Images in medicine
Gastric obstruction with death complication after decompressing
Obstrucción gástrica con complicación de muerte después de descompresión
Renato Gonçalves
, Carla Gonçalves, Isabel de La Cal Caballero, Gonçalo Miranda, Pedro Carlos, Sara Ferreira, Célia Tuna
Corresponding author
Centro Hospitalar Universitário da Cova da Beira, Portugal
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"renatojga94@gmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "Carla" "apellidos" => "Gonçalves" ] 2 => array:2 [ "nombre" => "Isabel de La Cal" "apellidos" => "Caballero" ] 3 => array:2 [ "nombre" => "Gonçalo" "apellidos" => "Miranda" ] 4 => array:2 [ "nombre" => "Pedro" "apellidos" => "Carlos" ] 5 => array:2 [ "nombre" => "Sara" "apellidos" => "Ferreira" ] 6 => array:2 [ "nombre" => "Célia" "apellidos" => "Tuna" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Centro Hospitalar Universitário da Cova da Beira, Portugal" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Obstrucción gástrica con complicación de muerte después de descompresión" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:6 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 518 "Ancho" => 755 "Tamanyo" => 29411 ] ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Female patient, 99 years old, dependent for activities of daily living.</p><p id="par0010" class="elsevierStylePara elsevierViewall">Undergoes to the Emergency Department, for two weeks of food refusal, associated, since the previous day, with abdominal distension, fecaloid vomiting and associated pallor.</p><p id="par0015" class="elsevierStylePara elsevierViewall">Was confused and with aggressive behavior, apyretic (36.1<span class="elsevierStyleHsp" style=""></span>°C), hypotensive (88/70<span class="elsevierStyleHsp" style=""></span>mmHg) and tachycardia (125<span class="elsevierStyleHsp" style=""></span>bpm), with distended abdomen, painful on palpation in all quadrants. Personal history of arterial hypertension and fracture of the proximal femur with surgical intervention in 2015.</p><p id="par0020" class="elsevierStylePara elsevierViewall">Analytically, he had leucocytosis, acute kidney injury, elevated troponin (973.2<span class="elsevierStyleHsp" style=""></span>ng/l – <span class="elsevierStyleItalic">reference value 0–15.6<span class="elsevierStyleHsp" style=""></span>ng/l</span>), pro-BNP (16<span class="elsevierStyleHsp" style=""></span>407<span class="elsevierStyleHsp" style=""></span>pg/ml – <span class="elsevierStyleItalic">reference value 0.0–125<span class="elsevierStyleHsp" style=""></span>pg/ml</span>) and C-reactive protein (8.95<span class="elsevierStyleHsp" style=""></span>mg/dl – 0.0–0.5<span class="elsevierStyleHsp" style=""></span>mg/dl). Electrocardiogram with atrial fibrillation, with no apparent acute pathology. Radiography of the abdomen with marked gastric distention with the presence of air-fluid levels (<a class="elsevierStyleCrossRefs" href="#fig0005">Figs. 1 and 2</a>).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0025" class="elsevierStylePara elsevierViewall">She was medicated with metoclopramide and, after evaluation by surgery, a nasogastric tube was placed, with drainage of fecal content. Moments later, the patient died, having chosen not to initiate invasive measures.</p><p id="par0030" class="elsevierStylePara elsevierViewall">The drainage of gastric contents may have provoked vascular collapse at the abdominal level, not forgetting, given analytical changes, the possible associated myocardial or mesenteric ischemia.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "multimedia" => array:2 [ 0 => array:6 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 794 "Ancho" => 755 "Tamanyo" => 64340 ] ] ] 1 => array:6 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 518 "Ancho" => 755 "Tamanyo" => 29411 ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/26039249/0000000400000001/v1_202101161038/S2603924920300926/v1_202101161038/en/main.assets" "Apartado" => array:4 [ "identificador" => "80822" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Imagen en medicina" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/26039249/0000000400000001/v1_202101161038/S2603924920300926/v1_202101161038/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2603924920300926?idApp=UINPBA00004N" ]
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