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báo cáo hóa học: " Respiratory distress and chest pain: a perforated peptic ulcer with an unusual presentation"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành hóa học dành cho các bạn yêu hóa học tham khảo đề tài: Respiratory distress and chest pain: a perforated peptic ulcer with an unusual presentation | Bruner and Gustafson International Journal of Emergency Medicine 2011 4 34 http www.intjem.eom content 4 1 34 o International Journal of Emergency Medicine a SpringerOpen Journal CASE REPORT Open Access Respiratory distress and chest pain a perforated peptic ulcer with an unusual presentation David I Bruner1 2 and Corey Gustafson2 Abstract Background Dyspnea and chest pain are common presenting complaints to the ED and coupled together can present a challenging diagnostic dilemma in patients in extremis. A thoughtful evaluation is required giving due diligence to the immediate life threats as well as multiple etiologies which can cause serious morbidity. A perforated peptic ulcer is one such possibility and requires rapid diagnosis and prompt intervention to avoid the associated high risk of morbidity and mortality. Method We present a case report of a 54 year old man with respiratory distress and chest pain as the initial Emergency Department presentation of a perforated duodenal ulcer. Results We d iscuss an unusual presentation of a perforated duodenal ulcer that was recognized in the emergency department and treated promptly. The patient was surgically treated immediately had a prolonged and complicated post-operative course but is ultimately doing well. We also provide a brief literature review of the risk factors imaging choices and management decision required to treat a perforated ulcer. Conclusions Perforated ulcers can have highly varied presentations and are occasionally difficult to diagnose in a complicated patient. Knowledge of the risk factors and a thorough history and physical can point to the diagnosis but timely and appropriate imaging is often required because delays in diagnosis and treatment lead to poor outcomes. Early administration of antibiotics and immediate surgical repair are necessary to limit morbidity and mortality. Introduction Dyspnea and chest pain are common presenting complaints to the Emergency Department ED and they often .