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Volume 83 - 2020 - Fasc.2 - Case series

Acid-base disturbances in dehydrated patients with cystic fibrosis : four case reports with review of literature

Most episodes of vomiting, reduced intake and diarrhoea in children can be evaluated and treated without additional tests. However, when the degree of clinical dehydration is not in line with the patient’s medical history, other diagnoses should be suspected. In the presence of a hyponatraemic hypochloraemic metabolic alkalosis, cystic fibrosis (CF) should be included in the differential diagnosis, especially if there is failure to thrive even in the absence of respiratory symptoms. Furthermore, young patients diagnosed with CF have a higher risk for an acute electrolyte decompensation caused by increased salt and fluid losses. We present 4 paediatric cases to raise the awareness of electrolyte disturbances in CF patients. (Acta gastroenterol. belg., 2020, 83, 315-318).


Successfully endoscopic retrieval of ingested toothpicks in colorectum : a report of four cases

Background : Toothpick ingestion is a rare event, but due to the low efficacy of radiographic examination, it can induce severe complications including perforation, abscess, and sepsis. Case report : Four patients with either defecation problems or abdominal/anal pain were admitted to our hospital. Colonoscopy showed all four cases had a toothpick impacted in the colorectal wall without perforation. Direct retrieval of the toothpick under endoscopy was achieved. All four patients were relieved and remained well during the follow-up. Conclusion : Endoscopy is the most effective method to discover or retrieve ingested wooden foreign bodies when there are no severe complications. (Acta gastroenterol. belg., 2020, 83, 319-321).