Improving outcome following life-threatening gastrointestinal bleeding not amenable to endoscopy in an ASA grade 5 patient: lessons learned
| Autor: | George A Demetriou, Olu Oluwajobi, Manojkumar S Nair, Eoin Dinneen |
|---|---|
| Rok vydání: | 2013 |
| Předmět: |
medicine.medical_specialty
Gastrointestinal bleeding medicine.medical_treatment Pericardial effusion Endoscopy Gastrointestinal Article Lesion Lumbar Stomach Neoplasms Laparotomy medicine Humans General anaesthesia Societies Medical Aged Neoplasm Staging medicine.diagnostic_test business.industry General Medicine medicine.disease Hemostasis Surgical United States Surgery Endoscopy Heart failure Female medicine.symptom business Gastrointestinal Hemorrhage Tomography X-Ray Computed |
| Zdroj: | BMJ case reports. 2013 |
| ISSN: | 1757-790X |
| Popis: | We present a 74-year-old woman, who developed massive haematemesis and hypovolaemic shock. Her management was challenging, as the bleeding site could not be identified during oesophagogastroduodenoscopy, she was not fit for a general anaesthesia and not able to lie flat due to heart failure, caused by pericardial effusion. She underwent an emergency laparotomy and gastrotomy under a combined thoracic epidural and lumbar spinal regional anaesthesia in a sitting position, 45° to horizontal plane. The bleeding site was identified as a Dieulafoy lesion on the posterior wall of the stomach and was controlled by under running the lesion. She had an uneventful recovery and is symptom-free post-surgery for a year at present. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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