Document Detail


Psychogenic coma following upper endoscopy: a case report and review of the literature.
MedLine Citation:
PMID:  18543575     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Failure to regain consciousness after general anesthesia has a multitude of life-threatening causes, including neurological injury, metabolic derangements, or drug effects. Failure to promptly recognize the cause of unconsciousness after anesthesia can result in significant patient morbidity or mortality, costly laboratory and radiographic evaluation, and physician anxiety. Rarely, patients fail to awaken after anesthesia due to a psychiatric cause. The early recognition of psychogenic coma can result in reduced iatrogenic complications, hospital cost, and physician anxiety. CASE: We present a case of a 28-year-old female who became unresponsive after general anesthesia for an upper endoscopy. Physical, laboratory, and radiographic examination after the procedure revealed no apparent organic cause for her failure to awaken. The patient spontaneously awoke after 16 hours without neurological deficit. DISCUSSION: We reviewed the literature and identified 10 previously reported cases of postanesthesia psychogenic coma. We have compared and contrasted our case with the 10 previous reports and propose bedside clues to assist the physician with diagnosing this unusual condition.
Authors:
John W Downs; Patrick E Young; Steven J Durning
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Publication Detail:
Type:  Case Reports; Journal Article; Review    
Journal Detail:
Title:  Military medicine     Volume:  173     ISSN:  0026-4075     ISO Abbreviation:  Mil Med     Publication Date:  2008 May 
Date Detail:
Created Date:  2008-06-11     Completed Date:  2008-08-01     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  2984771R     Medline TA:  Mil Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  509-12     Citation Subset:  IM    
Affiliation:
Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Anesthetics, Intravenous / adverse effects*
Coma / chemically induced*,  etiology,  psychology
Endoscopy, Gastrointestinal / adverse effects*
Female
Fentanyl / adverse effects*
Fundoplication
Glasgow Coma Scale
Humans
Propofol / adverse effects*
Risk Factors
Chemical
Reg. No./Substance:
0/Anesthetics, Intravenous; 2078-54-8/Propofol; 437-38-7/Fentanyl

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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