BMJ case reports
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Case Reports
Posterior reversible encephalopathy syndrome (PRES) in a patient with late postpartum eclampsia.
Posterior reversible encephalopathy syndrome (PRES) is a reversible neurological entity characterised by seizure, headaches, visual symptoms, impaired consciousness and other focal neurological findings. It is caused by a wide variety of causes ultimately leading to a vasogenic cerebral oedema of occipital and parietal lobes of the brain. We present here a young woman with headache, generalised tonic-clonic seizures and cortical blindness in a late postpartum stage. Reversibility of the symptoms and characteristic imaging findings led us to a diagnosis of PRES in our patient.
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We describe a case of extreme mixed overdose of calcium channel blockers, β-blockers and statins. The patient was successfully treated with aggressive resuscitation including cardiac pacing and multiorgan support, glucagon and high-dose insulin for toxicity related to calcium channel blockade and β-blockade, and ubiquinone for treating severe presumed statin-induced rhabdomyolysis and muscle weakness.
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Uvular necrosis following endotracheal general anaesthesia is a rare complication. We report two cases of uvular and soft palate necrosis after atraumatic intubation with endotracheal tube and, in the second case, laryngeal mask airway.
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Acute myocarditis may mimic myocardial infarction because the affected patients report 'classical' chest pain; the ECG changes and echocardiography are identical to those observed in acute coronary syndromes, and serum markers are increased. We describe a case with ST segment elevation on admission ECG, and coronary angiography was normal. Cardiac magnetic resonance with myocardial delayed enhancement sequences is a non-invasive alternative for diagnosing myocarditis.
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A young man presented with a sudden onset of severe abdominal pain and vomiting. He also had shortness of breath with right-sided pleuritic chest pain. On examination he was found to have a rigid and diffusely tender abdomen. ⋯ His postoperative course was uneventful. Pneumothorax is a rare complication of perforated duodenal ulcer and should be kept in mind while assessing patients who present with abdominal pain and dyspnoea. We have discussed various possibilities that should be considered in patients who present with a concomitant pneumothorax and pneumoperitoneum.