As ketamine gains traction as an alternative to opiates in the treatment of chronic pain, ketamine-induced ulcerative cystitis is now being recognized as a complication of its use. The first-line treatment is phenazopyridine, an over-the-counter medication for dysuria that historically has been known to cause methemoglobinemia. This report details the case of a patient presenting to the emergency department (ED) with methemoglobinemia.
Uterine rupture is a rare but potentially fatal complication of pregnancy. The incidence of uterine rupture is estimated to be between 0.3 and 11 per 10,000. Additionally, uterine sacculation is a sac or outpouching of the uterus that can lead to uterine rupture in pregnancy. Here we describe a case of a patient who was found to have a uterine sacculation on point-of-care ultrasound in the emergency department (ED) that was complicated by uterine rupture.
Ruptured ectopic pregnancy is one of the leading causes of maternal death. Point-of-care ultrasound (POCUS) has been shown to be highly sensitive for excluding ectopic pregnancy. Ectopic pregnancy after a hysterectomy is a rare but life-threatening occurrence. We present a case where POCUS helped to diagnose a post-hysterectomy ectopic pregnancy.
Approximately two million people present to the emergency department (ED) with eye-related complaints each year in the United States. Differentiating pathologies that need urgent consultation from those that do not is imperative. For some physicians, ocular ultrasound has eclipsed the dilated fundoscopic exam as the standard posterior segment evaluation in the ED.
Cardiac masses are a rare cause of chest pain. They can often be missed on a chest radiograph performed to evaluate non-specific chest pain and are not readily evaluated with traditional laboratory testing. However, these masses can be visualized with point-of-care ultrasound.
Testicular torsion, or the twisting of the spermatic cord compromising blood flow to the testis, is a urologic emergency with the potential to cause infertility in male patients. The diagnosis may be clinical or confirmed using imaging, with ultrasound being the modality of choice.
Author Affiliation Rajadurai Meenakshisundaram, MBBS, MD Apollo KH Hospital, Department of Emergency Medicine and Critical Care, Melvisharam, Tamil Nadu, India Joshua Vijay Joseph, MBBS, MEM, PG Apollo KH Hospital, Department of Emergency Medicine and Critical Care, Melvisharam, Tamil Nadu, India Prabakaran Perumal, MBBS Apollo KH Hospital, Department of Emergency Medicine and Critical Care, Melvisharam, Tamil […]
Author Affiliation Andrew Harkins, MD Advocate Christ Medical Center, Department of Emergency Medicine, Oak Lawn, Illinois Christine Bassig-Santos, BS Chicago Medical School at Rosalind Franklin University, North Chicago, Illinois Michael Cirone, MD Advocate Christ Medical Center, Department of Emergency Medicine, Oak Lawn, Illinois; University of Illinois-Chicago, Department of Emergency Medicine, Chicago, Illinois Case presentation Discussion […]
Author Affiliation Jason David, MD Nellis Air Force Base, Mike O’Callaghan Military Medical Center, Department of Emergency Medicine, Las Vegas, Nevada Jerad Eldred, MD University of Nevada, Las Vegas, University Medical Center of Southern Nevada, Department of Emergency Medicine, Las Vegas, Nevada David Raper, DDS Nellis Air Force Base, Mike O’Callaghan Military Medical Center, Department […]
Author Affiliation Alexandra H. Baker, MD Boston Children’s Hospital, Department of Pediatrics/Division of Emergency Medicine, Boston, Massachusetts; Harvard Medical School, Department of Pediatrics, Boston, Massachusetts Susan Lipsett, MD Boston Children’s Hospital, Department of Pediatrics/Division of Emergency Medicine, Boston, Massachusetts; Harvard Medical School, Department of Pediatrics, Boston, Massachusetts Case presentation Discussion ABSTRACT Case Presentation An eight-week-old […]
Author Affiliation John C. Bates, PA-C Einstein Healthcare Network, Department of Emergency Medicine, Philadelphia, Pennsylvania Victoria Kneller, DO Einstein Healthcare Network, Department of Emergency Medicine, Philadelphia, Pennsylvania Layla Abubshait, MD Einstein Healthcare Network, Department of Emergency Medicine, Philadelphia, Pennsylvania Case presentation Discussion ABSTRACT Case Presentation We describe a case of abdominal pain in a male […]
Author Affiliation Michael Muradian, MD Beaumont Health, Department of Emergency Medicine, Royal Oak, Michigan Stephen Fox, MD Beaumont Health, Department of Emergency Medicine, Royal Oak, Michigan Patrice Barish, MD Beaumont Health, Department of Emergency Medicine, Royal Oak, Michigan; Oakland University William Beaumont School of Medicine, Department of Emergency Medicine, Auburn Hills, Michigan Brett Todd, MD […]
Author Affiliation Kelechi Abarikwu, BS University of Arizona College of Medicine, Tucson, Arizona James S. Komara, DO Mayo Clinic, Department of Emergency Medicine, Phoenix, Arizona Andrej Urumov, MD Mayo Clinic, Department of Emergency Medicine, Phoenix, Arizona Case presentation Discussion ABSTRACT Case Presentation A 37-year-old man with severe obstructive sleep apnea presented to the emergency department […]
Author Affiliation Eddie X. Ortiz-Galloza, MD Kern Medical, Department of Emergency Medicine, Bakersfield, California Bianca Arechiga, DO Kern Medical, Department of Emergency Medicine, Bakersfield, California Jagdipak Heer, MD Kern Medical, Department of Emergency Medicine, Bakersfield, California Daniel Quesada, MD Kern Medical, Department of Emergency Medicine, Bakersfield, California Case presentation Discussion ABSTRACT Case Presentation We describe […]
Author Affiliation Juliana Wilson, DO, MPH University of Colorado Denver – Anschutz Medical Campus, Department of Emergency Medicine, Aurora, Colorado; Denver Health Medical Center, Department of Emergency Medicine, Denver, Colorado Matthew Mendes, MD University of Colorado Denver – Anschutz Medical Campus, Department of Emergency Medicine, Aurora, Colorado Marian E. Betz, MD, MPH University of Colorado […]
Author Affiliation Hannah Newhouse, PA-C, MSPAS West Virginia University Camden Clark Medical Center, Department of Emergency Medicine, Parkersburg, West Virginia Joseph Minardi, MD West Virginia University Camden Clark Medical Center, Department of Emergency Medicine, Parkersburg, West Virginia Frederic Rawlins, DO Virginia College of Osteopathic Medicine, Department of Emergency Medicine, Blacksburg, Virginia Introduction Case report Discussion […]
A 53-year-old female presented to the emergency department with three days of nausea and dyspnea on exertion after using methamphetamine. Initial electrocardiogram revealed an ST-elevation myocardial infarction. While awaiting transfer to the cardiac catheterization lab the patient suffered a witnessed cardiac arrest. During resuscitative efforts an enlarging pericardial effusion on point-of-care ultrasound led to the detection of a left ventricular free-wall rupture (LVFWR). This case illustrates the progression of a left ventricular free-wall rupture using point-of-care ultrasound.
During the coronavirus disease 2019 pandemic caused by the severe acute respiratory syndrome coronavirus 2, deaths from opiate drug overdoses reached their highest recorded annual levels in 2020. Medication-assisted treatment for opiate use disorder has demonstrated efficacy in reducing opiate overdoses and all-cause mortality and improving multiple other patient-centered outcomes. Treatment of tramadol dependence in particular poses unique challenges due to its combined action as opioid agonist and serotonin-norepinephrine reuptake inhibitor. Tramadol puts patients with dependence at risk for atypical withdrawal syndromes when attempting to reduce use. Little evidence is available to guide treatment of tramadol dependence.
Many patients seen in the emergency department (ED) have central venous access placed or previously established placement. Catheters inadvertently placed in the arterial circulation may lead to complications or adverse events.
Fournier’s gangrene is a severe, necrotizing, and potentially fatal, soft tissue infection of the perineum that can be difficult to diagnose clinically. Point-of-care ultrasound (POCUS) has established a critical role in emergency medicine as a quick diagnostic tool due to its safety, accuracy, and cost effectiveness.
Congenital bowel malrotation resulting in midgut volvulus is traditionally regarded as a diagnosis of infancy. Rarely, congenital bowel malrotation is diagnosed in adolescents or adults and requires a high index of suspicion. Presentations can be acute or chronic, and physical examination findings are nonspecific. Diagnosis is primarily achieved through abdominal computed tomography (CT) or during exploratory laparotomy. The pathophysiology in late-onset malrotation is similar to neonatal malrotation, with a division of Ladd’s bands – peritoneal fibrous bands that connect the cecum to the right lower quadrant retroperitoneum – as the definitive treatment. We present a case of congenital bowel malrotation in an adolescent with persistent and worsening migratory abdominal pain.