By computer search of the literature, we found few cases of hydronephrosis due to fecal impaction. Because such a complication is extremely rare, we describe an 81-year-old woman with dementia, gallstones, arterial hypertension, and diverticulosis of the sigma who was hospitalized for severe constipation, fecaloma, and bilateral hydronephrosis. Through simultaneous lavage by two rectal tubes and manual disimpaction of fecaloma, bilateral hydronephrosis was resolved. We also briefly review the appropriate literature.
We describe an elderly woman with a deep hyperphosphatemic hypocalcemic coma, hypernatremia, hypokalemia, metabolic acidosis, pancytopenia and respiratory and circulatory failure secondary to phosphate intoxication following the overdose administration of hypertonic sodium phosphate enema. The causes of increased colonic retention and absorption and decreased renal excretion are discussed. We recommend the use of the safer and less toxic cathartic medications or at least a very cautions use of such enemas in anyone with renal failure.
We report a case of a 37-year-old symptomatic male with anterior myocardial ischemia. Coronary angiography demonstrated systolic obstruction of the midportion of the left anterior descending coronary artery due to myocardial bridging. The patient was treated with a supra-arterial myotomy. Two years postoperatively, the patient is without evidence of myocardial ischemia. Angiography, 2 years postoperatively, shows no evidence of systolic narrowing of the left anterior descending coronary artery.
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