Acta Medica Port
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Review Case Reports
[Bouveret's Syndrome: A Case Report and a Brief Literature Review].
Bouveret's syndrome is a rare cause of gastric outlet obstruction. We report a case of a 68-year-old woman admitted with upper digestive obstruction. A few months later, and after several diagnostic tests and clinical surveillance, a cholecystoduodenal fistula was suspected. ⋯ This syndrome represents only 1% - 3% of all cases of gallstone ileus, being more frequent in women and in the elderly. The presentation is quite nonspecific, but in most cases the symptomatology suggests an upper digestive occlusion. Treatment can be achieved by lithotripsy, but most patients require a surgical approach.
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Frequent users contribute to an excessive volume of admissions in the emergency department, impairing the quality of healthcare services. The aim of this study was to identify and characterize the population of frequent users of the pediatric emergency department, establish an individual plan of intervention and evaluate its efficacy. ⋯ This population of frequent users seems to be a heterogeneous group with different problems and levels of complexity. A multidisciplinary and individual intervention, with a case manager, might contribute to reduce the excessive use of the emergency department and improve the provision of health care services to these children.