ABSTRACT
Self-expanding metal stents are an established treatment for malignant colon strictures, either as palliative treatment or as a bridge to later surgery. Little data exist regarding the use of stents for benign obstructions and the rate of subsequent complications related to the procedure is high. After reviewing the existing literature, we found only one case of stent placement in an intestinal obstruction caused by endometriosis, as a bridge to surgery. The use of prostheses in benign disease has a higher rate of complications such as stent migration and gut perforation. Such complications are even more likely to happen when the stent has been placed as a bridge to surgery and it is delayed for more than 7 days. This is the case of a young woman presenting an acute intestinal obstruction related to endometrioma. Stent placement was used in this case as a bridge to surgery with successful results.
Subject(s)
Colectomy/methods , Colonic Diseases/diagnosis , Colonic Diseases/surgery , Intestinal Obstruction/diagnosis , Intestinal Obstruction/surgery , Stents , Abdominal Pain/diagnosis , Abdominal Pain/etiology , Adult , Colonic Diseases/etiology , Emergency Service, Hospital , Endometriosis/complications , Endometriosis/diagnosis , Female , Follow-Up Studies , Humans , Intestinal Obstruction/etiology , Magnetic Resonance Imaging/methods , Tomography, X-Ray Computed/methods , Treatment OutcomeSubject(s)
Abdominal Pain/etiology , Gastric Balloon/adverse effects , Pancreatitis/etiology , Acute Disease , Adult , Humans , MaleABSTRACT
Anorexia nervosa is an eating disorder predominantly affecting young women and characterized by an intense fear of gaining weight and becoming fat. Liver injury with mild elevation of hepatic enzymes is a frequent complication, and steatosis of the liver is thought to be the major underlying pathology. However, acute hepatic failure with transaminase levels over 1000 u/L is a very rare complication, and the precise mechanism of the liver injury is still unclear. We report a case of a 35-year-old woman with a history of anorexia nervosa who developed acute liver damage with deep coma in relation to profound hypoglycemia. The treatment was hydration, correction of electrolyte and fluid imbalance, and gradual nutritional support to prevent refeeding syndrome. Our patient's consciousness was significantly improved with the recovery of liver function and normalization of transaminase levels. Although the mechanism of pathogenesis is largely unknown, we discuss the two principal hypotheses: starvation-induced autophagy and acute hypoperfusion.