Unusual gastrointestinal complications in neurosurgery

Area of Science:

• Neurosurgery
• Gastroenterology
• Critical Care Medicine

Background:

• Neurosurgical patients often present with altered consciousness and receive steroid therapy, complicating the diagnosis of gastrointestinal issues.
• Unusual gastrointestinal complications can arise in neurosurgical patients, posing diagnostic challenges.

Purpose of the Study:

• To highlight the diagnostic clinical features and pitfalls of unusual gastrointestinal complications in neurosurgical patients.
• To emphasize the importance of a high index of clinical suspicion for these conditions.

Main Methods:

• Presentation of nine neurosurgical patients with unusual gastrointestinal complications.
• Analysis of diagnostic clinical features and diagnostic challenges.

Main Results:

• Progressive abdominal distension and absent/sluggish bowel sounds were consistent features in comatose patients with peritonitis.
• High fever and elevated white cell counts were frequently absent, complicating diagnosis.

Conclusions:

• Clinical suspicion is paramount for diagnosing gastrointestinal complications in neurosurgical patients.
• Altered consciousness and steroid use mask typical signs of peritonitis, necessitating careful clinical evaluation.