BMJ case reports
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Portal vein thrombosis (PVT) following sleeve gastrectomy is rare. There are limited documented cases within the literature. The presentation of PVT varies on a spectrum from mild non-specific abdominal symptoms to life endangering clinical emergencies. ⋯ There were radiological changes suggestive of acute small bowel ischaemia. The patient underwent a laparotomy in theatre and 50 cm of the necrotic small bowel was resected. Postoperative care was carried out in the intensive care unit for 15 days.
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A 17-year-old male patient presented to A&E with swelling on the right side of his neck, extending to below the clavicle, associated with neck pain and dysphonia. On examination, subcutaneous supraclavicular and chest wall emphysema was noted. Clinical observations and bloods were normal. ⋯ He remained well, his dysphonia resolved and his subcutaneous emphysema improved. He was discharged after 3 days. He has not attended any formal follow-up but was well when contacted by phone.
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Our patient presented with repetitive, self-limited bouts of forceful hiccups in sleep. Eszopiclone, a commonly prescribed hypnotic, appeared to cause these intermittent hiccups. This case is a reminder that eszopiclone may cause this adverse effect, and that it may be the bed partner and not the patient who furnishes critical sleep medicine history.