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2 results

  • Chapter 44 - Eclampsia and pre-eclampsia

  • from Section III: - Organ dysfunction and management
  • Edited by Fang Gao Smith, University of Warwick
  • Edited in association with Joyce Yeung
  • Book:
    Core Topics in Critical Care Medicine
    Published online:
    06 July 2010
    Print publication:
    22 April 2010, pp 342-348

  • Summary

    The three common forms of presentation for acute gastrointestinal (GI) bleeds are: haematemesis, melaena, and haematochezia. This chapter discusses the complications associated with GI bleeding and management of GI bleeding. It lists the commonest causes of upper GI bleeding, and explains management of non-variceal upper GI bleeding and upper GI bleeding indications for surgery. Gastro-oesophageal varices are dilated submucosal veins which occur in approximately 40-60% of patients with cirrhosis. Control of active variceal bleeding has been shown to be achievable with sclerotherapy (80%) or band ligation (94%). The chapter discusses the incidence of upper GI perforation and lower GI perforation. Approximately 15% of patients with diverticulitis develop bowel perforation. The mortality rate is high (20-40%) as patients may suffer from sepsis and multiorgan failure. The chapter discusses initial management, specific management and post-operative complications of bowel perforation. Endoscopic treatment achieves haemostasis in the majority of patients with non-variceal bleeding.

  • Opposites attract: a case of magnet ingestion

  • Helen H.L. Wong, Bruce A. Phillips
  • Journal:
    Canadian Journal of Emergency Medicine / Volume 11 / Issue 5 / September 2009
    Published online by Cambridge University Press:
    21 May 2015, pp. 493-495
    Print publication:
    September 2009
    • Article
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  • Foreign-body ingestion is relatively common in the pediatric population and most objects pass through the gastrointestinal tract with minimal complications. Popular toy magnetic construction sets have resulted in numerous reports in the literature of serious complications including death following ingestion of multiple magnets. We report a case of a 5-year-old girl who presented to our emergency department with nonbilious vomiting and mild abdominal pain after accidentally ingesting 2 magnets 10 hours apart. Abdominal radiography showed the presence of 2 magnets, and a laparoscopy revealed multiple areas of bowel wall necrosis and perforation requiring subsequent laparotomy for repair of the bowel wall and retrieval of the magnets. This report aims to alert emergency care physicians of the necessity for early surgical referral with any multiple magnet ingestion to prevent severe complications.