open access

Vol 67, No 4 (2016)
Case report
Submitted: 2016-09-14
Accepted: 2016-11-17
Published online: 2016-12-23
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Acute gastrointestinal haemorrhage on board a cruise ship in the Antarctic Peninsula

Mathieu Carron, Peter Globokar, Bruno A Sicard
DOI: 10.5603/IMH.2016.0040
·
Pubmed: 28009388
·
International Maritime Health 2016;67(4):223-226.

open access

Vol 67, No 4 (2016)
MARITIME MEDICINE Case report
Submitted: 2016-09-14
Accepted: 2016-11-17
Published online: 2016-12-23

Abstract

Antarctic tourism on board cruise ships has expanded since the 1990s, essentially in the Antarctic Peninsula. Due to remoteness, medical cases may evolve into life threatening conditions as emergency medical evacuations are challenging. We discuss the case of a young crew member who suddenly fainted with an epigastric pain and abundant rectal bleeding while on board a cruise ship heading to the Deception Island (62°57.6 South, 60°29.5 West), 44 h away from Ushuaia by sea. A medical evacuation was necessary to save the patient whose haemoglobin level rapidly decreased from 11 g/dL to 8.7 g/dL over an 8 h period due to uncontrolled gastrointestinal bleeding. Following discussions between the French, Chilean and Argentinean Medical Top Side Support and Maritime Rescue Authorities and despite poor weather conditions, an emergency medical evacuation by air to Chile was made possible. The evacuation, which was 2 days shorter compared to an evacuation by sea, allowed the patient to reach a hospital facility in time to save his life whereas he decompensated in haemorrhagic shock. As passengers on cruise ships are typically elderly and often following anticoagulant therapies, the risk of bleeding is most important. Facing a gastric haemorrhage, a transfusion is often required. In remote areas, transfusion of fresh whole blood to stabilize a critical patient until he reaches a hospital must be considered.  

Abstract

Antarctic tourism on board cruise ships has expanded since the 1990s, essentially in the Antarctic Peninsula. Due to remoteness, medical cases may evolve into life threatening conditions as emergency medical evacuations are challenging. We discuss the case of a young crew member who suddenly fainted with an epigastric pain and abundant rectal bleeding while on board a cruise ship heading to the Deception Island (62°57.6 South, 60°29.5 West), 44 h away from Ushuaia by sea. A medical evacuation was necessary to save the patient whose haemoglobin level rapidly decreased from 11 g/dL to 8.7 g/dL over an 8 h period due to uncontrolled gastrointestinal bleeding. Following discussions between the French, Chilean and Argentinean Medical Top Side Support and Maritime Rescue Authorities and despite poor weather conditions, an emergency medical evacuation by air to Chile was made possible. The evacuation, which was 2 days shorter compared to an evacuation by sea, allowed the patient to reach a hospital facility in time to save his life whereas he decompensated in haemorrhagic shock. As passengers on cruise ships are typically elderly and often following anticoagulant therapies, the risk of bleeding is most important. Facing a gastric haemorrhage, a transfusion is often required. In remote areas, transfusion of fresh whole blood to stabilize a critical patient until he reaches a hospital must be considered.  

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Keywords

gastrointestinal haemorrhage, cruise ship, Antarctic, transfusion

About this article
Title

Acute gastrointestinal haemorrhage on board a cruise ship in the Antarctic Peninsula

Journal

International Maritime Health

Issue

Vol 67, No 4 (2016)

Article type

Case report

Pages

223-226

Published online

2016-12-23

DOI

10.5603/IMH.2016.0040

Pubmed

28009388

Bibliographic record

International Maritime Health 2016;67(4):223-226.

Keywords

gastrointestinal haemorrhage
cruise ship
Antarctic
transfusion

Authors

Mathieu Carron
Peter Globokar
Bruno A Sicard

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