Yuichi Takano1,2, Hiroaki Tanaka3, Michiari Kawamo1, Jun Sasaki1, Munetaka Hayashi1. 1. Department of Critical Care and Emergency Medicine Showa University Fujigaoka Hospital Yokohama Kanagawa Japan. 2. Division of Gastroenterology Department of Internal Medicine Showa University Fujigaoka Hospital Yokohama Kanagawa Japan. 3. Department of Psychiatry Showa University Fujigaoka Hospital Yokohama Kanagawa Japan.
Abstract
Case: A 38-year-old mentally retarded woman was transported to the emergency room for marked undernutrition. Two months prior, she had developed tooth decay and her food intake decreased severely. Over 2 months, her weight decreased from 47 to 31 kg (-16 kg). Computed tomography (CT) revealed extensive subcutaneous, mediastinal, and retroperitoneal emphysema. She was hospitalized and treatment with central venous hyperalimentation and antibiotics was initiated. CT performed 3 weeks after hospitalization showed that the systemic emphysema had completely disappeared. Outcome: She progressed favorably and was transferred to a specialized psychiatric hospital for further treatment. Conclusion: Regardless of the cause, this rare complication must be taken into account when treating patients suffering from long-term starvation or undernutrition. Whole-body management including nutritional management and careful follow-up observations are appropriate for treating this condition.
Case: A 38-year-old mentally retardedwoman was transported to the emergency room for marked undernutrition. Two months prior, she had developed tooth decay and her food intake decreased severely. Over 2 months, her weight decreased from 47 to 31 kg (-16 kg). Computed tomography (CT) revealed extensive subcutaneous, mediastinal, and retroperitoneal emphysema. She was hospitalized and treatment with central venous hyperalimentation and antibiotics was initiated. CT performed 3 weeks after hospitalization showed that the systemic emphysema had completely disappeared. Outcome: She progressed favorably and was transferred to a specialized psychiatric hospital for further treatment. Conclusion: Regardless of the cause, this rare complication must be taken into account when treating patients suffering from long-term starvation or undernutrition. Whole-body management including nutritional management and careful follow-up observations are appropriate for treating this condition.
Authors: A I Hatzitolios; M L Sion; A D Kounanis; E N Toulis; A Dimitriadis; I Ioannidis; G N Ziakas Journal: Postgrad Med J Date: 1997-10 Impact factor: 2.401