The Journal of the Louisiana State Medical Society : official organ of the Louisiana State Medical Society
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Case Reports
Clostridial enteritis necroticans versus secondary clostridial infection superimposed upon ischemic bowel disease.
Clostridial enteritis necroticans, or pig-bel, as seen in Papua New Guinea, is a necrotizing, segmental gangrene of the small intestine occurring in members of a malnourished population, who become ill after consuming large quantities of pork contaminated with Type C. Clostridium perfringens. We report a case of possible Clostridial enteritis necroticans with concomitant ischemic intestinal disease secondary to superior mesenteric arterial thrombosis occurring in a 53-year-old woman with a long history of diabetes mellitus, hypertension, and peripheral vascular disease. The differential diagnosis and the pathogenesis of C. perfringens enteritis necroticans are discussed.
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Physician-assisted suicide is a controversial practice that is gaining favor in some segments of today's society. I will analyze the proponents' arguments for physician-assisted suicide and discuss why I believe this is a practice that physicians should shun.
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Case Reports
Clinical case of the month. Chest pain, diaphoresis, and dyspnea in a hypertensive 53-year-old man.
Aortic dissection is a life-threatening condition requiring urgent diagnosis and treatment. The initial challenge for the physician lies in distinguishing aortic dissection from more common conditions such as myocardial infarction that also are characterized by chest pain. Subsequent management depends on imaging techniques that define whether just the descending aorta is affected or its more proximal portions as well. Mortality and morbidity are high, especially when the ascending aorta is involved.