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Washington University Experience | VASCULAR | Sickle cell anemia | 9A0 Case 9 History
Case 9 History ---- The patient was a 35 year old African-American woman with a clinical history significant for sickle cell anemia, thrombocytosis, and recurrent pulmonary embolism on home Xarelto treatment. She had a splenectomy in 2007. In March 2019, she had a cholecystectomy which was complicated by a biliary leak, for which she had a stent and drain placement. She continued to have yellow drainage, as well as concern for bloody drainage from this site, therefore her home Xarelto was held and she was started on antibiotics. The patient presented on 4/15 for abdominal pain and nausea, was found to have Clostridium difficile infection and was admitted for treatment. While in the hospital she was started on a Lovenox bridge. Per report, her hospital stay was unremarkable. On 4/24 she had an endoscopic retrograde cholangiopancreatography, performed for stent removal. Per report there was no perforation of the bile duct during the procedure. The patient was then brought back to floor and was doing well, but 30-45 minutes later when the nursing staff checked in on her, she was found to be unresponsive in pulseless electrical activity. A code was initiated and resuscitative efforts lasted for 30 minutes before the patient expired on 4/24. ---- At autopsy the weight of the unfixed brain was 1260g. The gross appearance was unremarkable and coronal sections failed to demonstrate gross pathology.
