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Emergency Radiology

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https://www.readbyqxmd.com/read/29238112/crevice-sign-as-an-indicator-of-plaque-laceration-associated-with-postoperative-severe-thromboembolism-after-carotid-artery-stenting-a-case-report
#1
Tomotaka Ohshima, Taiki Yamamoto, Shunsaku Goto, Kojiro Ishikawa, Toshihisa Nishizawa, Shinji Shimato
Carotid artery stenting (CAS) is increasingly utilized in patients with carotid artery stenosis. Various intraprocedural and postprocedural complications have been reported in the literature. We present a case of symptomatic major thromboembolism after CAS. The intraprocedural angiogram showed extraordinary slow filling of the contrast medium into the plaque, which we named as "crevice sign." An 83-year-old man presented repeat right amaurosis fugax for 6 months. The radiological examinations revealed 85% stenosis of the origin of the right internal carotid artery...
November 2017: Nagoya Journal of Medical Science
https://www.readbyqxmd.com/read/29235731/collaborative-model-for-training-and-credentialing-point-of-care-ultrasound-6-year-experience-and-quality-outcomes
#2
Carolynne J Cormack, Peter R Coombs, Kate E Guskich, Gabriel E Blecher, Neil Goldie, Ronnie Ptasznik
INTRODUCTION: Point-of-care ultrasound (PoCUS) is a rapidly growing area, providing physicians with a valuable diagnostic tool for patient assessment. This paper describes a collaborative model, utilising radiology department ultrasound expertise, to train and credential physicians in PoCUS. A 6-year experience of the implementation and outcomes of the programme established within the emergency departments of a large, multi-campus hospital network are presented. METHODS: A collaborative model was initially developed and implemented between radiology and emergency departments...
December 13, 2017: Journal of Medical Imaging and Radiation Oncology
https://www.readbyqxmd.com/read/29232349/management-of-intussusception-in-the-pediatric-emergency-department-risk-factors-for-recurrence
#3
Andrea Vo, Terry L Levin, Benjamin Taragin, Hnin Khine
BACKGROUND: The standard treatment for intussusception is air reduction enema (ARE) with inpatient observation for 24 to 48 hours to monitor for recurrence. More recent but limited observations suggest that patients who have undergone successful ARE can safely be discharged after 4 to 6 hours of observation. Our primary objective was to identify risk factors associated with early recurrence. Our secondary objectives included validating risk criteria from prior studies and identifying risk factors for ARE failures...
December 11, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29230336/metastatic-spinal-cord-compression-secondary-to-liver-cancer
#4
Daniel Gams Massi, Japhari Nyassinde, Ngor Side Diagne, Ramy Abdennaji, Kamadore Toure, Moustapha Ndiaye, Amadou Gallo Diop, Mouhamadou Mansour Ndiaye
Metastatic spinal cord compression (MSCC) is a medical emergency that requires rapid diagnosis and treatment to reduce pain, to preserve neurological functioning, and to prolong survival. The diagnosis of liver cancer is often neglected in the differential diagnosis of MSCC. Treatment is usually palliative and evolution is often fatal. This is a case report of a 28-year-old patient living in Mauritania hospitalized in November 2014 at the neurology department of Fann national teaching hospital in Dakar, for the management of a chronic dorsal spinal cord compression...
2017: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/29229158/risk-of-appendicitis-in-patients-with-incidentally-discovered-appendicoliths
#5
Muhammad Sohaib Khan, Mustafa Belal Hafeez Chaudhry, Noman Shahzad, Marvi Tariq, Wasim Ahmed Memon, Abdul Rehman Alvi
BACKGROUND: An appendicolith-related appendiceal obstruction leading to appendicitis is a commonly encountered surgical emergency that has clear evidence-based management plans. However, there is no consensus on management of asymptomatic patients when appendicoliths are found incidentally. The objective of this study was to determine the risk of appendicitis in patients with an incidental finding of the appendicolith. METHODS: A retrospective matched cohort study of patients with appendicolith discovered incidentally on computed tomographic scan from January 2008 to December 2014 at our institution was completed...
January 2018: Journal of Surgical Research
https://www.readbyqxmd.com/read/29226229/subspecialisation-in-emergency-radiology-proposal-for-a-harmonised-european-curriculum
#6
M G Wagner, M R Fischer, M Scaglione, U Linsenmaier, G Schueller, F H Berger, E Dick, R Basilico, M Stajgis, C Calli, S Vaidya, Stefan Wirth
Introduction: Radiology plays a crucial role in the emergency care setting by delivering early and precise diagnoses under pressure of time, right at the beginning of patient treatment. Although there is a need for postgraduate education in emergency radiology, most of the national bodies responsible do not offer it in a uniform fashion and a general proof of qualification is missing in Europe. Therefore, the European Society of Radiology (ESR) has founded the (Sub-)Society of Emergency Radiology (ESER), prompting them to develop a European curriculum...
2017: GMS Journal for Medical Education
https://www.readbyqxmd.com/read/29226008/variation-in-results-release-and-patient-portal-access-to-diagnostic-test-results-at-an-academic-medical-center
#7
Matthew D Krasowski, Caleb V Grieme, Brian Cassady, Nicholas R Dreyer, Karolyn A Wanat, Maia Hightower, Kenneth G Nepple
Background: Electronic health records (EHRs) are commonplace in industrialized countries. Many hospitals are granting their patients access to their medical information through online patient portals. In this report, we describe a retrospective analysis of patient access to diagnostic test results released through the patient portal (MyChart; Epic, Inc.) at a state academic medical center. Methods: We analyzed 6 months of data for anatomic pathology, clinical laboratory, and radiology test results to evaluate variations in results release (automated vs...
2017: Journal of Pathology Informatics
https://www.readbyqxmd.com/read/29225800/recommendations-for-imaging-based-diagnosis-and-management-of-renal-angiomyolipoma-associated-with-tuberous-sclerosis-complex
#8
REVIEW
María José Buj Pradilla, Teresa Martí Ballesté, Roser Torra, Felipe Villacampa Aubá
Renal angiomyolipomas are found in up to 80% of tuberous sclerosis complex (TSC) patients. Although these tumours are usually asymptomatic, lesions >3 cm in diameter are prone to bleeding and up to 10% of TSC patients may experience a massive and potentially fatal retroperitoneal haemorrhage. Diagnosis can be complicated because of the initial lack of symptoms and the fat-poor content of atypical renal angiomyolipomas. After diagnosis, tumour growth and the emergence of new tumours must be monitored. Treatment with mammalian target of rapamycin (mTOR) inhibitors can reduce tumour size and is indicated in patients with TSC-associated renal angiomyolipomas >3 cm in diameter...
December 2017: Clinical Kidney Journal
https://www.readbyqxmd.com/read/29224660/postpartum-hemorrhage
#9
Janice Newsome, Jonathan G Martin, Zachary Bercu, Jay Shah, Haris Shekhani, Gail Peters
Interventional radiologists are often called for emergent control of abnormal uterine bleeding. Bleeding, even heavy bleeding as a result of uterine fibroids is not a common emergent procedure; instead, pregnancy and pregnancy related conditions, trauma and malignancy associated with bleeding can be the source of many interventional radiology on call events or procedures. Postpartum hemorrhage (PPH) is the most common cause, and is defined as blood loss of 500mL after vaginal delivery or 1000mL after cesarean section...
December 2017: Techniques in Vascular and Interventional Radiology
https://www.readbyqxmd.com/read/29223594/femoral-neck-fractures-after-removal-of-hardware-in-healed-trochanteric-fractures
#10
REVIEW
Antonio Barquet, Peter V Giannoudis, Andrés Gelink
INTRODUCTION: Hardware removal in healed trochanteric fractures (TF) in the absence of infection or significant mechanical complications is rarely indicated. However, in patients with persistent pain, prominent material and discomfort in the activities of daily living, the implant is eventually removed. Publications of ipsilateral femoral neck fracture after removal of implants from healed trochanteric fractures (FNFARIHTF) just because of pain or discomfort are rare. The purpose of this systematic review of the literature is to report on the eventual risk factors, the mechanisms, the clinical presentation, and frequency, and to pay special emphasis in their prevention...
December 2017: Injury
https://www.readbyqxmd.com/read/29222217/necrotising-pneumonia-caused-by-non-pvl-staphylococcus-aureus-with-2-year-follow-up
#11
Bryn Hilton, Aniket N Tavare, Dean Creer
Necrotising pneumonia (NP) is a rare but life-threatening complication of pulmonary infection. It is characterised by progressive necrosis of lung parenchyma with cavitating foci evident upon radiological investigation. This article reports the case of a 52-year-old woman, immunocompetent healthcare professional presenting to Accident and Emergency with NP and Staphylococcus aureus septicaemia. The cavitating lesion was not identified on initial chest X-ray leading to a delay in antimicrobial optimisation. However, the patient went on to achieve a full symptomatic recovery in 1 month and complete radiological recovery at 2-year follow-up...
December 7, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29221814/use-of-interventional-radiology-as-initial-hemorrhage-control-to-improve-outcomes-for-potentially-lethal-multiple-blunt-injuries
#12
Hiroyuki Otsuka, Toshiki Sato, Keiji Sakurai, Hiromichi Aoki, Takeshi Yamagiwa, Shinichi Iizuka, Sadaki Inokuchi
INTRODUCTION: Recently, trauma management has been markedly improved with interventional radiology (IVR) and damage-control strategies. However, the indications for its use in hemodynamically unstable patients with severe trauma remains unclear. In some cases, IVR may be more effective than surgery for damage-control hemostasis; however, performing IVR in life-threatening trauma settings is challenging. To address this, we practiced and evaluated a trauma-management system with emergency physicians who trained for both severe trauma management, and techniques of surgery and IVR...
December 6, 2017: Injury
https://www.readbyqxmd.com/read/29221340/sudden-hypotension-occurring-after-4-days-of-left-sided-central-catheter-placement
#13
Youn-Jung Kim, Won Young Kim
Central venous catheters (CVCs) have an important role in the management of critically ill patients. In contrast to the immediate complications after CVC insertion, the late complications were difficult to be noticed without high suspicion despite their life-threatening outcome. We report a rare but fatal delayed vascular perforation occurring after 4 days of left-sided hemodialysis catheter insertion. A 74-year-old male with septic shock was treated with continuous renal replacement therapy (CRRT) and recovered smoothly during hospitalization...
September 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29218668/early-laparoscopic-adhesiolysis-for-small-bowel-obstruction-retrospective-study-of-main-advantages
#14
Claudia Hannele Mazzetti, Francesco Serinaldi, Eric Lebrun, Jean Lemaitre
BACKGROUND: The problem of managing adhesional small bowel obstruction (ASBO) is still unsolved. A conservative medical attitude is privileged even if it is associated to a high rate of recurrences, while surgery is applied to cases showing no improvement after 48-72 h. Adhesiolysis via laparotomy has been the standard surgical management, but it causes other adhesions in a vicious circle. The aim of the study is to evaluate the advantages of early laparoscopic adhesiolysis as an alternative approach...
December 7, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/29218626/treatment-related-changes-in-glioblastoma-a-review-on-the-controversies-in-response-assessment-criteria-and-the-concepts-of-true-progression-pseudoprogression-pseudoresponse-and-radionecrosis
#15
REVIEW
P D Delgado-López, E Riñones-Mena, E M Corrales-García
The assessment of response to therapy in glioblastoma remains a challenge, because the surrogate measures of survival are subject to radiographic misinterpretation. A solid and reliable definition of progression is needed for both clinical decision-making and for evaluating response within the clinical trials. Historically, assessment criteria have used radiologic and clinical features aimed to correctly classify patients into progressive or non-progressive disease. The widely used RANO criteria are a valuable tool in disease evaluation, both in the clinical setting and in the clinical trials...
December 7, 2017: Clinical & Translational Oncology
https://www.readbyqxmd.com/read/29218261/bilateral-occipital-lobe-hemorrhages-presenting-as-denial-of-blindness-in-posterior-reversible-encephalopathy-syndrome-a-rare-combination-of-anton-syndrome-and-encephalopathy
#16
Raja Godasi, Chintan Rupareliya, Pradeep C Bollu
Posterior reversible encephalopathy syndrome (PRES) or reversible posterior leukoencephalopathy (RPL) is an acute neurological syndrome characterized by the development of radiological abnormalities on brain imaging along with clinical manifestations, such as a headache, seizures, encephalopathy, etc. We report the case of a middle-aged male who presented to the emergency department after he woke up with complete blindness and was found to have hemorrhagic PRES. Intracranial hemorrhages were seen in around 15% of patients who presented with this condition...
October 4, 2017: Curēus
https://www.readbyqxmd.com/read/29213173/spine-pathology-in-a-girl-with-upper-limb-pain-a-co-incidence-or-a-causal-relationship
#17
Maria Gogou, Martha Spilioti, Despoina Tramma, Efimia Papadopoulou-Alataki, Athanasios Evangeliou
A 10-year-old girl was admitted to the Emergency Department due to a history of intermittent pain located in the left radiocarpal joint for a month, as well as in the interphalangeal joints of the left hand without any additional symptoms. Clinical examination revealed mild sensory deficits and diminished muscle strength of the left upper limb without any other pathologic findings. A Magnetic Resonance Imaging scan of the brain and spinal cord was performed, which confirmed a diagnosis of thoracic syringomyelia...
2017: Sudanese Journal of Paediatrics
https://www.readbyqxmd.com/read/29211360/cerebral-venous-thrombosis-as-a-diagnostic-challenge-clinical-and-radiological-correlation-based-on-the-retrospective-analysis-of-own-cases
#18
Anna Zimny, Edyta Dziadkowiak, Joanna Bladowska, Justyna Chojdak-Łukasiewicz, Aleksandra Loster-Niewińska, Marek Sąsiadek, Bogusław Paradowski
BACKGROUND: Cerebral venous thrombosis (CVT) is a rare condition which constitutes 0.5-1% of all strokes. The clinical and radiological picture of CVT is non-specific and can mimic other disorders. OBJECTIVES: The aim of the study was to retrospectively evaluate and correlate clinical and radiological symptoms presented by patients with CVT, both in the initial and follow-up neurological and neuroimaging examinations, with a special emphasis on diagnostic difficulties...
October 2017: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
https://www.readbyqxmd.com/read/29210887/composition-and-associated-factors-of-radiological-examination-in-major-trauma-patients-a-prospective-observational-study
#19
Liu Shanshou, Zhao Wei, Wang Xianqi, Xie Jiangang, Zhu Chaojuan, Wang Qianmei, Yin Wen, Li Junjie
The care of major trauma patients continues to be a challenge for emergency physicians and trauma surgeons. We found that the total number of radiological examinations for major trauma patients in this study was high and mainly comprised radiography and computed tomography (CT), with CT being more commonly adopted. The number of CT scans was positively correlated with severity of injury and intensive care unit length of stay. Further study is warranted to optimize radiological examinations involving major trauma patients...
November 28, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29206639/electrical-impedance-tomography-in-children-with-community-acquired-pneumonia-preliminary-data
#20
Marta B Mazzoni, Alessandra Perri, Anna M Plebani, Silvia Ferrari, Giacomo Amelio, Alessia Rocchi, Dario Consonni, Gregorio P Milani, Emilio F Fossali
BACKGROUND: Electrical impedance tomography (EIT) is a noninvasive pulmonary function test that provides spatial and temporal information of changes in regional lung ventilation. We aimed to assess the feasibility of EIT as a supplementary tool in the evaluation of community acquired pneumonia in children. Furthermore, we performed a prospective evaluation of regional lung ventilation changes during a six-month follow-up period. METHODS: We enrolled otherwise healthy children aged 2-15 years with radiological diagnosis of community acquired pneumonia on admission at pediatric emergency department...
September 2017: Respiratory Medicine
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