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El Farh R, Moueqqit O, Bouayed Z, El Kadiri Boutchich I, Alaoui Mhammedi O, El Fergui W, El Aidouni G, Bkiyar H, Housni B. Charting the Unknown: Green Urine After Propofol in Pediatric Trauma. Cureus 2024; 16:e56588. [PMID: 38646221 PMCID: PMC11031367 DOI: 10.7759/cureus.56588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/18/2024] [Indexed: 04/23/2024] Open
Abstract
The phenomenon of green urine discoloration, while rare, represents a captivating clinical puzzle that challenges the distinction between benign and pathological conditions. In this report, we present an intriguing case involving a 15-year-old trauma patient admitted following a motorcycle collision, where the ensuing unconsciousness necessitated propofol induction for intubation and sedation. Remarkably, around 48 hours post-admission, the patient displayed green urine discoloration, which resolved spontaneously within just 12 hours. This case serves as a compelling illustration of the uncommon occurrence of propofol-induced green urine in the context of critical care management, underscoring the imperative need to discern and appreciate medication-related chromatic alterations in urine.
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Affiliation(s)
- Reda El Farh
- Faculty of Medicine, Mohammed First University, Oujda, MAR
- Anesthesiology and Intensive Care Unit Department, Mohammed VI University Hospital, Oujda, MAR
| | - Othman Moueqqit
- General Medicine, Faculty of Medicine and Pharmacy, Mohammed First University, Oujda, MAR
| | - Zakaria Bouayed
- Anesthesiology and Intensive Care Unit Department, Mohammed VI University Hospital, Oujda, MAR
| | | | - Omar Alaoui Mhammedi
- Anesthesiology and Intensive Care Unit Department, Mohammed VI University Hospital, Oujda, MAR
| | - Wael El Fergui
- Anesthesiology and Intensive Care Unit Department, Mohammed VI University Hospital, Oujda, MAR
| | - Ghizlane El Aidouni
- Anesthesiology and Intensive Care Unit Department, Mohammed VI University Hospital, Oujda, MAR
| | - Houssam Bkiyar
- Anesthesiology and Intensive Care Unit Department, Mohammed VI University Hospital, Oujda, MAR
| | - Brahim Housni
- Anesthesiology and Intensive Care Unit Department, Mohammed VI University Hospital, Oujda, MAR
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Mhammedi Alaoui O, Douqchi B, Bella I, Ghazi I, Benaini I, El Kadiri Boutchich I, Laaribi I, El Aidouni G, Bkiyar H, Bouziane M, Housni B. Severe Sepsis Secondary to Toxic Megacolon Revealing an Inflammatory Bowel Disease. Cureus 2024; 16:e51459. [PMID: 38298320 PMCID: PMC10829693 DOI: 10.7759/cureus.51459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/30/2023] [Indexed: 02/02/2024] Open
Abstract
Patients with inflammatory bowel disease can present with numerous infectious complications, including intra-abdominal abscess, perforations of the intestine, fistula formation, and the occurrence of septicemia. Toxic megacolon (TM) is a potentially fatal complication of inflammatory bowel disease (IBD) and is associated with high morbidity and mortality. In this case report, we report a 49-year-old male patient who was admitted to the intensive care unit for the management of severe sepsis that was secondary to an inaugural toxic megacolon complicating a silent inflammatory bowel disease, with a Lichtiger score of 11. Nonresponse to anti-bacterial therapy, noradrenaline, and intravenous corticosteroid therapy required an emergency total colectomy. After surgery, the patient died because of his unresolved septic shock. Correct management of this condition requires an accurate assessment of the patient's history, a correct physical examination, abdominal radiographs, and sigmoid coloscopy, and frequently requires surgery. The indications for surgery in cases of toxic megacolon, massive hemorrhage, perforation, peritonitis, or non-response to medical therapy are the most important ones. Patients with a history of inflammatory bowel disease are particularly prone to infectious complications since therapy for these inflammatory diseases is based on the use of immunosuppressive drugs and frequent abdominal surgeries.
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Affiliation(s)
- Omar Mhammedi Alaoui
- Intensive Care Unit, Faculty of Medicine and Pharmacy of Oujda, Mohammed First University, Oujda, MAR
- Intensive Care Unit, Mohammed VI University Hospital, Oujda, MAR
| | - Badie Douqchi
- Intensive Care Unit, Mohammed First University, Oujda, MAR
- Intensive Care Unit, Mohammed VI University Hospital, Oujda, MAR
| | - Islam Bella
- Intensive Care Unit, Mohammed VI University Hospital, Oujda, MAR
- Intensive Care Unit, Faculty of Medicine and Pharmacy of Oujda, Mohammed First University, Oujda, MAR
| | - Imane Ghazi
- Intensive Care Unit, Mohammed VI University Hospital, Oujda, MAR
- Intensive Care Unit, Mohammed First University, Oujda, MAR
| | - Ilias Benaini
- Intensive Care Unit, Mohammed VI University Hospital, Oujda, MAR
- Intensive Care Unit, Mohammed First University, Oujda, MAR
| | - Ilias El Kadiri Boutchich
- Intensive Care Unit, Mohammed VI University Hospital, Oujda, MAR
- Intensive Care Unit, Mohammed First University, Oujda, MAR
| | - Ilyass Laaribi
- Intensive Care Unit, Mohammed VI University Hospital, Oujda, MAR
| | | | - Houssam Bkiyar
- Anesthesiology - Critical Care Unit, Mohammed VI University Hospital, Oujda, MAR
| | | | - Brahim Housni
- Intensive Care and Anesthesiology, Mohammed VI University Hospital, Oujda, MAR
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