Chunghee Joo, Eun Jung Cho and Seunghee Cho
DOI: 10.4172/2165-7920.10001362
Seizure-like movements after general anesthesia is not common, but it sometimes happens. However, abnormal movements following general anesthesia may be difficult to differentiate because it is difficult to find out the exact cause of these seizure-like movements. These cases can occur at any stage (during induction of anesthesia and emergence from anesthesia and early and late recovery of anesthesia). This is a rare case of seizure-like movement after tonsillectomy under general anesthesia.
Ensar Durmuà Â
DOI: 10.4172/2165-7920.10001363
Objective: The present study aims to investigate a patient with a large number of admissions to adult emergency service, to understand the cost of the patient to the public through the number of admissions and the invoice amount, and to reveal the solutions available for such patients. Introduction: Emergency services are the units providing free health services with intensive patient admissions in Turkey. Emergency department admissions were gradually increasing in recent years, with claims that emergency services are being abused by patients. Results: Our patient was found to admit to the emergency department 266 times in two years for reasons such as substance abuse, excessive drug use, and self-harm, and he was hospitalized 4 times in the service and 9 times in the intensive care unit. The invoice total of the examination and treatment bill was 21,763.05 Turkish Lira. Conclusion: Patients with addictions and psychiatric disorders have the potential to harm themselves and cause multiple emergency service admissions, leading to increased workload in the emergency service. It may be necessary to address these patients differently than other patients and to conduct a more detailed examination.
Julia Stephens and Jack Neppl
DOI: 10.4172/2165-7920.10001364
Introduction: Ventriculoperitoneal (VP) placement is the most common procedure performed by neurosurgeons with a high range of reported complication rates with a mean complication rate of 23.8%. Such complications included shunt failure, infection, shunt migration, pneumocephalus, and subdural hematoma. A small portion of the catheter migrations can lead to abdominal pain by penetrating walls of the viscera or the peritoneal wall. Because 15% of these cases result in death, recognizing and treating this complication quickly is essential. Case presentation: A 56-year-old Caucasian male with a history of hydrocephalus treated with multiple VP shunt placements presented to the ED in a community setting three times over the course of two months with RLQ pain. Clinical course: The patient continued to have severe abdominal pain despite multiple visits to the ED and an inpatient stay for treatment of suspected colitis. Referral to general surgery allowed for definitive diagnosis where a diagnostic colonoscopy showed the distal portion of a VP shunt was penetrating the wall of the cecum. Subsequent laparoscopy was performed to remove multiple disconnected VP shunts with closure of the cecotomy with two endoclips, which resulted in rapid improvement of the patient’s pain. Conclusion: When considering the differential diagnosis for abdominal pain in a patient with a VP shunt, it is necessary to recognize distal shunt migration as an uncommon but serious cause of the pain. Bowel perforation is a complication of VP shunt placement that occurs in 0.1-0.7% of patients, with 15% of these resulting in death.
