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Unmasking bowel obstruction in a Parkinson's patient: the influence of cognitive bias in frailty medicine
File(s)
omae109.pdf (259.87 KB)
Published version
Author(s)
Stevenson, Harvey
Ramsay, Daniele
Jerjes, Waseem
Type
Journal Article
Abstract
Recognising emergent acute pathology in the context of established chronic conditions can be challenging and is often overlooked due to cognitive biases in the physician’s decision making. In the context of Parkinson’s disease (PD), there is a large overlap between the non-motor symptoms of PD, common gastrointestinal symptoms amongst the elderly population, and symptoms associated with acute, severe GI pathology, which can result in diagnostic overshadowing. Here, a 68-year-old man with a background of PD reported nausea, constipation, and abdominal discomfort during routine frailty review by his general practitioner (GP). The patient reported these were common symptoms which usually resolved with laxatives. Aware of the potentially sinister nature of this presentation, the GP arranged transfer to the emergency department where CT subsequently revealed a closed-loop small bowel obstruction. This case highlights how frailty medicine is particularly susceptible to cognitive biases, which are commonly cited sources of medical errors.
Date Issued
2024-09-12
Date Acceptance
2024-07-22
Citation
Oxford Medical Case Reports, 2024, 2024 (9)
URI
URL
DOI
ISSN
2053-8855
Publisher
Oxford University Press
Journal / Book Title
Oxford Medical Case Reports
Volume
2024
Issue
9
Copyright Statement
© The Author(s) 2024. Published by Oxford University Press. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/ licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
License URL
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/39281336
PII: omae109
Subjects
biases
frailty
General & Internal Medicine
general practice
Life Sciences & Biomedicine
Medicine, General & Internal
Science & Technology
Publication Status
Published
Coverage Spatial
England
Article Number
omae109
Date Publish Online
2024-09-12