.The cyanosis and erection resolved immediately, suggesting that the tension pneumoperitoneum had caused significant venous obstruction. A 3 cm defect in the posterior wall of the stomach was repaired.Conclusion: The likelihood of pneumoperitoneum is reduced if standard guidelines for cardiopulmonary resuscitation are adhered to.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1991.tb116382.x

出版商:Wiley    

年代:1991

数据来源: WILEY

摘要:

Objective: To report a case of enteritis necroticans acquired in Australia, and to review the history, epidemiology, pathogenesis, clinical features, management and prevention of this disease.Clinical features: A 44‐year‐old diabetic and alcoholic restaurateur of Chinese‐‐Malay origin, who had been living in Australia for over 20 years, was admitted to hospital with bloody diarrhoea which progressed to fulminant toxaemia and circulatory collapse, and ultimately required laparotomy. Typical pathological features and the isolation ofClostridium perfringenstype C from faeces confirmed the diagnosis of enteritis necroticans.Intervention and outcome: He was treated initially with ampicillin, gentamicin, metronidazole and chloramphenicol, and later with penicillin and metronidazole, and he required large volumes of intravenously administered fluid and blood for his toxaemic, hypotensive state. Laparotomy was performed as a life‐saving procedure. Despite a lengthy convalescence, the patient recovered.Conclusions: Enteritis necroticans is a rare disease in developed countries, however it is likely to be underdiagnosed. Clinicians are encouraged to be on the alert for signs of severity that may indicate the need for laparotomy in a predisposed individual with features of this condition.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1991.tb116383.x

出版商:Wiley    

年代:1991

数据来源: WILEY

摘要:

Objective: To present a case in which acute failure of a liver graft was treated with an infusion of prostaglandin E1(PGE1).Clinical features: A nine‐year‐old girl underwent liver transplantation for Wilson's disease. Her course was complicated by primary non‐function of the graft as evidenced by poor bite production, rising bilirubin and liver enzyme levels and a severe coagulopathy.Intervention and outcome: PGE1was infused and there was recovery of graft function. The need for urgent re‐transplantation was avoided.Conclusions: PGE1may have an important role in liver transplantation considering the logistic difficulties of obtaining donor livers for urgent transplantation in Australia.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1991.tb116384.x

出版商:Wiley    

年代:1991

数据来源: WILEY

摘要:

Objective: To describe a case of neuroleptic malignant syndrome (NMS) resulting from withdrawal of low‐dose levodopa therapy for mild Parkinson's disease.Clinical features: Treatment with levodopa, 50 mg, and benserazide, 12.5 mg, three times a day was withdrawn from a 76‐year‐old woman with mild Parkinson's disease because she was experiencing intermittent confusion. Fever (38.5°, tachycardia, increased confusion, severe rigidity and generalised stimulus‐sensitive myoclonus developed after 12 hours. The creatine kinase level rose to 2058 U/L.Intervention and outcome: The fever abated with reintroduction of levodopa. Rigidity was slow to resolve and required additional treatment with dantrolene sodium.Conclusion: NMS may be precipitated by withdrawal of relatively low doses of levodopa, even in patients with mild Parkinson's disease. Hyperthermia and rigidity in NMS may result from involvement of separate central dopaminergic pathways.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1991.tb116385.x

出版商:Wiley    

年代:1991

数据来源: WILEY

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1991.tb116386.x

出版商:Wiley    

年代:1991

数据来源: WILEY

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1991.tb116389.x

出版商:Wiley    

年代:1991

数据来源: WILEY

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1991.tb116390.x

出版商:Wiley    

年代:1991

数据来源: WILEY

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1991.tb116393.x

出版商:Wiley    

年代:1991

数据来源: WILEY

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1991.tb116394.x

出版商:Wiley    

年代:1991

数据来源: WILEY

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1991.tb116401.x

出版商:Wiley    

年代:1991

数据来源: WILEY