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Case Reports in Emergency Medicine

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https://www.readbyqxmd.com/read/28203466/idiopathic-renal-infarction-mimicking-appendicitis
#1
Marco Di Serafino, Rosa Severino, Chiara Gullotto, Francesco Lisanti, Enrico Scarano
Renal infarction is a rare cause of referral to the emergency department, with very low estimated incidence (0.004%-0.007%). Usually, it manifests in patients aged 60-70 with risk factors for thromboembolism, mostly related to heart disease, atrial fibrillation in particular. We report a case of idiopathic segmental renal infarction in a 38-year-old patient, presenting with acute abdominal pain with no previous known history or risk factors for thromboembolic diseases. Because of its aspecific clinical presentation, this condition can mimic more frequent pathologies including pyelonephritis, nephrolithiasis, or as in our case appendicitis...
2017: Case Reports in Emergency Medicine
https://www.readbyqxmd.com/read/28194285/cerebral-salt-wasting-syndrome-caused-by-minor-head-injury
#2
Toshiki Fukuoka, Yuko Tsurumi, Arihito Tsurumi
A 34-year-old woman was admitted to hospital after sustaining a head injury in a motor vehicle accident (day 1). No signs of neurological deficit, skull fracture, brain contusion, or intracranial bleeding were evident. She was discharged without symptoms on day 4. However, headache and nausea worsened on day 8, at which time serum sodium level was noted to be 121 mEq/L. Treatment with sodium chloride was initiated, but serum sodium decreased to 116 mEq/L on day 9. Body weight decreased in proportion to the decrease in serum sodium...
2017: Case Reports in Emergency Medicine
https://www.readbyqxmd.com/read/28163938/evaluating-complications-of-chronic-sinusitis
#3
Phillip Hong, Charles A Pereyra, Uta Guo, Adam Breslin, Laura Melville
Chronic sinusitis is a relatively common diagnosis throughout the US. In patients with an otherwise unremarkable medical history the treatment is typically supportive, requiring only clinical evaluation. We present the case of a 25-year-old male with a history of chronic sinusitis that was brought to our emergency department with new-onset seizure. Three days before he had presented to his usual care facility with two days of headache and fever and was discharged stating headache, subjective fever, and neck stiffness...
2017: Case Reports in Emergency Medicine
https://www.readbyqxmd.com/read/28133553/congenital-diaphragmatic-hernia-presenting-in-a-7-day-old-infant
#4
Christopher Rouse, Luke Schmidt, Lee Brock, Angela Fagiana
A 7-day-old male infant presented to the emergency room after respiratory distress was noted at an outpatient well child check. On exam, he was observed to have tachypnea, increased work of breathing, and decreased breath sounds on the left side of the chest. On chest X-ray, he was found to have a left-sided congenital diaphragmatic hernia. The infant was transported to a tertiary care facility where the defect was repaired without complication. Interestingly, the mother had a history of a normal antenatal ultrasound, completed at 19 + 2 weeks of gestational age...
2017: Case Reports in Emergency Medicine
https://www.readbyqxmd.com/read/28116180/spontaneous-isolated-visceral-artery-dissection-in-a-middle-aged-male
#5
Eric Melnychuk, Robert Strony
Epigastric pain is a common complaint made by patients being evaluated in the emergency department. Spontaneous isolated visceral artery dissection is a rare cause with no reported prevalence. We present a case of a 37-year-old male evaluated in the emergency department for epigastric pain and subsequently diagnosed with a spontaneous isolated celiac artery dissection with involvement of the hepatic and splenic arteries. Recent case series suggest this disease may be managed medically in most cases. Surgical intervention may be considered for significant bleeding or signs of intestinal ischemia...
2017: Case Reports in Emergency Medicine
https://www.readbyqxmd.com/read/28116179/death-by-disimpaction-a-bradycardic-arrest-secondary-to-rectal-manipulation
#6
Christopher S Sampson, Cory M Shea
Rectal examination and fecal disimpaction are common procedures performed in the Emergency Department on a daily basis. Here, we report a rare case of a patient suffering a cardiac arrest and ultimately death likely due to rectal manipulation. A 66-year-old male presented to the Emergency Department (ED) with a complaint of abdominal distention and constipation. A rectal exam was performed. During the examination the patient became apneic. On the cardiac monitor the patient was found to be in pulseless electrical activity with a bradycardic rate...
2016: Case Reports in Emergency Medicine
https://www.readbyqxmd.com/read/28003918/superior-mesenteric-artery-syndrome-with-abdominal-compartment-syndrome
#7
Kevin Reece, Rachel Day, Janna Welch
Superior Mesenteric Artery (SMA) syndrome is a condition in which the duodenum becomes compressed between the SMA and the aorta, resulting in bowel obstruction which subsequently compresses surrounding structures. Pressure on the inferior vena cava (IVC) and aorta decreases cardiac output which compromises distal blood flow, resulting in abdominal compartment syndrome with ischemia and renal failure. A 15-year-old male with SMA syndrome presented with 12 hours of pain, a distended, rigid abdomen, mottled skin below the waist, and decreased motor and sensory function in the lower extremities...
2016: Case Reports in Emergency Medicine
https://www.readbyqxmd.com/read/28003917/frontal-mucocele-following-previous-facial-trauma-with-hardware-reconstruction
#8
Megan EuDaly, Chadd K Kraus
Mucoceles are cysts that can develop after facial bone fractures, especially those involving the frontal sinuses. Despite being rare, mucoceles can result in serious delayed sequelae. We present a case of a frontal mucocele that developed two years after extensive facial trauma following a motor vehicle crash (MVC) and review the emergency department (ED) evaluation and treatment of mucocele. Early recognition, appropriate imaging, and an interdisciplinary approach are essential for managing these rare sequelae of facial trauma...
2016: Case Reports in Emergency Medicine
https://www.readbyqxmd.com/read/27965902/tuberculosis-and-migration-a-challenge-for-medical-staff-and-public-health
#9
Ines Griesshammer, David Shiva Srivastava, Christophe von Garnier, Till Silvan Blaser, Aris Exadaktylos, Moritz Steib
A high number of asylum seekers enter Switzerland every year. They often originate from countries with a high TB prevalence. Our patient from Somalia presented with 2 lipoma-like tumors with pain on palpation on his left chest wall but no symptoms including coughing, fever, night-sweats, or loss of weight. CT scan then showed diffuse infiltrations of his lung and multiple abscesses on his left chest wall. Therefore contagious tuberculosis (TB) was suspected and the patient was put in isolation. In the follow-up the diagnosis of open TB was proofed with bronchial secretion and EBUS-guided biopsy that showed acid-fast rods...
2016: Case Reports in Emergency Medicine
https://www.readbyqxmd.com/read/27895945/congenital-renal-fusion-and-ectopia-in-the-trauma-patient
#10
Andrew A Rosenthal, Jordan J Ditchek, Seong K Lee, Rafael Sanchez, Chauniqua Kiffin, Dafney L Davare, Eddy H Carrillo
We present two separate cases of young male patients with congenital kidney anomalies (horseshoe and crossed fused renal ectopia) identified following blunt abdominal trauma. Despite being rare, ectopic and fusion anomalies of the kidneys are occasionally noted in a trauma patient during imaging or upon exploration of the abdomen. Incidental renal findings may influence the management of traumatic injuries to preserve and protect the patient's renal function. Renal anomalies may be asymptomatic or present with hematuria, flank or abdominal pain, hypotension, or shock, even following minor blunt trauma or low velocity impact...
2016: Case Reports in Emergency Medicine
https://www.readbyqxmd.com/read/27822396/acute-paraplegia-as-a-presentation-of-aortic-saddle-embolism
#11
Lisandro Irizarry, Anton Wray, Kim Guishard
Background. Acute onset paraplegia has a myriad of causes most often of a nonvascular origin. Vascular etiologies are infrequent causes and most often associated with postsurgical complications. Objective. To describe the occurrence and possible mechanism for aortic saddle embolism as a rare cause of acute paraplegia. Case Report. Described is a case of a 46-year-old female who presented with the sudden onset of nontraumatic low back pain with rapidly progressive paraplegia which was subsequently determined to be of vascular origin...
2016: Case Reports in Emergency Medicine
https://www.readbyqxmd.com/read/27807487/tibiofibula-transposition-in-high-energy-fractures
#12
Peter R Loughenbury, Rebecca A Gledhill, Nick Evans
We report two cases of failed attempts at closed reduction of high-energy tibial fractures with an associated fibula fracture. The first case was a 39-year-old male involved in high-speed motorbike collision, while the second was a 14-year-old male who injured his leg following a fall of three metres. Emergency medical services at the scenes of the accidents reported a 90-degree valgus deformity of the injured limb and both limbs were realigned on scene and stabilized. Adequate alignment of the tibia could not be achieved by manipulation under sedation or anaesthesia...
2016: Case Reports in Emergency Medicine
https://www.readbyqxmd.com/read/27761272/clinical-heterogeneity-of-guillain-barr%C3%A3-syndrome-in-the-emergency-department-impact-on-clinical-outcome
#13
Athanasios Papathanasiou, Ioannis Markakis
Guillain-Barré syndrome (GBS) is mainly classified into acute inflammatory demyelinating polyneuropathy (AIDP) and acute motor axonal neuropathy (AMAN). Although diagnosis of GBS requires progressive weakness and universal areflexia or hyporeflexia, cases of GBS with preserved or increased deep tendon reflexes (DTRs) have been increasingly recognized. We report three cases of GBS, presenting at a single unit in six months. Our first case presented with pure sensory symptoms. The second case had nonspecific generalized weakness, while the third presented with typical ascending weakness...
2016: Case Reports in Emergency Medicine
https://www.readbyqxmd.com/read/27703817/conservative-treatment-of-carpometacarpal-dislocation-of-the-three-last-fingers
#14
Hélène Jumeau, Philippe Lechien, Florence Dupriez
Posterior carpometacarpal (CMC) dislocation is a rare condition. Treatment is usually surgical though no strict consensus can be found upon literature review. If diagnosed early and no associated fractures are found, CMC dislocation could benefit from conservative treatment comprising closed reduction and splint immobilisation. We report the case of a 26-year-old man diagnosed with a posterior dislocation of the third, fourth, and fifth CMC joints after a fall of 1.5 meters, treated by external reduction under procedural sedation and immobilisation with a cast for 6 weeks...
2016: Case Reports in Emergency Medicine
https://www.readbyqxmd.com/read/27668101/a-ruptured-ectopic-pregnancy-presenting-with-a-negative-urine-pregnancy-test
#15
Johnathan Michael Sheele, Rachel Bernstein, Francis L Counselman
A negative urine pregnancy test in the emergency department traditionally excludes the diagnosis of pregnancy. We report a rare case of ruptured ectopic pregnancy in a patient with a negative urine pregnancy test but with a serum beta-human chorionic gonadotropin (β-hCG) of 10 mIU/mL. The patient developed hemoperitoneum and required laparoscopy by Obstetrics and Gynecology (OB/Gyn). This case highlights the fallibility of the urine pregnancy test in diagnosing early pregnancy.
2016: Case Reports in Emergency Medicine
https://www.readbyqxmd.com/read/27651958/spider-bite-a-rare-case-of-acute-necrotic-arachnidism-with-rapid-and-fatal-evolution
#16
Mario Pezzi, Anna Maria Giglio, Annamaria Scozzafava, Orazio Filippelli, Giuseppe Serafino, Mario Verre
The spider bites are quite frequent and often resolve quickly without leaving outcomes; only some species are capable of causing necrotic and systematic lesions in humans. Among them, we should mention the genus Loxosceles. The venom released from the spider bite of Loxosceles species is composed of proteins, enzymes, and nonenzymatic polypeptides. The phospholipase D family was identified as the active component of the venom. This family of enzymes is responsible for the local and systemic effects observed in loxoscelism...
2016: Case Reports in Emergency Medicine
https://www.readbyqxmd.com/read/27642528/pulmonary-embolism-presenting-as-abdominal-pain-an-atypical-presentation-of-a-common-diagnosis
#17
Hasan Rehman, Elizabeth John, Payal Parikh
Pulmonary embolism (PE) is a frequent diagnosis made in the emergency department and can present in many different ways. Abdominal pain is an unusual presenting symptom for PE. It is essential to maintain a high degree of suspicion in these patients, as a delay in diagnosis can be devastating for the patient and confers a high risk of mortality if left untreated. Here, we report the case of a 53-year-old male who presented to the emergency department with worsening right upper quadrant abdominal pain with fevers...
2016: Case Reports in Emergency Medicine
https://www.readbyqxmd.com/read/27635267/lyme-disease-presenting-with-multiple-cranial-nerve-deficits-report-of-a-case
#18
Abhishek Chaturvedi, Keith Baker, Donald Jeanmonod, Rebecca Jeanmonod
Lyme disease is a tick-transmitted multisystem inflammatory disease caused by the spirochete Borrelia burgdorferi. With more than 25,000 CDC reported cases annually, it has become the most common vector-borne disease in the United States. We report a case of 38-year-old man with Lyme disease presenting with simultaneous palsy of 3rd, 5th, 7th, 9th, and 10th cranial nerves.
2016: Case Reports in Emergency Medicine
https://www.readbyqxmd.com/read/27579187/necrotizing-fasciitis-presenting-as-an-itchy-thigh
#19
Thor Shiva Stead, V Shushrutha Hedna
We present a case of necrotizing fasciitis diagnosed in the emergency department. The clinical presentation and diagnostic findings of necrotizing fasciitis are discussed.
2016: Case Reports in Emergency Medicine
https://www.readbyqxmd.com/read/27563472/severe-methemoglobinemia-due-to-sodium-nitrite-poisoning
#20
Kenichi Katabami, Mineji Hayakawa, Satoshi Gando
Case. We report a case of severe methemoglobinemia due to sodium nitrite poisoning. A 28-year-old man was brought to our emergency department because of transient loss of consciousness and cyanosis. He was immediately intubated and ventilated with 100% oxygen. A blood test revealed a methemoglobin level of 92.5%. Outcome. We treated the patient with gastric lavage, activated charcoal, and methylene blue (2 mg/kg) administered intravenously. Soon after receiving methylene blue, his cyanosis resolved and the methemoglobin level began to decrease...
2016: Case Reports in Emergency Medicine
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