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Bacterial meningitis after incomplete retrograde obliteration for duodenal varices with encephalopathy: A case report
We report a case of bacterial meningitis in a 72-year-old female with nonalcoholic steatohepatitis who underwent incomplete retrograde obliteration for duodenal varices with encephalopathy. Two months after incomplete retrograde obliteration, she became febrile, drowsy, and was transported to hospit...
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7406980/ https://www.ncbi.nlm.nih.gov/pubmed/32793317 http://dx.doi.org/10.1016/j.radcr.2020.07.029 |
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author | Chikamori, F. Ito, S. |
author_facet | Chikamori, F. Ito, S. |
author_sort | Chikamori, F. |
collection | PubMed |
description | We report a case of bacterial meningitis in a 72-year-old female with nonalcoholic steatohepatitis who underwent incomplete retrograde obliteration for duodenal varices with encephalopathy. Two months after incomplete retrograde obliteration, she became febrile, drowsy, and was transported to hospital. Her serum ammonia level was normal. Endoscopy revealed that previously embolized coil was partially migrated into the duodenal lumen. Cerebrospinal fluid examination confirmed the diagnosis of bacterial meningitis. She was treated with intravenous antibiotics. As there was a risk of bleeding, trans-ileocolic vein obliteration of duodenal varices was attempted. The patient slowly recovered and was discharged. This case indicated two problems could occur by coil migration after incomplete retrograde obliteration for duodenal varices with encephalopathy. One was bacterial meningitis and the other was risk of bleeding from duodenal varices. We conclude that cerebrospinal fluid examination is recommended for patients with high fever and abnormal mental status after incomplete retrograde obliteration, and immediate complete obliteration should be attempted for a risk of bleeding. |
format | Online Article Text |
id | pubmed-7406980 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-74069802020-08-12 Bacterial meningitis after incomplete retrograde obliteration for duodenal varices with encephalopathy: A case report Chikamori, F. Ito, S. Radiol Case Rep Interventional Radiology We report a case of bacterial meningitis in a 72-year-old female with nonalcoholic steatohepatitis who underwent incomplete retrograde obliteration for duodenal varices with encephalopathy. Two months after incomplete retrograde obliteration, she became febrile, drowsy, and was transported to hospital. Her serum ammonia level was normal. Endoscopy revealed that previously embolized coil was partially migrated into the duodenal lumen. Cerebrospinal fluid examination confirmed the diagnosis of bacterial meningitis. She was treated with intravenous antibiotics. As there was a risk of bleeding, trans-ileocolic vein obliteration of duodenal varices was attempted. The patient slowly recovered and was discharged. This case indicated two problems could occur by coil migration after incomplete retrograde obliteration for duodenal varices with encephalopathy. One was bacterial meningitis and the other was risk of bleeding from duodenal varices. We conclude that cerebrospinal fluid examination is recommended for patients with high fever and abnormal mental status after incomplete retrograde obliteration, and immediate complete obliteration should be attempted for a risk of bleeding. Elsevier 2020-08-04 /pmc/articles/PMC7406980/ /pubmed/32793317 http://dx.doi.org/10.1016/j.radcr.2020.07.029 Text en © 2020 The Authors. Published by Elsevier Inc. on behalf of University of Washington. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). |
spellingShingle | Interventional Radiology Chikamori, F. Ito, S. Bacterial meningitis after incomplete retrograde obliteration for duodenal varices with encephalopathy: A case report |
title | Bacterial meningitis after incomplete retrograde obliteration for duodenal varices with encephalopathy: A case report |
title_full | Bacterial meningitis after incomplete retrograde obliteration for duodenal varices with encephalopathy: A case report |
title_fullStr | Bacterial meningitis after incomplete retrograde obliteration for duodenal varices with encephalopathy: A case report |
title_full_unstemmed | Bacterial meningitis after incomplete retrograde obliteration for duodenal varices with encephalopathy: A case report |
title_short | Bacterial meningitis after incomplete retrograde obliteration for duodenal varices with encephalopathy: A case report |
title_sort | bacterial meningitis after incomplete retrograde obliteration for duodenal varices with encephalopathy: a case report |
topic | Interventional Radiology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7406980/ https://www.ncbi.nlm.nih.gov/pubmed/32793317 http://dx.doi.org/10.1016/j.radcr.2020.07.029 |
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