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A 15-year-old boy with quadriplegic cerebral palsy presented with a 2-day history of profuse diarrhoea and a 12-hour history of ‘coffee-ground’ vomiting. He had a prolonged history of poorly controlled constipation and diarrhoea, treated with regular movicol.
The patient was hypotensive, with metabolic acidosis and hyperlactaemia, and was therefore intubated and ventilated and needed fluid resuscitation and inotropic support. Investigations revealed C reactive protein 350 mg/L and white cell count 30×1012/L. …
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