Abstract | BACKGROUND: CASE PRESENTATION: A 46-year-old man was sent to our institution due to disturbance in consciousness and general weakness. Brain computed tomography (CT) scan showed multiple hyperdense lesions over the bilateral hemisphere at the white-gray matter junction. Empiric antibiotic treatment with vancomycin and ceftriaxone was prescribed. Due to acute generalized exanthematous pustulosis (AGEP), we ordered betamethasone and diphenhydramine. Two days later, the patient had bloating and abdominal tenderness. Moreover, contrast-enhanced abdominal CT scan revealed PCI of the ascending colon. Since ischemic bowel disease was suspected, laparoscopy and colonoscopy were carried out. However, no abnormal mucosa or mass lesion was noted. Then, tachycardia, hypotension, and change in consciousness along with loss of brainstem reflex and increased intracranial pressure were noted. After further treatment, the patient's condition worsened, and he eventually died. CONCLUSION: As the outcomes of PCI range from benign to life-threatening, an accurate diagnosis must be made to prevent unnecessary abdominal surgeries. Benign PCI in a patient without PCI correlated to underlying diseases, but received short-term corticosteroid treatment should be considered.
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Authors | Nien-Ying Tsai, Chung-Hsing Chou, Yi-Chiao Cheng |
Journal | International journal of colorectal disease
(Int J Colorectal Dis)
Vol. 34
Issue 10
Pg. 1805-1808
(Oct 2019)
ISSN: 1432-1262 [Electronic] Germany |
PMID | 31471694
(Publication Type: Case Reports, Journal Article)
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Topics |
- Adolescent
- Adult
- Brain
(diagnostic imaging, pathology)
- Female
- Humans
- Laparoscopy
- Magnetic Resonance Imaging
- Male
- Meningitis, Aseptic
(complications, diagnostic imaging)
- Middle Aged
- Pneumatosis Cystoides Intestinalis
(complications, diagnostic imaging)
- Radiography, Abdominal
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