Fatigue and Chills in a 60-Year-Old Hypertensive Alcoholic
| Autor: | Peter Alan Kosovsky, Brighita Weinberg, Ulrick Vieux, Bernard Lewin |
|---|---|
| Rok vydání: | 1986 |
| Předmět: |
medicine.medical_specialty
Perforation (oil well) Diverticulitis Colonic Abdominal wall Pneumoperitoneum medicine Humans Pneumomediastinum Mediastinal Emphysema Sigmoid Diseases Crepitus business.industry General Medicine Middle Aged medicine.disease Subcutaneous Emphysema Surgery Radiography medicine.anatomical_structure Intestinal Perforation Retropneumoperitoneum Abdomen Female Chills medicine.symptom business Subcutaneous emphysema |
| Zdroj: | JAMA: The Journal of the American Medical Association. 256:383 |
| ISSN: | 0098-7484 |
| DOI: | 10.1001/jama.1986.03380030085033 |
| Popis: | History A 60-year-old woman with a history of alcohol abuse and hypertension presented to the emergency room because of increasing fatigue and shaking chills. Her temperature was 39.7°C (103.4°F) and her blood pressure was 90/60 mm Hg. Tenderness was present in the left upper and lower quadrants of the abdomen with guarding. Crepitus was noted along the left lateral side of the abdominal wall. Laboratory findings included a white blood cell count of 20 000/mm 3 (20.0×10 9 /L) with a leftward shift, abnormal results on liver function tests, anemia, a serum urea nitrogen concentration of 44 mg/ dL (15.5 mmol/L), and a creatinine level of 1.6 mg/dL (140 μmol/L), in addition to a prolonged prothrombin time. Roentgenograms of the abdomen and chest were obtained (Fig 1). Diagnosis Pneumoretroperitoneum, pneumomediastinum, and subcutaneous emphysema secondary to sigmoid diverticulitis with extraperitoneal perforation. A plain x-ray film of the abdomen showed a calcified |
| Databáze: | OpenAIRE |
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