Venous Congestion in Ischemic Bowel Case

diagnosis

A 57-year-old man with cirrhosis presented to the emergency department with acute abdominal pain that had been present for 1 day. On physical examination, his abdomen was tender to palpation over the epigastrium and lower abdomen, with rebound tenderness and guarding. Laboratory studies revealed a white-cell count of 8400 per cubic millimeter (normal range, 4000 to 11,000) and a serum lactate level of 18.4 mmol per liter (normal range, 0.5 to 2.2). Computed tomography revealed pneumatosis intestinalis. Because of concern about ischemic bowel, the patient underwent emergency laparotomy. During surgery, the jejunum and ileum were noted to be cyanotic and congested, and the mesenteric veins contained visible air with venous pulsation . No bowel was resected, because bowel peristalsis was present. Mesenteric ischemia can be caused by acute arterial or venous thromboembolism or by decreased blood flow to the splanchnic vessels, usually owing to hypotension in patients with atherosclerotic disease. If a patient presents with acute peritonitis, urgent laparotomy is indicated to evaluate for infarcted bowel. After surgery, the patient was admitted to the intensive care unit and received vasopressors, fluids, antibiotic agents, and low-molecular-weight heparin, and he had a full recovery.

diagnosis
Interferon-free therapy for hepatitis C ‘cured’ 90% of patients

Currently, doctors treating hepatitis C patients with cirrhosis (liver scarring) can only offer treatments that rely on the drug interferon, which unfortunately, only works for less than half of patients. Now, a new study found that an interferon-free combination of drugs was safe, well tolerated and cured over 90% of …

diagnosis
What is cirrhosis of the liver?

Cirrhosis of the liver describes a condition where scar tissue gradually replaces healthy liver cells. The main causes are sustained, excessive alcohol consumption, viral hepatitis B and C, and fatty liver disease – however, there are other possible causes. People with cirrhosis may develop jaundice (yellowing of the skin, eyes, …

diagnosis
Hepatitis A

Hepatitis A is a virus that causes┬áinfection and inflammation of the liver.┬áIt rarely results in serious liver damage or death and does not develop chronic liver disease. Unlike hepatitis B or C, it does not lead to chronic liver disease, but it can result in significant loss of income and …

Show Buttons
Hide Buttons