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Medical practice
Published in Michael Stolberg, Gabrielle Falloppia, 1522/23–1562, 2023
Today, the rupture of enlarged and swollen veins or varices in the lower part of the esophagus is considered an important cause of vomiting blood, often associated with black, tarry stools. These veins swell when the blood flow through the liver is obstructed, for example, in liver cirrhosis, forcing the blood to take its route from the portal vein to the vena cava via small veins that are not designed for such large volumes of blood. They can therefore easily rupture, all the more so when there is a reflux of gastric acid into the esophagus. It is thus quite possible that Falloppia gave here the earliest surviving account of esophageal varices as a cause of hematemesis and bloody stools in chronic liver disease.
Demented and Contracted
Published in Michael Fine, James W. Peters, Robert S. Lawrence, The Nature of Health, 2018
Michael Fine, James W. Peters, Robert S. Lawrence
Sometimes, what you hear is what you get. What I found when I went to the emergency room to meet the old woman and begin her treatment was nothing more, and nothing less than what I had heard: demented and contracted. She lay on her side in a bed, her arms and knees bent in a fetal position. She could not talk. Could not walk. She lay in a bed and was fed. Bed sores. No family. A scribbled record from the nursing home; a barely legible few words from the warehouse where they had 50 of them all the same. Vomiting blood. No history, no sense of what she was like before her admission to a nursing home, or when that happened, no sense of who she was or what she felt. She had thrown up blood in the nursing home twice, but her blood count was still normal. No bleeding from the rectum. No sense of the human being, the person in the body, the self. No sense of self or dignity. A body in a bed who had thrown up blood. But in the next 28 hours, that poor old demented and contracted woman would help me understand something new about the meaning of life, and help me begin to understand the meaning of health.
Unintentional poisoning from decanted toxic household chemicals
Published in Clinical Toxicology, 2023
Katharina von Fabeck, Audrey Boulamery, Corinne Schmitt, Mathieu Glaizal, Luc de Haro, Nicolas Simon
An 11-year-old girl ingested one mouthful of a cleaner containing 7.25% of caustic soda, 83.6% of water, and 4.75% of bleach. In this case, the product was also decanted into a water bottle by another person. When the poison center was called by the hospital, the patient was symptom-free. A short time later, she developed hypersiallorhea, pain in her mouth and pharynx, a small amount of blood in spit, swollen lips, and a swollen uvula. The girl was very anxious. Since she was vomiting blood and had a swollen tongue, the girl was transferred to the nearest university hospital. Gastroscopy on day 1 showed grade IIb esophagitis, on day 6 grade IIa/I esophagitis, and finally on day 10 the lesions had healed [2]. She was treated with proton-pump inhibitors. Up to day 10, she was fed parenterally, on day 10 she started drinking soup. She left the hospital on day 11. A gastroscopy 3 months later revealed no stenosis, just some small white membranes. The girl was considered to have healed, with a following gastroscopy planned for 3 years later.
Patient-reported minor adverse events after colonoscopy: a systematic review
Published in Acta Oncologica, 2019
Mia W. Steffenssen, Issam Al-Najami, Gunnar Baatrup
Marquez et al. [13] used telephone or e-mail follow-up to obtain data for 2, 14 and 30 days follow-up. In the end, 64% of participants had responded to all the questionnaires. At baseline, the investigators asked about symptoms present in a 30-day period before the colonoscopy. The MAEs assessed in the questionnaires were: abdominal pain, bloating, diarrhea, constipation, nausea, vomiting, blood in stools, rectal pain and headache. Other MAEs reported by patients were disorientation, fatigue, itchiness, fever and dehydration. However, no appendix of the questionnaire was included; also it is uncertain what literature the questions were based upon. At the 2 days follow-up, 17% reported at least one MAE. At the 14 and 30 days follow-up, 11%, and 3% reported at least one MAE, respectively. Abdominal pain (9%) and bloating (6%) were the most commonly reported on day 2 and 14. However, on day 30, only 1% had abdominal pain (Table 2).
Diagnostic and therapeutic approach to upper gastrointestinal bleeding
Published in Paediatrics and International Child Health, 2019
Vomiting blood which may be bright red or of a coffee-ground colour, small or large and may be associated with clots. A coffee-ground colour is caused by a change of Hb to acid haematin when it comes in contact with acid in the stomach. Bright red indicates brisk bleeding, i.e. the Hb does not have time to convert to acid haematin. It is assumed that a fistful of clots is equivalent to 500 ml of blood which provides an indication of the degree of blood loss [8].