Curbside Consultation in Endoscopy: 49 Clinical Questions, Second Edition

Joseph Leung, MD; Simon Lo, MD

Question 35: A 78-Year-Old Vietnamese Woman Who Collapsed At Home Was Found To Be Febrile And In Shock With A Systolic Bp Of 80 Mm Hg. She Is Mildly Jaundiced With Abdominal Guarding. How Would You Manage Her? (continued)

Catherine Ngo, MD; Joseph Leung, MD, FRCP, FACP, FASGE, MACG

The emergency management of someone in shock includes initial aggressive resuscitation and identification of immediately reversible causes, including underlying cardiopulmonary events. The presence of fever, abdominal guarding, and jaundice would suggest an acute abdomen and possible biliary sepsis as a cause of the hypotension. Difficulty in the management of this elderly patient may include a language barrier, as she may not speak English, and thus the need to get help from family members or an interpreter is essential to obtain a detailed history. Biliary sepsis complicated by shock is a…
The GI Bookshelf Related Content