BackgroundPolyethylene glycol (PEG) is widely used for bowel cleaning in preparation for colonoscopy because of its safety. Septic shock after PEG preparation is an extremely rare complication. Herein, we describe a case of septic shock that occurred immediately after colonoscopy preparation with PEG.Case presentationA 75-year-old Japanese male who had previously developed diabetes after total pancreatectomy received PEG in preparation for colonoscopy. He had been admitted to the emergency intensive care unit 4 days earlier due to hematochezia presenting with shock. He ingested PEG to prepare for a colonoscopy examination, which was performed to identify the source of his bleeding over a 5-h period, but suddenly exhibited septic shock and markedly elevated procalcitonin levels. A blood culture subsequently revealed Citrobacter braakii. Immediate resuscitation and intensive care with appropriate antibiotics improved his condition.ConclusionsClinicians should be aware of the possibility of deteriorating conditions after bowel preparation with PEG among severely ill patients with recent episodes of hemorrhagic shock.
In 2021, we surveyed hematologists and pediatric hematologists in the Chugoku region of Japan to determine their opinions and attitudes about the support with education and jobs provided for patients undergoing hematopoietic stem cell transplantation. A questionnaire was sent to 31 doctors in 25 hospitals; 23(74%)doctors responded. Twelve hospitals(67%)had an employment assistance office, but more than half of them had no consultations during the year. Only three doctors considered themselves to be providing good job support. Seven doctors(41%)had experience with online classes. All hospitals evaluated themselves as providing insufficient support to high school and college students. Only 3 of 17 hematologists(18%)had experience in providing support for education. There were regional differences in the support systems for education and employment. Multiple professions need to cooperate, and relationships among neighborhood institutions must be strengthened, to support all patients, including adolescents and young adults.
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