A case of pneumoperitoneum complicating cardiopulmonary resuscitation in a 54 year old man is presented. With clinical evidence of evolving peritonism, he underwent laparotomy, but no visceral rupture was discovered. A search of the literature reveals at least 12 cases of pneumoperitoneum following cardiopulmonary resuscitation, the majority from lesser curve gastric rupture, with several cases showing no evident rent at laparotomy or autopsy. To assist critical management decisions, especially with respect to performing laparotomy, several authors have proposed investigations and algorithms to separate those with visceral rupture from those without. These are evaluated, and in the context of the case presented, considered neither highly specific nor sensitive.
A six-year-old, male, neutered Cocker spaniel was referred for a three-week history of progressive thoracic limb stiffness. The dog became non-ambulatory due to severe thoracic limb stiffness, which was exacerbated by external stimuli. The pelvic limbs appeared to be normal. Based on the history and the physical examination, a presumptive diagnosis of focal tetanus of the thoracic limbs was made. The dog was treated supportively with tetanus antitoxin, antimicrobials, sedation and muscle relaxants; however, this treatment did not control the muscle spasms adequately. Magnesium sulphate was added to alleviate the muscle spasms and to reduce the sedation requirements. The dog improved and was discharged after three weeks of intensive treatment.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.