An older man was admitted to the hospital for planned bowel resection. He reported drinking 8 to 10 ounces of whiskey daily for many years. During previous hospitalizations, he had no documented alcohol withdrawal symptoms or seizures. His last drink was 3 days prior to admission.
Over the first week postoperatively, he had no symptoms of alcohol withdrawal. On postadmission day 6 he developed an anastomotic leak, requiring urgent reoperation and antibiotics. On postadmission day 9, he became acutely disoriented and inattentive, with new abdominal tenderness. Imaging showed large intra-abdominal abscesses, and percutaneous drains were placed. His heart rate and blood pressure remained normal.
Identify all potential conflicts of interest that might be relevant to your comment.
Conflicts of interest comprise financial interests, activities, and relationships within the past 3 years including but not limited to employment, affiliation, grants or funding, consultancies, honoraria or payment, speaker's bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued.
Err on the side of full disclosure.
If you have no conflicts of interest, check "No potential conflicts of interest" in the box below. The information will be posted with your response.
Not all submitted comments are published. Please see our commenting policy for details.
Brothers TD, Bach P. Challenges in Prediction, Diagnosis, and Treatment of Alcohol Withdrawal in Medically Ill Hospitalized Patients: A Teachable Moment. JAMA Intern Med. 2020;180(6):900–901. doi:10.1001/jamainternmed.2020.1091
Coronavirus Resource Center
Customize your JAMA Network experience by selecting one or more topics from the list below.
Create a personal account or sign in to: