Archives

Ultrasonography of a Helical Left Common Carotid Artery

Busack, MD, et al.

For at least two decades, point-of-care ultrasound has become the standard of care for placing central venous lines. This surprising anatomical orientation is rare and cautions physicians to fully explore a patient’s anatomy prior to placing central lines.

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55 year-old Female with Hematuria

Long, MD, et al.

A 55 year-old female presented to the emergency department with left sided abdominal pain and hematuria. Computed tomography scan of her abdomen and pelvis demonstrated a large left renal mass with extension into the left ureter, left renal vein, and inferior vena cava.

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Disseminated Gonorrhea

Estrada, DO, et al.

Sexually transmitted infections have risen sharply over the last decade in the United States. The incidence of gonorrhea has risen to 172 reported cases per 100,000 people over the past year.

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A Hidden Complication of Pigtail Catheter Insertion

Garcia de Alencar, MD, et al.

We report a case of a 92-year-old male who presented with dyspnea and shock, noted to have a pneumothorax requiring tube thoracostomy. Computed tomography demonstrated pigtail within the lung parenchyma. We discuss the implications of this occurrence.

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Endotracheal Metastasis Causing Airway Obstruction

Yano, MD, et al.

Endotracheal metastasis, a critical complication of primary lung cancer, is an extremely rare lesion. A 73-year-old woman who had previously received treatment for lung cancer presented to our emergency department with dyspnea.

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Diabetic Muscle Infarction

Ahmed, MD, et al.

A 58-year-old male with past medical history of diabetes mellitus presented with pain to the bilateral groin for six weeks. Magnetic resonance imaging of the patient’s lower extremities revealed acute myoedema, and he was diagnosed with myositis secondary to diabetic muscle infarction.

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Pseudo-duplication of the Gallbladder

Adamski, DO, et al.

Correct identification of Phrygian cap and pseudo-duplication should trigger a careful survey of the gallbladder in its entirety to rule out pathology. These anatomic variants may lead to partial under-distension of the gallbladder and can cause the gallbladder wall to appear falsely thickened.

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Pseudoatrial Flutter: When the Problem Lies Outside the Heart

Ceruti, MD, et al.

If these disorders are not promptly recognized, consequences can lead to hospitalization and execution of unnecessary diagnostic tests, thereby increasing the costs and clinical risks such as nosocomial infections and thromboembolism. We present a pseudoatrial flutter generated by a Parkinson’s-like movement.

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Cardiac Standstill With Intracardiac Clot Formation

Sakamoto, MD, et al.

This case describes and depicts cardiac standstill with thrombosed blood within the chambers of the heart. This was likely due to stasis of blood from a prolonged no-flow state. After viewing this ultrasound finding, the decision was made to halt resuscitative efforts in this case of a patient in cardiac arrest.

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Retained Catheter in the Aorta

Huang, MD, et al.

Due to the recent increase in endovascular procedures, retained foreign bodies such as stents and catheters in vasculature have become a common and serious complication. Treatments for these complications vary depending on the acuity and stability of the foreign body in the vessel. We discuss a rare case of an adult found to have an incidental retained umbilical artery catheter in the aorta.

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Monocular Vision Loss: A Rare Cause

Lane, PA-C, et al.

A 62-year-old woman with a history of metastatic breast cancer and known meningioma presented with unilateral vision loss associated with anisocoria and an afferent pupillary defect. On magnetic resonance imaging we found the cause to be optic nerve compression by a right frontal meningioma.

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Sonographic Detection of Cutaneous Myiasis

Nicholas, MD, et al.

Cutaneous maggots are occasionally encountered in the emergency department. We present a case in which maggots were visually identified and ultrasound was used to detect additional maggots below the skin crevices in a patient with elephantiasis nostras verrucosa.

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Contact Information

WestJEM/ Department of Emergency Medicine
UC Irvine Health

333 The City Blvd. West, Rt 128-01
Suite 640
Orange, CA 92868, USA
Phone: 1-714-456-6389
Email: westjem@gmail.com

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WestJEM
ISSN: 1936-900X
e-ISSN: 1936-9018

CPC-EM
ISSN: 2474-252X

Our Philosophy

Emergency Medicine is a specialty which closely reflects societal challenges and consequences of public policy decisions. The emergency department specifically deals with social injustice, health and economic disparities, violence, substance abuse, and disaster preparedness and response. This journal focuses on how emergency care affects the health of the community and population, and conversely, how these societal challenges affect the composition of the patient population who seek care in the emergency department. The development of better systems to provide emergency care, including technology solutions, is critical to enhancing population health.