Mr. Smith is a 36-year-old male, unemployed for past 6 months. He has smoked one pack of cigarettes per day for 16 years. His father was an alcoholic. He drinks a 12-pack of beer/day, but has not had any for 2 days. He has had several admissions for detoxification and has graduated from a rehabilitation program.
Presenting S/S: Vomiting bright red blood, dizziness, passing black tarry stools for two days.
Relevant Lab values: Hgb 10.3; HCT 28%; WBC 12,400; platelets 120,000; blood alcohol level 152; Na 136; K 3.4; CO2 26; Cl 105; Mg 1.0; BUN 7; CR 0.7
Liver function tests: SGOT 234; Protein 4.9; SGPT 84; Albumin 2.7; LDH 310; Alk phos 114; CPK 369; Total bilirubin 5.0; PT 12.8 sec;
Conjugated Bilirubin 3.4; Unconjugated Bilirubin 1.6
Relevant diagnostic tests:
Upper endoscopy - normal duodenum, erosive & portal hypertensive gastropathy & varices in the distal esophagus.
What are the potential complications of this case and why might they occur?