Southern medical journal
-
To detect the readmission rates of a hospitalist group at a community hospital, to identify probable causes of rehospitalizations, and to propose solutions to decrease the rate of readmissions. ⋯ Our readmission rate (1.6%) is significantly lower than that of previous studies (23.2%), as we included the readmissions only due to the same diagnosis. Patient education, family involvement in discharge process, and scheduling follow-up appointments could potentially reduce readmissions, despite multiple unmodifiable factors. We suspect all-cause readmissions have room for more improvement, which should be the focus of intervention.
-
Colonoscopy is a routine procedure done tens of thousands of times per year for screening purposes. The vast majority of these procedures are uneventful. There are, however, complications that can arise from this procedure, including hollow viscus perforation and hemorrhage. ⋯ We present a case of a 67-year-old female who underwent a routine screening colonoscopy at our institution and presented to the emergency department several hours later complaining of abdominal pain. Ultimately, abdominal computed tomography showed a large splenic laceration, which was treated operatively. The diagnosis of splenic laceration should be considered for patients with continued abdominal pain post-colonoscopy when other etiologies have been evaluated and ruled out.
-
The association between acute coronary events and acute allergic reactions has been recognized for several years. The first reported case occurred in 1950, during an allergic reaction to penicillin. In 1991, Kounis and Zavras described the syndrome of allergic angina and allergic myocardial infarction, currently known as Kounis syndrome. ⋯ This syndrome has been reported in association with a variety of medical conditions, environmental exposures, and medication exposures. Entities such as Takotsubo cardiomyopathy, drug-eluted stent thrombosis, and coronary allograft vasculopathy appear to be associated with this syndrome. In this review, we discuss the pathobiology, clinical features, associated entities, and management of Kounis syndrome.
-
Southern medical journal · Nov 2010
Case ReportsThoracic aortic pseudoaneurysm following noncardiovascular surgery: a rare complication that can mimic common chest emergencies.
Pseudoaneurysm of the thoracic aorta is an extremely rare and potentially fatal condition that can mimic acute coronary syndrome, aortic dissection, or pulmonary embolism. Chest trauma and aortic surgery are the usual predisposing factors. ⋯ Computed tomography or magnetic resonance angiography is the preferred diagnostic test. In this paper, we report the case of a 58-year-old woman who presented with atypical chest pain due to a thoracic aortic pseudoaneurysm, most likely a result of previous nonvascular surgery.
-
Southern medical journal · Oct 2010
Case ReportsNecrotizing fasciitis due to an infected urachal cyst in an adult.
Urachal cyst complications requiring surgical intervention are rarely seen in adults, because the urachus is normally obliterated in infancy. Necrotizing fasciitis due to an infected urachal cyst in an adult female has not been reported. We describe the case of a fifty-year-old female who required aggressive surgical management of abdominal wall necrotizing soft tissue infection from an infected urachal cyst.