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Images in emergency medicine
Laparotomy for treatment of seizures
  1. P Szawarski1,
  2. L Dvorkin2,
  3. E Tam3
  1. 1
    Department of Anaesthesia, Queen Elizabeth Hospital, London, UK
  2. 2
    Department of Surgery, North Middlesex University Hospital, London, UK
  3. 3
    Department of Radiology, Northwick Park Hospital, Harrow, UK
  1. Dr P Szawarski, Department of Anaesthesia, Queen Elizabeth Hospital, Stadium Road, Woolwich, London SE18 4QH, UK; zmierzchowiec{at}aol.com

http://dx.doi.org/10.1136/emj.2007.049221

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    A 57-year-old man self-referred to the emergency department. Upon arrival he had a grand mal seizure followed by a cardiac arrest. Cardiac output was promptly restored. As seizures continued infusions of propofol, midazolam and phenytoin were started. Empirical aciclovir and ceftriaxone were also given. A head CT and lumbar puncture were non-diagnostic. An amylase of 795 IU/l precipitated an abdominal CT scan (figs 1A and B).

    Figure 1 Abdominal slices of (A) the stomach and (B) the colon and rectum.

    The contrast-enhanced CT …

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    2008 BMJ Publishing Group Ltd and the British Association for Emergency Medicine