1/8. Toxicity associated with a prolonged half-life of phenytoin in a 97-year-old woman: bezoar formation? Case report and clinical pathological conference.phenytoin metabolism is best described using nonlinear (Michaelis-Menton) kinetics. When calculated pharmacokinetic values, including half life and clearance, do not correspond to measured variables, alternative reasons must be sought. We present an interesting case of phenytoin toxicity and suggest that formation of a bezoar may be one possible answer to prolonged toxicity.- - - - - - - - - - ranking = 1keywords = life (Clic here for more details about this article) |
2/8. Failure of gastric emptying and charcoal administration in fatal sustained-release theophylline overdose: pharmacobezoar formation.We report the case of a fatal theophylline overdose from a sustained-release preparation in a 54-year-old woman. Initial serum theophylline concentration was 31.3 mg/L. Manifestations of mild toxicity cleared in the emergency department after treatment with gastric lavage, charcoal, and a cathartic. A life-threatening overdose was not suspected, and the patient arrested eight hours after discharge from the ED. At autopsy, her serum theophylline concentration was 190.1 mg/L. A white, waxy mass weighing 318.8 g and containing 29 g theophylline, representing the residue of many sustained-release tablets, was found in her stomach. This case reinforces the importance of obtaining repeat serum theophylline levels in patients with sustained-release theophylline overdose. Gastric pharmacobezoar formation should be considered in cases of sustained-release theophylline overdose with rising theophylline levels and patient deterioration, despite adequate gut decontamination.- - - - - - - - - - ranking = 0.2keywords = life (Clic here for more details about this article) |
3/8. Gastric trichobezoar: an important cause of abdominal pain presenting to the pediatric emergency department.abdominal pain is a common presenting complaint of children seen in urgent care settings. It is the manifestation of a wide variety of disease processes ranging from benign to immediately life-threatening. Gastric bezoars are among the etiologies of chronic childhood abdominal pain that, when undiagnosed, may result acutely in serious complications, including gastric ulceration, bleeding and perforation, intussusception, and small bowel obstruction. To reinforce the importance of including this entity in the differential diagnosis of abdominal pain, we present the case of a 10-year-old girl with a history of chronic epigastric complaints who was ultimately presented with acute small bowel obstruction following fragmentation and distal migration of her gastric trichobezoar. Finally, we review and briefly summarize the current literature regarding the etiology, diagnosis, and management of this disorder in children.- - - - - - - - - - ranking = 0.2keywords = life (Clic here for more details about this article) |
4/8. Small bowel obstruction caused by a congenital intestinal web with an enteric bezoar in an adult: report of a case.An intestinal web is a rare congenital anomaly, typically reported in childhood, but often remaining asymptomatic throughout the entire life span of the individual. We report the case of a symptomatic intestinal web associated with an enteric bezoar in an adult, which to the best of our knowledge has never been documented before. A 25-year-old man presented with acute small bowel obstruction, and laparotomy revealed a stenotic area of the ileum as well as impaction of an enteric bezoar. We resected this segment of ileum and an intestinal web was subsequently found in the stenotic area. The patient recovered well and has remained asymptomatic for 3 years. Although rare, a congenital intestinal web may be a cause of adult small bowel obstruction requiring surgical resection.- - - - - - - - - - ranking = 0.2keywords = life (Clic here for more details about this article) |
5/8. Untreated trichotillomania and trichophagia: surgical emergency in a teenage girl.Trichophagia secondary to trichotillomania can be a potentially life-threatening condition if left untreated. This report documents the unique case of a 16-year-old girl whose untreated trichotillomania led to a trichobezoar requiring surgical intervention and follow-up psychiatric treatment. Challenges in the identification and treatment of the disorder and its complications are discussed as well as the importance of early and accurate diagnosis.- - - - - - - - - - ranking = 0.2keywords = life (Clic here for more details about this article) |
6/8. Update on gastroparesis.gastroparesis is a manifestation of diabetic autonomic neuropathy. Gastrointestinal autonomic neuropathy contributes to morbidity, mortality, reduced quality of life, and increased healthcare costs of a patient with diabetes mellitus. Complications from gastroparesis include ketoacidosis, infection, and bezoar formation. The gold standard for the diagnosis of gastroparesis is a gastric emptying study. Other tests and procedures may also be performed to eliminate other causes of the symptoms. In general, treatment involves dietary and lifestyle adjustment as well as pharmacological interventions. Gastric electrical stimulation has recently emerged as an effective strategy in the management of these patients. research is evolving in this area to include the use of botulinum toxin to control symptoms of gastroparesis. patients with gastroparesis can be frustrated with the symptoms they experience, the intensive treatment regimens they must follow, as well as the medical procedures they undergo during the course of their treatment. quality of life is an important factor to consider when caring for and supporting these patients. This article will provide an overview of gastroparesis and the latest treatments available to improve gastric motility and prevent further complications.- - - - - - - - - - ranking = 0.6keywords = life (Clic here for more details about this article) |
7/8. charcoal bezoar. Small-bowel obstruction secondary to amitriptyline overdose therapy.Nasogastric administration of activated charcoal is effective in decreasing the half-life of amitriptyline. A case is reported in which this therapy for amitriptyline overdose led to charcoal bezoar formation and small-bowel obstruction. amitriptyline's atropinic side effects on the gut make this a possible complication in such patients.- - - - - - - - - - ranking = 0.2keywords = life (Clic here for more details about this article) |
8/8. Emergency gastrotomy: treatment of choice for iron bezoar.The authors believe that gastrotomy and surgical removal of tablets is the treatment of choice in massive iron ingestion with development of an "iron bezoar" unresponsive to gastric lavage. Prompt surgical treatment in such cases may be lifesaving.- - - - - - - - - - ranking = 0.2keywords = life (Clic here for more details about this article) |