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Case Reports in Emergency Medicine

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https://www.readbyqxmd.com/read/30009060/pediatric-acute-promyelocytic-leukemia-presenting-to-the-emergency-department-as-refusal-to-ambulate
#1
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
https://www.readbyqxmd.com/read/29984009/cycling-induced-spontaneous-coronary-artery-dissection-in-a-healthy-male
#2
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
https://www.readbyqxmd.com/read/29974002/iatrogenic-splenic-laceration-presenting-as-syncope
#3
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
https://www.readbyqxmd.com/read/29974001/accidental-drowning-the-importance-of-early-measures-of-resuscitation-for-a-successful-outcome
#4
Ljiljana S Sulovic, Aleksandar P Pavlovic, Jovan B Zivkovic, Zorica N Zivkovic, Snezana S Filipovic-Danic, Slađana 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
https://www.readbyqxmd.com/read/29974000/intra-abdominal-hemorrhage-following-cardiopulmonary-resuscitation-a-report-of-two-cases
#5
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
https://www.readbyqxmd.com/read/29862090/bilateral-lower-extremity-paralysis-in-a-caucasian-male-presenting-to-the-emergency-department
#6
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
https://www.readbyqxmd.com/read/29854485/successful-management-of-cervical-ectopic-pregnancy-with-bilateral-uterine-artery-embolization-and-methotrexate
#7
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
https://www.readbyqxmd.com/read/29850287/traumatic-penile-pain-a-case-of-dorsal-vein-thrombophlebitis-after-intercourse
#8
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
https://www.readbyqxmd.com/read/29850286/nutcracker-cuboid-fracture-a-case-report-and-review
#9
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
https://www.readbyqxmd.com/read/29850285/ticagrelor-as-an-alternative-for-clopidogrel-associated-acute-arthritis
#10
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
https://www.readbyqxmd.com/read/29805816/a-case-of-impalement-brain-injury-that-could-achieve-good-neurological-outcome-by-introducing-early-sedation-and-immobilization-strategy
#11
Wataru Takayama, Kaho Yamasaki, Akira Endo, Yasuhiro Otomo
Impalement brain injury is rare, and the initial management of this condition is not well-established. We present a case of a well-managed brain injury caused by impalement with a metal bar. A 29-year-old man whose head had been impaled by a metal bar was transferred to our hospital. Upon arrival, he was agitated, with an unsteady gait and prominent odor of alcohol on his breath. He exhibited normal vital signs and neurological findings, except for his level of consciousness. To address the risk of secondary brain injury caused by movement of the foreign body, we immediately administered a sedative agent and muscle relaxant after the initial neurological evaluation...
2018: Case Reports in Emergency Medicine
https://www.readbyqxmd.com/read/29755798/bradycardia-after-tube-thoracostomy-for-spontaneous-pneumothorax
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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