Accidental Ingestion of Nitric Acid in an Agricultural Company: A Case Study and Literature Review

Introduction: Though common in society, caustic accidental ingestion is rare in the agricultural industry. This study describes a case of ingestion of nitric acid used as an agricultural fertilizer by an ordinary worker at the Société de Cultures Légumières. Clinical Case: This is a 33-year-old unschooled woman who ingested a sip of nitric acid from an abandoned labelled acid canister near a farming plot of land. She showed a burn of the oral cavity with a bleeding tablecloth and an intense retrosternal pain. The duodenal oesophagus fibroscopy screening that was carried out 18 hours after the accident, revealed an esophagitis class 2b. The tests revealed no anomalies. Fifteen (15) days after the accident, the FOGD was normal. Following an 8-month-follow up, no signs of stenosis or degeneration were noted. Conclusion: The accidental ingestion of nitric acid is rare in adult. Its treatment is mainly symptomatic and aims at preserving vital functions without directly fighting the ingested substance off. The right actions must be integrated into the 15-minute Health and Safety awarenesssessions for optimum pre-hospital management. The hospital evaluation is mandatory and is carried out thanks to the digestive endoscopy, which is still relevant in this indication, but is completed by the thoraco-abdominal CT. The latter is very sensitive the transmural necrosis diagnosis.

Accidental ingestion of foreign bodies/harmful materials in children from Bahrain:A retrospective cohort study

BACKGROUND Children like to discover their environment by putting substances in their mouths.This behavior puts them at risk of accidentally ingesting foreign bodies(FBs)or harmful materials,which can cause serious morbidities.AIM To study the clinical characteristics,diagnosis,complications,management,and outcomes of accidental ingestion of FBs,caustics,and medications in children.METHODS We conducted a retrospective cohort study of all children admitted for accidental ingestion to the Department of Pediatrics,Salmaniya Medical Complex,Bahrain,between 2011 and 2021.Demographic data,type of FB/harmful material ingested,and investigations used for diagnosis and management were recorded.The patients were divided into three groups based on the type of ingested material(FBs,caustics,and medications).The three groups were compared based on patient demographics,socioeconomic status(SES),symptoms,ingestion scenario,endoscopic and surgical complications,management,and outcomes.The FB anatomical location was categorized as the esophagus,stomach,and bowel and compared with respect to symptoms.The Fisher’s exact,Pearson’s χ^(2),Mann-Whitney U,and Kruskal-Wallis tests were used for comparison.RESULTS A total of 161 accidental ingestion episodes were documented in 153 children.Most children were boys(n=85,55.6%),with a median age of 2.8(interquartile range:1.8-4.4)years.Most participants ingested FBs(n=108,70.6%),31(20.3%)ingested caustics,and the remaining 14(9.2%)ingested medications.Patients with caustic ingestion were younger at the time of presentation(P<0.001)and were more symptomatic(n=26/31,89.7%)than those who ingested medications(n=8/14,57.1%)or FBs(n=52/108,48.6%)(P<0.001).The caustic group had more vomiting(P<0.001)and coughing(P=0.029)than the other groups.Most FB ingestions were asymptomatic(n=55/108,51.4%).In terms of FB location,most esophageal FBs were symptomatic(n=14/16,87.5%),whereas most gastric(n=34/56,60.7%)and intestinal FBs(n=19/32,59.4%)were asymptomatic(P=0.002).Battery ingestion was the most common(n=49,32%).Unsafe toys were the main source of batteries(n=22/43,51.2%).Most episodes occurred while playing(n=49/131,37.4%)or when they were unwitnessed(n=78,57.4%).FBs were ingested more while playing(P<0.001),caustic ingestion was mainly due to unsafe storage(P<0.001),and medication ingestion was mostly due to a missing object(P<0.001).Girls ingested more jewelry items than boys(P=0.006).The stomach was the common location of FB lodgment,both radiologically(n=54/123,43.9%)and endoscopically(n=31/91,34%).Of 107/108(99.1%)patients with FB ingestion,spontaneous passage was noted in 54(35.5%),endoscopic removal in 46(30.3%),laparotomy in 5(3.3%)after magnet ingestion,and direct laryngoscopy in 2(1.3%).Pharmacological therapy was required for 105(70.9%)patients;79/105(75.2%)in the FB group,22/29(75.9%)in the caustic group,and 4/14(28.8%)in the medication group(P=0.001).Omeprazole was the commonly used(n=58;37.9%)and was used more in the caustic group(n=19/28,67.9%)than in the other groups(P=0.001).Endoscopic and surgical complications were detected in 39/148(26.4%)patients.The caustic group had more complications than the other groups(P=0.036).Gastrointestinal perforation developed in the FB group only(n=5,3.4%)and was more with magnet ingestion(n=4)than with other FBs(P<0.001).In patients with FB ingestion,patients aged<1 year(P=0.042),those with middle or low SES(P=0.028),and those with more symptoms at presentation(P=0.027)had more complications.Patients with complications had longer hospital stays(P<0.001)than those without.CONCLUSION Accidental ingestion in children is a serious condition.Symptomatic infants from middle or low SES families have the highest morbidity.Prevention through parental education and government legislation is crucial.

Train post‑derailment behaviours and containment methods:a review

Railway accidents,particularly serious derailments,can lead to catastrophic consequences.Therefore,it is essential to prevent derailment escalation to reduce the likelihood of severe derailments.Train post-derailment behaviours and containment methods play a critical role in preventing derailment escalation and providing passive safety protection and accident prevention in the event of a derailment.However,despite the increasing attention on this field from academia and industry in recent years,there is a lack of systematic exploration and summarization of emerging applications and containment methods in train post-derailment research.For this reason,this paper presents a comprehensive review of existing studies on train post-derailment behaviours,encompassing various topics such as post-derailment contact-impact models,dynamic modelling and simulation techniques,and the primary factors influencing post-derailment behaviours.Significantly,this review introduces and elucidates substitute guidance mechanisms(SGMs),which serve as railway-specific passive safety protection and accident prevention measures.The various types of SGMs are depicted,and their ongoing developments and applications are explored in depth.The review additionally points out several unresolved challenges including the adverse effects of SGMs,and proposes future research directions to advance the theoretical understanding and practical application of train post-derailment behaviours and containment methods.This review seeks to be a valuable reference for railway industry professionals in preventing catastrophic derailment consequences through post-derailment containment methods.

A STAMP-Game model for accident analysis in oil and gas industry

Accidents in engineered systems are usually generated by complex socio-technical factors.It is beneficial to investigate the increasing complexity and coupling of these factors from the perspective of system safety.Based on system and control theories,System-Theoretic Accident Model and Processes(STAMP)is a widely recognized approach for accident analysis.In this paper,we propose a STAMP-Game model to analyze accidents in oil and gas storage and transportation systems.Stakeholders in accident analysis by STAMP can be regarded as players of a game.Game theory can,thus,be adopted in accident analysis to depict the competition and cooperation between stakeholders.Subsequently,we established a game model to study the strategies of both supervisory and supervised entities.The obtained results demonstrate that the proposed game model allows for identifying the effectiveness deficiency of the supervisory entity,and the safety and protection altitudes of the supervised entity.The STAMP-Game model can generate quantitative parameters for supporting the behavior and strategy selections of the supervisory and supervised entities.The quantitative data obtained can be used to guide the safety improvement,to reduce the costs of safety regulation violation and accident risk.

Uncertainty and sensitivity analysis of in-vessel phenomena under severe accident mitigation strategy based on ISAA-SAUP program

The phenomenology involved in severe accidents in nuclear reactors is highly complex.Currently,integrated analysis programs used for severe accident analysis heavily rely on custom empirical parameters,which introduce considerable uncertainty.Therefore,in recent years,the field of severe accidents has shifted its focus toward applying uncertainty analysis methods to quantify uncertainty in safety assessment programs,known as“best estimate plus uncertainty(BEPU).”This approach aids in enhancing our comprehension of these programs and their further development and improvement.This study concentrates on a third-generation pressurized water reactor equipped with advanced active and passive mitigation strategies.Through an Integrated Severe Accident Analysis Program(ISAA),numerical modeling and uncertainty analysis were conducted on severe accidents resulting from large break loss of coolant accidents.Seventeen uncertainty parameters of the ISAA program were meticulously screened.Using Wilks'formula,the developed uncertainty program code,SAUP,was employed to carry out Latin hypercube sampling,while ISAA was employed to execute batch calculations.Statistical analysis was then conducted on two figures of merit,namely hydrogen generation and the release of fission products within the pressure vessel.Uncertainty calculations revealed that hydrogen production and the fraction of fission product released exhibited a normal distribution,ranging from 182.784 to 330.664 kg and from 15.6 to 84.3%,respectively.The ratio of hydrogen production to reactor thermal power fell within the range of 0.0578–0.105.A sensitivity analysis was performed for uncertain input parameters,revealing significant correlations between the failure temperature of the cladding oxide layer,maximum melt flow rate,size of the particulate debris,and porosity of the debris with both hydrogen generation and the release of fission products.

Preliminary safety analysis for heavy water-moderated molten salt reactor

The heavy water-moderated molten salt reactor(HWMSR)is a newly proposed reactor concept,in which heavy water is adopted as the moderator and molten salt dissolved with fissile and fertile elements is used as the fuel.Issues arising from graphite in traditional molten salt reactors,including the positive temperature coefficient and management of highly radio-active spent graphite waste,can be addressed using the HWMSR.Until now,research on the HWMSR has been centered on the core design and nuclear fuel cycle to explore the viability of the HWMSR and its advantages in fuel utilization.However,the core safety of the HWMSR has not been extensively studied.Therefore,we evaluate typical accidents in a small modular HWMSR,including fuel salt inlet temperature overcooling and overheating accidents,fuel salt inlet flow rate decrease,heavy water inlet temperature overcooling accidents,and heavy water inlet mass flow rate decrease accidents,based on a neutronics and thermal-hydraulics coupled code.The results demonstrated that the core maintained safety during the investigated accidents.

Risk identification and safety assessment of human-computer interaction in integrated avionics based on STAMP

To solve the problem of risk identification and quantitative assessment for human-computer interaction(HCI)in complex avionics systems,an HCI safety analysis framework based on system-theoretical process analysis(STPA)and cognitive reliability and error analysis method(CREAM)is proposed.STPACREAM can identify unsafe control actions and find the causal path during the interaction of avionics systems and pilot with the help of formal verification tools automatically.The common performance conditions(CPC)of avionics systems in the aviation environment is established and a quantitative analysis of human failure is carried out.Taking the head-up display(HUD)system interaction process as an example,a case analysis is carried out,the layered safety control structure and formal model of the HUD interaction process are established.For the interactive behavior“Pilots approaching with HUD”,four unsafe control actions and35 causal scenarios are identified and the impact of common performance conditions at different levels on the pilot decision model are analyzed.The results show that HUD's HCI level gradually improves as the scores of CPC increase,and the quality of crew member cooperation and time sufficiency of the task is the key to its HCI.Through case analysis,it is shown that STPACREAM can quantitatively assess the hazards in HCI and identify the key factors that impact safety.

Transient Analysis of a Reactor Coolant Pump Rotor Seizure Nuclear Accident

The reactor coolant pump(RCP)rotor seizure accident is defined as a short-time seizure of the RCP rotor.This event typically leads to an abrupt flow decrease in the corresponding loop and an ensuing reactor and turbine trip.The significant reduction of core coolant flow while the reactor is being operated at full load can have very negative consequences.This potentially dangerous event is typically characterized by a complex transient behavior in terms of flow conditions and energy transformation,which need to be analyzed and understood.This study constructed transient flow and rotational speed mathematical models under various degrees of rotor seizure using the test data collected from a dedicated transient rotor seizure test system.Then,bidirectional fluid-solid coupling simulations were conducted to investigate the flow evolution mechanism.It is found that the influence of the impeller structure size and transient braking acceleration on the unsteady head(Hu)is dominant in rotor seizure accident events.Moreover,the present results also show that the rotational acceleration additional head(Hu1)is much higher than the instantaneous head(Hu2).

Information-motivation-behavioral guided nursing for stroke patients with pulmonary dysfunction:A randomized controlled trial

BACKGROUND Patients with stroke frequently experience pulmonary dysfunction.AIM To explore the effects of information-motivation-behavioral(IMB)skills modelbased nursing care on pulmonary function,blood gas indices,complication rates,and quality of life(QoL)in stroke patients with pulmonary dysfunction.METHODS We conducted a controlled study involving 120 stroke patients with pulmonary dysfunction.The control group received routine care,whereas the intervention group received IMB-model-based nursing care.Various parameters including pulmonary function,blood gas indices,complication rates,and QoL were assessed before and after the intervention.RESULTS Baseline data of the control and intervention groups were comparable.Post-intervention,the IMB model-based care group showed significant improvements in pulmonary function indicators,forced expiratory volume in 1 sec,forced vital capacity,and peak expiratory flow compared with the control group.Blood gas indices,such as arterial oxygen pressure and arterial oxygen saturation,increased significantly,and arterial carbon dioxide partial.pressure decreased significantly in the IMB model-based care group compared with the control group.The intervention group also had a lower complication rate(6.67%vs 23.33%)and higher QoL scores across all domains than the control group.CONCLUSION IMB model-based nursing care significantly enhanced pulmonary function,improved blood gas indices,reduced complication rates,and improved the QoL of stroke patients with pulmonary dysfunction.Further research is needed to validate these results and to assess the long-term efficacy and broader applicability of the model.

Exploring the Factors Associated with 12-Month Non-Return to Work among Motorcyclists Involved in Road Accidents

Introduction: Motorcyclists bear a disproportionate burden of morbidity and mortality from road accidents. In addition, the consequences of these accidents affect the ability of victims to return to work. This study aimed to determine the prevalence and factors associated with non-return to work among surviving motorcyclists involved in road accidents 12 months after the event. Materials and Methods: It was a cross-sectional study conducted using data from a cohort of motorcyclists involved in accidents and recruited in five hospitals in Benin from July 2019 to January 2020. The dependent variable was non-return to work 12 months after the accident (yes vs no). The independent variables were categorized into two groups: baseline and 12-month follow-up variables. Logistic regression was used to determine the factors associated with non-return to work at 12 months among the participants. Results: Among the 362 participants, 55 (15.19%, 95% CI = 11.84 - 19.29) had not returned to work 12 months after the accident. Risk factors for non-return to work identified were: smoking (aOR = 4.41, 95% CI = 1.44 - 13.56, p = 0.010), hospitalization (aOR = 2.87, 95% CI = 1.14 - 7.24, p Conclusion: The prevalence of non-return to work at 12 months was high among surviving motorcyclists involved in road accidents in Benin. Integrated support for patients based on identified risk factors should effectively improve their return to work.

Management of Traumatic Brain Injuries at the Kara Regional Hospital

Introduction: Traumatic Brain Injury (TBI) is a major public health problem causing significant morbidity and mortality in young adults. This study aimed to describe the epidemiological, diagnostic, therapeutic, and evolutionary aspects of TBI. Materials and Methods: This was a prospective, descriptive study conducted from 1 April 2022 to 31 March 2023 on patients admitted to and treated for cranioencephalic trauma in the General Surgery department of Kara Regional Hospital. Results: Eighty-three (83) patients with cranioencephalic trauma were managed out of 773 patients admitted to the department during the study period. The mean age was 34 ± 14.98 years and the sex ratio was 3.6 in favour of men. Motorbike taxi drivers were the social group most affected (n = 33, 40%). The causes of trauma were dominated by public road accidents (n = 80;96%). TBI was mild (n = 40;48%), moderate (n = 35;42%) and severe (n = 8;10%). Cerebral CT scans were performed in 19 patients (23%). Cerebral contusion (n = 4) was the most frequent cerebral lesion. Six patients (7%) with severe head injuries were transferred to Kara University Hospital. Six deaths (7%) occurred in patients with severe head injuries. The main sequelae were intermittent headaches in all patients reviewed, and memory problems (6%). Conclusion: Traumatic brain injuries are common at Kara Regional Hospital. Severe cranial trauma is less frequent but leads to death because of financial difficulties and limited technical facilities.

Epidemiological and Computed Tomography Aspects of Facial Trauma at Kira Hospital in Bujumbura

Background: Maxillofacial trauma affects young adults more. The injury assessment is difficult to establish in low-income countries because of the imaging means, particularly the scanner, which is poorly available and less financially accessible. The aim of this study is to describe the epidemiological profile and the various tomodensitometric aspects of traumatic lesions of the face in patients received in the Radiology department of Kira Hospital. Patients and methods: This is a descriptive retrospective study involving 104 patients of all ages over a period of 2 years from December 2018 to November 2019 in the medical imaging department of KIRA HOSPITAL. We included in our study any patient having undergone a CT scan of the head and presenting at least one lesion of the facial mass, whether associated with other cranioencephalic lesions. Results: Among the 384 patients received for head trauma, 104 patients (27.1% of cases) presented facial damage. The average age of our patients was 32.02 years with extremes of 8 months and 79 years. In our study, 87 of the patients (83.6%) were male. The road accident was the circumstance in which facial trauma occurred in 79 patients (76% of cases). These injuries were accompanied by at least one bone fracture in 97 patients (93.3%). Patients with fractures of more than 3 facial bones accounted for 40.2% of cases and those with fractures of 2 to 3 bones accounted for 44.6% of cases. The midface was the site of the fracture in 85 patients (87.6% of cases). Orbital wall fractures were noted in 57 patients (58.8% of cases) and the jawbone was the site of a fracture in 50 patients (51.5% of cases). In the vault, the fractures involved the extra-facial frontal bone (36.1% of cases) and temporal bone (18.6% of cases). Cerebral contusion was noted in 41.2% of patients and pneumoencephaly in 15.5% of patients. Extradural hematoma was present in 16 patients and subdural hematoma affected 13 patients. Conclusion: Computed tomography is a diagnostic tool of choice in facial trauma patients. Most of these young patients present with multiple fractures localizing to the mid-level of the face with concomitant involvement of the brain.

Button Cell Ingestion in Infants: A Report of Five Cases

Button cell ingestion is a common household accident among infants, often leading to serious complications that require immediate diagnosis and urgent removal. We report five cases of button cell ingestion involving infants aged between 9 and 32 months, including four boys and one girl. The ingestion was accidentally discovered in two infants, while in the other three, it was suspected during play. In three cases, mothers attempted to induce vomiting by giving fluids, but the batteries remained in the digestive tract for 38 hours to 5 days. After confirming the diagnosis, the batteries were removed within 4 to 36 hours. The locations of the cells were the esophagus in two cases, the cardia in one, the stomach in one, and the bowel in one. One case involved a large cell in the esophagus, while the others involved smaller cells. Complications occurred in four cases, including esotracheal fistula, esophageal ulceration, and perforation of the jejunum and caecum. In one case, the digestive mucosa appeared normal upon endoscopy. One patient died.

Analysis of the Tragedy of Vila Socóin Cubatão (São Paulo, Brazil) Using the Haddon Matrix: A Comprehensive Examination of Socio-Environmental Factors and Risk Mitigation Strategies

The tragedy of Vila Socó epitomizes the socio-environmental repercussions of rapid industrialization in Cubatão. Beginning in the 1940s with the construction of the Anchieta highway, the city experienced an influx of migrants drawn by burgeoning industries, leading to unplanned urban growth and the emergence of vulnerable communities like Vila Socó. This article examines the interconnected factors—such as demographic shifts, inadequate planning, and regulatory oversight—that culminated in the devastating fire of 1984, claiming numerous lives and highlighting systemic failures. Utilizing the Haddon Matrix, this study dissects the Vila Socó incident, emphasizing the roles of human error, infrastructure integrity, and socio-economic disparities in disaster causation. By contextualizing the tragedy within Cubatão’s industrial trajectory, it underscores the urgent need for comprehensive risk assessment and proactive mitigation strategies in rapidly developing regions globally. Beyond its immediate focus, this work offers broader insights into the dynamics of industrial disasters and their socio-economic implications. As pipelines continue to play a vital role in global energy infrastructure, the lessons drawn from Vila Socó’s tragedy resonate deeply, emphasizing the imperative of robust safety protocols and accountable governance to prevent similar catastrophes in the future.

Conceptual Strategy for Mitigating the Risk of Hydrogen as an Internal Hazard in Case of Severe Accidents at Nuclear Power Plant Considering Existing Risks and Uncertainties Associated with the Use of Traditional Strategies

Hydrogen challenge mitigation stands as one of the main objectives in the management of severe accidents at Nuclear Power Plants (NPPs). Key strategies for hydrogen control include atmospheric inertization and hydrogen removal with Passive Autocatalytic Recombiners (PARs) being a commonly accepted approach. However, an examination of PAR operation specificity reveals potential inefficiencies and reliability issues in certain severe accident scenarios. Moreover, during the in-vessel stage of severe accident development, in some severe accident scenarios PARs can unexpectedly become a source of hydrogen detonation. The effectiveness of hydrogen removal systems depends on various factors, including the chosen strategies, severe accident scenarios, reactor building design, and other influencing factors. Consequently, a comprehensive hydrogen mitigation strategy must effectively incorporate a combination of strategies rather than be based on one strategy, taking into consideration the probabilistic risks and uncertainties associated with the implementation of PARs or other traditional methods. In response to these considerations, within the framework of this research it has been suggested a conceptual strategy to mitigate the hydrogen challenge during the in-vessel stage of severe accident development.

Statistical Analysis of Accident Proneness of Drivers

A mathematical model describing the risks of road accidents has been built on the basis of statistical data of drivers’ accident rate. It has been revealed that drivers can be divided by the degree of their accident proneness into four categories with sharply differing probabilities of road accidents. It has been shown that there is a possibility of classification of drivers in accordance with specified categories.

Child Victims of Road Traffic Accidents: Epidemiological and Clinical Aspects in the Medical and Surgical Emergency Department of the Donka National Hospital

Introduction: Children involved in road accidents most often suffer head or limb injuries. The severity of these injuries varies according to the age of the child, the type of road user and whether or not protective devices are used. The aim of this study was to carry out a census of admissions and to identify the epidemiological and clinical profile of children involved in road traffic accidents at Donka National Hospital. Methods: This is a descriptive cross-sectional study of children involved in traffic accidents over a 3-month period from September 1 to November 30, 2021. All children admitted to the emergency department for a traffic accident were included in the study. Results: During the study period, 435/530 children (82.1%) were victims of road accidents. Boys accounted for 54.94% of cases, compared with 45.06% for girls. The age group most affected was 12-17 years old (48.97%). October had the highest accident rate (36.4%). Pedestrians are most affected (52.87%). Bicycles and mopeds were involved in 59.77% of accidents. Head injury was the most frequent pathology (33.33%). The study showed that 12.64% of victims were referred to intensive care, pediatric surgery, etc. We recorded 8 cases of death (1.84%). Conclusion: This study highlighted the characteristics, incidence and risk factors for accidents in children admitted to emergency departments. Accident prevention, particularly serious accidents in children, requires more precise knowledge of the factors and circumstances leading to their occurrence.

Decoding RoPax Ship Capsizes and Development of an ISO Ship Safety Standard

Marine accidents often result in significant losses of human life, environmental damage, and property destruction. Additionally, ships and offshore plants are large-scale and complex systems, making safety assessments challenging. However, the advent of onboard electronic systems has made it possible to monitor and respond more effectively. These new technologies can enhance safety levels while reducing the workload on crews. In this paper, authors analyze recent accidents involving ships with high structures above the water, such as car carriers or RoPax vessels, and propose preventive safety indicators to help prevent similar accidents from recurring.

Analysis of Traffic Accidents in Vietnam

Understanding the causes and solutions of road traffic accidents is important for developing road and action plans in a country. In Vietnam, awareness of traffic participants is the main cause of serious traffic accidents. In recent years, the number of road traffic accidents in Tuyen Quang province with deaths has decreased, but the number of accidents has increased significantly. The article uses data on traffic accidents in Tuyen Quang over the (2016-2023) has been analytically reviewed. From there, analyze accident characteristics and causes of traffic accidents in Tuyen Quang province, and propose solutions to improve traffic safety in Tuyen Quang, Vietnam. The findings can be information for managers and researchers interested in studying the province of Tuyen Quang, Vietnam road traffic safety. Additionally, the findings have led the government to achieve national targets in reducing the number of accidents and serious injuries.

Acute Colonic Pseudo-Obstruction (ACPO): An Expanding Colon with Unusual Risk Factors

The distention of the colon without mechanical or anatomical obstruction, Acute Colonic Pseudo-obstruction (ACPO), is a common condition occurring in the critically ill. ACPO in the setting of an acute pulmonary embolism and embolic stroke is a rarity. A 76-year-old female with shortness of breath, left hemiparesis and right-sided paresthesias presented with acute pulmonary embolism and acute infarcts of the left caudate nucleus, thalamus and occipital lobe. Her hospitalization was complicated with persistent distention of the large bowel without dilation of the small bowel. Empiric antibiotics were initiated without improvement and laboratory studies including Clostridium difficile were negative. She underwent nasogastric decompression and two decompressive colonoscopies with a resolution of her symptoms. This case illustrates an example of acute abdominal distension, without underlying etiology, in the setting of acute embolism of the pulmonary and cerebral vasculature. Early identification and action with decompressive colonoscopy were key to preventing further bowel damage or rupture.