Cases reported "Alcoholic Intoxication"

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1/5. A case of acute renal failure and compartment syndrome after an alcoholic binge.

    A 25 year old man presented with anuria and bilateral leg pain two days after an alcoholic binge. He subsequently developed rhabdomyolysis causing acute renal failure, with compartment syndrome of both lower legs. This required urgent dialysis and fasciotomy respectively within six hours of admission. He remained dialysis dependent for three weeks and only after four months was he able to weight bear on both legs. Alcohol is a leading cause of rhabdomyolysis. Early recognition and prompt treatment is essential to prevent serious complications.
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2/5. Acute renal failure following binge drinking and nonsteroidal antiinflammatory drugs.

    Two college students who developed reversible acute deterioration in renal function following binge drinking of beer and the use of nonsteroidal antiinflammatory drugs (NSAIDs) are reported. Both patients presented with back and flank pain with muscle tenderness, but showed no evidence of overt rhabdomyolysis. The first case had marked renal failure, with a peak serum creatinine reaching 575 mumol/L (6.5 mg/dL), and acute tubular necrosis was documented by renal biopsy. The second case had only modest elevation in serum creatinine, and renal function rapidly improved on rehydration. The contribution of the potential muscle damage associated with alcohol ingestion to the changes in renal function in these two cases is not clear. However, the major mechanism for the acute renal failure was thought to be related to inhibition of renal prostaglandin synthesis in the face of compromised renal hemodynamics secondary to alcohol-induced volume depletion.
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3/5. Sudden death associated with alcohol consumption.

    Evaluation of a binge drinker who died suddenly after a weekend of heavy beer consumption, and had been resuscitated successfully, revealed no evidence of clinically detectable heart disease. Baseline electrophysiological testing was normal. Following intravenous ethanol infusion, paired ventricular extrastimuli from the right ventricle induced a rapid polymorphic ventricular tachycardia requiring cardioversion. Repeat electrophysiological testing 24 hours later without alcohol infusion was again normal. The patient was discharged on no medications and was instructed to refrain from drinking alcohol. Approximately 3 months later the patient died suddenly after heavy beer consumption. Alcohol should be considered in the evaluation of survivors of cardiac arrest and alcohol challenge may be useful in their evaluation.
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4/5. Acute alcoholic esophagitis.

    We report two patients with acute, transient esophagitis following alcoholic binges. Double-contrast esophagrams of both patients revealed erosive esophagitis with multiple superficial ulcers in the mid and distal esophagus. While acute alcoholic esophagitis may produce clinical and radiographic findings that are indistinguishable from other more common types of esophagitis, this diagnosis is supported by the patients' recent drinking history.
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5/5. atrial fibrillation in healthy non-alcoholic people after an alcoholic binge.

    After alcoholic binges, atrial fibrillation developed in four people who usually drank little or no alcohol. All spontaneously reverted to sinus rhythm within a day. Investigations revealed no evidence of underlying disease or cardiac abnormalities. They were advised to avoid excessive alcohol intake, and an average of two years later none has had a further attack of atrial fibrillation.
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