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Case Reports in Emergency Medicine

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https://www.readbyqxmd.com/read/29755798/bradycardia-after-tube-thoracostomy-for-spontaneous-pneumothorax
#1
Yomi Fashola, Sanjeev Kaul, Douglas Finefrock
We present the case of an elderly patient who became bradycardic after chest tube insertion for spontaneous pneumothorax. Arrhythmia is a rare complication of tube thoracostomy. Unlike other reported cases of chest tube induced arrhythmias, the bradycardia in our patient responded to resuscitative measures without removal or repositioning of the tube. Our patient, who had COPD, presented with shortness of breath due to spontaneous pneumothorax. Moments after tube insertion, patient developed severe bradycardia that responded to Atropine...
2018: Case Reports in Emergency Medicine
https://www.readbyqxmd.com/read/29755797/a-rare-and-lethal-complication-cerebral-edema-in-the-adult-patient-with-diabetic-ketoacidosis
#2
Christopher W Meaden, Beth J Kushner, Stacey Barnes
Commonly seen in the emergency department, diabetic ketoacidosis is a potentially lethal sequela of uncontrolled diabetes mellitus. In the adult population, a rare complication of diabetic ketoacidosis is cerebral edema. This case report discusses a 26-year-old male with new onset diabetes mellitus who developed cerebral edema leading to death.
2018: Case Reports in Emergency Medicine
https://www.readbyqxmd.com/read/29755796/transorbital-craniocerebral-penetration-by-a-sharp-object-with-an-intact-globe
#3
Abdullelah A Alamri, Ahmed R Algethami, Faisal Alghamdi
Traumatic eye injuries are common in children and are mostly superficial. Vigilance must always be practiced when examining these children to avoid missing any hidden serious injuries that may result in devastating complications. We describe the acute and definitive management of a child treated 17 h after transorbital craniocerebral penetration by a sharp object. Despite the rarity of these types of injury, a good outcome can be achieved if they are promptly recognized and managed.
2018: Case Reports in Emergency Medicine
https://www.readbyqxmd.com/read/29732225/cortical-blindness-and-altered-mental-status-following-routine-hemodialysis-a-case-of-iatrogenic-cerebral-air-embolism
#4
Lawrence Lau, Kory London
Cerebral air embolism is a known complication from a myriad of iatrogenic causes. This case describes a 60-year-old female presenting from hemodialysis with altered mental status, bilateral homonymous hemianopia, and repetitive speech. A noncontrast head CT revealed air in the vein of Galen and the deep cerebral veins of the left thalamus and occipital sulcus, a complication from air being introduced into the patient via improper flushing of dialysis tubing. The retrograde flow of air bubbles in the upright patient during dialysis was likely responsible for the air embolus lodging in the cerebral vasculature...
2018: Case Reports in Emergency Medicine
https://www.readbyqxmd.com/read/29721341/bilateral-carotid-and-vertebral-artery-dissection-from-blunt-trauma
#5
Catherine Coss, Jeffrey Jones
Carotid and vertebral artery injuries are rare following blunt trauma. They can, however, lead to severe consequences with a significant associated rate of stroke and intracranial hemorrhage, particularly if the diagnosis and treatment are delayed. We report a case of a 23-year-old female who presented to the Emergency Department with bilateral carotid and vertebral artery dissection following a motor vehicle collision (MVC).
2018: Case Reports in Emergency Medicine
https://www.readbyqxmd.com/read/29682363/acute-intoxication-following-dimethyltryptamine-ingestion
#6
Matthew H Bilhimer, Rachel F Schult, Kristan V Higgs, Timothy J Wiegand, Rachel M Gorodetsky, Nicole M Acquisto
Ayahuasca is a hallucinogenic tea that is most commonly comprised of the vine Banisteriopsis caapi alone or in combination with other plants such as Psychotria viridis . This concoction results in an orally active form of dimethyltryptamine (DMT), a hallucinogenic amine. Despite use in South America as a medicinal agent and component in religious ceremonies, interest in its recreational use and spiritual effects has led to increased use in the United States. We describe a unique case following ingestion of ayahuasca tea in a patient with history of schizophrenia resulting in personal injury and property damage...
2018: Case Reports in Emergency Medicine
https://www.readbyqxmd.com/read/29670774/emergent-presentation-of-an-adult-with-undiagnosed-coarctation-of-the-aorta
#7
Shannon Armistead, David Mullins, Stephen Sherick, John Ashurst
Coarctation of the aorta is typically thought to be a childhood disease. However, emergency physicians must keep a broad differential diagnosis when faced with a young patient with signs and symptoms of acute congestive heart failure. The authors present a case of newly diagnosed coarctation of the aorta in a 26-year-old male who was first misdiagnosed with pneumonia.
2018: Case Reports in Emergency Medicine
https://www.readbyqxmd.com/read/29666717/aortic-dissection-presenting-as-septic-shock-a-case-report-and-literature-review
#8
Jing Feng, Rui Liu, Sai Ma, Changkui Cao, Wei Zhang, Yang Zhao, Shinan Nie
Acute aortic dissection is a life-threatening clinical emergency, which mostly occurs in aged patients and presents with sharp chest pain. In this paper, we reported a case of acute aortic dissection, which induced septic shock in a young woman, without typical chest pain. The septic shock was possibly due to the bacterial translocation caused by aortic dissection-induced intestinal ischemia and intestinal epithelial barrier dysfunction. Our case appeared as the first case report of aortic dissection presenting as septic shock...
2018: Case Reports in Emergency Medicine
https://www.readbyqxmd.com/read/29666716/survival-after-cardiac-arrest-secondary-to-massive-pulmonary-embolism
#9
Abdullah E Laher, Muhammed Moolla, Feroza Motara, Fathima Paruk, Guy Richards
Introduction: It is estimated that the diagnosis of pulmonary embolism (PE) is missed in as many as 84% of all cases of PE. Cardiac arrest following PE is generally associated with poor outcomes. Case Report: A 43-year-old man presented to the Emergency Department (ED) in cardiac arrest. Swelling of his right lower limb was noted on arrival. Point of care ultrasound was performed during ongoing cardiopulmonary resuscitation (CPR) and showed a thrombus in the right iliofemoral vein as well as dilatation of the right ventricle...
2018: Case Reports in Emergency Medicine
https://www.readbyqxmd.com/read/29666715/identification-of-hollow-viscus-injury-with-fast-examination-in-kurdistan-iraq
#10
Ruj Al-Sindy, Heleen Alaqrawy, Mahmood Sh Hafdullah, Christine Butts
Point-of-care ultrasound has become indispensable in the evaluation of trauma, particularly in low resource areas, where it may be the only rapidly available imaging modality. The FAST (Focused Assessment with Sonography in Trauma) in particular can be lifesaving, by rapidly detecting signs of intra-abdominal hemorrhage. However, the FAST is primarily designed to identify free fluid associated with solid organ injury and is thought to have less sensitivity and power in identifying evidence of hollow viscus injury...
2018: Case Reports in Emergency Medicine
https://www.readbyqxmd.com/read/29581903/ingested-foreign-body-migration-to-the-liver-an-unusual-cause-of-persistent-abdominal-pain-in-a-54-year-old-female
#11
Alan Lucerna, James Espinosa, Kelly Schuitema, Risha Hertz
Abdominal pain is a common presentation in emergency medicine. We describe the case of a 54-year-old female who presented to the emergency department due to worsening abdominal pain. She had a history of right upper quadrant (RUQ) abdominal pain that had been ongoing for several months. The pain had been thought by the primary care team to be related to gastritis and she had been prescribed a proton pump inhibitor (PPI). Her abdominal pain increased in the three days prior to her presentation to the emergency department (ED)...
2018: Case Reports in Emergency Medicine
https://www.readbyqxmd.com/read/29527363/methicillin-sensitive-staphylococcus-aureus-suppurative-thyroiditis-with-thyrotoxicosis
#12
Sha Yan, Laryssa Patti
Intravenous drug use (IVDU) can lead to numerous complications from skin abscesses to bacteremia to endocarditis. Here, we present a rare case of acute suppurative thyroiditis as a complication of IVDU, in which a 26-year-old female with a past medical history of IVDU presented to the emergency department for evaluation of a large right sided neck mass. On exam, she had signs of sepsis and thyrotoxicosis. Fine needle aspiration confirmed suppurative thyroiditis. Blood cultures and culture from fine needle aspiration grew Staphylococcus aureus ...
2017: Case Reports in Emergency Medicine
https://www.readbyqxmd.com/read/29456875/delayed-presentation-of-submucosal-retained-toothbrush-from-self-inflicted-injury-in-patient-with-schizophrenia
#13
Caleb H Creswell, Tony L Kille, Matthew R Hoffman, Tabassum Kennedy, Seth H Dailey
Foreign body ingestion occurs in not only children but also adults, particularly those with history of neurologic disease, alcohol use, or psychiatric disease. We present the case of a 40-year-old male with schizophrenia who presented to the emergency room with a long history of pharyngeal foreign body sensation which had recently progressed to include trismus, odynophagia, and dyspnea. Flexible laryngoscopy demonstrated fullness of the right posterior pharyngeal wall and computed tomography (CT) showed a linear opaque foreign body extending from the level of the oropharynx to the thyroid ala...
2017: Case Reports in Emergency Medicine
https://www.readbyqxmd.com/read/29435374/a-case-of-status-epilepticus-associated-transient-hyperammonemia-in-the-emergency-department
#14
Brittany Pelsue, Jonathan G Rogg
This report describes a case of transient hyperammonemia following tonic-clonic status epilepticus with an initial ammonia level of 537 Umol/L. This appears to be the highest transient ammonia level reported in the literature in this clinical scenario. This is an affirmation that an initial elevated ammonia level in the absence of hepatic dysfunction should be interpreted with caution when associated with status epilepticus. Repeat levels should be drawn to identify transient hyperammonemia and determine the need for treatment if levels do not decrease...
2017: Case Reports in Emergency Medicine
https://www.readbyqxmd.com/read/29403666/fatal-mesenteric-ischemia-induced-by-synthetic-cannabinoids-a-case-report-and-literature-review
#15
David Hakimian, Orr Tomer, Nurith Hiller, Samuel N Heyman, Sarah Israel
Worldwide use of synthetic cannabinoids (SCs) is rapidly increasing, in part due to the generation of numerous new compounds, sidestepping legal restrictions. Their detection using standard toxicology panels is difficult, due to their vast heterogeneity and lack of structural resemblance to cannabinoids. Sympathetic overactivity and arterial spasm play a role in some of the life-threatening reactions to SCs, such as coronary or cerebral vasoconstriction. Here we report a patient with repeated consumption of SCs that led to mesenteric ischemia and death...
2017: Case Reports in Emergency Medicine
https://www.readbyqxmd.com/read/29387495/endobronchial-foreign-body-presenting-as-exacerbation-of-asthma
#16
James E Tsang, June Sun, Gaik C Ooi, Kenneth W Tsang
Airway foreign bodies are a leading cause of death among children and require urgent recognition by medical personnel. While most cases are diagnosed readily from a clinical history of acute respiratory distress, some cases remain more indolent and present later. We report the case of a 7-year-old boy who aspirated a "LEGO" toy and presented with a week history of increasing respiratory distress compatible with known asthma. Despite a normal chest X-ray, a low-dose computed tomography showed the presence of a foreign body in the left main bronchus, which was subsequently removed by fiberoptic bronchoscopy...
2017: Case Reports in Emergency Medicine
https://www.readbyqxmd.com/read/29230332/mechanisms-involving-myocardial-injury-in-tropical-stings-and-bites
#17
Thirunavukarasu Kumanan, Mahesan Guruparan, Ratnasamy Vithiya, Indika Gawarammana
It is known that a number of toxic substances produce myocardial injury by several mechanisms involving interruption of coronary blood flow due to stimulation of clotting mechanism and coronary vasospasm. Number of toxic substances may cause direct myocardial toxicity independent of coronary blood flow. Acute myocardial injury due to stings and bites is a rare entity and not well understood. Here we illustrate a case of myocardial injury due to Russell's viper envenomation.
2017: Case Reports in Emergency Medicine
https://www.readbyqxmd.com/read/29201469/perforated-duodenal-diverticulum-with-subtle-pneumoretroperitoneum-on-abdominal-x-ray
#18
Yuzeng Shen, Mark Kwok Fai Leong
Abdominal pain is one of the most common presenting complaints at the Emergency Department (ED). Given the myriad of possible differential diagnoses for abdominal pain, it becomes more important to diagnose conditions requiring emergent surgical intervention early. We present a case of an elderly male patient with abdominal pain secondary to perforated hollow viscus, subtle evidence of pneumoretroperitoneum on the initial supine abdominal X-ray, and review the signs of pneumoperitoneum and pneumoretroperitoneum on plain abdominal X-rays...
2017: Case Reports in Emergency Medicine
https://www.readbyqxmd.com/read/29158923/diffuse-subcutaneous-emphysema-pneumomediastinum-and-pneumothorax-following-robotic-assisted-laparoscopic-hysterectomy
#19
Laryssa Patti, William Haussner, Grant Wei
Robotic assisted laparoscopic surgery is becoming more widely available, but despite its multiple benefits, it is not without risk. This case is of a 62-year-old female who presented to the emergency department for dyspnea two days after robotic assisted laparoscopic hysterectomy. Physical exam revealed diffuse facial, neck, upper extremity, torso, and lower extremity crepitus, which was diagnosed as diffuse subcutaneous air on computed tomography (CT). Imaging also revealed right apical pneumothorax and pneumomediastinum...
2017: Case Reports in Emergency Medicine
https://www.readbyqxmd.com/read/29109872/severe-decompression-illness-case-report-prehospital-recognition-and-regional-transport-considerations
#20
Julie Estrada, David Meurer, Kevin De Boer, Karl Huesgen
A 46-year-old male presented to our tertiary care emergency department (ED) with shortness of breath and chest pain following an uneventful four-hour SCUBA dive at 100 feet. His prehospital emergency medical services (EMS) assessment revealed transient hypotension and hypoxia. He later developed progressive skin mottling. Serology was significant for acute kidney injury, transaminitis, hemoconcentration, and hypoxia on an arterial blood gas. Computed tomography (CT) angiography demonstrated intravascular gas throughout the mesenteric and pulmonary arteries as well as the portal venous system...
2017: Case Reports in Emergency Medicine
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