Volume 15, Issue 7, November 2014
Christina L. Bourne, MD et al.
Documentation and billing for laceration repair involves a description of wound length. We designed this study to test the hypothesis that emergency department (ED) personnel can accurately estimate wound lengths without the aid of a measuring device.
Volume 15, Issue 7, November 2014
Michael W. Manning, MS et al.
A 63-year-old female presented to the emergency department with complaints of her “heart beating out of my chest,” palpitations, and shortness of breath. She was three months postoperative a #23 Edwards Sapien Transapical Aortic Valve Replacement (TAVR).
Volume 15, Issue 7, November 2014
Steven G. Schauer, DO et al.
A 55-year-old female presented to the emergency department at a small community hospital with cough, fever, dyspnea and blood-streaked sputum. A chest radiograph was ordered.
Volume 15, Issue 6, September 2014
Matthew M. Thompson, DO et al.
Abdominal pain frequently represents a diagnostic challenge in the acute setting. In pregnant patients, the gravid abdomen and concern for ionizing radiation exposure further limit evaluation. If undiagnosed, appendicitis may cause disastrous consequences for the mother and fetus. We present the case of a pregnant female who was admitted for right lower quadrant abdominal pain. Advanced imaging of the abdomen and pelvis was interpreted to be either indeterminate or normal and a diagnosis of acute appendicitis was made on purely clinical grounds. This patient’s management and a literature review of diagnostic techniques for acute appendicitis during pregnancy are discussed.
Volume 15, Issue 6, September 2014
Phillip Stafford, MD et al.
The urinary tract is an often forgotten and under-appreciated source of infection in anuric hemodialysis patients. Bladder abscess, also called pyocystis, is a severe complication of low urinary flow that can be difficult to detect, leading to delays in treatment and increased morbidity. The emergency physician should maintain a high suspicion for pyocystis, which can be quickly diagnosed by bedside ultrasound. We report a case of a hemodialysis patient with an initially minor presentation who developed sepsis secondary to pyocystis and prostate abscess.
Volume 15, Issue 6, September 2014
Nese C. Oray, MD et al.
Traumatic perforation of the esophagus due to blunt trauma is a rare thoracic emergency. The most common causes of esophageal perforation are iatrogenic, and the upper cervical esophageal region is the most often injured. Diagnosis is frequently determined late, and mortality is therefore high. This case report presents a young woman who was admitted to the emergency department (ED) with esophageal perforation after having fallen from a high elevation. Esophageal perforation was diagnosed via thoracoabdominal tomography with ingestion of oral contrast. The present report discusses alternative techniques for diagnosing esophageal perforation in a multitrauma patient.
Volume 15, Issue 6, September 2014
Linda L. Herman, MD et al.
Haff disease, rhabdomyolysis after ingesting certain types of fish, was first reported in 1924 in Europe. There have been a limited number of cases reported in the United States. We present the case of a patient who presents with symptoms of rhabdomyolysis after eating cooked buffalo fish purchased at a suburban grocery market.
Volume 15, Issue 6, September 2014
Mihir Patel, MD et al.
A 50-year-old man presented with sudden onset abdominal pain and non-productive cough. Past medical history was significant for hypertension, treated with hydrochlorothiazide, azilsartan and a beta-blocker. Cardiovascular exam was notable for soft diastolic murmur in right second intercostal space and an abdominal bruit in umbilical region.
Volume 15, Issue 4, July 2014
Wesley Eilbert, MD et al.
Mesenteric venous thrombosis is a rare cause of abdominal pain, which if left untreated may result in bowel infarction, peritonitis and death. The majority of patients with this illness have a recognizable, predisposing prothrombotic condition. Oral contraceptives have been identified as a predisposing factor for mesenteric venous thrombosis in reproductive-aged women. In the last fifteen years new methods of hormonal birth control have been introduced, including a transdermal patch and an intravaginal ring. In this report, we describe a case of mesenteric venous thrombosis in a young woman caused by a vaginal contraceptive ring.
Volume 15, Issue 4, July 2014
Kashyap Tadisina, BS et al.
Fireworks are used to celebrate a variety of religious, patriotic, and cultural holidays and events around the world. Fireworks are common in the United States, with the most popular holiday for their use being national Independence Day, also known as July Fourth.
Volume 15, Issue 4, July 2014
Maryam Kia, MD et al.
A 55-year-old woman with a 3-month history of abdominal pain presented to the emergency department with chief complaints of worsening abdominal pain and per os intolerance since 3 days ago. Her medical history was noteworthy for watery diarrhea without fever, loss of appetite, weight loss, and nausea and vomiting.
Volume 15, Issue 4, July 2014
Vu Huy Tran, MD et al.
Ketamine associated urinary dysfunction has become increasingly more common worldwide. Point-of-care ultrasound (POCUS) is an established modality for diagnosing hydronephrosis in the emergency department. We describe a case of a young male ketamine abuser with severe urinary urgency and frequency in which POCUS performed by the emergency physician demonstrated bilateral hydronephrosis and a focally thickened irregular shaped bladder. Emergency physicians should consider using POCUS evaluate for hydronephrosis and bladder changes in ketamine abusers with lower urinary tract symptoms. The mainstay of treatment is discontinuing ketamine abuse.
Volume 15, Issue 4, July 2014
William Hurley, MD et al.
We describe a case series of seven patients presenting to an emergency department with symptoms of paralytic shellfish poisoning. They developed varying degrees of nausea, vomiting, diarrhea, weakness, ataxia and paresthesias after eating mussels harvested from a beach near their resort. Four patients were admitted to the hospital, one due to increasing respiratory failure requiring endotracheal intubation and the remainder for respiratory monitoring. All patients made a full recovery, most within 24 hours. The ability to recognize and identify paralytic shellfish poisoning and manage its complications are important to providers of emergency medicine.
Volume 15, Issue 4, July 2014
Jean Chin-Yu Lo, MD et al.
Rivaroxaban is a newer anticoagulant initially approved by the Food and Drug Administration to treat nonvalvular atrial fibrillation. Rivaroxaban has several characteristics that are more favorable than warfarin. One of the characteristics is decreased risk of hemorrhage. We report one of the first case reports of severe intracranial hemorrhage associated with rivaroxaban in an elderly patient with decreased renal function. We aim to alert emergency medicine providers regarding the likelihood of encountering these patient as newer anticoagulants rise in popularity.
Volume 15, Issue 4, July 2014
Jared Sutton, MD et al.
A 2 year old fully immunized male with no personal history of chicken pox presented to the emergency department with a chief complaint of a rash for one week after returning from a hiking trip in a remote island in Canada. After initially being diagnosed with contact dermatitis, a diagnosis of herpes zoster was made by confirmatory viral polymerase chain reaction testing. The purpose of this case report is to examine the literature for the incidence and etiology of shingles in children without a prior history of a primary varicella rash outbreak.
Volume 15, Issue 4, July 2014
Daniel M. Aronovich, DO et al.
A 44 year-old Caucasian male was found floating in the sea for an unknown duration of time and was pulled out by fire rescue paramedics. He was unconscious, pulseless, and in asystole as determined by emergency medical services. Cardio-pulmonary resuscitation (CPR) was commenced immediately.
Volume 15, Issue 4, July 2014
Serpil Yaylaci, MD et al.
An 11-year-old boy was admitted to emergency department with abdominal pain, bilious vomiting and rectal bleeding one day after falling from bicycle. He stated that he landed directly onto the handlebar through his left lower quadrant of the abdomen.
Volume 15, Issue 4, July 2014
Caleb P. Canders, MD et al.
A 42-year-old woman presented with a left lower extremity ulcer. Three weeks prior, she had been struck by a motor vehicle and developed bullae on her thigh, the main area of impact. She could not afford to see a primary doctor, and had been applying a low-cost, over-the-counter topical antiseptic solution to the site since the accident.
Volume 15, Issue 4, July 2014
Jesse Kellar, MD et al.
A 19-year-old man presented to the emergency department complaining of two days of right arm pain and swelling. The pain started while lifting weights. He did not experience a pop or pulling sensation. He stated his arm felt a little cold but otherwise denied numbness or tingling. He denied chest pain, neck pain or shortness of breath.
Volume 15, Issue 4, July 2014
Danielle D. Campagne, MD et al.
A restrained 20 year old male driver presents after a rollover motor vehicle collision. He is repetitive after sustaining a loss of consciousness, but is a Glasco Coma Scale of 15 on arrival. He is complaining of left ear and shoulder pain. He has no focal findings other than a ruptured left tympanic membrane
Volume 15, Issue 4, July 2014
Ozlem Bilir, MD et al.
A 60 year old female, with a history of atrial fibrillation who was on warfarin therapy, presented to our emergency department with chief complaint of the most severe headache that she ever had. Her vital signs, systemic and neurological examinations were normal.
Volume 15, Issue 4, July 2014
Jiro Tamura, MD et al.
A 59-year-old man had been admitted to our hospital three times with tarry stool, hematemesis, and abdominal discomfort. His medical history included no abdominal operation. Repeated upper endoscopy, colonoscopy, and computed tomography (CT) had been negative.
Volume 15, Issue 4, July 2014
Michael R. Minckler, MD et al.
A 51-year-old male with a history of chronic obstructive pulmonary disease and obstructive sleep apnea presents to the emergency department complaining of 48 hours of progressive right eye pain and swelling after he ran into his dresser while sleep-walking. He does not know which surface of the dresser contacted his eye. He denies changes in visual acuity, flashes, or floaters.
Volume 15, Issue 4, July 2014
Yalcin Golcuk, MD et al.
A 83-year-old man with a history of urinary stone disease presented to the emergency department with abdominal and right-sided flank pain. Examination demonstrated distended abdomen and right costovertebral angle tenderness.
