SMA Syndrome Causes Gastric Outlet Obstruction [ED Consults Surgery Resident]
Case #116
Before we get in to today’s case, I have an update from last week’s malpractice lawsuit about a pediatric osteosarcoma misdiagnosis.
Many readers pointed out that only frozen sections were mentioned in the case.
These would be woefully inadequate for a final diagnosis.
Further review of the allegations against the pathologist reveal that permanent sections were also reviewed:
The plaintiff also hired a pathology expert witness:
Thank you to the many pathologists who provided feedback on this case!
This week’s case concerns a 26-year-old woman presented to the ED with abdominal pain and constipation.
A CT scan showed a gastric outlet obstruction causing severe gastric distension.
It appeared that she was suffering from SMA syndrome.
General surgery was consulted.
A surgery resident came to the ED, and placed an NG tube with the help of an ED nurse.
An x-ray confirmed appropriate positioning of the NG tube.
The gastric contents were thick and difficult to aspirate.