A 85-year-old man with sudden onset of dyspnea and chest pain with an history of immobilization due to right tibia plateau fracture after traffic accident 2 months ago was admitted to our emergency department.
A previously healthy 30-year-old woman (gravida 1 para 1) presented to the emergency department (ED) with 5 days of lower abdominal pain, fever, and nausea. On examination, she had a temperature of 37.6° Celsius, pulse 116 beats/ minute, blood pressure 123/65 mmHg, respiratory rate 18 breaths/minute, and oxygen saturation 98% on room air. On bimanual examination, the patient exhibited bilateral adnexal tenderness, but no cervical motion tenderness. Relevant laboratory studies included negative urine beta-hCG, white blood cell count 17.4×103/μL and lactate 2.4 mmol/L.
An 81-year-old female with history of end stage renal disease on hemodialysis presented with worsening of abdominal pain of 2 days’ duration. The pain started as a dull ache over the lower abdomen 2 months earlier, diffuse but especially prominent over the lower quadrant, and was unrelieved by analgesic medications.
A 49-year-old man was brought to the emergency department by ambulance after he sustained a stab wound to the chest. He was alert but diaphoretic, with an initial systolic blood pressure of 90 by palpation and a heart rate of 110. A 1 cm laceration was noted at the left lower sternal border. Lung sounds were clear bilaterally, and heart sounds were muted.
A 61-year-old male with a 1-year history of bilateral lower extremity swelling and a chronic cough was referred to the emergency department (ED) for an abnormal echocardiogram. The patient also reported experiencing intermittent episodes of chest pressure. He stated that he was referred from his doctor after he received a cardiac echocardiography examination that showed possible mitral valve vegetations. On review of systems, he also admitted to intermittent chest palpitations.
This case study describes a patient who suffered blunt force trauma to the scrotum. Use of bedside emergency ultrasound facilitated early diagnosis of a ruptured testicle and allowed for prompt urological consultation and timely surgical repair. The utility of bedside emergency ultrasound in the evaluation of testicular trauma, as well as the outcome of our case, is discussed here.
Flank pain with hematuria is a common chief complaint in the emergency department (ED). Patients are often diagnosed with renal calculi or pyelonephritis and discharged with analgesics or antibiotics and follow-up. This case study describes a patient who presented to the ED with a 1 week history of flank pain and hematuria and was subsequently found to have a large renal mass on bedside ultrasound.
A 32 year-old female presented to the emergency department (ED) with complaints of mild vaginal spotting accompanied by uterine cramping. She was referred to the ED for an “abnormal pregnancy.” She was a G1P0 and her last menstrual period was 7 weeks 5 days prior. Physical examination demonstrated a well appearing female with normal vital signs.
Hepatic abscess is an uncommon occurrence in North America, but can be a diagnostic challenge for emergency department physicians. The clinical signs and symptoms may vary, leading to delays in diagnosis and higher morbidity. We present a case of a 35-year old male with a hepatic abscess initially misdiagnosed as pneumonia. On subsequent return to the ED for back pain complaints, a bedside ultrasound led to the appropriate diagnosis. This case report and discussion will attempt to review the literature on the etiology, diagnosis and treatment of hepatic abscess for the emergency physician.
A 63-year-old female with pulmonary hypertension presented to the emergency department (ED) with hemoptysis. Vital signs were significant for tachypnea, with respirations of 30 per minute, and hypoxia, with an oxygen saturation of 88%. Physical examination revealed a …
A 35-year-old man presented to the emergency department (ED) for acute urinary retention and penile pain for 4 hours. The patient denied any significant medical history or history of trauma. Physical exam revealed testicles that were nontender, without masses. However,…
This case demonstrates how EUS can be used as a rapid and helpful tool in the diagnosis of thyrotoxicosis. An enlarged thyroid gland with hypervascular flow on Doppler ultrasound can corroborate clinical data and lead to the correct diagnosis in a timelier manner.
Typically, clinicians think of ectopic pregnancies as occurring outside of the uterus. This case is important in underscoring the fact that there are variants of ectopic pregnancies that exist within the uterus. One classic type is the cornual ectopic pregnancy, which occurs in a congenital bicornate uterus. The shape of this uterus may allow for implantation to occur high in one of the cornual limbs.
Pleural effusions are a common finding in emergency departments, with cytologic analysis traditionally required for definitive diagnosis. This article describes a classic sonographic appearance of tuberculous pleural effusion.
This case demonstrates that the potential use of bedside ultrasound by emergency physicians can be a rapid and helpful diagnostic tool in differentiating an uncomplicated infectious condition, mastitis, from more complex pathology, such as breast cancer, that was ultimately diagnosed in this patient.
A 54-year-old depressive woman was admitted to the emergency department with a Glasgow Coma Scale of six (E1V1M4) and hypothermia (34°C). A drug overdose was early suspected by history as the patient was treated by tricyclic antidepressants (TCA).
The following case describes a 26-year-old female who presented to the emergency department with a nontrauamtic retrobulbar hematoma associated with warfarin toxicity. The application and limitations of focused bedside ocular sonography for this condition are discussed.
Author Affiliation Peter J. Bloomfied, MD, MPH Olive View-UCLA Medical Center, Department of Emergency Medicine, Sylmar, CA; Brotman Medical Center, Department of Emergency Medicine, Culver City, CA Adam B. Landman, MD, MS, MIS Robert Wood Johnson Foundation Clinical Scholars Program, Yale University School of Medicine, Department of Emergency Medicine, New Haven, CT; US Department […]
