1283: The person behind the problem -the importance of communication between health services

M. Neves1, C. Jorge1, N. André2
1 General Practice, USF Serpa Pinto, Porto, Portugal; 2 General Practice, USF Escariz, Arouca, Portugal
Introduction: In Portugal, addiction management services tend to not communicate regularly with other health services, which can lead to loss on information that could be important for the health care of the patient.
Case report: We describe a case of a 42 year old male, with Crohn's disease and a past history of heroin and cocaine addiction being now on opioid substitution treatment with methadone, abstemious from illicit drugs for the past 18 months. Four months after the first appointment in Primary Care, he complained about a cough and right superior back pain with anterior irradiation, especially in the morning and with deep respiratory movements. He denied fever or any relation of the pain with physical efforts. These symptoms had been present for the last few months and they were referred at the appointments at the addiction services, where he was given pain killers. The electrocardiogram was normal and a chest radiography showed a rounded opacity in the right superior lobe of the lung. On the tomography, it was identified a nodular lesion in the periphery of the posterior segment of the superior right lobe, with irregular borders and spikes affecting the pleura. In the mediastinum, there was a paratracheal adenopathic nodules conglomerate with tracheal compression and deformation. After biopsy, a lung adenocarcinoma was diagnosed.
Conclusion: This clinical case shows how important it is to keep a constant communication between health services and to look at the addiction patient seeing the person behind the addiction.

Disclosure: No conflict of interest declared