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An unusual cause of bowel ischemia in an intensive care unit patient with herpes simplex virus encephalitis

We present a case of an unexpected cause of bowel ischemia in an intensive care unit patient with herpes simplex virus encephalitis who required an operation. A 79-year-old lady was being worked up and treated for encephalitis with antibiotics and an antiviral. On Day 13, she developed abdominal pai...

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Autores principales: Seomangal, Karishma, Bashir, Yasir, Boland, Michael, Neary, Paul
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6792076/
https://www.ncbi.nlm.nih.gov/pubmed/31632635
http://dx.doi.org/10.1093/jscr/rjz267
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author Seomangal, Karishma
Bashir, Yasir
Boland, Michael
Neary, Paul
author_facet Seomangal, Karishma
Bashir, Yasir
Boland, Michael
Neary, Paul
author_sort Seomangal, Karishma
collection PubMed
description We present a case of an unexpected cause of bowel ischemia in an intensive care unit patient with herpes simplex virus encephalitis who required an operation. A 79-year-old lady was being worked up and treated for encephalitis with antibiotics and an antiviral. On Day 13, she developed abdominal pain, and an ultrasound showed cholelithiasis but no cholecystitis; thus conservative treatment was advocated. By Day 18, pain localized to the right iliac fossa, and she had an emergency laparotomy that showed bowel ischemia and perforation of the caecum with the cause being a terminal ileal adhesional band. An extended right hemicolectomy and ileostomy was performed. Patients with significant comorbidities who are intensive care unit-dependent may still have unexpected clinical challenges. We advocate an increased clinical vigilance in this cohort for unexpected life-threatening presentations such as bowel ischemia and more specifically the cause of the bowel ischemia.
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spelling pubmed-67920762019-10-18 An unusual cause of bowel ischemia in an intensive care unit patient with herpes simplex virus encephalitis Seomangal, Karishma Bashir, Yasir Boland, Michael Neary, Paul J Surg Case Rep Case Report We present a case of an unexpected cause of bowel ischemia in an intensive care unit patient with herpes simplex virus encephalitis who required an operation. A 79-year-old lady was being worked up and treated for encephalitis with antibiotics and an antiviral. On Day 13, she developed abdominal pain, and an ultrasound showed cholelithiasis but no cholecystitis; thus conservative treatment was advocated. By Day 18, pain localized to the right iliac fossa, and she had an emergency laparotomy that showed bowel ischemia and perforation of the caecum with the cause being a terminal ileal adhesional band. An extended right hemicolectomy and ileostomy was performed. Patients with significant comorbidities who are intensive care unit-dependent may still have unexpected clinical challenges. We advocate an increased clinical vigilance in this cohort for unexpected life-threatening presentations such as bowel ischemia and more specifically the cause of the bowel ischemia. Oxford University Press 2019-10-14 /pmc/articles/PMC6792076/ /pubmed/31632635 http://dx.doi.org/10.1093/jscr/rjz267 Text en Published by Oxford University Press and JSCR Publishing Ltd. All rights reserved. © The Author(s) 2019. http://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Case Report
Seomangal, Karishma
Bashir, Yasir
Boland, Michael
Neary, Paul
An unusual cause of bowel ischemia in an intensive care unit patient with herpes simplex virus encephalitis
title An unusual cause of bowel ischemia in an intensive care unit patient with herpes simplex virus encephalitis
title_full An unusual cause of bowel ischemia in an intensive care unit patient with herpes simplex virus encephalitis
title_fullStr An unusual cause of bowel ischemia in an intensive care unit patient with herpes simplex virus encephalitis
title_full_unstemmed An unusual cause of bowel ischemia in an intensive care unit patient with herpes simplex virus encephalitis
title_short An unusual cause of bowel ischemia in an intensive care unit patient with herpes simplex virus encephalitis
title_sort unusual cause of bowel ischemia in an intensive care unit patient with herpes simplex virus encephalitis
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6792076/
https://www.ncbi.nlm.nih.gov/pubmed/31632635
http://dx.doi.org/10.1093/jscr/rjz267
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