Volume 16, Issue 1, January 2015
Zachary Smith, DO et al.
Bouveret syndrome is a rare presentation of gastric outlet obstruction caused by a gallstone in the proximal duodenum via a bilioenteric fistula. This is an infrequent although clinically significant cause of abdominal pain, almost exclusively in the elderly.
Volume 16, Issue 1, January 2015
Erica Cacioppo, MD et al.
A 42-year-old male with a history of multiple shoulder dislocations presented to the emergency department via emergency medical services with both arms locked above his head, stating that he had been jumped at a bar and had since been unable to move his arms.
Volume 16, Issue 1, January 2015
Katherine C. Wurlitzer, BS et al.
A 68-year-old woman presented with a pruritic, blistering rash. Three months prior, she had developed itchy lesions on her hands and feet, spreading to her chest and abdomen.
Volume 16, Issue 1, January 2015
Kelley Smith, MD et al.
Acute compartment syndrome (ACS) is a condition typically associated with long bone fractures or severe trauma; however, non-traumatic etiologies also occur. We describe a case of an otherwise healthy female pediatric patient presenting with unilateral forearm pain without an inciting injury.
Volume 16, Issue 1, January 2015
Daniel Ng, MD et al.
Necrotizing fasciitis caused by Klebsiella pneumoniae has been described in Southeast Asia, but has only recently begun to emerge in North America. The hypermucoviscous strain of K. pneumoniae is a particularly virulent strain known to cause devastatingly invasive infections, including necrotizing fasciitis.
Volume 16, Issue 1, January 2015
Sean P. Stickles, MD et al.
A 60-year-old man presented to the emergency department complaining of acute onset posterior ankle pain. He reported playing tennis earlier in the afternoon when he suddenly stopped and pivoted, noting a “pop” sensation and pain to the right posterior ankle.
Volume 16, Issue 1, January 2015
Bryan Madden, MD et al.
As studies continue to demonstrate the efficacy of intravenous tissue plasminogen activator (tPA) in acute ischemic stroke, the exclusion criteria continue to narrow, and the time-window continues to increase. The most dreaded adverse effect of tPA, hemorrhagic conversion of an ischemic stroke, is well known and well published.
Volume 16, Issue 1, January 2015
Todd Schneberk, MD, MA et al.
A 57-year-old female presented to the emergency department with left sided facial rash with associated pain, blurred vision and oral discomfort. Past medical history included hypertension, and remote scleroderma (untreated).
Volume 16, Issue 1, January 2015
Ellen Jones, MD et al.
A 36-year old man presents to the emergency room five days after undergoing extracorporeal shock wave lithotripsy (ESWL) for a symptomatic 11mm left renal pelvis stone. The patient has persistent symptoms of severe left flank pain at presentation.
Volume 16, Issue 1, January 2015
Jeniffer S. Gausepohl, MD et al.
A 59-year-old Caucasian man with past medical history significant for hypertension and hyperlipidemia presented to the emergency department with a four-day history of increasing throat pain and bilateral neck swelling. Associated symptoms included voice hoarseness, shortness of breath, dysphagia, and odynophagia.
Volume 15, Issue 7, November 2014
Katherine R. Harter, MD, MPH et al.
We report the case of a 33-year-old woman returning from Haiti, presenting to our emergency department (ED) with fever, rash and arthralgia. Following a broad workup that included laboratory testing for dengue and malaria, our patient was diagnosed with Chikungunya virus, which was then reported to the Centers for Disease Control and Prevention for initiation of infection control.
Volume 15, Issue 7, November 2014
Paul J. Myers, DO, et al.
Sydenham Chorea (SC) is an acute rheumatic fever complication. SC is the most common acquired childhood chorea, usually affecting children five to fifteen years of age.1 It occurs following an untreated group A streptococcal infection and a latent period of one to six months.1,2 Despite rheumatic fever diminishing, 18% to 36% of acute rheumatic fever patients develop SC.3 Full recovery often takes several months; some patients suffer permanent neurologic sequelae.1
An 11-year old male presented to the Emergency Department with two days of uncontrolled body twitching. The movements affected his right arm and leg, with occasional lip twitches; he experienced intermittent confusion and hyperactivity. The patient denied recent illness, but recalled a fever with headache and vomiting several months prior. Besides the above findings, his physical examination was normal.
Volume 15, Issue 7, November 2014
Mian Adnan Waheed, MD et al.
Propofol is frequently used in the emergency department to provide procedural sedation for patients undergoing various procedures and is considered to be safe when administered by trained personnel.
Volume 15, Issue 7, November 2014
Kenneth S. Whitlow, DO et al.
High altitude pulmonary edema (HAPE) is a form of high altitude illness characterized by cough, dyspnea upon exertion progressing to dyspnea at rest and eventual death, seen in patients who ascend over 2,500 meters, particularly if that ascent is rapid.
Volume 15, Issue 7, November 2014
Daniel J. Shogilev, MD et al.
cute appendicitis is the most common abdominal emergency requiring emergency surgery. However, the diagnosis is often challenging and the decision to operate, observe or further work-up a patient is often unclear.
Volume 15, Issue 7, November 2014
Chris Cruz, MD, et al.
A 26-year old man presented to the emergency department for two months of worsening right hip and thigh pain. He complained of radicular pain from his buttocks to his calf and has difficulty bearing weight on his right leg. He denies a history of trauma, fever, prior surgery, or arthritis. In addition, he was being evaluated by a gastroenterologist for recurrent diarrhea. In the middle of his encounter, the radiologist called to discuss a result of his computed tomography (CT) performed three days prior. CT images showed inflamed loops of bowel involving the distal ileum and rectum. A fistula is seen from the rectum, extending into the distal ileal loop and the posterior pelvis (Figures 1 and 2). An abscess was found between the piriformis and gluteus medius. He was admitted for intravenous antibiotic therapy, including a consultation with general surgery for Chrohn’s Disease (CD). He responded well to antibiotics and was discharged six days later.
Volume 15, Issue 7, November 2014
Joseph McCarthy, DO et al.
A 52-year-old male presented to the emergency department with chest pain, shortness of breath and hemoptysis that had been worsening over the past two days.
Volume 15, Issue 7, November 2014
Scott Sullivan, MD et al.
A 10 year-old male presented to the ED with knee pain after falling off his bicycle. He landed on his flexed knee with an audible “pop.” He could not extend his knee or walk. Physical examination revealed an effusion and high riding patella with a palpable inferior pole defect. He was neurovascularly intact, and the remaining examination of his lower extremity was unremarkable.
Volume 15, Issue 7, November 2014
John Ashurst, DO et al.
A 77 year-old woman presented with a one day history of central chest pressure that radiated to the neck and right upper extremity. She had a history of hypertension and chronic obstruction pulmonary disease.
Volume 15, Issue 7, November 2014
Brent Felton, DO et al.
A 57-year-old male with a history of diabetes mellitus, hepatitis C, and intravenous drug abuse presented to the emergency department complaining of abdominal pain of three months duration that had worsened in the week prior to presentation.
Volume 15, Issue 7, November 2014
Kristin Berona, MD et al.
A 76-year-old female with a history of Parkinson’s, dementia, and hypertension presented to the emergency department with non-bilious, non-bloody vomiting and abdominal pain for 2 days.
