RESUMO
Mesenteric venous thrombosis (MVT) is an uncommon clinical condition with potential high morbidity. We report here a patient who presented with acute-onset MVT and bowel infarction, which was successfully ameliorated with intramesenteric vein thrombolytic therapy.
Assuntos
Cateterismo Venoso Central/métodos , Fibrinolíticos/administração & dosagem , Veias Mesentéricas , Veia Porta , Terapia Trombolítica/métodos , Trombose Venosa/tratamento farmacológico , Adulto , Feminino , Seguimentos , Humanos , Infusões Intravenosas , Tomografia Computadorizada por Raios X , Trombose Venosa/diagnóstico por imagemRESUMO
An 18-year-old, previously healthy man admitted with abdominal pain, high-grade fevers, nausea and emesis was found to have multiple hepatic abscesses. Aspiration cultures grew Fusobacterium necrophorum, a rare bacterium causing potentially fatal liver abscesses in humans. Following sequential percutaneous drainages and narrowing of antibiotics, the patient was discharged on a 6-week antibiotic course and showed no signs of infection. A week after presentation it was discovered that he had experienced upper respiratory symptoms and sore throat prior to presentation. Because oropharyngeal infections are a potential source of bacteremia, they must be considered in the differential diagnosis of patients presenting with hepatic abscesses and no evidence of immunocompromise.
Assuntos
Processamento de Imagem Assistida por Computador , Pneumatose Cistoide Intestinal/diagnóstico por imagem , Pneumatose Cistoide Intestinal/cirurgia , Tomografia Computadorizada por Raios X , Adulto , Humanos , Mucosa Intestinal/patologia , Pneumatose Cistoide Intestinal/patologia , Prognóstico , Sistema de Registros , Sensibilidade e EspecificidadeRESUMO
Myocardial injury is known to occur in victims of both thermal and electrical burns. A variety of mechanisms have been ascribed to the pathogenesis of cardiac damage during burn shock. However, limited evidence exists that coronary artery thrombosis plays a frequent role. Distinguishing between acute coronary syndrome (impending myocardial infarction from coronary artery occlusion) vs global cardiac injury is essential; the care diverges drastically. The following case describes a patient who was angiographically proven to have acute coronary thrombosis amidst burn shock ftera 50% TBSA electrical flash burn. Managing the patient's burn shock, myocardial injury, and multiple surgical procedures while considering antiplatelet medications for a newly placed coronary artery stent presented a number of challenges not previously reported.