title: Profound opiate toxicity in gastroparesis following therapeutic dose.
abstract: Gastroparesis is defined by the presence of delayed gastric emptying without mechanical obstruction. Patients may present with severe discomfort that can mimic an acute abdomen including abdominal pain, vomiting, nausea, bloating, fullness and early satiety. The prevalence of gastroparesis is estimated at 24 per 100 000 and women are more commonly affected than men. It is associated with a number of conditions including diabetes, Parkinson's disease, multiple sclerosis, previous abdominal surgeries and connective tissue disorders, including scleroderma and Ehlers-Danlos syndrome. Drugs known to prolong gastric transit time, such as opiates, have been shown to exacerbate symptoms. We report a case of a 20-year-old woman with Ehlers-Danlos syndrome who developed respiratory depression after being administered a therapeutic dose of morphine. This occurred due to opiate toxicity confounded by gastroparesis. The patient required further support from intensive care until she recovered, and eventually underwent a gastric pacing procedure for symptomatic relief.
authors.affiliation: Department of Accident & Emergency, Broomfield Hospital, Chelmsford, UK.
authors.forename: Henry
authors.initials: H
authors.lastname: Craven
authors.affiliation: Broomfield Hospital, Chelmsford, UK.
authors.forename: Hina
authors.initials: H
authors.lastname: Iftikhar
authors.affiliation: Department of Accident & Emergency, Broomfield Hospital, Chelmsford, UK.
authors.forename: Pallav
authors.initials: P
authors.lastname: Bhatnagar
mesh_terms: D003937:Diagnosis, Differential; D019468:Disease Management; D004535:Ehlers-Danlos Syndrome / Q000150:complications*; D005260:Female; D018589:Gastroparesis / Q000139:chemically induced / Q000175:diagnosis*; D006801:Humans; D009020:Morphine / Q000009:adverse effects*; D055815:Young Adult
chemical_list: D009020:Morphine