Incisional hernia as an unusual cause of hepatic encephalopathy in a 62-year-old man with cirrhosis: a case reportReportar como inadecuado




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Journal of Medical Case Reports

, 3:7315

First Online: 17 September 2009Received: 04 March 2008Accepted: 04 February 2009DOI: 10.4076-1752-1947-3-7315

Cite this article as: Ustaoglu, M., Bakir, T., Bektas, A. et al. J Med Case Reports 2009 3: 7315. doi:10.4076-1752-1947-3-7315

Abstract

IntroductionHepatic encephalopathy may be initiated by many factors such as gastrointestinal bleeding, infections, fluid and electrolyte disturbances. Hypokalemia is one of the most commonly encountered electrolyte abnormalities causing hepatic encephalopathy in patients with cirrhosis.

Case presentationWe present the case of a 62-year-old Caucasian man with decompensated liver cirrhosis having multiple episodes of hepatic encephalopathy precipitated by vomiting. He had an incisional hernia at the right lumbar region. A barium contrast study of the small intestine and magnetic resonance imaging showed that the hernial sac included gastric antrum and bowel. We observed that hepatic encephalopathy coincided with hypokalemia as a result of a large volume of vomiting triggered by the collapsed hernial sac. Hepatic encephalopathy was resolved by administration of intravenous potassium.

ConclusionThis case illustrates that a hernia causing a large volume of vomiting may be a precipitant factor in the development of hepatic encephalopathy.

AbbreviationsALTalanine aminotransferase

ASTaspartate aminotransferase

HEhepatic encephalopathy

INRinternational normalized ratio

MELDmodel for end-stage liver disease.

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Autor: Muge Ustaoglu - Tulay Bakir - Ahmet Bektas - Osman Cure - Bulent Gungor

Fuente: https://link.springer.com/







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