IntroductionThe drugs gabapentin and ketamine are used frequently in the peri-operative setting. There is poor documentation whether or not gabapentin and ketamine interact to cause prolonged depression of the central nervous system.Case PresentationThe following is a case report in which a patient, a 58-year-old African-American man, with a history of post-traumatic stress disorder and chronic pain underwent a cervical laminoplasty procedure. The patient presented post-operatively in a dissociative state with paralysis, anarthria and preservation of consciousness. All organic causes were excluded, with the exception of prolonged central nervous system depression from a gabapentin/ketamine drug interaction. A new onset conversion disorder could also not be excluded.ConclusionAlthough this case by itself is not enough evidence to substantiate a true adverse reaction between gabapentin and ketamine, it is enough to warrant further investigation.
BackgroundColorectal cancer (CRC) is a common and lethal disease with thousands of new cases of large bowel cancer diagnosed in the United States each year. Colorectal cancer frequently causes obstruction of the large bowel. Cases of obstructions and perforations have been documented with masses well below 6 cm in diameter. Obstruction and/or perforation are important predictors of prognosis with respect to colorectal carcinomas.Case PresentationThe following is the presentation of an unusual case of a 13 × 12 × 16 cm colonic adenocarcinoma without any signs of obstruction or perforation.ConclusionPerioperative mortality rates for colorectal cancer with obstruction have been documented anywhere from 5% to 47.6%, making obstruction an important predictive factor in long-term patient survival. Although a correlation between obstruction and patient outcome has been determined, a correlation between colorectal tumor size/staging and obstruction has yet to be investigated.
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