| Psychogenic coma following upper endoscopy: a case report and review of the literature. | |
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MedLine Citation:
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PMID: 18543575 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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John W Downs; Patrick E Young; Steven J Durning |
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Publication Detail:
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Type: Case Reports; Journal Article; Review |
Journal Detail:
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Title: Military medicine Volume: 173 ISSN: 0026-4075 ISO Abbreviation: Mil Med Publication Date: 2008 May |
Date Detail:
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Created Date: 2008-06-11 Completed Date: 2008-08-01 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 2984771R Medline TA: Mil Med Country: United States |
Other Details:
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Languages: eng Pagination: 509-12 Citation Subset: IM |
Affiliation:
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Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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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:
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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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