Deceased
Julianne Fulham
Demographics
58y, female
Date of death
2016-11-28
Finding date
2019-04-18
Cause of death
Ischaemic small bowel due to bowel obstruction most likely due to a combination of adhesions from previous surgery and recurrent Crohn's disease
AI-generated summary
Mrs Fulham, aged 58, died from ischaemic small bowel due to obstruction from adhesions and Crohn's disease recurrence. On 22 November, she presented to GP with two weeks of diarrhoea, vomiting, nausea, and abdominal pain. The GP noted possible obstruction, ordered imaging and bloods, and referred non-urgently to gastroenterology. The abdominal X-ray report failed to comment on bowel gas distribution. Six days later, she presented to hospital with severe pain and bilious vomiting but was discharged after phone consultation with minimal analgesia and advised to see her GP. A breakdown in communication meant the GP was either not informed or failed to ensure urgent review. A medical review on 28 November would likely have identified obstruction, prompting urgent transfer for CT scanning and surgical intervention, offering the best prospect of survival. Key lessons: vomiting is a critical symptom in Crohn's disease raising obstruction concern; imaging interpretation must address bowel; acute presentations require direct medical assessment, not phone-based decisions; and Crohn's requires regular specialist follow-up.
AI-generated summary and tagging — may contain inaccuracies; refer to original finding for legal purposes. Report an inaccuracy.
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