RESUMO
Acute renal failure (ARF) development is likely the most relevant event in the natural history of severely decompensated cirrhosis. It is a common complication affecting 20-49% of inpatients with decompensated cirrhosis. Also, its presence is associated with a notable increase in morbidity and mortality, and hampers management of classical cirrhosis decompensations such as ascites or hepatic encephalopathy.
Assuntos
Encefalopatia Hepática , Síndrome Hepatorrenal , Humanos , Síndrome Hepatorrenal/diagnóstico , Síndrome Hepatorrenal/etiologia , Síndrome Hepatorrenal/terapia , Ascite/etiologia , Ascite/terapia , Encefalopatia Hepática/etiologia , Encefalopatia Hepática/terapia , Pacientes Internados , Cirrose Hepática/complicaçõesRESUMO
Esophageal fish bone impaction (EFBI) is a common reason for presentation in the Emergency Department and afrequent indication for urgent esophagogastroduodenoscopy (EGD). Although it is usually effectively diagnosed andtreated by EGD, a confirmed diagnosis prior to the endoscopy is rare as blood tests, radiography and direct laryngoscopy are usually normal. We herein report three cases ofEFBI. Two patients had been previously discharged withouta correct diagnosis. In one case, the patient had a severecomplication that required urgent surgery which could haveprobably been averted with an early diagnosis. Remarkably, a cervical computed tomography (CT) scan was key todiagnose the EFBI in one case and a large retroesophagealabscess in another cases, thus guiding their management.Both patients, who underwent an urgent EGD, had a favorable outcome without the need for hospitalization. Therefore, meticulous anamnesis, adequate imaging and urgentEGD are key to treat patients with EFBI. (AU)
Assuntos
Humanos , Masculino , Feminino , Adulto , Diagnóstico Precoce , Hospitais , Endoscopia Gastrointestinal , Esôfago/cirurgia , Corpos Estranhos/complicações , Corpos Estranhos/diagnóstico por imagem , Corpos Estranhos/cirurgiaRESUMO
Esophageal fish bone impaction (EFBI) is a common reason for presentation in the emergency department and a frequent indication for urgent esophagogastroduodenoscopy (EGD). Although it is usually effectively diagnosed and treated by EGD, a confirmed diagnosis prior to the endoscopy is rare as blood tests, radiography and direct laryngoscopy are usually normal. We herein report three cases of EFBI. Two patients had been previously discharged without a correct diagnosis. In one case, the patient had a severe complication that required urgent surgery which could have probably been averted with an early diagnosis. Remarkably, a cervical CT scan was key to diagnose the EFBI in one case and a large retroesophageal abscess in another cases, thus guiding their management. Both patients that underwent an urgent EGD had a favorable outcome without the need for hospitalization. Therefore, meticulous anamnesis, adequate imaging and urgent EGD are key to treat patients with EFBI.
