Canadian journal of surgery. Journal canadien de chirurgie
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Three cases of immobilization hypercalcemia are presented and the incidence, clinical symptoms, laboratory investigation, pathophysiology and treatment of this metabolic abnormality are reviewed. Immobilization hypercalcemia is more common that has previously been suspected. Vague clinical symptoms may not suggest the diagnosis of hypercalcemia. ⋯ Treatment is directed towards lowering the serum calcium level using intravenous hydration, furosemide and salmon calcitonin. Definitive treatment consists of mobilizing the patient. Exercises in bed have not been effective in preventing or treating immobilization hypercalcemia.
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Possible intra-abdominal injuries were sought in 101 patients admitted with blunt abdominal trauma. The serum amylase level was measured in the first 12 hours after the accident. ⋯ The mean value of the serum amylase for those who had laparotomy was 1190 IU, while it was only 363 IU for those not operated upon. The authors conclude that hyperamylasemia in blunt abdominal trauma is not specific to pancreatic injury, but may suggest the presence of a serious intra-abdominal lesion.