scholarly journals Case Report: Delayed Post-partum Preeclampsia in rural Ecuador

2017 ◽  
Author(s):  
David Gaus ◽  
Miguel Obregón ◽  
Carolina Betncourt
Keyword(s):  
Blood Pressure ◽  
Emergency Department ◽  
Abdominal Pain ◽  
Case Report ◽  
Magnesium Sulfate ◽  
Post Partum ◽  
Hypertensive Urgency ◽  
Case Presentation

<p><strong>Case Presentation</strong>: We report a case of delayed, post-partum preeclampsia in a mother 4 weeks post-partum who presented to our emergency department with headache and abdominal pain. Hypertensive urgency was diagnosed.  Subsequently, a 24 hour urine indicated significant proteinuria, and delayed postpartum preeclampsia was established.  Her blood pressure normalized and adequate diuresis was maintained.  Magnesium Sulfate was not initiated.</p>

scholarly journals Case Report: Delayed Post-partum Preeclampsia in rural Ecuador

2017 ◽  
Vol 2 (2) ◽  
Author(s):  
Miguel Obregón ◽  
Carolina Betancourt ◽  
David Gaus
Keyword(s):  
Blood Pressure ◽  
Emergency Department ◽  
Magnesium Sulfate ◽  
Post Partum ◽  
Hypertensive Urgency ◽  
Case Presentation ◽  
Delay In Diagnosis ◽  
Peripartum Period ◽  
High Index Of Suspicion ◽  
Time Of Presentation

Background: Delayed, Post-partum preeclampsia is an unusual presentation of preeclampsia.  Delay in diagnosis at the time of presentation could result in progression to eclampsia.  Consideration should be given to routine post-partum checkup at 3-4 weeks rather than 6 weeks in countries where home birthing is still common. Case Presentation: We report a case of delayed, post-partum preeclampsia in a mother 4 weeks post-partum who presented to our emergency department with headache and abdominal pain. Hypertensive urgency was diagnosed.  Subsequently, a 24 hour urine indicated significant proteinuria, and delayed postpartum preeclampsia was established.  Her blood pressure normalized and adequate diuresis was maintained.  Magnesium Sulfate was not initiated. Conclusion: A high index of suspicion for preeclampsia is required in hypertension in the peripartum period.  This is also true up to one month post partum.  When should magnesium sulfate be discontinued in these patients who have adequate diuresis and normal blood presssures, the signs normally used in the immediate post-partum period that the preeclampsia has resolved?

Descending Cervical-Sacral Pain after the Administration of Antivenom to the Scorpion Sting Poisoning: A Case Report

2020 ◽  
Vol 2 (2) ◽  
pp. 93-96
Author(s):  
Josué Saúl Almaraz Lira ◽  
Alfredo Luis Chávez Haro ◽  
Cristian Alfredo López López ◽  
Remedios del Pilar González Jiménez
Keyword(s):  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Case Report ◽  
Signs And Symptoms ◽  
Cervical Region ◽  
Scorpion Sting ◽  
Case Presentation ◽  
Sacral Region ◽  
Scorpion Stings

Introduction. Scorpion stings occur mainly in spring and summer, with an estimate of 1.2 million cases per year worldwide. About 300,000 poisonings occur within a year, primarily affecting children and adults older than 65 years. In 2019, Guanajuato (Mexico) ranked third in poisoning by scorpion sting with a total of 43,913 cases. The intoxication grades are three where the signs and symptoms are varied. There are two types of antivenom in the Mexican market, and we use Alacramyn® in our case. Case presentation. A 70-year-old female —with grade 1 scorpion sting poisoning, 30 minutes of evolution, with type 2 diabetes and high blood pressure— received two vials of antivenom according to current regulations. She presented transient vagal reaction and subsequent transient pain in the cervical region that radiates to the sacral region. At discharge, there are no data compatible with scorpion sting poisoning. Conclusions. Transient pain in the cervical region to the sacral region may be secondary to an anxiety crisis, hypersensitivity to IgG, or secondary reaction to administration in less time than recommended by the provider. The benefit was greater than the reactions that occurred.

scholarly journals Ovarian Torsion in a 5-Year Old: A Case Report and Review

2012 ◽  
Vol 2012 ◽  
pp. 1-3 ◽  
Author(s):  
Matthew F. Ryan ◽  
Bobby K. Desai
Keyword(s):  
Emergency Department ◽  
Abdominal Pain ◽  
Case Report ◽  
Urinary Tract ◽  
Clinical Suspicion ◽  
Ovarian Torsion ◽  
Surgical Emergencies ◽  
High Clinical Suspicion ◽  
Tract Infections ◽  
Prompt Diagnosis

Ovarian torsion represents a true surgical emergency. Prompt diagnosis is essential to ovarian salvage, and high clinical suspicion is important in this regard. Confounding the diagnosis in general are more commonly encountered abdominal complaints in the Emergency Department (ED) such as constipation, diarrhea, and urinary tract infections and more common surgical emergencies such as appendicitis. Prompt diagnosis can be further complicated in low-risk populations such as young children. Herein, we describe the case of a 5-year-old girl with a seemingly benign presentation of abdominal pain who was diagnosed in the ED and treated for acute ovarian torsion after two prior clinic visits. A brief discussion of evaluation, treatment, and management of ovarian torsion follows.

scholarly journals Case report: 2 cases of cardiac arrest caused by rhino-cardiac reflex while disinfecting nasal cavity before endonasal transsphenoidal endoscopic pituitary surgery

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Wen Wang ◽  
Hongwei Cai ◽  
Huiping Ding ◽  
Xiaoping Xu
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Heart Rate ◽  
Cardiac Arrest ◽  
Case Report ◽  
Nasal Cavity ◽  
Pituitary Surgery ◽  
Case Presentation ◽  
Clinical Anesthesia ◽  
Vagus Reflex

Abstract Background Trigeminal-cardiac reflex (TCR) is a brainstem vagus reflex that occurs when any center or peripheral branch of the trigeminal nerve was stimulated or operated on. The typical clinical manifestation is sudden bradycardia with or without blood pressure decline. The rhino-cardiac reflex which is one type of TCR is rare in clinical practice. As the rhino-cardiac reflex caused by disinfection of the nasal cavity is very rare, we report these two cases to remind other anesthesiologists to be vigilant to this situation. Case presentation This case report describes two cases of cardiac arrest caused by rhino-cardiac reflex while disinfecting nasal cavity before endoscopic transsphenoidal removal of pituitary adenomas. Their heart rate all dropped suddenly at the very moment of nasal stimulation and recovered quickly after stimulation was stopped and the administration of drugs or cardiac support. Conclusion Although the occurrence of rhino-cardiac reflex is rare, we should pay attention to it in clinical anesthesia. It is necessary to know the risk factors for preventing it. Once it occurs, we should take active and effective rescue measures to avoid serious complications.

Survival of multiple nail gun injuries to the head, lung, and heart: A case report

2020 ◽  
Author(s):  
Suo-Hsien Wang ◽  
Mao-Yu Chen ◽  
Tzu-Yen Huang ◽  
Che-Chia Chang ◽  
Chih-Ying Chien
Keyword(s):  
Emergency Department ◽  
Case Report ◽  
Suicide Attempt ◽  
Surgical Planning ◽  
Surgical Intervention ◽  
Treatment Strategies ◽  
Emergency Physicians ◽  
Significant Morbidity ◽  
Case Presentation ◽  
The Brain

Abstract Background: Most nail gun injuries occur at the extremities due to working accidents. Injuries to the brain or thorax are relatively rare, and cases with both injuries are even rarer. Initial evaluation, resuscitation and surgical planning can be challenging. Case presentation: Here, we present a case with nail gun injuries to the brain, lung, and heart by suicide attempt. The patient presented to the emergency department under shock. After resuscitation and surgical intervention, he was discharged without significant morbidity. Conclusions: Multiple nail gun injuries, especially those to vital organs such as the brain, lung, and heart, can be challenging to emergency physicians and surgeons. Imaging tools, treatment strategies, and possible complications are discussed in this article to provide optimized outcomes in such situations.

scholarly journals A prickly situation: an attempted Caterpillar ingestion - case report

2020 ◽  
Vol 49 (1) ◽  
Author(s):  
Amar K. Bhardwaj ◽  
Naif Fnais ◽  
Christopher J. Chin
Keyword(s):  
Emergency Department ◽  
Case Report ◽  
Foreign Body ◽  
Oral Cavity ◽  
Direct Laryngoscopy ◽  
Effective Technique ◽  
Efficient Manner ◽  
Case Presentation ◽  
Tussock Moth ◽  
Initial Method

Abstract Background Foreign body ingestion is a common problem in pediatrics. Each foreign body can present its’ own unique challenges during removal, and we present the management of an ingested Spotted Tussock Moth (Lophocampa maculata), more commonly known as a caterpillar. Case presentation An 18-month-old boy presented to the emergency department with difficulty handling secretions and odynophagia. It was reported he had placed a caterpillar in his mouth and then spat it out. On examination, hundreds of miniscule filaments (setae) were seen embedded in his lips and tongue. Our service was consulted out of concern for airway involvement. The patient was taken to the operating room where a direct laryngoscopy under general anesthesia with spontaneous ventilation was performed to confirm the setae were confined to the anterior tongue and lips. Once we were satisfied the airway was stable, the airway was secured, and we then began to remove the setae. The initial method used was to use Adson-Brown forceps to remove the setae, however this proved difficult and time-consuming given the volume of setae and how thin the setae were. Ultimately, a more effective technique was developed: a 4 × 4 AMD-RITMES® gauze was applied to the mucosa in order to dry up any secretions and then a piece of pink, waterproof BSN medical® tape was applied to the mucosa. After 3 s of contact it was removed. This technique was then repeated and was used to remove the vast majority of the setae. Conclusion To our knowledge, we have described the first technique to remove the caterpillar setae from the oral cavity mucosa in a fast, safe and efficient manner.

scholarly journals Retenção Urinária Como Manifestação de Hematocolpos

2020 ◽  
Vol 33 (13) ◽  
Author(s):  
Íris Santos Silva ◽  
Renata Martello ◽  
António Mendes ◽  
Albertino Chaves
Keyword(s):  
Emergency Department ◽  
Abdominal Pain ◽  
Case Report ◽  
Urinary Retention ◽  
Genital Tract ◽  
Rare Condition ◽  
Tanner Stage ◽  
Imperforate Hymen ◽  
Uncommon Condition ◽  
Rare Symptom

Hematocolpos is an obstruction of the menstrual flow due to an anomaly of the genital tract, with imperforate hymen being the most common one. It is an uncommon condition, with a prevalence of 1:1000 – 1:16 000. It is usually an asymptomatic condition until the onset of menarche, when there is accumulation of blood in the vagina (hematocolpos) or in the uterus (hematometra). A rare symptom of hematocolpos could be urinary retention. Our case report is about a 12-year-old girl, with no menarche and Tanner stage M4/P5, who was admitted to our emergency department with abdominal pain and urinary retention. A brief review of this rare condition is presented, in order to remind clinicians about its existence, so that it can be diagnosed and treated as quickly as possible.

scholarly journals Bladder Diverticulitis: A Case Report

2011 ◽  
Vol 2011 ◽  
pp. 1-3 ◽  
Author(s):  
Michael Silberman ◽  
Rebecca Jeanmonod
Keyword(s):  
Emergency Department ◽  
Urinary Tract Infection ◽  
Abdominal Pain ◽  
Case Report ◽  
Urinary Tract ◽  
Tract Infection ◽  
Acute Urinary Retention ◽  
Disease Process ◽  
Multifactorial Disease ◽  
Bladder Diverticulum

Bladder diverticulum, an outpouching of the mucosa through the muscular wall of the bladder, is a multifactorial disease process that can be either acquired or congenital. Although small diverticuli are usually asymptomatic, a large diverticulum may result in hematuria, urinary tract infection, acute abdomen due to its rupture, acute urinary retention, or neoplasm formation. We describe the case of an elderly gentleman who presented to the emergency department with abdominal pain and was ultimately diagnosed with bladder diverticulitis, a disease not previously described in the literature.

Bilateral Serous Retinal Detachment in Preeclampsia: Case Report

2017 ◽  
Vol 71 (2) ◽  
pp. 143-145
Author(s):  
Ivo Kjaev ◽  
Jana Kjaeva Nivicka ◽  
Sasha Kjaeva ◽  
Dafina Karadjova ◽  
Irena Aleksioska ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Case Report ◽  
Retinal Detachment ◽  
Medical Condition ◽  
Post Partum ◽  
Rare Complication ◽  
Serous Retinal Detachment ◽  
Initial Assessment ◽  
Ocular Involvement ◽  
Ocular Ultrasound

Abstract Introduction. Preeclampsia presents a medical condition in pregnancy that is manifested with increased blood pressure and protein urine. Ocular involvement is rare. Retinal detachment in preeclampsia is a rare complication; it only occurs in 1-2% of severe preeclampsia but in 10% of those with eclamptic seizures. Case report. A pregnant patient G1P0 visited the outpatient clinic of the University Clinic for Ophthalmology complaining on visual disturbances. The chief complaint was blurred vision and headaches. She was in 31 week of gestation and complained that she had increased blood pressure over the last month. After initial assessment she was suspected of central serous retinal ablation (CSCR). Ocular ultrasound and posterior segment OCT (optical coherence tomography) confirmed the diagnosis. Treatment and outcome. Obstetric examination confirmed high blood (TA180/130) pressure with dipstick urine showing(+++). Unfortunately, the ultrasound showed an eutrophic pregnancy in 31 g.w. with fetus mortus inutero. The patient was administered to the intensive care unit. She had an ophthalmologic check-upat 2 weeks and one month post-partum that showed regression and visual acuity was getting better. The final check-up after 6 months revealed that retina was in place with no subretinal substantial fluid and no macular edema. Conclusion. Serous retinal detachment is a rare complication of preeclampsia. In most case it resolves spontaneously few weeks post delivery.

An Emergency Department Approach to Drug Treatment of Hypertensive Urgency and Emergency

2005 ◽  
Vol 18 (5) ◽  
pp. 363-376 ◽  
Author(s):  
Kevin O. Rynn ◽  
Frank L. Hughes ◽  
Brian Faley
Keyword(s):  
Blood Pressure ◽  
Emergency Department ◽  
Treatment Options ◽  
Severity Of Illness ◽  
Joint National Committee ◽  
Patient Specific ◽  
National Committee ◽  
Hypertensive Urgency ◽  
Specific Patient ◽  
Hypertensive Urgencies

Patients who present with hypertensive urgency or emergency require immediate attention to assess the severity of illness. Guidelines from the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure are available but do little to address the management of acute elevations in blood pressure. Various treatment options, both old and new, exist to manage these patients in the emergency department. Decisions on therapy are patient specific and depend on the underlying cause of elevated blood pressure. This article sets out to describe specific patient presentations and reviews current available options in the management of hypertensive urgencies and emergencies.

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