Gastrointestinal Perforation Complicated by Continuous Opioids Administration for Intrahepatic Cystic Hemorrhage Pain Management

Intracystic hemorrhage is a rare complication of multiple hepatic cysts and can lead to hemorrhagic shock. Hence, measures should be taken to prevent the rupture of cysts. The incidence of intestinal perforation is high in patients undergoing hemodialysis. The diagnosis can be difficult in a patient...

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Bibliographic Details
Published inCureus Vol. 14; no. 8; p. e27829
Main Authors Matsuoka, Ayaka, Koami, Hiroyuki, Goto, Taku, Shinada, Kota, Sakamoto, Yuichiro
Format Journal Article
LanguageEnglish
Published Palo Alto Springer Science and Business Media LLC 09.08.2022
Springer Nature B.V
Cureus
Subjects
Abdomen
Analgesics
Anemia
Anesthesiology
Aneurysms
Anticoagulants
Blood tests
Case reports
Colon
Cysts
Emergency Medicine
Fentanyl
Hemodialysis
Hemodynamics
Hemoglobin
Hemorrhage
Hemorrhagic shock
Kidney diseases
Liver
Medical imaging
Mesentery
Pain
Patients
Surgery
Veins & arteries
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Summary:Intracystic hemorrhage is a rare complication of multiple hepatic cysts and can lead to hemorrhagic shock. Hence, measures should be taken to prevent the rupture of cysts. The incidence of intestinal perforation is high in patients undergoing hemodialysis. The diagnosis can be difficult in a patient without typical symptoms. We report the case of a woman in her late 60s with multiple renal and hepatic cysts, which caused chronic renal failure managed with dialysis. She presented with abdominal pain and was diagnosed with intrahepatic cystic bleeding. Continuous intravenous fentanyl was administered for pain management, which temporarily alleviated pain, but abdominal pain recurred with increased intensity when she resumed feeding. Subsequently, a contrast-enhanced computed tomography revealed perforation of the lower gastrointestinal tract. Therefore, in cases of intrahepatic cystic hemorrhage that require administration of analgesics, the complications of other diseases that may also cause acute abdominal pain should also be considered.
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ISSN:2168-8184
2168-8184
DOI:10.7759/cureus.27829