A Rake’s Progress

2020 ◽  
pp. 169-174
Author(s):  
Pat Croskerry
Keyword(s):  
Emergency Department ◽  
Abdominal Pain ◽  
Shoulder Pain ◽  
Heart Attack ◽  
Correct Diagnosis ◽  
Uneventful Recovery ◽  
Left Shoulder ◽  
Loss Of Consciousness ◽  
Middle Aged ◽  
Rake's Progress

This case discusses a middle-aged male who experiences abdominal pain and loss of consciousness at a mall. His wife believes he is having a heart attack and rushes him to a nearby emergency department. He is also experiencing some left shoulder pain and diaphoresis, which is misinterpreted at triage. This communication error leads to him being misassigned to a cardiac area. Eventually, the correct diagnosis is made, and the patient makes an uneventful recovery.

scholarly journals An unusual abdominal pain in the emergency department: a delayed presentation of diaphragmatic injury

2016 ◽  
Vol 12 (2) ◽  
Author(s):  
Ciro Paolillo ◽  
Valentina Siragusa
Keyword(s):  
Emergency Department ◽  
Abdominal Pain ◽  
Shoulder Pain ◽  
Diaphragmatic Injury ◽  
Left Shoulder ◽  
Delayed Presentation ◽  
Vague Abdominal Pain

We present a case of delayed traumatic diaphragma rupture. The patient complained of a vague abdominal pain and left shoulder pain. Only the relevance of a remote trauma aroused the suspicion.

scholarly journals Just the Facts: Point-of-care ultrasound in the management of shoulder dislocations

CJEM ◽  
2020 ◽  
Vol 22 (3) ◽  
pp. 287-290
Author(s):  
Ryan Henneberry ◽  
Tara Dahn ◽  
Paul Atkinson
Keyword(s):  
Emergency Department ◽  
Range Of Motion ◽  
Shoulder Pain ◽  
Shoulder Dislocation ◽  
Point Of Care ◽  
Left Shoulder ◽  
Point Of Care Ultrasound ◽  
Posterior Shoulder Dislocation ◽  
Posterior Shoulder

A 59-year-old man presents with left shoulder pain after falling while playing with his dog at the park. He drove himself to the emergency department (ED). He reports 5/10 pain and has reduced range of motion of the shoulder. His shoulder looks normal on exam and is not squared off. You wonder if he might have a posterior shoulder dislocation.

scholarly journals Ileocecal Fistula Caused by Multiple Foreign Magnetic Bodies Ingestion

2018 ◽  
Vol 2018 ◽  
pp. 1-3
Author(s):  
Vittorio Cherchi ◽  
Gian Luigi Adani ◽  
Elda Righi ◽  
Umberto Baccarani ◽  
Giovanni Terrosu ◽  
...  
Keyword(s):  
Emergency Department ◽  
Abdominal Pain ◽  
Foreign Body ◽  
Clinical Condition ◽  
Correct Diagnosis ◽  
Intestinal Wall ◽  
Accidental Ingestion ◽  
The Us ◽  
Manual Suture ◽  
One Year

The incidence of accidental foreign body (FBs) ingestion is 100,000 cases/year in the US, with over than 80% of cases occurring in children below 5 years of age. Although a single FB may pass spontaneously and uneventfully through the digestive tract, the ingestion of multiple magnetics can cause serious morbidity due to proximate attraction through the intestinal wall. Morbidity and mortality depend on a prompt and correct diagnosis which is often difficult and delayed due to the patient's age and because the accidental ingestion may go unnoticed. We report our experience in the treatment of an 11-year-old child who presented to the emergency department with increasing abdominal pain, vomiting, diarrhea, and fever. Surgery evidenced an ileocecal fistula secondary to multiple magnetic FB ingestion with attraction by both sides of the intestinal wall. A 5-centimeter ileal resection was performed, and the cecal fistula was closed with a longitudinal manual suture. The child was discharged at postoperative day 8. After one year, the patient’s clinical condition was good.

scholarly journals Mimickers of Acute Appendicitis

2021 ◽  
Author(s):  
Esam Amer
Keyword(s):  
Magnetic Resonance Imaging ◽  
Computed Tomography ◽  
Emergency Department ◽  
Abdominal Pain ◽  
Acute Appendicitis ◽  
Imaging Modality ◽  
Correct Diagnosis ◽  
Emergency Setting ◽  
Magnetic Resonance Imaging Mri ◽  
Clinical Conditions

Acute appendicitis (AA) is a common surgical diagnosis in patients presenting to the Emergency Department with acute abdominal pain. A wide variety of other clinical conditions can present with a very similar presentation to acute appendicitis and therefore it can be occasionally challenging to make the correct diagnosis. In this review paper, the focus is to shed some light on the differential diagnosis of acute appendicitis which includes a variety of gastrointestinal, vascular, urological, and gynaecological conditions. In the emergency setting there are three main imaging modalities to evaluate patients presenting with abdominal pain, this includes computed tomography (CT), ultrasound (US) and magnetic resonance imaging (MRI). The choice of imaging modality for each clinical condition is variable and as such being familiar with those differential diagnoses is vital in deciding what is the best imaging modality for every patient presenting with abdominal pain.

scholarly journals Bilateral Luxatio Erecta Humeri

2021 ◽  
Vol 2 (5) ◽  
pp. 249-250
Author(s):  
Miguel Martinez-Romo ◽  
Shahram Lotfipour ◽  
C. Eric McCoy
Keyword(s):  
Emergency Department ◽  
Shoulder Pain ◽  
Clinical Presentation ◽  
Humeral Shaft ◽  
Middle Aged ◽  
Case Presentation ◽  
Scapular Spine ◽  
Luxatio Erecta ◽  
Inferior Dislocation ◽  
Middle Aged Male

Case Presentation: We describe a middle-aged male presenting to the emergency department with bilateral shoulder pain, holding both arms in abduction after trauma. Radiographs demonstrated a bilateral inferior dislocation of the glenohumeral joints consistent with luxatio erecta humeri. Discussion: We review the clinical presentation of luxatio erecta and its complications. We also describe the characteristic presentation on radiographs. Our case illustrates the hallmark findings of luxatio erecta of an abducted humeral shaft parallel to the scapular spine.

The Vacillated Vagrant

2020 ◽  
pp. 187-192
Author(s):  
Pat Croskerry
Keyword(s):  
Emergency Department ◽  
Tertiary Care Hospital ◽  
Correct Diagnosis ◽  
Tertiary Care ◽  
Care Hospital ◽  
Shortness Of Breath ◽  
Chest Tightness ◽  
Middle Aged ◽  
Fundamental Attribution Error ◽  
Affective Bias

In this case, a middle-aged male is brought to the emergency department of a tertiary care hospital from the airport. He has had an episode of shortness of breath and chest tightness, associated with nausea, paresthesias, and headache. Initially, he undergoes a cardiac workup and is cleared of any problems with his heart. He is discharged to the community and advised to return if there is any recurrence of symptoms. He does return for a further four visits over a 2-week period, during which he is referred to various other disciplines and services before his correct diagnosis is made. The case illustrates how a variety of biases influence the course of his management, notably diagnosis momentum, fundamental attribution error, and affective bias.

scholarly journals Lyme Disease as an Underlying Cause of Supraspinatus Tendinopathy in an Overhead Athlete

2012 ◽  
Vol 92 (5) ◽  
pp. 740-747 ◽  
Author(s):  
Christian L. Coulon ◽  
Dennis Landin
Keyword(s):  
Lyme Disease ◽  
Shoulder Pain ◽  
Health Care Professionals ◽  
Physical Therapist ◽  
Correct Diagnosis ◽  
Clinical Signs ◽  
Left Shoulder ◽  
Initial Examination ◽  
Clinical Role ◽  
Overhead Athletes

Background and Purpose Supraspinatus tendinopathy is a common cause of shoulder pain seen in overhead athletes, but there appear to be no published cases that present Lyme disease as the underlying cause of tendinopathy. Lyme disease is diagnosed primarily by clinical signs and symptoms and then supported by laboratory tests, including enzyme-linked immunosorbant assay (ELISA) and Western blot testing. This case demonstrates the importance of a physical therapist's input and clinical role in reaching the correct diagnosis in an athlete with Lyme disease who had a diagnosis of rotator cuff impingement and tendinitis. Case Description A 34-year-old male tennis player was seen for physical therapy for right shoulder impingement and tendinitis diagnosed by an orthopedic surgeon. He was unable to participate in sporting activities due to impairments in strength and pain. Initial examination revealed distal supraspinatus impingement and tendinopathy. Outcomes The patient was not progressing with commonly accepted interventions and began to have “arthritis-like” shoulder pain in the uninvolved left shoulder. Suspicious of an underlying condition, the physical therapist informed the physician of the patient's updated status and referred the patient to the physician to discuss the current symptoms in therapy. After testing, the patient was diagnosed with chronic Lyme disease and underwent antibiotic therapy. Discussion Many active patients spend time in the outdoors, increasing their risk of exposure to a vector for Borrelia burgdorferi. Physical therapists spend a larger portion of time with patients than other health care professionals and due to this extended contact and musculoskeletal knowledge are able to recognize atypical musculoskeletal disorders or musculoskeletal manifestations of unusual pathologies, including Lyme disease.

A Stone Left Unturned

2020 ◽  
pp. 253-258
Author(s):  
Pat Croskerry
Keyword(s):  
Emergency Department ◽  
Abdominal Pain ◽  
Young Woman ◽  
Crohn Disease ◽  
Emergency Physician ◽  
Hemorrhagic Cystitis ◽  
Correct Diagnosis ◽  
Technical Quality ◽  
History Of

In this case, a young woman presents to the emergency department with severe abdominal pain. She has a history of Crohn disease and this attack feels similar to previous flare-ups. The emergency physician orders urinalysis, blood work, and an abdominal series. Although the technical quality of his viewing of the images is limited, he is satisfied that there are no signs of obstruction or perforation. The patient settles well with analgesics and antiemetics. The urinalysis shows signs of infection, and the emergency physician prepares to discharge the patient on antibiotics for what he believes is hemorrhagic cystitis. At this point, a radiologist provides an interpretation of the patient’s abdominal series that allows for a correct diagnosis of her abdominal pain.

scholarly journals A Case Report of Fungicial Poisoning

2021 ◽  
Vol 11 (4-S) ◽  
pp. 1-2
Author(s):  
Uma Malaika Rapolu ◽  
Nabeela Tarannum ◽  
Enara Bawani ◽  
Mohd Danish
Keyword(s):  
Emergency Department ◽  
Abdominal Pain ◽  
Case Report ◽  
Acute Toxicity ◽  
Animal Study ◽  
Food Crops ◽  
Loss Of Consciousness ◽  
Reproductive Ability ◽  
Chief Complaints ◽  
Commercial Landscape

Myclobutanil may be a conazole class fungicide. Mostly employed in food crops(like apple, banana, asparagus, beans, cranberry, grape, plum, soybean, tomato, strawberry) and in other commercial landscape. Moreover it’s lower acute toxicity is seen. In animal study, it can effect reproductive ability. Workers in fields are mostly affected. Common symptoms include headache, eye irritation, itching, nausea, vomiting, abdominal pain, nose bleeding. A 39 year old male patient was brought to emergency department with chief complaints nausea, vomiting, seizures, loss of consciousness, and nose bleeding. Patient was provided with treatment upon admission. Keywords: Myclobutanil, conazole, fungicide.

Bedside ultrasound in the emergency department and abdominal pain

2016 ◽  
Vol 37 (S 01) ◽  
Author(s):  
M Algaba Montes ◽  
AÁ Oviedo García ◽  
M Patricio Bordomás
Keyword(s):  
Emergency Department ◽  
Abdominal Pain ◽  
Bedside Ultrasound
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