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The Norovirus epidemic...or just a stone? Revising the diagnosis with an abdominal radiograph.

Authors
  • Wagner, Siegfried K
  • Remoundos, Dionysios D
  • Abdulla, Muaad
Type
Published Article
Journal
BMJ Case Reports
Publisher
BMJ
Publication Date
Jan 01, 2013
Volume
2013
Identifiers
DOI: 10.1136/bcr-2013-009520
PMID: 23771969
Source
Medline
License
Unknown

Abstract

During an acute outbreak of Norovirus in the local area, a 77-year-old woman was admitted with a short history of diarrhoea and vomiting. A working diagnosis of viral gastroenteritis complicated by acute renal failure, secondary to dehydration, was made. Despite judicious fluid resuscitation and regular antiemetics, the patient's symptoms persisted with only mild improvement in her renal function. An abdominal radiograph revealed evidence of significant small bowel obstruction and subsequent CT of the abdomen and pelvis identified a 1.5 cm intraluminal density at a transition point raising the suspicion of gallstone ileus. An urgent laparotomy with stone removal was carried out without complications. The patient recovered well postoperatively and was discharged home after 3 days.

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