Altered Mental Status After Esophagogastroduodenoscopy.

Area of Science:

• Gastroenterology
• Oncology
• Internal Medicine

Background:

• This case involves a 79-year-old male with a history of atrial fibrillation and esophageal cancer, who previously underwent trans-hiatal esophageal resection and chemotherapy.
• The patient presented with severe anemia and melena requiring blood transfusions prior to the current evaluation.

Observation:

• The patient underwent an outpatient esophagogastroduodenoscopy (EGD) which revealed an intact esophagogastric anastomosis and two gastric ulcers without signs of active bleeding.
• Following the EGD, the patient was discharged in stable condition but later developed a deteriorating level of consciousness.

Findings:

• The esophagogastroduodenoscopy (EGD) itself did not reveal any immediate complications or findings that would explain the subsequent altered mental status.
• The patient's altered mental status developed several hours after the outpatient endoscopic procedure.

Implications:

• This case underscores the importance of vigilant post-procedure monitoring, especially in elderly patients with significant comorbidities undergoing gastrointestinal endoscopy.
• Further investigation may be warranted to determine the cause of altered mental status in this patient, considering potential links to the recent EGD or underlying conditions.
• This scenario emphasizes the need for comprehensive patient assessment and management strategies in the context of gastrointestinal cancer survivorship and anticoagulation management.