Establishment of normative biometric data for body composition based on computed tomography in a North American cohort.

Background & Aims: Accurate and reproducible biomarkers are required to allow a more personalized approach to patient care. Body composition is one such biomarker affecting outcomes in a range of surgical and oncological conditions. The aim of this study is to determine the age and sex specific distribution of body composition data, based on information gathered from computed tomography (CT).

Pain Management in a Terminally Ill Patient with a Surrogate Decision-maker: A Challenge.

When health care proxies are in charge of pain management, it may become very difficult to address the patient's pain if the health care proxy has misconceptions about analgesics. We report a case of an 87-year-old lady who was found to be pulseless, and after successful cardiopulmonary resuscitation (CPR), was intubated and remained so for over a month in the intensive care unit (ICU). The medical team could not provide the patient with pain medication, as the daughter who was the surrogate decision-maker did not allow the administration of any pain medication in the false belief that it would kill the patient.

Pneumatosis intestinalis: cost paid for rheumatoid arthritis treatment.

A 75-year-old woman with rheumatoid arthritis on rituximab presented with a 1-week history of constipation and abdominal distension. Subsequent workup showed presence of air in the bowel wall without perforation initially. Due to positive blood cultures, worsening leucocytosis and high suspicion for perforation, an exploratory laparotomy was performed revealing necrotic bowel, walled off perforation and abscess.

Hepatic artery pseudoaneurysm following percutaneous transhepatic cholangiogram: an extremely rare complication.

A 72-year-old female patient who was admitted for ischaemic stroke had developed ascending cholangitis. Percutaneous transhepatic cholangiogram was performed to drain the infected bile, but this was complicated by haemorrhagic shock and hepatic haematoma. Mesenteric angiogram showed right hepatic artery (RHA) pseudoaneurysm which was embolised, there by stopping her bleeding.