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Case Reports in Emergency Medicine

Martin A C Manoukian, Amode R Tembhekar, Sarah E Medeiros
A positive seatbelt sign following a motor vehicle accident is associated with an increased risk of intra-abdominal injury and hemoperitoneum. Injury to the uterus in reproductive-age women can also occur. In this report, we describe a 29-year-old nulligravida female who presented to the emergency room following a motor vehicle accident at freeway speeds. A positive seatbelt sign was noted, and a focused assessment with sonography for trauma revealed hemoperitoneum with an incidental finding of uterine leiomyomata...
2018: Case Reports in Emergency Medicine
David P Betten, Jennifer L Jaquint
The development of a retropharyngeal hematoma may lead to acute airway compromise requiring emergent airway stabilization. We describe the development of a retropharyngeal hematoma in an elderly woman who sustained a fall from standing approximately 10 hours prior to symptom onset who was taking the antiplatelet agents clopidogrel and aspirin. This delayed onset of rapid airway compromise secondary to a retropharyngeal hematoma following a fall in a patient taking clopidogrel is an unusual and potentially life threatening event...
2018: Case Reports in Emergency Medicine
Alan Lucerna, James Lee, James Espinosa, Risha Hertz, Victor Scali
The urachus is a midline tubular structure that stretches from the apex of the bladder and connects to the umbilicus. Urachal remnants result from incomplete regression of the fetal urachus in infancy. We report the case of a 21-year-old male who presented to the emergency department with purulent drainage from his umbilicus in association with a chronic intermittent "pulling sensation" in the umbilicus and suprapubic areas. An infected urachal remnant was diagnosed and was treated with an oral antibiotic and ultimately with outpatient excision of the remnant...
2018: Case Reports in Emergency Medicine
Matthew K Edwards, Erica N Christenson, Brian M Corliss, Adam J Polifka, Brandon R Allen
[This corrects the article DOI: 10.1155/2017/8386459.].
2018: Case Reports in Emergency Medicine
Brittany A Walsh, W Douglas Gregorie, Jessica S Whittle
Blunt cerebrovascular injury (BCVI) is a term encompassing traumatic carotid and vertebral artery dissection or disruption. While the reported incidence appears to be increasing as diagnostic modalities improve, these injuries are often diagnosed only after patients have developed acute neurologic symptoms. These injuries often result in severe permanent neurologic disability or death. The gold standard for diagnosis has historically been a 4-vessel arteriogram. However, newer data are suggesting that computed tomographic angiography may be more appropriate for most patients and new criteria for its utilization have been developed...
2018: Case Reports in Emergency Medicine
Alan Lucerna, James Lee, James Espinosa
Influenza is a contagious viral illness that usually presents with upper respiratory and pulmonary symptoms. While generally self-limited, pulmonary, renal, metabolic, neurologic, and cardiac complications have all been described in the literature. Here we describe a case of a 46-year-old male with multiple episodes of syncope, found to have severe bradycardia, sinus arrest, and positive influenza B, requiring permanent pacemaker placement. The viruses responsible for the flu can be differentiated into four types: A, B, C, and D...
2018: Case Reports in Emergency Medicine
Stephen M Foreman, Michael J Stahl
No abstract text is available yet for this article.
2018: Case Reports in Emergency Medicine
Leonardo Toscano, Daniel Terra, Siul Salisbury
Bullet embolism is an uncommon complication from heart gunshot injuries because most of the patients die immediately after trauma. The low frequency of this complication combined with the possible absence of symptoms makes the condition a challenge for the surgeon, delaying diagnostics and leading to severe complications or death. In this case, a small calibre bullet entered the left ventricle and then impacted the femoris artery.
2018: Case Reports in Emergency Medicine
Kiyohiro Oshima, Masato Murata, Makoto Aoki, Jun Nakajima, Yusuke Sawada, Yuta Isshiki, Yumi Ichikawa, Shuichi Hagiwara
Equestrianism is associated with a risk of severe trauma due to falls and/or direct injury from the horse, depending on the mechanism of injury. This article presents four cases of equestrian injury treated in Gunma University Hospital: Case 1: hepatic injury (fall and kick by the horse); Case 2: left hemopneumothorax and pulmonary contusion with multiple rib fractures (fall and trampling by the horse); Case 3: lumbar compression fracture (fall); and Case 4: scrotum injury (horse bite). Equestrian injuries may be high-energy traumas...
2018: Case Reports in Emergency Medicine
Guifang Yang, Changluo Li, Yong Long, Lijuan Sheng
In clinical practice, thallium poisoning is very hard to diagnose, because it is a very uncommon disease and its clinical manifestations are extremely complicated. In the present study, we investigated a case of a 53-year-old man who was hospitalized for persistent stabbing pain in the abdomen and lower extremities for 20 days. Physical examination revealed diffuse alopecia of the scalp. The final diagnosis of thallium poisoning was confirmed based on high blood and urine thallium levels. The patient was cured by an oral administration of Prussian blue combined with hemoperfusion and continuous veno-venous hemofiltration...
2018: Case Reports in Emergency Medicine
Kevin R Schwartz, Jennifer M Hanson, Alison M Friedmann
A previously healthy 10-year-old girl presented to the emergency department (ED) with a headache and vomiting which resolved with oral NSAIDs. The patient returned two days later unable to ambulate with mental slowing and lower extremity bruising. Labs demonstrated marked leukocytosis, severe anemia and thrombocytopenia, and disseminated intravascular coagulation (DIC). Brain MRI showed multiple intracranial hemorrhages. A peripheral blood smear demonstrated blasts with many Auer rods. A diagnosis of acute promyelocytic leukemia (APL) was made and therapy including all-transretinoic acid (ATRA) was initiated...
2018: Case Reports in Emergency Medicine
Farrukh Nadeem Jafri, David Solarz, Craig Hjemdahl-Monsen
Introduction: Spontaneous coronary artery dissection (SCAD) is a rare but important cause of acute coronary syndrome with a spectrum of disease that can include unstable angina, acute myocardial infarction, or sudden cardiac death. It has also been found in case reports to be caused by shear stress from physical exertion. We present a rare cycling induced SCAD that occurred in our institution in an otherwise healthy male with no cardiac risk factors. Case Presentation: A 36-year-old male presented to the emergency department with complaints of lightheadedness and diaphoresis after a bicycle fall...
2018: Case Reports in Emergency Medicine
Dhanalakshmi Thiyagarajan, Rebecca Jeanmonod
Millions of colonoscopies are performed annually for routine health maintenance in the United States. Patients commonly have adverse events from colonoscopy preparation, anesthesia, and procedural complications. We report a case of syncope secondary to iatrogenic splenic laceration from colonoscopy.
2018: Case Reports in Emergency Medicine
Ljiljana S Sulovic, Aleksandar P Pavlovic, Jovan B Zivkovic, Zorica N Zivkovic, Snezana S Filipovic-Danic, SlańĎana V Trpkovic
Case Report: The case of a drowning teenager is described involving application of cardiopulmonary resuscitation (CPR) by an untrained rescuer in the field and fast transport to a hospital enabling a positive resuscitation outcome despite an underorganized emergency medical service in a rural area. In our case hypoxia led to extended functional disorders of the cardiovascular system, which fully recovered after adequate therapy. Conclusion: Knowledge about BLS measures by ordinary citizens, together with continuous education of health professionals concerning modern techniques of CPR, is crucial for increasing the number of patients surviving after cardiac arrest...
2018: Case Reports in Emergency Medicine
Christos Koutserimpas, Argyrios Ioannidis, Petros Siaperas, Andreas Skarpas, Andreas Tellos, Georgios Velimezis, Ioannis Karanikas
Cardiopulmonary resuscitation (CPR) represents an emergency procedure, consisting of chest compressions and artificial ventilation. Two rare cases of intra-abdominal bleeding following cardiac compressions are reported. The first case was a 29-year-old female with massive pulmonary embolism (PE). Following CPR due to cardiac arrest, she showed signs of intra-abdominal bleeding. A liver laceration was found and sutured. The patient passed away, due to massive PE. The second patient was a 62-year-old female, suffering from cardiac arrest due to drowning at sea...
2018: Case Reports in Emergency Medicine
Yicheng K Bao, Vishwanath C Ganesan, Richard Rapp, Shunzhong S Bao
Reported is a case of a 39-year-old Caucasian man who presented to the emergency department with sudden onset bilateral lower extremity paralysis after consuming a large amount of carbohydrates and alcohol. A CT, MRI, and lumbar puncture were performed with negative results; lab results showed hyperthyroidism and hypokalemia. The patient was diagnosed with thyrotoxic periodic paralysis. In a patient presenting with sudden onset paralysis and hypokalemia, the emergency physician should include thyrotoxic periodic paralysis in the differential diagnosis and focus on treating and working up the hypokalemia instead of the paralysis...
2018: Case Reports in Emergency Medicine
Keitaroh Takeda, John Mackay, Susan Watts
Cervical ectopic pregnancy (CEP) is a rare form of ectopic pregnancy. Cases diagnosed early in pregnancy can be managed medically, but more advanced pregnancies often require hysterectomy. Uterine artery embolization (UAE) is a novel approach to CEP for those who wish to preserve fertility. Here we present the case of a 44-year-old female with a 2-week history of vaginal bleeding and abdominal pain who was diagnosed with CEP and successfully treated with bilateral UAE (BUAE) in combination with methotrexate...
2018: Case Reports in Emergency Medicine
Garry J Kennebrew, Benjamin Daggett, Reis B Ritz
Dorsal Vein thrombosis, also known as Mondor's disease of the penis, is a superficial thrombophlebitis first described in the literature by Falco in 1955. Mondor's disease refers to a superficial thrombophlebitis of any locale. Diagnosis can be made clinically with palpation of a mobile, cord-like thickening on dorsum of penis without associated evidence of inflammation, infection, or dermatologic changes. Bedside ultrasonography with color Doppler can aid in the diagnosis of penile thrombophlebitis by revealing a noncompressible superficial vessel with normal surrounding flow...
2018: Case Reports in Emergency Medicine
Alan Lucerna, James Espinosa, Nicholas Butler, Ashley Wenke, Nicole Caltabiano
Here we report the case of a 20-year-old female restrained driver who presented to the emergency department (ED) after a motor vehicle accident. She sustained an isolated fracture of her left cuboid, consistent with a nutcracker cuboid fracture. A cuboid fracture is considered rare. It is even more uncommon for a cuboid fracture to occur in isolation, without other associated injuries to the foot. We discuss the mechanism, relevant anatomy, diagnosis, and principles of treatment of the nutcracker cuboid fracture...
2018: Case Reports in Emergency Medicine
Starr-Mar'ee C Bedy, Jacob P Kesterson, Greg Flaker
A 65-year-old Caucasian man was hospitalized for a non-ST-elevation myocardial infarction. On discharge, the patient was started on multiple new medications, including clopidogrel and atorvastatin. Twenty-six days after discharge, he presented to the Emergency Department (ED) with polyarthralgias. He was instructed to stop atorvastatin and to follow up with rheumatology and cardiology clinic. At cardiology clinic follow-up 43 days after ED discharge, clopidogrel was discontinued and patient was switched to ticagrelor...
2018: Case Reports in Emergency Medicine
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