Key result
Severe heart failure presenting with tender hepatomegaly can masquerade as acute bowel obstruction.
Why the study?
Major surgical interventions based on incorrect diagnoses raise significant clinical concerns by exposing patients to unnecessary anaesthesia, transfusion, and infection risks.
Case Report (n=1)
No
Answers are grounded in this paper and cite their sources.
This case report highlights how congestive hepatomegaly from heart failure can mimic acute intestinal obstruction, emphasizing the need for thorough clinical and radiological evaluation to avoid unnecessary exploratory laparotomies.
Reports of major surgical interventions based on incorrect diagnoses have raised significant concerns in the medical community. These errors expose patients to the inherent risks of surgery, including complications from general anaesthesia, challenges with blood transfusions, the potential for wound sepsis, and the risk of septicaemia if aseptic techniques are not meticulously followed. Instances of wrong-site amputations and confusion over surgical sites, such as herniorrhaphy locations, have been documented. This paper presents a case of a missed diagnosis leading to an unnecessary exploratory laparotomy in an adult male patient initially diagnosed with intestinal obstruction due to severe abdominal pain. Intraoperative findings revealed no abdominal pathology, and the correct diagnosis of tender hepatomegaly secondary to congestive cardiac failure was established. The patient recovered well after the proper treatment regimen was initiated. This case highlights the critical need for accurate diagnosis to avoid unnecessary surgical risks and prompts reflection on how many similar cases may have had less fortunate outcomes.
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Orhe et al. (2024) conducted a case report in Congestive cardiac failure misdiagnosed as intestinal obstruction (n=1). Exploratory laparotomy followed by anti-cardiac failure regimen (furosemide, carvedilol, spironolactone, digoxin) was evaluated on Clinical recovery and accurate diagnosis. Congestive cardiac failure presenting with tender hepatomegaly in a 52-year-old man was misdiagnosed as intestinal obstruction, leading to an unnecessary laparotomy before medical recovery.
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