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 […]

Juliana Wilson, DO, MPH

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.

Hannah Newhouse, PA-C, MSPAS

A myriad of pathologies can cause abdominal pain. Genitourinary causes including testicular torsion must be considered.

Leslie Mukau, MD

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.

Jie Tang, MD, MSc, MPH

Ethylene glycol intoxication can be lethal if diagnosis is delayed. Often, prompt diagnosis may need to be based on indirect laboratory findings.

James Waymack, MD

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.

Sarah Jabre, MD

The perforation of a cecal diverticulum is a rare and challenging condition for the emergency physician.

Lauren Ramm, MD

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.

Ellen McMahon, MD

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.

Marguerite Gilmore,

Patients commonly present with neck masses to the Emergency Department. The acute presentation of such a mass can be alarming to patients and their families. In this report we discuss a rare etiology of an acutely presenting neck mass in an adult.

Justin Pinkston, MD

Necrotizing mediastinitis is a rare complication following a dental procedure. It is frequently lethal and requires prompt diagnosis with advanced imaging, administration of broad-spectrum antimicrobials, and early surgical consultation.

Brandon M. Carius, DSc, MPAS, PA-C

A cornual pregnancy describes a rare ectopic location positioned within the myometrium next to the fallopian tube, which can be difficult to find on traditional ultrasound imaging. Given its location and the stretch within the uterine wall, cornual pregnancies can progress for weeks prior to diagnosis. Ruptures can, therefore, be catastrophic with disproportionally high maternal mortality rates compared to other ectopic pregnancies.

Kimberly Fender, MD

Endophthalmitis is a rare intraocular infection caused by numerous organisms from several possible sources. Fungal endophthalmitis is a rare subset of this pathology with limited diagnostics available. One of the few options to make this diagnosis is vitreous sampling, which is invasive, and results are not immediately available.

Nicholus M. Warstadt, MD

Aripiprazole is an atypical antipsychotic with unique receptor-binding properties that has a favorable safety profile in therapeutic doses compared to other antipsychotics. Massive aripiprazole overdose in children, however, presents with profound lethargy and may have neurologic, hemodynamic, and cardiac effects, often requiring admission to a high level of care.

Lauren Willoughby, MD

Conducted electrical weapons, commonly known by their proprietary eponym, TASER, are frequently used by law enforcement. A review of the literature yielded descriptions of taser barb removal from soft tissue and surgical intervention for barbs lodged in sensitive areas such as the eye and head, but not from other osseous sites.

Michael F. Sobin, MD

Anesthesia-assisted rapid opioid detoxification (AAROD) is a controversial method of treating opioid dependence that involves sedating patients during a period of provoked withdrawal. Reported adverse outcomes of the procedure demonstrate the importance of recognizing the potential complications of AAROD.

Lisa Armstrong, MD

As the medical community and world have combatted the coronavirus disease 2019 (COVID-19) pandemic, a significant advance was the development of a vaccine against the virus that has already claimed over 4.5 million lives worldwide.1 Vaccines manufactured by Pfizer-BioNTech and Moderna were the first two COVID-19 vaccines given emergency use authorization by the United States Food and Drug Administration. Preliminary data demonstrated not only the vaccines’ efficacy rates of greater than 95% after a second dose, but also marked safety. Initial data showed only 21 cases of anaphylaxis of greater than 1.8 million doses administered. The majority of those patients had a history of anaphylaxis and presented within the first 15 minutes after administration of the vaccine.2