May 2025 Critical Care Case of the Month: Where’s the Rub?

By: Rashke RA, Weisman E

Abstract:

No abstract available. Article truncated after 150 words. Chief Complaint: A 70-year-old woman with a 13-year history of Crohn’s disease presented with two days of severe generalized myalgias, progressive pleuritic chest pain and malaise, followed by the acute onset of  confusion and oxygen desaturation. History of Present Illness: She had been admitted one week earlier with bloody diarrhea and cramping lower abdominal pain, presumptively diagnosed with a Crohn’s flair and treated with solumedrol 40mg Q12 hourly. An esophagogastroduodenoscopy (EGD) and colonoscopy were performed on the second hospital day, showing angiodysplastic gastric lesions with stigmata of recent bleeding, and severe inflammation with serpentine ulceration of the rectum through the cecum. The angiodysplastic lesions were treated with argon plasma coagulation and colonic biopsies were performed. The patient received 2 units of packed red blood cells. She was discharged the next day on prednisone 40mg and pantoprazole 40mg daily.

She was only home a few hours when she experienced onset of …

URL: https://www.swjpcc.com/critical-care/2025/5/1/may-2025-critical-care-case-of-the-month-wheres-the-rub.html