Large Sternocleidomastoid Haematoma after Minor Trauma in a Postradiation Neck

2012 ◽  
Vol 19 (6) ◽  
pp. 420-422
Author(s):  
YJ Cheon ◽  
BC Kang ◽  
HS Kim
Keyword(s):  
Emergency Department ◽  
Radiation Therapy ◽  
Head And Neck ◽  
Nasopharyngeal Cancer ◽  
Blunt Injury ◽  
Minor Trauma ◽  
Emergency Physicians ◽  
Head And Neck Tumours ◽  
Life Threatening

Sternocleidomastoid (SCM) muscle haematoma after minor blunt injury is rare. Radiation therapy as a treatment for head and neck tumours e.g. nasopharyngeal cancer can result in complications, including fibrosis, scarring, and atrophy. We report a 51-year-old man suffering from massive haematoma of SCM muscle after minor blunt injury to a postradiation neck. Signs of haematoma were absent during his first visit to the emergency department. Emergency physicians need to be aware that bleeding from a postradiation neck, even after minor trauma, may be life threatening.

Considerations for early acute myocardial infarction rule-out for emergency department chest pain patients: the case of copeptin

2012 ◽  
Vol 50 (2) ◽  
Author(s):  
Giuseppe Lippi ◽  
Mario Plebani ◽  
Salvatore Di Somma ◽  
Valter Monzani ◽  
Marco Tubaro ◽  
...  
Keyword(s):  
Emergency Department ◽  
Acute Coronary Syndrome ◽  
Chest Pain ◽  
Clinical Decision Making ◽  
Current Evidence ◽  
Emergency Physicians ◽  
Prognostic Information ◽  
Coronary Syndrome ◽  
Life Threatening ◽  
Rule Out

AbstractThe evaluation of patients admitted at the emergency department (ED) for chest pain is challenging and involves many different clinical specialists including emergency physicians, laboratory professionals and cardiologists. The preferable approach to deal with this issue is to develop joint protocols that will assist the clinical decision-making to quickly and accurately rule-out patients with non life-threatening conditions that can be considered for early and safe discharge or further outpatient follow-up, rule-in patients with acute coronary syndrome and raise the degree of alert of the emergency physicians on non-cardiac life-threatening emergencies. The introduction of novel biomarkers alongside the well-established troponins might support this process and also provide prognostic information about acute short-term or chronic long-term risk and severity. Among the various biomarkers, copeptin measurement holds appealing perspectives. The utility of combining troponin with copeptin might be cost-effective due to the high negative predictive value of the latter biomarker in the rule-out of an acute coronary syndrome. Moreover, in the presence of a remarkably increased concentration (e.g., more than 10 times the upper limit of the reference range), to reveal the presence of acute life-threatening conditions that may not necessarily be identified with the use of troponin alone. The aim of this article is to review current evidence about the clinical significance of copeptin testing in the ED as well as its appropriate placing within diagnostic protocols.

scholarly journals Consequences of Misdiagnosed and Mismanaged Hereditary Angioedema Laryngeal Attacks: An Overview of Cases from the Romanian Registry

2018 ◽  
Vol 2018 ◽  
pp. 1-6
Author(s):  
Dumitru Moldovan ◽  
Noémi Bara ◽  
Valentin Nădășan ◽  
Gabriella Gábos ◽  
Enikő Mihály
Keyword(s):  
Emergency Department ◽  
Effective Treatment ◽  
Hereditary Angioedema ◽  
Case Reports ◽  
Laryngeal Edema ◽  
Emergency Physicians ◽  
Treatment Protocols ◽  
Life Threatening

Emergency department (ED) physicians frequently encounter patients presenting with angioedema. Most of these involve histamine-mediated angioedema; however, less common forms of angioedema (bradykinin-mediated) also occur. It is vital physicians correctly recognize and treat this; particularly since bradykinin-mediated angioedema does not respond to antihistamines, corticosteroids or epinephrine and hereditary angioedema (HAE) laryngeal attacks can be fatal. Here we present four case reports illustrating how failures in recognizing, managing, and treating laryngeal edema due to HAE led to asphyxiation and death of the patient. Recognition of the specific type of angioedema is critical for rapid and effective treatment of HAE attacks. Bradykinin-mediated angioedema should be efficiently differentiated from the most common histamine-mediated form. Improved awareness of HAE and the associated risk of life-threatening laryngeal edema among emergency physicians, patients, and relatives and clear ED treatment protocols are warranted. Moreover, appropriate treatments should be readily available to reduce fatalities associated with laryngeal edema.

Clinical evidence on PET–CT for radiation therapy planning in head and neck tumours

2010 ◽  
Vol 96 (3) ◽  
pp. 328-334 ◽  
Author(s):  
Esther G.C. Troost ◽  
Dominic A.X. Schinagl ◽  
Johan Bussink ◽  
Wim J.G. Oyen ◽  
Johannes H.A.M. Kaanders
Keyword(s):  
Radiation Therapy ◽  
Head And Neck ◽  
Clinical Evidence ◽  
Therapy Planning ◽  
Head And Neck Tumours ◽  
Radiation Therapy Planning ◽  
Pet Ct

scholarly journals Spontaneous Isolated Celiac Artery Dissection: A Case Report

2020 ◽  
Vol 4 (3) ◽  
pp. 414-416
Author(s):  
Clifford Freeman ◽  
Aaron Lacy ◽  
Aubrey Miner ◽  
Devin Rogers ◽  
Austin Smith ◽  
...  
Keyword(s):  
Emergency Department ◽  
Abdominal Pain ◽  
Case Report ◽  
Celiac Artery ◽  
Chief Complaint ◽  
Diagnostic Tools ◽  
Artery Dissection ◽  
Emergency Physicians ◽  
Threatening Condition ◽  
Life Threatening

Introduction: Abdominal pain is a common chief complaint that can represent a wide breadth of diagnoses, ranging from benign to life-threatening. As our diagnostic tools become more sophisticated, we are able to better identify more causes of potentially life-threatening diseases. One such disease that is relatively unfamiliar to clinicians is spontaneous isolated celiac artery dissection (SICAD). Case Report: We describe a case of a 46-year-old man who presented to our emergency department with a chief complaint of abdominal pain and was found to have a SICAD and was successfully treated with anticoagulation, antihypertensives, and observation. Conclusion: It is important for emergency physicians to keep this potentially life-threatening condition in mind and to know the appropriate first steps once identified.

scholarly journals Timely Diagnosis of Pneumoperitoneum by Point-of-care Ultrasound in the Emergency Department: A Case Series

2021 ◽  
Vol 5 (4) ◽  
pp. 377-380
Author(s):  
Jung Yum ◽  
Taryn Hoffman ◽  
Leily Naraghi
Keyword(s):  
Emergency Department ◽  
Abdominal Pain ◽  
Elderly Patients ◽  
Point Of Care ◽  
Case Series ◽  
Point Of Care Ultrasound ◽  
Emergency Physicians ◽  
Hollow Viscus ◽  
Timely Diagnosis ◽  
Life Threatening

Introduction: Pneumoperitoneum is a life-threatening diagnosis that requires timely diagnosis and action. We present a case series of patients with perforated hollow viscus who were accurately diagnosed by emergency physicians using point-of-care ultrasound (POCUS) while in the emergency department (ED). Case Series: Three elderly patients presented to the ED with the complaints of syncope, abdominal pain with constipation, and unresponsiveness. The emergency physicians used POCUS to diagnose and then expedite the necessary treatment. Conclusion: Point-of-care ultrasound can be used by emergency physicians to diagnose pneumoperitoneum in the ED.

scholarly journals Emergency department ultrasound — practical and political

CJEM ◽  
1999 ◽  
Vol 1 (02) ◽  
pp. 121-122 ◽  
Author(s):  
Ron Matthews
Keyword(s):  
Emergency Department ◽  
The Body ◽  
Bedside Ultrasound ◽  
Rapid Evaluation ◽  
Emergency Physicians ◽  
Life Threatening

Practically speaking, bedside ultrasound is well within the scope of emergency physicians (EPs) and is gaining acceptance. The literature supports the use of limited, goal-directed ultrasound in the diagnosis of many emergent conditions. EPs should use ultrasound as a tool to answer specific questions (e.g., Is there blood in the belly?); they should not surf the body for clues. ED ultrasound offers rapid evaluation of potentially life-threatening conditions

scholarly journals Analysis of the critical dose of radiation therapy in the incidence of Osteoradionecrosis in head and neck cancer patients: a case series

BDJ Open ◽  
2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Zain Iqbal ◽  
Panayiotis Kyzas
Keyword(s):  
Radiation Therapy ◽  
Head And Neck ◽  
Pathological Fracture ◽  
Case Series ◽  
Electronic Patient Records ◽  
Head And Neck Tumours ◽  
Necrotic Bone ◽  
The Mean ◽  
Associated Risk Factors ◽  
Mandibular Surgery

Abstract Introduction Osteoradionecrosis (ORN) is a dramatic complication following radiation therapy (RT) for head and neck tumours. Symptoms include pain, trismus, and malodour. ORN can present with exposed necrotic bone, an orocutaneous fistula, and/ or a pathological fracture. Aims To analyse the RT dose responsible for the pathogenesis of ORN and its associated risk factors. Methods The data of 17 patients from 2005 to 2017 were retrospectively reviewed from the Pinnacle(3), WebPublication, and Electronic patient records (EPR) provided by Christie Hospital and Pennine Acute NHS Trust. Results The mean RT dose that ORN sites received was 57.3 Gy. The mean onset duration for ORN after RT was 640.6 days. six patients (35.2%) developed ORN following post-RT dental extractions. Conclusion RT dosages of >57.3 Gy significantly increase the likelihood of developing ORN. Mandibular surgery, post-RT dental extraction, concurrent smoking, and alcohol abuse all amplify the risk of developing ORN.

Neurological changes following radiation therapy for head and neck tumours

2002 ◽  
Vol 44 (2) ◽  
pp. 120-129 ◽  
Author(s):  
V.F.H Chong ◽  
J.B.K Khoo ◽  
L.L Chan ◽  
H Rumpel
Keyword(s):  
Radiation Therapy ◽  
Head And Neck ◽  
Head And Neck Tumours
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