Irish journal of medical science
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A 29-year-old man was admitted with a 7-day history of progressive non-specific abdominal pain that progressed to small bowel obstruction following ingestion of a 20-pence coin 4-months previously. Colonoscopic retrieval was unsuccessful. A subsequent laparotomy revealed a chronically inflamed thickened terminal ileum with mesenteric fat encroachment necessitating a right hemicolectomy. Histopathological analysis confirmed Crohn's disease with impaction of the 20-pence coin in a distal terminal ileum stricture near the ileo-caecal valve. ⋯ This case describes a rare presentation of Crohn's disease and highlights the need to consider underlying gastrointestinal pathology in patients presenting with a deteriorating clinical condition in the presence of an incidental foreign body.
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Pneumomediastinum and subcutaneous emphysema are rare complications of acute asthma. If pneumomediastinum occurs it can cause compression on major vessels in the mediastinum and neck and can lead to low blood pressure along with chest pain and other life-threatening complications. Therefore, knowledge of this condition and its proper management are very important for doctors. ⋯ The authors report on a case of pneumomediastinum and surgical emphysema and discuss the diagnostic and therapeutic implications of this condition. In this report a 20 year-old girl presented to A and E department of Mayo General Hospital with an acute exacerbation of asthma complicated by pneumomediastinum and subcutaneous emphysema.
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The Irish childhood obesity epidemic, one of the highest ranking internationally, represents a major threat to public health. We sought to perform a retrospective observational study of a clinic based cohort of obese Irish children. ⋯ Obese Irish children present with significant long-term health risks, including hypertension at baseline.
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Since the discovery of Helicobacter pylori in the early 1980s several treatment regimens have been developed to effectively treat this infection. International guidelines have allowed consensus on the best management and improved eradication rates. In recent years increasing antimicrobial resistance and falling eradication rates highlight the need for updated guidelines. In this article we review the most recent European management guidelines and in view of the unavailability of some drugs consider new treatment regimens for the management of H. pylori in Ireland.
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We present a case of dapsone induced methaemoglobinaemia that occurred in a patient who presented to the Emergency Department of a University Hospital. It is an uncommon condition that requires specific and urgent treatment in severe cases. ⋯ Acquired methaemoglobinaemia is an uncommon condition that presents with non-specific signs and symptoms. It is caused by a variety of exogenous agents and results in a "saturation gap" between oxygen saturation on pulse oximetery and arterial blood gas analysis. Specific treatment with intravenous methylene blue is the treatment of choice. Full resolution can be expected with treatment but severe cases can be associated with shock and mortality.