0
Pulmonary and Critical Care Pearls |

Massive Upper GI Bleeding in a Long-term Hemodialysis Patient*

Alpana Chandra, MD; Raymond Tso, MD; Jacob Cynamon, MD; Gregg Miller, MD
Author and Funding Information

*From the Department of Medicine (Drs. Chandra, Tso, and Miller), Division of Critical Care Medicine, and Department of Radiology (Dr. Cynamon), Montefiore Medical Center, Bronx NY.

Correspondence to: Alpana Chandra, MD, Montefiore Medical Center, Division Critical Care Medicine, Goldzone Main Floor, 111 E 210th St, Bronx, NY 10467; e-mail: achandra@montefiore.org



Chest. 2005;128(3):1868-1873. doi:10.1378/chest.128.3.1868
Text Size: A A A
Published online

Extract

A 55-year-old diabetic, hypertensive man receiving long-term hemodialysis presented to the emergency department with a complaint of two episodes of lightheadedness, the last being on the morning of hospital admission while straining at stool. He denied having lost consciousness at any time. The patient had been dialysis dependent for the last 5 years and had recurrent episodes of arteriovenous graft thrombosis requiring revisions, with recent placement of a right internal jugular hemodialysis catheter 2 weeks ago after removal of a left internal jugular vein hemodialysis catheter. His diabetes and hypertension were poorly controlled, and he had recently been switched from oral medications to insulin. A review of systems did not reveal any history of conduction abnormalities, heart failure symptoms, or previous ischemic events, but was significant for both resting and exertional dyspnea for the last 1 week.

First Page Preview

View Large
First page PDF preview

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Figures

Tables

Suggested Readings

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Related Content

Customize your page view by dragging & repositioning the boxes below.

Find Similar Articles
CHEST Journal Articles
  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543