Gastrointestinal bleeding is common, and severe bleeding often requires intensive care unit admission. Optimal management requires hemostatic resuscitation, management of antiplatelet and anticoagulant agents, acid suppression, and a multidisciplinary approach to localization for hemorrhage control, summarized in Fig. 93.1 .…
Acute megacolon refers to a syndrome defined by abnormal colonic distention in the absence of mechanical obstruction. Megacolon may be a manifestation of Ogilvie’s syndrome or toxic megacolon. The sequelae of these disorders results in diffuse colonic dysmotility. Ogilvie’s syndrome…
Mechanical bowel obstruction occurs when there is an occlusion of the lumen of the intestine that causes a blockage of the normal flow of intraluminal contents through the gastrointestinal tract. As a common surgical emergency, 3.2 million cases of bowel…
Introduction Sepsis is defined as life-threatening organ dysfunction caused by a dysregulated host response to infection and accounts for approximately 20% of deaths worldwide. Despite tremendous advancements in early diagnosis and both surgical and antimicrobial therapies, it remains a leading…
Acute pancreatitis is an inflammatory condition of the exocrine pancreas, the severity of which can range from mild edematous changes to severe acute necrotizing pancreatitis. Pancreatitis is one of the most common diseases requiring inpatient hospitalization with an incidence of…
Evaluating the patient with a possible acute abdomen and intraabdominal sepsis in the intensive care unit (ICU) can be challenging. Patients frequently have multiple potential sources of sepsis and are often unable to describe symptoms or localize tenderness on physical…
Introduction Acute liver failure (ALF), also known as fulminant hepatic failure, is a compelling example of complex critical illness. The initiating event is extreme liver injury from a variety of possible causes. Thereafter, a severe multisystem critical illness rapidly develops,…
Hepatic encephalopathy encompasses a spectrum of neuropsychiatric abnormalities that occur in patients with liver disease in the absence of other brain disease. , The spectrum includes personality changes, impaired mental function, motor abnormalities (i.e., asterixis, tremors, hyperventilation, hyperactive reflexes), and…
Definition Hepatopulmonary syndrome (HPS) is defined by an abnormally low arterial oxygen level associated with intrapulmonary vascular dilatations (IPVDs) in patients with liver disease. The presence of coexisting cardiopulmonary disease, which may contribute to impaired gas exchange, should be considered…
An association between advanced liver disease, ascites, and renal failure described in 1861 was named hepatorenal syndrome (HRS) by Helvig and Schutz in 1932. Until recently, HRS has been thought of as a purely functional form of renal failure without…