RESUMO
Acute pancreatitis (AP) is a rare event in pregnancy that is characterized by a sudden and severe inflammation of the pancreas. The clinical manifestation of AP during pregnancy is highly variable ranging from a mild form to a severe and potentially life-threatening presentation. We share a case of a 29-year-old female (gravida II, para I) who presented in her 33rd gestational week. The patient complained of upper abdominal pain and nausea. Her previous history revealed that she had four episodes of vomiting (food-containing, non-projectile) at home. Her uterine tone was normal, and her cervix was closed. Her white blood cell count was 13,000/mm3, and her C-reactive protein (CRP) level was 65 mg/L. She underwent an emergency laparotomy due to suspected acute appendicitis; however, no peritonitis was found intraoperatively. Further blood tests showed high levels of triglyceride at 87.5 mmol/L. The electrophoretic pattern of lipoprotein was consistent with type V hyperlipoproteinemia. An abdominal computed tomography (CT) confirmed the diagnosis of acute pancreatitis. During follow-up after one month, the patient showed triglyceride levels at 4.75 mmol/L and cholesterol at 6.07 mmol/L. Acute pancreatitis due to hypertriglyceridemia is a rare finding; nonetheless, it should be considered as a potential etiology in pregnant patients with nonobstructive abdominal pain.
RESUMO
Background Appendicitis is a common clinical problem that has multifactorial etiologies. Accounting for almost 1 million hospital days per year, it poses serious health hazards. If not treated on time, it may burst. Surgical intervention is the best option in such cases. Prophylactic use of antibiotics has been shown to reduce post-operative infections. Methodology This prospective observational study aimed to evaluate the adherence to the antibiotic prophylaxis guidelines for appendectomy in patients admitted to the surgical department at Salmanyia Medical Complex in Bahrain from January to August 2020. From the electronic records of these patients, information was extracted and evaluated regarding demographic data, the type of antibiotics given for prophylaxis, the timing of the administration of the antibiotics, and any alternative antibiotic given based on local hospital guidelines. Results The current study revealed that the majority of the patients (98%, N=273) admitted to the Salmanyia Medical Complex, Bahrain, were not administered the antibiotics within the prescribed time (30-60 minutes) as per hospital guidelines. Also, the antibiotics administered for prophylaxis prior to the appendectomy procedure were not according to the guidelines, i.e., Cefazolin 1g with Metronidazole 500 mg. Out of a total of 278 patients included in the study, none were administered the right choice as provided by the local guidelines. Second, 1.8% of patients (5 out of 278) were not administered any antibiotics for prophylaxis prior to the surgical procedure for appendicitis. Conclusion The study concluded that most patients were not administered antibiotics according to the local guidelines of the hospital.
RESUMO
An abdominal aortic aneurysm (AAA) is a disease characterized by an abnormal bulge or swelling in the aorta. It could be serious if left unobserved, and with time, it swells and eventually ruptures, resulting in massive bleeding inside, and, more likely, causes death. This report presents a case study of a 61-year-old male who presented with back pain; no other fatal symptoms such as breathlessness or rapid heart rate were seen. His abdominal ultrasound report showed the presence of a distal aortic dissecting aneurysm, resulting in rapid diagnosis and treatment.
