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 A rare case of isolated gall bladder perforation in blunt trauma abdomen: a case report

2020 ◽  
Vol 8 (2) ◽  
pp. 754
Author(s):  
Omesh K. Meena ◽  
Monish Raj
Keyword(s):  
Emergency Department ◽  
Case Report ◽  
Early Diagnosis ◽  
Gall Bladder ◽  
Blunt Trauma ◽  
Rare Case ◽  
Clinical Presentation ◽  
Rare Event ◽  
Gallbladder Perforation ◽  
New Delhi

Blunt trauma abdomen leading to gallbladder perforation is a rare event usually recognized on evaluation and treatment of other visceral injuries during laparotomy. The gallbladder is relatively a well-protected organ. Isolated gallbladder perforation is extremely rare. The clinical presentation is variable, early diagnosis and treatment is of extreme importance to reduce morbidity and mortality associated with gallbladder perforation. We report a case of a patient who sustained isolated gallbladder injury following blunt trauma abdomen to emergency department in Safdarjung Hospital, New Delhi.

scholarly journals Pulmonary Embolism - A Case Report

2017 ◽  
Vol 12 (1) ◽  
pp. 40-44
Author(s):  
Samsun Nahar ◽  
Momenuzzaman ◽  
Fatema Begum ◽  
KN Khan ◽  
Quazi Anisuzzaman ◽  
...  
Keyword(s):  
Emergency Department ◽  
Pulmonary Embolism ◽  
Differential Diagnosis ◽  
Case Report ◽  
Early Diagnosis ◽  
Diagnosis And Treatment ◽  
The Past ◽  
Incidental Discovery

PE remains a clinically challenging diagnosis, more often missed than found, with no decline in its incidental discovery at autopsy over the past 30 years. Pulmonary embolism should be considered in the differential diagnosis of every dyspnoea event that presents at an emergency department. We describe a case of 68 years old man with symptoms of dyspnoea who later diagnosed as pulmonary embolism. This case report emphasizes early diagnosis and treatment to avoid fatal outcome.University Heart Journal Vol. 12, No. 1, January 2016; 40-44

scholarly journals Open Lip Schizencephaly: A Case Report.

2021 ◽  
Vol 26 (2) ◽  
pp. 27-29
Author(s):  
Andrés Felipe Herrera Ortiz ◽  
Héctor Eduardo Ortiz Sandoval
Keyword(s):  
Computed Tomography ◽  
Emergency Department ◽  
Differential Diagnosis ◽  
Mental Retardation ◽  
Case Report ◽  
Physical Examination ◽  
Structural Disorder ◽  
Septum Pellucidum ◽  
Brain Computed Tomography ◽  
Impaired Awareness

Schizencephaly is an extremely rare congenital structural disorder presented in 1.54/100,000 births. In this article, we present one of the few cases of schizencephaly reported in Colombia, in which the linguistic barrier and the lack of resources made the differential diagnosis a challenge. The patient presented to the emergency department with focal impaired-awareness seizures associated with an inability to speak since birth. On physical examination, it was evident the loss of cephalic support, mental retardation, and left- sided hemiparesis for which a non-contrast brain computed tomography was performed showing findings that are in relation to open- lip schizencephaly (right frontoparietal brain cleft lined by gray matter which is connecting the subarachnoid space to the ventricular system, polymicrogyria and absence of septum pellucidum). Neuro-rehabilitation and antiseizure therapy were established with good outcomes. It is important to understand that nowadays does not exist any curative procedure, the mainstay of treatment is based on neuro- rehabilitation which should be initiated as soon as possible because it improves the cognitive and motor status of patients.

scholarly journals Rapid Clinical Management of Leishmaniasis in Emergency Department: A Case Report with Clinical Review of Recent Literature

Biology ◽  
2020 ◽  
Vol 9 (11) ◽  
pp. 351
Author(s):  
Andrea Piccioni ◽  
Federico Valletta ◽  
Christian Zanza ◽  
Yaroslava Longhitano ◽  
Enrico Torelli ◽  
...  
Keyword(s):  
Emergency Department ◽  
Differential Diagnosis ◽  
Case Report ◽  
Visceral Leishmaniasis ◽  
Early Identification ◽  
Laboratory Tests ◽  
Clinical Presentation ◽  
Recent Literature ◽  
Diagnostic Techniques ◽  
Common Cause

Systemic or localized lympho-adenomegaly is a common cause of access to the emergency department (ED), and differential diagnosis is often complicated. The combination of anamnesis, physical examination, laboratory tests, and instrumental diagnosis are extremely important to orientate toward a rapid and correct therapy, even if a prompt discrimination of the etiology of this lymphadenomegaly is not often possible. Our aim with this review is to improve the management of a differential diagnosis between hematological and infective diseases as leishmaniasis in ED and suggest quick diagnostic techniques that might be useful for early identification. Together in the review, we describe a case report of a young man affected from visceral leishmaniasis who presented to our ED and was incorrectly addressed to the wrong ward for the study of his condition. Subsequently, we focus on the clinical presentation of visceral leishmaniasis and compare it to the most common differential diagnoses that are usually taken into account in the management of such patients.

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 A141 SPONTANEOUS ESOPHAGEAL PERFORATION: AN UNREPORTED COMPLICATION OF LYMPHOCYTIC ESOPHAGITIS

2021 ◽  
Vol 4 (Supplement_1) ◽  
pp. 128-129
Author(s):  
A LAGROTTERIA ◽  
A W Collins ◽  
A Someili ◽  
N Narula
Keyword(s):  
Computed Tomography ◽  
Emergency Department ◽  
Case Report ◽  
Proton Pump Inhibitor ◽  
Proton Pump ◽  
Esophageal Perforation ◽  
Distal Esophagus ◽  
Chest Discomfort ◽  
History Of ◽  
Lymphocytic Esophagitis

Abstract Background Lymphocytic esophagitis is a new and rare clinicopathological entity. It is a histological pattern characterized by lymphocytic infiltrate without granulocytes. Its etiology and clinical significance remains unclear. The clinical manifestations are typically mild, with reflux and dysphagia the most commonly reported symptoms. Aims We describe a case report of spontaneous esophageal perforation associated with lymphocytic esophagitis. Methods Case report Results A previously well 31-year-old male presented to the emergency department with acute food impaction. His antecedent symptoms were acute chest discomfort and continuous odynophagia following his most recent meal, with persistent globus sensation. The patient had no reported history of allergies, atopy, rhinitis, or asthma. A previous history of non-progressive dysphagia was noted after resuscitation. Emergent endoscopy revealed no food bolus, but a deep 6 cm mucosal tear in the upper-mid esophagus extending 24 to 30 cm from the incisors. Chest computed tomography observed small volume pneumoperitoneum consistent with esophageal perforation. The patient’s recovery was uneventful; he was managed conservatively with broad-spectrum antibiotics, proton pump inhibitor therapy, and a soft-textured diet. Endoscopy was repeated 48 hours later and revealed considerable healing with only a residual 3-4cm linear laceration. Histology of biopsies taken from the mid and distal esophagus demonstrated marked infiltration of intraepithelial lymphocytes. There were no eosinophils or neutrophils identified, consistent with a diagnosis of lymphocytic esophagitis. Autoimmune indices including anti-nuclear antibodies and immunoglobulins were normal, ruling out a contributory autoimmune or connective tissue process. The patient was maintained on a proton pump inhibitor (pantoprazole 40 mg once daily) following discharge. Nearly six months following his presentation, the patient had a recurrence of symptoms prompting representation to the emergency department. He described acute onset chest discomfort while eating turkey. Computed tomography of the chest redemonstrated circumferential intramural gas in the distal esophagus and proximal stomach. Conclusions Esophageal perforation is a potentially life-threatening manifestation of what had been considered and described as a relatively benign condition. From isolated dysphagia to transmural perforation, this case significantly expands our current understanding of the clinical spectrum of lymphocytic esophagitis. Funding Agencies None

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.

An Unusual Case of Pelvic Appendicitis

PEDIATRICS ◽  
1976 ◽  
Vol 58 (2) ◽  
pp. 292-293
Author(s):  
Michael A. LaCombe
Keyword(s):  
Emergency Department ◽  
Case Report ◽  
Early Diagnosis ◽  
Unusual Case ◽  
Signs And Symptoms ◽  
Memorial Hospital ◽  
Pubic Bone ◽  
Bowel Habit ◽  
Gross Hematuria ◽  
Misleading Interpretation

The atypical signs and symptoms, the misleading interpretation of symptoms by the patient's family, and the remarkable radiograph in the following case emphasize the difficulty in early diagnosis of pelvic appendicitis. CASE REPORT A 10-year-old boy came to the Emergency Department of Community Memorial Hospital, Toms River, New Jersey, complaining of pain in the pubic bone of four hours' duration. His mother thought he might have fallen on the cross-bar of his bike and was concerned about a possible fracture of the pelvis. The boy denied any nausea, vomiting, anorexia, or change in bowel habit and had no pain elsewhere. He had noticed no gross hematuria.

scholarly journals Cardiac Sarcoidosis as an Uncommon Etiology for Posterior Circulation Stroke Presenting with Alexia without Agraphia

2018 ◽  
Vol 2018 ◽  
pp. 1-3
Author(s):  
Mohankumar Kurukumbi ◽  
Lauren Gardiner ◽  
Shevani Sahai ◽  
John W. Cochran
Keyword(s):  
Case Report ◽  
Early Diagnosis ◽  
Cardiac Involvement ◽  
Clinical Presentation ◽  
Cardiac Sarcoidosis ◽  
Systemic Disease ◽  
Pulmonary Sarcoidosis ◽  
Posterior Circulation ◽  
Presenting Symptoms ◽  
Memory And Recall

Sarcoidosis is a systemic disease with cardiac involvement occurring in 20-50% of cases. Cardiogenic stroke caused by cardiac sarcoidosis, especially PCA infarction, is a rare clinical presentation that necessitates timely diagnosis and may warrant treatment prophylaxis against CVA. In this case report, we describe a 54-year-old Caucasian male presenting with left PCA stroke in the setting of cardiac and pulmonary sarcoidosis, and hypertension. His presenting symptoms included right partial hemianopia, difficulty with naming, memory, and recall, and alexia without agraphia. Cardiogenic stroke is an uncommon manifestation of cardiac sarcoidosis, and given the disabling nature of these sequelae, the importance of early diagnosis and prevention with anticoagulation is crucial to prevent morbidity and mortality.

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