An alcoholic patient who continues to drink: case progression

doi:10.1136/bmj.332.7533.98

BMJ 2006;332:98 (14 January), doi:10.1136/bmj.332.7533.98

Practice

Interactive case report

An alcoholic patient who continues to drink: case progression

Stuart McPherson, specialist registrar¹, Colin John Rees, consultant gastroenterologist¹

¹ Department of Gastroenterology, South Tyneside Healthcare NHS Foundation Trust, South Shields NE34 0PL

Correspondence to: C J Rees Colin.rees@sthct.nhs.uk

The first 150 words of the full text of this article appear below.

Last week (7 January, BMJ 2006;332: 33[Free Full Text]), we described the caseof Mr Bond, who has alcoholic liver disease and presented withhaematemesis. The key to his initial management was resuscitation.He was tachycardic, which may partly have been due to alcoholwithdrawal and agitation but probably suggested a haemodynamicresponse to a clinically important bleed. His heart rate wasnotably raised given that he was taking $beta$ blockers.

Mr Bond was stabilised in the accident and emergency departmentwith aggressive fluid resuscitation through large bore cannulas.Blood was cross-matched, and he was given intravenous vitaminK and tranexamic acid to correct his clotting abnormalities.After resuscitation Mr Bond had gastroscopy to establish thecause of his bleeding. A single oesophageal varix was visiblethat was continuous with a gastric varix (fig). The varix wasbleeding. Our preferred endoscopic treatment would have beenband ligation, . . . [Full text of this article]

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This article has been cited by other articles:

McPherson, S., Rees, C. J. (2006). An alcoholic patient who continues to drink: case outcome. BMJ 332: 276-276 [Full text]

Rapid Responses:

Read all Rapid Responses

Comment on the case study: David H Marjot
bmj.com, 19 Jan 2006 [Full text]
a joint approach: Najat Khalifa, et al.
bmj.com, 22 Jan 2006 [Full text]
recognising his drinking as his major problem: Gerry O'Connor
bmj.com, 23 Jan 2006 [Full text]
Author and patient comments: Colin J Rees, et al.
bmj.com, 27 Jan 2006 [Full text]