Chronic mesenteric ischaemia presenting as possible large bowl malignancy: an easily overlooked differential diagnosis

2021 ◽  
Vol 14 (3) ◽  
pp. e240202
Author(s):  
Benjamin McDonald
Keyword(s):  
Computed Tomography ◽  
Emergency Department ◽  
Weight Loss ◽  
Differential Diagnosis ◽  
Damage Control ◽  
Damage Control Surgery ◽  
Mesenteric Ischaemia ◽  
Abdominal Symptoms ◽  
Chronic Mesenteric Ischaemia ◽  
Descending Colon

An 80-year-old woman presented to a regional emergency department with postprandial pain, weight loss and diarrhoea for 2 months and a Computed Tomography (CT) report suggestive of descending colon malignancy. Subsequent investigations revealed the patient to have chronic mesenteric ischaemia (CMI) with associated bowel changes. She developed an acute-on-chronic ischaemia that required emergency transfer, damage control surgery and revascularisation. While the patient survived, this case highlights the importance of considering CMI in elderly patients with vague abdominal symptoms and early intervention to avoid potentially catastrophic outcomes.

scholarly journals Point-of-care Ultrasound Identification of Iliopsoas Abscess in Emergency Department: A Case Report

2020 ◽  
Vol 4 (3) ◽  
pp. 404-406
Author(s):  
Nehal Al-Sadhan ◽  
Ottto Liebmann ◽  
Kristin Dwyer
Keyword(s):  
Computed Tomography ◽  
Emergency Department ◽  
Weight Loss ◽  
Differential Diagnosis ◽  
Case Report ◽  
Point Of Care ◽  
Iliopsoas Muscle ◽  
Point Of Care Ultrasound ◽  
Iliopsoas Abscess ◽  
Lower Back

Introduction: The iliopsoas muscle is a rare place for an abscess to collect. While these abscesses can have high mortality, they are often misdiagnosed. The use of point-of-care ultrasound (POCUS) can aid in earlier diagnosis. Case Report: A 45-year-old male presented to the emergency department (ED) with severe lower back pain. The pain radiated to both of his legs and was associated with fever, weight loss, and malaise. The differential diagnosis for this patient was broad. A POCUS was performed at the bedside and revealed bilateral iliopsoas abscesses. This finding was then confirmed by computed tomography. Conclusion: In this case report we will discuss how to identify an iliopsoas abscess using POCUS in ED patients, and the utility of POCUS to facilitate an expedited diagnosis.

scholarly journals Damage control in the emergency department, a bridge to life

2021 ◽  
Vol 52 (2) ◽  
pp. e4004801
Author(s):  
Laureano Quintero ◽  
Juan Jose Melendez-Lugo ◽  
Helmer Emilio Palacios-Rodríguez ◽  
Natalia Padilla ◽  
Luis Fernando Pino ◽  
...  
Keyword(s):  
Emergency Department ◽  
Trauma Patient ◽  
Damage Control ◽  
Damage Control Surgery ◽  
Hemodynamic Instability ◽  
Massive Hemorrhage ◽  
Severely Injured ◽  
Airway Injury ◽  
Hemostatic Resuscitation ◽  
Altered State Of Consciousness

Patients with hemodynamic instability have a sustained systolic blood pressure less or equal to 90 mmHg, a heart rate greater or equal to 120 beats per minute and an acute compromise of the ventilation/oxygenation ratio and/or an altered state of consciousness upon admission. These patients have higher mortality rates due to massive hemorrhage, airway injury and/or impaired ventilation. Damage control resuscitation is a systematic approach that aims to limit physiologic deterioration through a group of strategies that address the physiologic debt of trauma. This article aims to describe the experience earned by the Trauma and Emergency Surgery Group (CTE) of Cali, Colombia in the management of the severely injured trauma patient in the emergency department following the basic principles of damage control surgery. Since bleeding is the main cause of death, the management of the severely injured trauma patient in the emergency department requires a multidisciplinary team, which should perform damage control maneuvers aimed at rapidly control bleeding, hemostatic resuscitation and/or prompt transfer to the operating room, if required.

scholarly journals Endotracheal Metastasis Causing Airway Obstruction

2020 ◽  
Vol 4 (1) ◽  
pp. 96-98
Author(s):  
Yudai Yano ◽  
Takashi Fujiwara ◽  
Masanobu Mizuta
Keyword(s):  
Computed Tomography ◽  
Lung Cancer ◽  
Emergency Department ◽  
Differential Diagnosis ◽  
Respiratory Symptoms ◽  
Primary Lung Cancer ◽  
Chest Computed Tomography ◽  
Important Differential Diagnosis ◽  
Emergency Tracheostomy ◽  
Rare Lesion

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. A chest computed tomography and nasopharyngolaryngoscopy showed an endotracheal mass below the epiglottis, obstructing the trachea almost completely. The patient had an emergency tracheostomy, and then the mass was removed via median laryngotomy. This lesion was proven to be a recurrent metastasis of lung cancer. Clinicians should recognize endotracheal metastasis as an important differential diagnosis in cancer patients presenting with respiratory symptoms.

scholarly journals Bilateral Blindness Due to Acute Isolated Sphenoid Sinusitis- Is It Reversible? A Case Report

2014 ◽  
Vol 15 (2) ◽  
pp. 146-148
Author(s):  
Roshan Kumar Verma ◽  
Naresh K Panda
Keyword(s):  
Computed Tomography ◽  
Emergency Department ◽  
Differential Diagnosis ◽  
Case Report ◽  
Early Diagnosis ◽  
Paranasal Sinuses ◽  
Sphenoid Sinus ◽  
Vision Loss ◽  
Clinical Presentation ◽  
Sphenoid Sinusitis

Acute isolated sphenoid sinusitis is a rare and is seen in only 3% of all cases of all sinusitis. It is frequently misdiagnosed because of its vague clinical presentation. We report a case of 35year old female who presented to our emergency department with complaints of painless rapidly developing bilateral vision loss. Non contrast computed tomography of paranasal sinuses showed only mild opacification of sphenoid sinus. Endoscopic sphenoidectomy was performed within 4 hrs of presentation. After 48 hrs of surgery the patient vision returned to 6/6 bilaterally. Acute sphenoid sinusitis should be considered in the differential diagnosis of acute vision loss. Awareness, early diagnosis, astute clinical sense and emergent intervention can prevent permanent complication.DOI: http://dx.doi.org/10.3329/jom.v15i2.20700 J MEDICINE 2014; 15 : 146-148

scholarly journals Symptomatic Liver Metastasis Prompting Diagnosis of Uveal Melanoma

2019 ◽  
Vol 6 (3) ◽  
pp. 164-167
Author(s):  
Caroline C. Awh ◽  
Matthew W. Wilson
Keyword(s):  
Computed Tomography ◽  
Emergency Department ◽  
Weight Loss ◽  
Liver Metastasis ◽  
Uveal Melanoma ◽  
Primary Site ◽  
Bone Lesions ◽  
Computed Tomography Scan ◽  
Medical Oncologist ◽  
Tomography Scan

We report the case of a 66-year-old male with symptomatic liver metastasis as the presenting manifestation of primary uveal melanoma. Upon initial presentation to an emergency department with 2 months of abdominal pain, back pain, and unintended weight loss, a computed tomography scan demonstrated diffuse liver and bone lesions, prompting referral to a medical oncologist. He was eventually examined by an ophthalmologist, who found a lesion suspicious for uveal melanoma. This was ultimately confirmed to be the primary site of his malignant metastatic melanoma, which caused his death within 2 months of presentation.

1328: Simultaneous Damage Control Surgery and Endovascular Procedure in Hybrid Emergency Department System

2020 ◽  
Vol 49 (1) ◽  
pp. 671-671
Author(s):  
Kaori Ito ◽  
Taichiro Tsunoyama ◽  
Tsuyoshi Nagao ◽  
Kahoko Nakazawa ◽  
Ayumi Tomonaga ◽  
...  
Keyword(s):  
Emergency Department ◽  
Damage Control ◽  
Damage Control Surgery ◽  
Endovascular Procedure

Large mediastinal neoplasm penetrating the myocardium

Perfusion ◽  
2018 ◽  
Vol 34 (2) ◽  
pp. 170-172
Author(s):  
Mosaad El Banna ◽  
Luis Geraldes ◽  
Julia Grapsa ◽  
Cristiana Ramalhao ◽  
Santhi Adigopula ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Emergency Department ◽  
Differential Diagnosis ◽  
Abdominal Pain ◽  
Female Patient ◽  
Cardiac Tumor ◽  
Right Heart ◽  
The Right

A 90-year-old female patient presented to the emergency department with abdominal pain. Computed tomography (CT) set the suspicion of a cardiac tumor in the right heart chambers. We describe the presentation, the differential diagnosis and the decision for management of the patient.

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